Chapter 14 (1)

Question 1

Idiopathic oral inflam lesion that affects 40% of population and features a thin exudate and red rim

Answer 1

aphthous ulcer (canker sore, recurrent aphthous stomatitis)

Question 2

Smoking, stress, trauma, fever, and certain foods will cause recurrance of ________

Answer 2

aphthous ulcers

Question 3

Aphthous ulcers are treated with (3)

Answer 3

NSAIDs
corticosteroids
vitamin B12 (cobalamin)

Question 4

Commonly infects young children; 80% are asymptomatic but 10-20% have ACUTE HERPETIC GINGIVOSTOMATITIS

Answer 4

Herpes simplex virus (cold sores/herpetic stomatits)

Question 5

Most adults carry the latent infx for HSV in the TRIGEMINAL GANGLION, and when it reactivates, it is then called

Answer 5

recurrent herpetic stomatitis

Question 6

Self-limiting lesions that feature a small group of vesicles 1-3mm, itching, burning, tingling and possible pyrexia (2)

Answer 6

HSV 1- OROFACIAL

HSV 2- GENITAL

Question 7

UV light, pyrexia, cold, trauma, URTI, pregnancy (provoking exposures) can call recurrance of

Answer 7

HSV

Question 8

If HSV spreads to brain and is life threatening, it is called _______, and can affect the CNS

Answer 8

herpesviral encephalitis

Question 9

MC oral FUNGAL infx that presents as gray-to white, can be scraped off, and will be erythema below

Answer 9

oral candadiasis (candida albicans/THRUSH)

Question 10

Type of oral proliferative lesion, nodular mass from chronic irritation that causes hyperplasia, MC along BITE LINE along the BUCCAL MUCOSA

Answer 10

fibroma

Question 11

• Type of oral proliferative lesion seen in PREGGOS, children, along GINGIVA
• Due to hormonal factors and irritation

Answer 11

pyogenic granuloma

Question 12

Raised WHITE PATCH that CAN’T be scraped off, due to inflam from tobacco, alcohol, candidiasis
- Males 2x

Answer 12

leukoplakia

Question 13

LEUKOPLAKIA is found via dx of EXCLUSION to rule out CA, since 25% are precancerous and transition into ________

Answer 13

squamous cell carcinoma

Question 14

LEUKOPLAKIA like condition that presents as a RED VELVETY area and 50% is precancerous

Answer 14

erythroplakia

Question 15

LEUKOPLAKIA like condition with an EPSTEIN BARR VIRUS infxn + late stage immunosuppression

Answer 15

hairy leukoplakia

Question 16

LEUKOPLAKIA like condition

- HPV infx, with hyperkeratosis and a WARTY appearance that commonly PROGRESSES to SCC

Answer 16

verrucous leukoplakia

Question 17

____ cancer is usually dx when already in its ADVANCED stages

Answer 17

oral

Question 18

• 95% of all cases of oral cancer are ________, with common MULTIPLE primary tumors
• Risks include alcohol, tobacco, HPV16

Answer 18

squamous cell carcinoma

Question 19

SQUAMOUS CELL CARCINOMA is leukoplakia-like, and presents with WHITISH-GRAY or _____, found on the ______ tongue and floor of mouth
- MC site of metastasis is CERVICAL NODES

Answer 19

erythematous

ventral

Question 20

If SCC is ___ it has a more FAVORABLE prognosis due to fewer mutations
- Found on BASE OF TONGUE, TONSILLAR CRYPTS

Answer 20

HPV-16

Question 21

Primary salivary gland diseases are RARE, and are MC in the _____

Answer 21

parotid gland

Question 22

Dry mouth, found in salivary gland disease that is due to decreased saliva production

Answer 22

xerostomia

Question 23

Two causes of xerostomia

Answer 23

aging ( >70 yrs)
sjorgren syndrome (salivary gland disease is 2ndry)

Question 24

Two main features of XEROSTOMIA (salivary gland disease,) in addition to fissuring and ulceration of the tongue

Answer 24

dysphagia (difficulty swallowing)

dysarthria (diff forming speech)

Question 25

Salivary gland disease that includes INFLAMMATION and ENLARGEMENT

Answer 25

sialadenitis

Question 26

MC viral cause of sialadenitis, presents in parotids and is self limiting in CHILDREN but in ADULTS can cause pancreatitis & orchitis

Answer 26

mumps

Question 27

Blockage/rupture of glandular duct that connects salivary gland to oral cavity, presents on LOWER LIP in kids & elderly

Answer 27

mucocele

Question 28

Salivary gland neoplasms MC affect the ____, and are 65-80% (MC) in the _____ glands (but LEAST likely to be MALIGNANT)

Answer 28

elderly | parotid (LEAST malignant)

Question 29

Salivary gland neoplasms occur in the ______ glands 10% and _______ & minor salivary glands 10-25%, with the latter being MALIGNANT 50-90% of the time - Smaller glands are less common, but have an increased malignancy risk

Answer 29

submandibular | sublingual (more MALIGNANT)

Question 30

- Benign, glandular neoplasm that comprises 60% of PAROTID tumors - Cartilage & bone, encapsulated

Answer 30

pleomorphic adenoma

Question 31

If a pleomorphic adenoma transitions into CA (2-10% do), it is then termed:

Answer 31

carcinoma ex pleomorphic adenoma

Question 32

The ____ esophageal sphincter tends to have MORE dysfunciton

Answer 32

lower

Question 33

______ lesions of the esophagus presents with ATRESIA, tracheal fistula, fibrosis, while ____ lesions show aperistalsis

Answer 33

mechanical | functional

Question 34

____ is seen with lesions that have ectopic gastric mucosa, in the UPPER 1/3 of the esophagus, and is MC asymptomatic

Answer 34

ectopia

Question 35

Triad of ____ includes 1. incomplete LES relaxation 2. increased LES tone 3. esophageal aperistalsis

Answer 35

achalasia (failure to relax) (esophagus)

Question 36

Patient with ACHALASIA will have DYSPHAGIA, REGURGITATION, and the ________ esophagus becomes dilated

Answer 36

proximal

Question 37

____ achalasia is MC, due to loss of inhib innerv to LES, are IDIOPATHIC while ______ achalasia occurs comorbidly and involves INFLAMMATION near AUERBACH'S PLEXUS

Answer 37

primary | secondary

Question 38

Esophageal Varices: Portal venous congestion -> portal HTN portal BF --> esophageal ______ - Dilated & tortuous esophageal vessels in the _____ esophagus

Answer 38

venous plexus | distal

Question 39

Esophageal varices are MC secondary to _______, 90% from ALCOHOLIC LIVER DISEASE

Answer 39

liver cirrhosis

Question 40

Risk for severe ____ comes with ESOPHAGEAL VARICES, and HYPOVOLEMIC SHOCK

Answer 40

hemorrhage

Question 41

_______ is common esophageal inflammation where symptoms do not correlate well with the degree of inflammation, MC cause is ______ (GERD) - Irritation, alcohol, smoking

Answer 41

esophagitis | reflux

Question 42

______ is the cause of ESOPHAGITIS if the patient experiences "SOUR BRASH," while ______ is acute and self limited & caused by tobacco, alc, etc. ______ type occurs most in the immunosuppressed

Answer 42

GERD chemical infectious

Question 43

_________ is the MC laceration of the esophagus and is due to inadequate LES relax, from forceful vom as in alcholism, bulimia, acute illness. occurs in the ____ junction - Esophageal lacerations are commonly treated with a ________

Answer 43

mallory-weiss tear gastroesophageal balloon tamponade

Question 44

________ occurs following a WIDENING of the ESOPHAGEAL HIATUS , stomach protrudes into thorax

Answer 44

hiatal hernia

Question 45

_______ hiatal hernia is MC in 95% of cases and involves a BELL-shaped dilation while the _______ type has a separate portion of the stomach protruding

Answer 45

axial (SLIDING) | non-axial (ROLLING)

Question 46

While hiatal hernias are common (20% adults), ______ % are ASYMPTOMATIC, and symptoms are MC in ______ type, are found via a DDX of exclusion

Answer 46

90% | non-axial (rolling)

Question 47

Esophageal metaplasia considered a preneoplastic lesion that occurs in the DISTAL esoph - Stratified squamous --> column epi (contains goblet cells) - Red velvety bands "tongues"

Answer 47

barrett esophagus

Question 48

With barrett esoph complications may occur such as esophageal _____ ( ^ 30-100x), the risk is proportional to metaplasia/dysplasia, but to decrease chances the pt should stop _____

Answer 48

adenocarcinoma | irritants

Question 49

- A _______ is a benign, smooth musc tumor, - ________ is 50% of *US* esoph cancers, with a risk being barrett esoph, occurs in DISTAL 1/3 - _______ is the MC esoph tumor WORLDWIDE (2nd and 3rd world), 90%

Answer 49

leiomyoma adenocarcinoma squamous cell carcinoma

Question 50

Adenocarcinoma risk is decreased with increased _________

Answer 50

fruit/veggie consumption

Question 51

- Features of adenocarcinoma are MC in the ______ stages, include obstruction, cachexia, weakness - _______ invasion of lymphatics + dx late leads to a poor prognosis

Answer 51

late | early

Question 52

MC demographic for the risk of squamous cell carcinoma, which will have a very poor prognosis if there is lymphatic mets (2)

Answer 52

``` > 45 yo males (4x) african americans (6x) ```

Question 53

ESOPHAGEAL SQUAMOUS CELL CARCINOMA has distinct ________ and occurs in the ________ 1/3 of the esophagus

Answer 53

stricture | middle

Question 54

Esophageal adenocarcinomas commonly have _______ mutations and are located in the _________ of the esophagus

Answer 54

TP53 | distal 1/3 (same as BARRET'S)