Allergies and immunologic Diseases

Question 1

canker sores
familial relationship,
unknown pathogenesis; immune mediated process
most common in children and young adults

Answer 1

recurrent aphtous ulcerations

Question 2

what are the 3 clinical variations of recurrent aphthous ulcerations?

Answer 2

minor
major
herpetiform

Question 3

most common recurrent aphthous ulcerations

Answer 3

minor aphthous ulcerations

Question 4

most common form
only on NONKERATINIZED MUCOSA
most common sites are buccal and labial mucosa ventral tongue, floor of mouth and soft palate
1-5 PAINFUL ulcers preceded by erythematous macule and prodromal symptoms
ERYTHEMATOUS HALO

Answer 4

minor aphthous

Question 5

which one of the aphthous ulcerations heal without scaring?

Answer 5

minor

Question 6

3-10 mm diameter -
1-3 cm diameter-
1-3 mm diameter -

Answer 6

minor
major
herpetic

Question 7

1-5 PAINFUL ULCER -
1-10 lesions per episode
many present per episode

Answer 7

minor
major
herpetic

Question 8

heal in 7-14 days
heal in 2-6 weeks
heal in 7-10 days

Answer 8

minor
major
herpetic

Question 9

buccal and labial mucosa, ventral tongue, floor of the mouth, soft palate

labial mucosa, soft palate, tonsillar fauces

any oral mucosal surface

Answer 9

minor

major

herpetic

Question 10

true or false

minor aphthous does not cross the MGJ

Answer 10

true

Question 11

true or false

major aphthous has lesser erythmatous halo compared to minor

Answer 11

true

Question 12

which of the the following has resemblance to primary HSV?
minor
major
herpetiform

Answer 12

Herpetiform

Question 13

which of the following has most frequent recurrences?
minor
major
herpetiform

Answer 13

herpetiform

Question 14

what is the medication for Recurrent Aphthous Ulcerations?

Answer 14

topical HIGH-potency corticosteroids

Question 15

multisystem disorder with oral aphthous like ulcerations
affects genetically predisposed individual
Highest prevalence in Turkey, Japan and Eastern mediterranean countries

Answer 15

Behcet’s syndrome

Question 16

what is the triad for behcet’s syndrome

Answer 16

oral ulcerations
genital ulcerations
ocular disease

Question 17

which of the following has cutaneous leisions, arthritis, CNS involvement, cardiovascular, GI, pulmonary, renal?

oral
genital
ocular

Answer 17

ocular disease of the behcet’s syndrome

Question 18

posterior uveitis

Answer 18

ocular

Question 19

you have a positive pathergy test. what is the diagnosis?

Answer 19

behcet’s syndrome

Question 20

what is the treatment for behcet’s syndrome?

Answer 20

topical or systemic immunosuprressive therapy

early aggressive therapy for severe cases

Question 21

non-necrotizing granulomatous inflammation,
persistent non-tender swelling
LIPS most common site, may involve any oral mucosal or perioral location

Answer 21

orofacial ganulomatosis

Question 22

what are the two forms of orofacial granulomatosis?

Answer 22

cheilitis granulomatosa

melkersson-rosenthal syndrome

Question 23

which of the two orofacial granulomatosis have only lips involvement

Answer 23

chelitits granulomatosa

Question 24

A person has bell’s palsy, fissured tongue, non-tender lip swelling.
non-necrotizing granulomatous inflammation

Answer 24

melkerssson-rosenthal syndrome (one of the two orofacial granulomatosis

Question 25

what are the microscopic features of orofacial granulomatosis?

Answer 25

superfical vascular ectasia, vasculitis, edema non-necrotizing granulomas no evidence of foreign material and specific stains to rule out specific infection

Question 26

medication for orofacial granulomatosis

Answer 26

intralesional corticosteroids work best | multiple injections may be necessary

Question 27

necrotizing granulomatous process with vasculitis can affect upper airway, lungs, kidneys, skin and mucosa wide range of age group

Answer 27

wegener's granulomatosis

Question 28

what are the 3 categories of wegener's granulomatosis

Answer 28

1. Generalized wegener's 2. limited 3. superficial

Question 29

generalized wegeners

Answer 29

upper and lower respiratory tract, kidneys

Question 30

limited wegener's

Answer 30

upper and lower respiratory tract

Question 31

superficial wegener's

Answer 31

lesions primarily of skin and mucosa

Question 32

STRAWBERRY GINGIVITIS - panthognomonic | this is very specific to this condition

Answer 32

wegener's granulomatosis

Question 33

destruction of nasal septum (saddle-nose deformity) dry cough, hemoptysis, dyspea, chest pain proteinuria, palatal ulcer with oral-antral fistula

Answer 33

wegnener's granulomatosis

Question 34

what is the microscopic appearance of wegener's granulomatosis?

Answer 34

subepithelial hemorrhage, vasculitis poorly formed granulomas, mixed inflammation

Question 35

autoantibodies directed against neutrophils have been identified in high percentage of these patients (ANCA)

Answer 35

wegener's

Question 36

what is the prognosis of wegener's granulomatosis

Answer 36

complete response in 75% relapse in 30% prednisone and cyclophosphamide vs methotrexate

Question 37

what are the two types of allergic reaction to systemic drugs?

Answer 37

fixed drug eruption | lichenoid drug reaction

Question 38

fixed drug eruption?

Answer 38

inflmaatory alteration that recur at the same site after the administration of a medication

Question 39

lichenoid drug reaction

Answer 39

medicaiton induced mucosal alterations which mimic appearche of lichen planus which is white line or stria

Question 40

what are there 3 allergic contact stomatitis?

Answer 40

1. dentrifice-related sloughing 2. orla mucosal cinnamon reaction 3. lichenoid amalgam reaction

Question 41

what is associated with sodium lauryl sulfate and sodium pyrophophate? found in toothpastes

Answer 41

dentrifice-related sloughing

Question 42

clinical varation of oral mucosal cinnamon reaction toothpaste: chewing gum/candy:

Answer 42

diffuse, gingiva localized

Question 43

patient has erythema with overlying SHAGGY HYPERKERATOSIS, | pain and buring

Answer 43

oral mucosal cinnamon reaciton

Question 44

how long does it take to resolve oral mucosal cinnamon reaction

Answer 44

1 week following discontinuation of the cinnamon product

Question 45

lichenoid amalgam reaction

Answer 45

associated with old amalgam restorations undergoin corrosion and release of metallic ions mucosal alterations mimic lichen planus HOWEVER are LOCALIZED. may be white or erythematous

Question 46

what is the differential diagnosis of lichenoid amalgam reaction?

Answer 46

true leukoplakia would the differential diagnosis. | key is to look if the amalgam is contacting the mucosa

Question 47

will smith reaction in mr. hitch

Answer 47

angioedema

Question 48

IgE mediated hypersensitivity reaction

Answer 48

angioedema

Question 49

NON-PAINFUL pruritus and erythema may be seen solitary or multiple sites may be involved relatively rapid onset of sof ttissue swelking

Answer 49

Angioedema

Question 50

what inhibitor is involved in angioedema?

Answer 50

C1 esterase inhibitor and | ACE inhibitor

Question 51

excess bradykin

Answer 51

angioedema