Disease of Head and Neck - Mouth and Upper Airway Flashcards

1
Q

Caries

A

Tooth Decay
Common

Bacteria ferment sugars and produce acids that dissolves minerals in enamel

Prevention - Brushing, fluoride forms fluorapatite in enamel which increases resistance to bacterial acids

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2
Q

Gingivitis

A

Inflammation of sqamous mucosa - edema and bleeding
Cause - improper oral hygiene - plaque formation (bacteria, saliva protein and cell debris)
Prevention - brushing flossing

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3
Q

Periodontitis

A

Inflammation goes deeper
Can cause tooth loss, sepsis, infective endocarditis, local and systemic abscesses

Higher risk in immunecompromised pts - AIDS, Diabetes, Crohn’s, leukemia,

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4
Q

Tori

A

Benign - nodular bony overgrowth of jaw bone

Hard as a rock
Bilateral on the mandible (torus mandibularis)
hard palate is most common location (torus palatines)
Uncertain cause - bruxism

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5
Q

Fibroma

A

Reactive fibrous papule from chronic irritation
benign

Associated with jagged teeth, ill fitting denture

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6
Q

Pyogenic granuloma

A

Benign
Pregnant women

Capillary hemangioma
Rapid growth, ulceration, cellularity and mitotic activity

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7
Q

Peripheral Giant Cell granuloma

A

Benign

proliferation of giant cells and fibrous stroma in gingiva

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8
Q

Mucocele

A

Accumulation of mucin producing mass
Extravasation type - trauma to minor salivary glands
Retention type - blovked salivary dict with mucin filled epithelial lines cyst

LIP

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9
Q

Aphthous Ulcers (canker sores)

A
Superficial oral ulcers 
Very painful - not dangerous 
In children mostly 
May be associated with celiac disease or IBS 
cause unknown
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10
Q

Glossitis

A

Inflammation of the tongue
Nutritional deficiencies - B vit and Iron
May be traumatic - ill fitting dentures and jagged teeth

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11
Q

Oral Herpes Simplex Virus Infections

A
Mostly HSV1 (HSV2 can also be sexually transmitted)
Usually asymptomatic in young children. can develop acute herpetic gingivostomatitis
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12
Q

Acute herpres Gingivostomatitis

A

Abrupt onset of vesicles throughout mouth
Fever, Lymphadenopathy, anorexia
Take 3-4 weeks to clear
May be diagnosed by cytology (Tzanck test)

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13
Q

Recurrent Oral Herpes Simplex

A

HSV dormant in local nerve ganglia
Can cause recurrent stomatitis when patient is ill, IC
Recurrent lesions usually heal in 10 days
Denivir

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14
Q

Oral Candidiasis (Thrush)

A

Fungus - normal flora
Overgrowth in IC or altered oral flora
Superficial curdy white membrane of inflammatory debris - easily scraped off

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15
Q

Hairy Leukoplakia

A

White fluffy patches - lateral border of tongue
In IC
Cant be scraped off
Caused by EBV

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16
Q

Squamous cell carcinoma

A

Most common cancer of mouth!
Predisposing factors - Tobacco, Alcohol and HPV
Precursors - leukoplakia and Erythroplakia
Often diagnosed after invasion/metastasis has occurred
Field cancerization
met - lymph, lung, liver bone

17
Q

Leukoplakia

A

White patch that doesn’t scrape off
clinical presentation hyperkeratosis
dysplasia is seen. should be considered premalignant until proven otherwise

18
Q

Erythroplakia

A

Red, often ulcerated or eroded lesion

Can become cancerous

19
Q

Odontogenic cysts and tumor

A

Arising in tissues that form teeth
tumor is rare (both benign and malignant)
most common lesions include dentigerous cysts, keratocysts, ameloblastoma

20
Q

Dentigerous Cyst

A

Cyst that originates around an unerupted tooth
Squamous lining
Complete excision is curative
can recur if incompletely excised

21
Q

odontogenic keratocyst (OKC)

A

More locally aggresive than odontogenic cyst
High recurrence rate in parakerotic variant
Multiple OKC + Many cutaneous basal cell carcinoma - Nevoid basal cell carcinoma syndrome

22
Q

Ameloblastoma

A

Low grade malignant tumor from odontogenic epithelium
Locally invasive tumor
Recurs if not completely excised
metastases rare

23
Q

Rhinitis

A

Inflammation of nasal mucosa
Caused by viruses - adeno, echo, rhino
can get secondary bacterial infections

24
Q

allergic rhinitis

A

hypersensitivity to pollen, fungi etc
IgE mediated
Eosinophils

25
Q

Chronic rhinitis

A

Repeated infections or allergic rhinitis
More severe superimposed bacterial infections that extend into sinuses

LEAD TO NASAL POLYPS

26
Q

Nasal inflammatory Polyps

A

After chronic rhinitis
Edematous mucosa orinflamed stroma
Can ulcerate and grow quite large

27
Q

Pharyngitis and Tonsillitis

A

Viral - rhino, echo, adeno, influneza
Bacteria - strep and staph

Strep can cause - RF and then RHD
Post streptococcol glomerulonephritis

28
Q

Angiofibroma

A

Nasopharyngeal tumor - benign
Exclusive to adolescent males
androgen receptor positive
Bleeds easily and profusely *

29
Q

Olfactory Neuroblastoma (Esthesioneurblastoma)

A

Malignant neuroblastic tumor of olfactory nerve
any age - median 50
bad prognosis - depending on grade and stage

Long cytoplasmic processes - fibrillary background

30
Q

Nasopharyngeal carcinoma

A

African childhood cancer *
Also in Chinese
Risk factor - EBV, nitroamines in diet and smoking
Three histologic types (based on differentiation
keratinizing squamous - least radiosensitive
Non keratinizing squamous
Undifferentiated - most radiosensitive

Up to 70% - lymph node metastasis
this tumor if patient has squamous or undifferentiated carcinoma in cervical nodes without a known primary

otitis media in adults - think of this
epistaxis, local invasion of cranial nerve VI

31
Q

sinusitis

A

most common caused by viruses as part of common cold
Chronic - secondary bacterial infection
preceded by rhinitis

Can cause meningitis

32
Q

Unusual Sinusitis

A

kartagener syndrome - defective ciliary action - bronchiectasis ans situs inversus

Fungi - diabetes or IC
if aggresive and necrotizing - consider mucormycosis

33
Q

Murcormycosis

A

aka zygomycosis
Bread mold fungi
Mucor, rhizopus, absidia, cunninghamella
In IC

34
Q

Sinonasal papilloma

A

Benign tumors of squamous mucosa
Two Types
Exophytic - more common
Inverted - high recurrence ! more aggressive