OPATH/DX/RAD Flashcards
One of the characteristics of the Brandywine type of dentinogenesis imperfecta (type III) includes:
A. opacification of the dental pulp. B. periapical radiolucencies. C. severely affected primary teeth. D. associated with osteogenesis imperfecta.
B. PA RADIOLUCENCIES:
The Brandywine type (type III) of dentinogenesis imperfecta has features not seen in either type I or type II dentinogenesis imperfecta. These distinctive features include
- multiple pulp exposures
- periapical radiolucencies
- variable radiographic appearance.
Radiographically, opacification of dental pulps is seen in type I and type II dentinogenesis imperfecta. This is due to continued deposition of abnormal dentin. In patients with type I, the primary teeth are more severely affected than their permanent teeth. Type I is a dentin abnormality that occurs in patients with concurrent osteogenesis imperfecta.
Which of the following is the MOST common non-odontogenic cyst?
A. Globulomaxillary cyst B. Incisive canal cyst C. Median palatal cyst D. Nasoalveolar cyst E. Nasolabial cyst
B. INCISIVE CANAL CYST:
The incisive canal cyst (median anterior maxillary cyst or nasopalatine cyst) is the most common non-odontogenic cyst. It is most commonly found in the incisive canal, as the name implies. Clinically, this cyst is asymptomatic.
- The globulomaxillary cyst: (bw Max LI & C) is often asymptomatic; however, it can shift the interproximal contact points/areas of adjacent teeth toward the incisal edges, as roots of the maxillary lateral and cuspids are pushed apart.
- The median palatal cyst is often located in the midline of the hard palate. Clinically, this cyst can produce a swelling.
- The nasoalveolar cysts or nasolabial cysts are cysts found primarily in soft tissue and not in bone. Clinically, these cysts can cause swelling in the mucolabial fold.
Wickham striae are grayish white “lines” commonly seen in:
A. black hairy tongue. B. Fordyce disease. C. lichen planus. D. nicotinic stomatitis. E. white spongy nevus.
C. LICHEN PLANUS:
Lichen planus affects both the skin and oral mucous membranes. In addition to the characteristic violaceous lesions, which are usually etched with fine grayish white lines (Wickham striae), one may observe white scaly areas over a light pink base similar to psoriasis. Furthermore, lichen planus usually causes lesions to appear on the buccal mucosa, tongue, gingiva, and/or lips. Purplish papules may also be found on the skin. Patients may present asymptomatic or complain of pain in the affected areas.
- Hairy tongue is a disorder that results in the elongation of filiform papillae of the tongue leading to the characteristic brown-black color of the dorsum of the tongue.
- Fordyce disease causes buccal and/or labial mucosal lesions. This condition causes an aggregation of numerous small yellowish spots beneath the mucosal surface. They are ectopic sebaceous glands.
- Nicotinic stomatitis is typically found on the hard palate of pipe smokers and is characterized by several white elevations with a central red area.
- White sponge nevus is a congenital condition that alters the texture of the oral, vaginal, and/or anal mucosa. It causes painless lesions that are typically “pearly” white in appearance.
Which of the following MOST commonly occurs in postmenopausal women and results in a tingling sensation of the tongue?
A. Bullous lichen planus B. Glossopharyngeal neuralgia C. Orolingual paresthesia D. Trigeminal neuralgia E. White sponge nevus
C. OROLINGUAL PARESTHESIA:
Orolingual paresthesia causes a tingling or burning sensation of the tongue and oral mucosa. The tissue appears normal. This condition most commonly occurs in postmenopausal women.
- Bullous lichen planus is a form of lichen planus in which necrosis of the basal cell layer is so severe in restricted foci that bullae form.
- Glossopharyngeal neuralgia involves the ninth cranial nerve and results in the development of sharp shooting pain in the ear, pharynx, tonsils, and nasopharynx. It often occurs unilaterally with a trigger zone.
- Trigeminal neuralgia is a major neuralgia involving the fifth cranial nerve yielding a searing, stabbing pain initiated by touching a trigger zone on the face. This condition is unilateral in most instances.
- White sponge nevus appears on the oral mucosa with a thickened, spongy texture and opalescent hue.
Increasing kilovolts-peak will produce:
A. more x-rays. B. lower x-ray quality. C. more "boiled off" electrons. D. higher average energy electrons.
D. higher average energy electrons:
Increasing kilovolts-peak (kVp) increases the voltage difference from cathode to anode, resulting in more energetic electrons and thus higher-energy electrons. These high-energy x-rays are known as higher, not lower (choice B), quality x-rays. The kVp has no effect on the quantity of x-rays (choice A), which is determined only by the mA-s product (milliamps seconds). Electrons are boiled-off (choice C) in the generator.
All of the following are TRUE with respect to the microscopic examination of pleomorphic adenomas, EXCEPT:
A. presence of basophilic mucoid areas. B. presence of fibroblast-like spindle cells. C. presence of duct-like structures. D. presence of plasmacytoid hyaline cells. E. presence of sheets of large, white epithelial cells.
E. presence of sheets of large, white epithelial cells: it’s small, dark epithelial cells*
Pleomorphic adenomas are the most common type of salivary tumors found in the oral cavity. These tumors comprise approximately 40% of intra-oral salivary gland tumors. Typical sites for pleomorphic adenomas are the palate, lip, and buccal glands. Microscopic exam typically reveals the presence of sheets of small, dark epithelial cells, not sheets of large, white epithelial cells. Common features of this tumor include the presence of basophilic mucoid areas; fibroblast-like spindle cells, duct-like structures, and plasmacytoid hyaline cells.
When an x-ray is generated, its energy is:
A. directly proportional to its wavelength. B. inversely proportional to its frequency. C. directly proportional to its frequency. D. independent of wavelength and frequency.
C. directly proportional to its frequency:
Energy is directly related to frequency (high energy means high frequency) and inversely related to wavelength (high-energy and high-frequency waves have short wavelengths), which makes choices A, B, and D incorrect. The exact relationships are: energy = frequency X Planck’s constant, and speed = frequency X wavelength.
Which of the following correctly identifies the frequency in which salivary calculi appear in each respective salivary gland?
A. Parotid > submandibular > sublingual B. Parotid > sublingual > submandibular C. Sublingual > parotid > submandibular D. Submandibular > parotid > sublingual E. Submandibular > sublingual > parotid
D. Submandibular > parotid > sublingual:
Salivary calculi can be seen at any age; however, they peak in the third to sixth decade of life, with a male predominance. More than 80% of all stones occur in the submandibular gland.The remaining 20% of stones are found in the parotid gland; sublingual gland calculi are rarely found. In other words, the frequency in which salivary calculi appear in each respective salivary gland is as follows: submandibular > parotid > sublingual. Submandibular sialoliths, composed of calcium phosphate and organic matrix, are secondary to the more viscous and alkaline secretions of this gland as well as the anatomically “uphill” path of the Wharton duct.
Excessive x-ray exposure (>60 Gy) has been implicated in all of the following EXCEPT:
A. pronounced radiation caries. B. trismus. C. osteoradionecrosis. D. hyposalivation.
D. HYPOSALIVATION:
Hyposalivation typically starts to occur in exposures ranging from 20 to 30 Gy. Excessive radiation exposure greater than 60 Gy has been implicated in pronounced radiation caries, trismus, and osteonecrosis, to name a few.
An elevated Bence-Jones protein level and multiple radiolucent areas in the mandible and skull are signs of which of the following types of cancer?
A. Hepatocellular B. Myeloma C. Ovarian D. Pancreatic E. Prostate
B. MYELOMA:
Tumor markers can be used to aid in the screening, diagnosing, and monitoring of an individual’s response to the treatment of the cancer. Furthermore, tumor markers can aid in the staging of an individual’s cancer. Bence-Jones proteins can be used to diagnose and determine the prognosis of multiple myeloma. Therefore, with the appearance of radiolucencies in the mandible and skull and Bence-Jones proteins in the blood, one should be able to conclude that the patient has multiple myeloma.
- Hepatocellular carcinoma can be monitored with the detection of alpha-fetoprotein.
- Ovarian cancer is monitored by the presence of CA 125; a high level of this tumor marker is closely related to a poor prognosis.
- Pancreatic, colorectal, and gastric carcinoma can be followed by the presence of CA 19-9.
- Prostate cancer is monitored by the presence of PSA (prostate-specific antigen).
The appearance of Forchheimer spots on the soft palate is MOST likely associated with:
A. Respiratory syncytial virus B. Rhinovirus C. Rosacea D. Rubella E. Rubeola
D. RUBELLA:
The prodromal illness for rubella, otherwise known as the German measles, is associated with the development of fever, headache, conjunctivitis, lymphadenopathy, and (occasionally) Forchheimer spots, which are small, red lesions found on the soft palate.
- Respiratory syncytial virus (RSV) is associated with lower respiratory involvement, including pneumonia and bronchiolitis. RSV can also cause rhinorrhea, low-grade fever, and mild wheezing.
- Rhinovirus often causes signs and symptoms of the common cold, such as rhinorrhea, fatigue, and mild temperature elevations.
- Rosacea is a skin disease of the face in which the blood vessels enlarge, resulting in a constant “flushed” appearance of the cheeks and nose.
- Rubeola , or measles, is a common disease contracted by children. This highly contagious disease has an incubation period of approximately 10 days followed by a prodromal period. During the prodromal illness, patients typically experience conjunctivitis, rhinorrhea, and a hacking cough. The appearance of Koplik spots (small, irregular, grayish white lesions on upper buccal mucosa) are considered pathognomonic. Before the appearance of the characteristic rash, there is an abrupt increase in the child’s temperature.
A 52-year-old male presents with multiple aphthous ulcers in the mouth, inflammatory ocular changes, and intestinal ulceration. Based on this information, the MOST likely diagnosis is:
A. Behç et syndrome. B. Bell palsy. C. Peutz-Jeghers syndrome. D. tic douloureux. E. white sponge nevus.
A. BECHET SYNDROME:
Behç et syndrome is characterized by recurring oral and genital ulcers and eye lesions. It is a multisystem disorder. Recurring oral ulcers occur in 90% of the patients and cannot be differentiated from RAS. Some have mild oral lesions others have deep scarring lesions characteristic of major RAS. Arthritis; intestinal ulceration; venous thrombosis; and renal, pulmonary, and CNS disease are other signs of the syndrome. Skin lesions are large and pustular.
- Bell palsy is characterized with unilateral paresis of the facial nerve. It starts with slight pain around the one ear, followed by abrupt paralysis of the facial muscles on the affected side. The eye on the affected side stays open leading to corneal ulcerations, drooping of the corner of the mouth results in drooling, and masseter weakness leads to food retention in vestibule areas. This is the most common form of facial paralysis, and the onset of its associated signs and symptoms is relatively abrupt. Since this cranial nerve disorder results from an inflammation of the seventh cranial nerve, symptoms include paralysis of the facial muscles on the affected side. There is flattening of creases on the forehead, change of facial expression, and loss of taste sensations from the anterior two thirds of the tongue (when the chorda tympani is affected).
- Peutz-Jeghers syndrome is a condition characterized by oral and external skin pigmentation as well as intestinal polyposis. The oral features often result in perioral and lip freckling and dark-brown spots on the lips, anterior tongue, and buccal mucosa. There is also freckling of the distal aspect of the fingers and toes.
- The most common cranial neuralgia is trigeminal neuralgia, or tic douloureux. This condition is characterized by paroxysms of intense shooting, stabbing, and excruciating pain. The pain is usually unilateral, rarely lasts for more than a few seconds, and is precipitated by light touch/stimulation of the trigger zones present on skin/mucosa of the involved nerve branch. Shaving, showering, eating, talking, and even wind exposure can trigger the pain. Intraoral trigger zones can be very tricky to diagnose, as the stabbing pain can mimic the pain experienced with a cracked tooth.
- White sponge nevus is a benign congenital condition that involves mucous membranes of the oral (most common), vaginal, nasal, and/or anal mucosa by producing painless lesions that are typically “pearly” white in appearance, although they can appear grayish white. it presents as bilateral, symmetric, and white soft spongy or velvety thick plaques on buccal mucosa. It is also seen on the ventral tongue, floor of mouth, labial mucosa, soft palate, and alveolar mucosa.
AIDS-related hairy leukoplakia is MOST commonly found on which of the following oral surfaces?
A. Buccal mucosa B. Dorsum of the tongue C. Hard palate D. Lateral border of the tongue E. Soft palate
D. LATERAL BORDER OF TONGUE:
Hairy leukoplakia is a benign epithelial hyperplasia associated with the Epstein-Barr virus (EBV). This oral disorder often precedes or accompanies “full-blown AIDS” and rarely occurs in individuals who are not HIV-infected. Hairy leukoplakia is usually found on the lateral borders of the tongue and rarely elsewhere in the oral mucosa. This condition is characterized by white lesions ranging from small flat areas to extensive and “hairy” areas.
Which of the following pairs of units measures the same thing?
A. Gray, Sievert B. REM, Gray C. Roentgen, Sievert D. Rad, Gray
D. RAD, GRAY:
Rad and Gray both measure absorbed radiation. The measure of 1 Gray = 100 Rad. REM (choice B) and Sievert (choices A and C) both measure dose equivalents from differing types of radiation. Dose equivalent is the biological effect of radiation on tissues. The measure 1 Sievert = 100 REM. Roentgen and coul/kg measure the amount of radiation in air under standard, normalized conditions.
If a patient presents with lupus erythematosus-like eruptions on the buccal mucosa, this individual was MOST likely taking which of the following medications?
A. Diphenhydramine B. Furosemide C. Hydrocodone D. Procainamide E. Ranitidine
D. PROCAINAMIDE:
Lupus erythematosus is a systemic disorder of autoimmune etiology. The oral lesions typically associated with this disorder are often present on the buccal mucosa and are reddish lesions with slightly raised borders that surround a depressed center. Drugs like
- hydralazine
- methyldopa
- phenytoin
- procainamide
are known to produce these “lupus-like” eruptions.
- Diphenhydramine, furosemide, and hydrocodone are all commonly associated with xerostomia.
- Ranitidine does not commonly cause any oral side effects.
All of the following are known to predispose an individual to the development of oral squamous cell carcinoma, EXCEPT:
A. increasing age. B. hepatitis. C. tobacco usage. D. chronic alcohol usage. E. Plummer-Vinson syndrome.
B. HEPATITIS:
Hepatitis is an infectious disease primarily affecting the liver; this disorder does not predispose an individual to the development of squamous cell carcinoma. However, it dramatically increases the incidence of liver cancer. Oral squamous cell carcinoma accounts for 2% to 3% of all malignancies in the United States. The development of this disease is age-related, with a dramatic increase in incidence in those over the age of 40, and the male/female ratio is approximately 3:1. Other factors include tobacco usage, primarily; chronic alcohol usage; iron deficiency in Plummer-Vinson syndrome, and deficiencies of other vitamins. Evidence suggests that candidiasis and herpes simplex virus also increase the risk for oral squamous cell carcinoma.
A 3-year-old child presents with a sudden onset of fever, sore throat, and grayish white oropharyngeal lesions surrounded by red areola. If these vesicles were noted to enlarge and then ulcerate, the MOST likely diagnosis would be:
A. chickenpox. B. herpangina. C. herpes zoster. D. infectious mononucleosis. E. warts.
B. HERPANGINA:
Herpangina is a disease caused by the coxsackievirus A (and possibly the coxsackievirus B) and echovirus. This disorder is typically seen in children less than 4 years of age. Individuals with the disorder often present with a sudden onset of fever, sore throat, and grayish white oropharyngeal lesions surrounded by red areola. These lesions often enlarge and then ulcerate.
- Chickenpox is caused by the varicella zoster virus and results in gingival and oral lesions that rupture to form shallow ulcers; the mucosa is very erythematous.
- Herpes zoster is caused by a reactivation of the varicella zoster virus, leading to unilateral vesicular eruptions and ulcerations in a linear pattern following the sensory distribution of the trigeminal nerve or one of its branches.
- Infectious mononucleosis is caused by the Epstein-Barr virus and often results in the development of fatigue, malaise, and numerous small oral ulcerations that often appear several days before the characteristic lymphadenopathy; there may also be some degree of gingival bleeding and petechiae at the junction of the hard and soft palate.
- Warts may appear anywhere on the skin or in the oral cavity; the “classical” wart can be described as a papillary lesion with a thick white keratinized surface.
A patient presents with flushing and sweating of the involved side of the face during eating. If the patient’s condition is a possible complication of parotid tumor or a surgical procedure, the most likely diagnosis would be:
A. Auriculotemporal syndrome B. Causalgia C. Glossopharyngeal neuralgia D. Mé niè re disease E. Sphenopalatine neuralgia
A. AURICULOTEMPORAL SYNDROME:
Auriculotemporal syndrome is caused by damage of the auriculotemporal nerve and subsequent re-innervation of the sweat glands by the parasympathetic salivary fibers. This condition causes a flushing and sweating of the involved side of the face during eating. This condition is a possible complication of parotid tumor or a surgical procedure.
- Causalgia is a rare severe pain syndrome that arises due to injury or sectioning of a peripheral sensory nerve. It can occur following difficult extraction. The burning pain can arise a few days to weeks after an extraction and is often evoked by thermal stimuli.
- Glossopharyngeal neuralgia involves the ninth cranial nerve and results in the development of sharp shooting pain in the ear, pharynx, tonsils, and nasopharynx. It often occurs unilaterally and is associated with a trigger zone.
- Ménière disease causes deafness, tinnitus, vertigo, and vomiting and often begins in middle age.
- Sphenopalatine neuralgia or cluster headache causes unilateral spasms of intense pain in the region of the eyes, ears, and maxilla.
Current in a filament typically averages:
A. 70 kVp. B. 5 to 20 kVp. C. 120 V. D. 5 to 20 mA.
D. 5 - 20 mA
The units used to measure current is milliamperes or mA. Typical current to a filament in the cathode is 5 to 20 mA.
Kilovoltage peak, or kVp, which is used to measure voltage. The typical kVp of the x-ray machine is about 70 to 90 in order to cause rapid electron acceleration, while 120 V is typically the voltage of the original power source.
Permissible film holders for x-rays of small children include:
A. dentist, covered with lead apron. B. assistant, covered with lead apron. C. receptionist, covered with lead apron. D. parent, covered with lead apron. E. film holders are never acceptable even if covered by lead apron.
D. parent, covered with lead apron:
If a person is needed to hold a film for a child, the best choice is the parent. The parents should be thoroughly instructed before taking an x-ray, to avoid unnecessary re-takes. The parent is carefully shielded, often with two lead aprons(front and back), and a film badge monitor. Individuals who are occupationally exposed to radiation, such as dentists (choice A) and assistants (choice B), are not permitted to hold patients or to hold image receptors/films during exposure; nor should any individual, such as a receptionist (choice C), be regularly used for this service. It is recommended that, during the exposure, dental personnel who perform dental radiography stand behind a protective barrier. In situations in which dental personnel cannot stand behind a protective barrier, they must stand at least 6 feet away from the patient and the x-ray tube, not in the path of the primary beam. It is best to avoid human film holders and use film-holding instruments, if possible.
Which of the following is TRUE regarding higher quality x-ray beams?
A. They are absorbed more by soft tissue. B. They scatter more. C. They produce less heat. D. They are absorbed more by soft tissue and scatter more.
B. X-rays tend to be absorbed or scattered. As an x-ray beam enters tissue, some x-rays are absorbed, whereas others bounce around and leave the tissue (scatter). Low-energy x-rays tend to be absorbed more (choices A and D). High-energy (hard beam, high quality) x-rays are not absorbed well. They pass through tissue and scatter more. Heat (choice C) is produced by the cathode and would not be a factor in the quality of x-ray beams.
Pseudoanodontia is synonymous with:
A. absence of teeth. B. impaction of teeth. C. partial anodontia. D. false anodontia.
B. Impaction of teeth:
(pseudoanodontia) is common. It affects the mandibular third molars and maxillary cuspids most frequently. Impaction occurs because of obstruction from crowding, abnormal eruption path, or some other physical barrier. Absence of teeth is known as anodontia. It can be complete, with all teeth missing, or it can be partial anodontia, with one or several teeth missing. When the teeth have been exfoliated or extracted, it is termed false anodontia.
A patient presents with outgrowths that appear as aggressive pyogenic granulomas that do NOT metastasize but are of multicentric origin. If the patient has bluish/purplish lesions on the palate, buccal mucosa, and skin, which of the following is the correct diagnosis?
A. Fibroma B. Hairy tongue C. Kaposi sarcoma D. Papilloma E. Verruca vulgaris
C. Kaposi sarcoma:
is caused by a type of herpes virus. It is an “AIDS-defining illness” and occurs in late-stage HIV disease. It is a rare tumor that commonly appears as an aggressive pyogenic granuloma. It does not metastasize but is of multicentric origin. Patients typically present with bluish/purplish lesions of the palate, buccal mucosa, and skin. The tissue involved is the endothelial lining of blood vessels. Death from this condition most commonly occurs from gastrointestinal tract ulceration.
- Fibroma is usually a smooth pink, firm, protruding mass often found on the labial mucosa and tongue.
- Hairy tongue is a disorder that results from the elongation of filiform papillae of the tongue, leading to the characteristic brown-black color of the dorsum of the tongue.
- A papilloma is a tumor that appears as a single, round, or oval entity 1 to 3 mm in diameter with a verrucous or cauliflower surface.
- Verruca vulgaris are warts that resemble papillomas, except that they grow rapidly and result in multiple discrete lesions.
Which of the following is a neuralgia characterized by a “trigger zone” in the oropharynx or tonsillar fossa that manifests with pain in the ear, pharynx, nasopharynx, tonsil, and/or posterior tongue?
A. Bell palsy B. Geniculate neuralgia C. Glossopharyngeal neuralgia D. Melkersson-Rosenthal syndrome E. Trigeminal neuralgia
C. Glossopharyngeal neuralgia:
or ninth-nerve tic, is similar to the more well-known trigeminal neuralgia. The pain experienced by the patient is similar to that of trigeminal neuralgia but is confined to the distribution of the ninth cranial nerve; this neuralgia, characterized by a “trigger zone” in the oropharynx or tonsillar fossa, manifests with pain in the ear, pharynx, nasopharynx, tonsil and/or posterior tongue.
- Bell palsy is the most common form of facial paralysis, and the onset of its associated signs and symptoms are relatively abrupt. Since this cranial nerve disorder results from an inflammation of the seventh cranial nerve, symptoms include paralysis of the facial muscles on the affected side and loss of taste sensation in the anterior two-thirds of the tongue.
- Geniculate neuralgia is an exceedingly rare disorder with pain similar to that of trigeminal neuralgia but is primarily experienced deep in the ear.
- Melkersson-Rosenthal syndrome is a cranial nerve syndrome that often presents with a triad of symptoms: recurrent facial paralysis, facial edema (particular labial), and plication of the tongue. However, not every patient presents with all components of the triad. Lip swelling is the constant dominant feature and usually begins prior to the facial paralysis.
- The most striking disorder of the trigeminal nerve is a condition known as trigeminal neuralgia or tic douloureux. This condition is characterized by excruciating and frequently recurring paroxysms of pain in the lips, gums, cheek, or chin. Although the pain rarely lasts for more than a few seconds, spasmodic pain is typically so sharp and severe that the patient typically winces, hence, the name tic douloureux. One of the features of this disorder is unilateral facial pain with trigger zones. In other words, stimulation or movement of one of these trigger zones will initiate the paroxysm.
On a radiographic exam, what would a chevron artifact (sharp, angular lucency) indicate?
A. Dentinal dysplasia B. Dentinogenesis imperfecta C. Internal resorption D. Pulp calcification
A. Dentinal dysplasia (DD): is a rare condition that affects dentin (autosomal-dominant condition).
- Type I DD: has residual fragments of pulp tissue that appear typically as angular horizontal radiolucencies, called chevrons. The roots of these teeth are underdeveloped and and malformed. Because of this, patients may be more susceptible to periodontal disease.
- Type II DD: affects the crowns and pulp chambers of teeth.
- Type III DD: has pulp chambers and canals that are extremely large. Internal resorption of the dentin of pulpal walls is part of an inflammatory response to pulpal injury, sometimes with no apparent trigger. Resorption occurs as a result of the activation of osteoclasts or dentinoclasts on internal surfaces of the crown.
- In dentinogenesis imperfecta (DI): opacification of dental pulps occurs, owing to continued deposition of abnormal dentin in types I and II.
- Pulp calcification is common with increasing age, or it occurs for no apparent reason. Calcifications are either diffuse or nodular (pulp stones). Linear deposits are found in the root canals, parallel to the blood vessels. Pulp stones are usually found in the pulp chamber.
Which of the following viral diseases is LEAST likely to affect the gingiva?
A. Chicken pox B. Herpangina C. Herpes zoster D. Primary HIV infection E. Recurrent intraoral herpes simplex
B. Herpangina:
Although all of the viral diseases can affect the gingiva, herpangina (coxsackieviruses A and possibly B) primarily affects the oral mucosa, pharynx, and tongue. In this condition there is a sudden onset of fever, sore throat, and oropharyngeal vesicles. This condition often affects children under 4 years of age during the summer months.
- Chickenpox primarily affects the gingiva and oral mucosa.
- Herpes zoster (reactivation of varicella zoster virus) primarily affects the cheeks, tongue, gingiva, or palate.
- Primary HIV infection causes acute gingivitis and oropharyngeal ulceration.
- Recurrent intraoral herpes simplex results primarily in gingivitis and small vesicles on the oral mucosa.
All of the following characteristics are seen in Ewing sarcoma, EXCEPT:
A. onion-skin appearance of bone. B. occurrence between 5 and 30 years old. C. predilection for the ramus of the mandible. D. tumors consisting of undifferentiated small cells alternating with areas of cartilage.
D. tumors consisting of undifferentiated small cells alternating with areas of cartilage:
In mesenchymal chondrosarcoma, the undifferentiated small cell proliferation resembles Ewing sarcoma. The alternating areas of cartilage found by the small cells distinguishes the diseases.
Ewing sarcoma has:
- moth-eaten radiolucency and erosion of the cortex with expansion.
- the variable periosteum looks like onion skin.
- Ninety percent of Ewing sarcoma occurs between 5 and 30 years. The younger a patient is diagnosed (under 10 years of age), the poorer the prognosis.
- When the jaws are involved, there is a predilection for the ramus of the mandible, with a few cases reported in the maxilla.
The appearance of a “strawberry” or “raspberry” tongue is MOST commonly associated with which of the following disorders?
A. Iron-deficiency anemia B. Pellagra C. Scarlet fever D. Severe cyanocobalamin deficiency E. Syphilis
C. SCARLET FEVER:
The appearance of a “strawberry” or “raspberry” tongue is most commonly associated with patients diagnosed with scarlet fever. The appearance of the tongue is caused by hypertrophy of the fungiform papillae as well as changes in the filiform papillae. Patients who present with “bald” tongue generally have one of the following disorders: iron-deficiency anemia; pellagra; severe cyanocobalamin deficiency, otherwise known as pernicious anemia, or syphilis.
