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Pathology 2 > Common Oral Diseases > Flashcards

Common Oral Diseases Flashcards

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1
Q

What are tori and exostoses?

A

Benign, reactive bony protuberances arising from the cortical plate

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2
Q

Which type of torus is more common: palatal or mandibular?

A

palatal

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3
Q

What are the characteristics of palatal tori?

A
  • 25% of US population
  • Females (2:1)
  • Asians and Inuits (Eskimo)
  • No treatment
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4
Q

What are the characteristics of mandibular tori?

A
  • 10% of US population
  • Most are bilateral
  • Single or multiple nodules
  • Slight male gender predominance
  • Asians and Inuits
  • No treatment
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5
Q
A

palatal torus

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6
Q

What are the characteristics of a mandibular torus?

A
  • Less common than palatal tori
  • 10% of US population
  • Most are bilateral
  • Single or multiple nodules
  • Slight male gender predominance
  • Asians and Inuits
  • No treatment (unless necessary for partial/denture)
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7
Q
A

mandibular torus

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8
Q
A

buccal exostoses

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9
Q
A

mandibular tori

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10
Q
A

traumatic ulcer

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11
Q
A

traumatic ulcer

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12
Q

What is the most common “tumor” of the oral cavity?

A

traumatic (irritation) fibroma

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13
Q

What is traumatic (irritation) fibroma?

A
  • Inflammatory fibrous hyperplasia
  • Not a true neoplasm of fibroblasts - a reactive lesion rather than a true neoplasm
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14
Q

What is a giant cell fibroma?

A
  • Distinct from irritation fibroma – may not be associated with an identifiable source of chronic irritation and occurs at younger age
  • Often exhibits a papillary surface and may be clinically mistaken for papilloma
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15
Q

Differential diagnoses for this

A

giant cell fibroma
squamous papilloma

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16
Q

Differential diagnoses for this

A

giant cell fibroma
squamous papilloma

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17
Q

What are the characteristics of epulis fissuratum?

A
  • Redundant fibrous tissue
  • Associated with denture flange
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18
Q
A

epulis fissuratum

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19
Q

What is inflammatory papillary hyperplasia?

A
  • Denture papillomatosis
  • Poor oral hygiene combined with ill-fitting prosthesis
  • Surgical excision and correct prosthesis
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20
Q
A

inflammatory papillary hyperplasia

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21
Q

With medication associated gingival enlargement the englargment begins in the interdental papillae and forms…

A

pseudopockets

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22
Q
A

Medication Associated Gingival Enlargement

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23
Q

What are the features of medication associated gingival enlargement?

A
  • Non-specific clinical appearance
  • Multiple drugs are synergistic
  • Severity is related to patient susceptibility and local factors
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24
Q

What are the medications associated with gingival enlargement?

A
  • Anticonvulsants
    – Dilantin (phenytoin) – 50%
  • Calcium channel blockers
    – Procardia (nifedipine) – 25%
  • Immunosupressants
    – Sandimmune (cyclosporin) – 25%
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25
How can you tell the difference between medication related gingival enlargement and giant cell fibroma?
medication related gingival enlargement is more diffuse throughout the mouth
26
What is the treatment strategy for medication related gingival enlargement?
* Control local factors - anti-plaque agents (chlorhexidine) * Drug substitution * Drug therapy - folic acid, metronidazole, azithromycin * Surgical excision - gingivectomy
27
What is a pyogenic granuloma?
A reactive vascular lesion - essentially a capillary hemangioma
28
Who is more likely to get pyogenic granuloma?
Definite female predilection - vascular effects of hormones
29
Why is the name pyogenic granuloma stupid?
Name is a misnomer. It is unrelated to infection. It is not “pyogenic” and is not a true granuloma
30
What are the characteristics of a pyogenic granuloma?
* A reactive vascular lesion - essentially a capillary hemangioma * May exhibit rapid growth * Gingiva most common site, but not limited to gingiva. It occurs throughout the body on any skin or mucosal surface
31
pyogenic granuloma
32
What are the clinical variants of pyogenic granuloma?
* Pyogenic granuloma * Granuloma gravidarum - Pregnancy tumor * Epulis granulomatosum * Pulp polyp
33
What is a granuloma gravidarum?
* pregnancy tumor * A clinical variant of pyogenic granuloma * May involute without treatment post partum and undergo fibrous maturation
34
What is the differential diagnosis for this...
- peripheral ossifying fibroma - pyogenic granuloma
35
What is a peripheral ossifying fibroma?
* Reactive lesion – not a neoplasm * Fibrous hyperplasia with osseous metaplasia - may appear radio-opaque
36
Where does a peripheral ossifying fibroma form?
exclusively on the gingiva
37
What are the characteristics of peripheral ossifying fibroma?
* Reactive lesion – not a neoplasm * Teenagers and young adults * Occurs exclusively on the gingiva * Fibrous hyperplasia with osseous metaplasia - may appear radio-opaque * May recur * May move teeth
38
What is a peripheral giant cell granuloma?
* Reactive lesion – not a neoplasm
39
Where does a peripheral giant cell granuloma form?
Occurs exclusively on gingiva and edentulous alveolar ridge
40
What are the characteristics of peripherl giant cell granuloma?
* Older adults * Occurs exclusively on gingiva and edentulous alveolar ridge * Contains hemosiderin - may be bluish-purple * May recur
41
What are the differential diagnosis for a bump on the gums?
- traumatic fibroma - giant cell fibroma - epulis fissuratum - inflammatory papillary hyperplasia - pyogenic granuloma - peripheral ossifying fibroma - peripheral giant cell granuloma
42
What diseases are caused by human papilloma virus?
* Squamous papilloma * Verruca vulgaris * Condyloma acuminatum
43
What are the features of squamous papilloma?
* Solitary lesion in adult * Pedunculated, exophytic papule * Numerous surface projections
44
Differential diagnosis for this...
- giant cell fibroma - squamou papilloma - verruca vulgaris
45
What is verruca vulgaris?
* Skin of hands in children * Multiple, clustered lesions common * White, verrucoid surface * Autoinoculation of oral mucosa
46
What is condyloma acuminatum?
* Venereal wart: sexually transmitted disease * Multiple, clustered lesions common * Sessile, pink exophytic mass, larger than squamous papilloma * can be on yo penis or vulva (not showing pics of that)
47
When does primary herpetic gingivostomatitis happen?
- Initial exposure to virus in an individual without immunity - Generally occurs at young age after physical contact with infected individual
48
What are the symptoms of primary herpetic gingivostomatitis?
* Flu-like illness with fever, malaise, arthralgia, headache * Cervical lymphadenopathy
49
Recurrent herpes intraorally occurs on...
mastricatory/bound down tissue (hard palate or gingiva)
50
Recurrent aphthae is only on...
nonmasticatory/moveable tissue
51
Primary herpes intraorally occurs on...
masticatory and nonmasticatory tissue (any tissue type)
52
What are the clinical forms of recurrent aphthous stomatitis?
- minor - major - herpetiform
53
Aphthous-like Lesions may be Associated with Systemic Disease such as...
* Behcet’s Syndrome * Reiter’s Syndrome * Inflammatory Bowel Disease – Ulcerative colitis – Crohn’s Disease * Malabsorption Syndromes – Gluten Sensitive Enteropathy * Cyclic Neutropenia * HIV / AIDS
54
What is important about minor aphthae?
* Recurrent disease * Shallow, painful ulcerations on non-keratinized mucosa * Solitary or multiple lesions * Heal in two weeks
55
What is important about major aphthae?
* Larger (> 0.5cm) * Deeper - may heal with scarring * Heal slowly - weeks to months
56
What is important about herpetiform aphthae?
* Crops of small, shallow, painful ulcers * Heal in two weeks * Short remissions
57
How does someone typically get angular cheilitis?
drooling
58
What is the differential diagnosis for this...
hyperplastic candidiasis leukoplakia
59
What are the features of hyperplastic candidiasis?
- does not wipe off - been there for a long time - isolate lesion - leukoplakia
60
How do you know if something is candidiasis?
does it wipe off - leaves behind a red background
61
What is one of the only diseases found on the midline of the dorsum of the tongue?
Central Papillary Atrophy/Median Rhomboid Glossitis
62
What is important to know about atrophic candidiasis/erythematous candidiasis?
be sure to treat the disease and the denture
63
What is the differential diagnosis for this...
mucocele granula epidermoid cyst
64
What are the types of gingivitis?
1. Plaque-associated gingivitis 2. Necrotizing ulcerative gingivitis – NUG 3. Medication-induced gingivitis – Drug-related gingival hyperplasia 4. Allergic gingivitis – Plasma cell gingivitis 5. Specific infection-related gingivitis – Herpes Simplex Virus 6. Dermatosis-related gingivitis – Desquamative gingiviti
65
gingivits
66
What are systemic diseases that can have periodontitis as a manifestation?
* Diabetes mellitus * Human Immunodeficiency Virus infection * Decreased numbers of leukocytes – Neutropenia * Abnormal function of leukocytes – Leukocyte dysfunction syndromes * Papillon-Lefevre Syndrome
67
What is pericoronitis?
inflammation associated with the soft tissue over the area where the third molars are located
68
pericoronitis
69
foliate papillae and lingual tonsils (not pathology)
70
What is the differential diagnosis for this...
oral lymphoepithelial cyst mucocele lipoma salivary stone (sialolithiasis)
71
What is hairy tongue?
* Elongated filliform papillae * Exogenous pigmentation may impart a brown or black appearance * Various associated factors – Heavy smoking – Antibiotic therapy
72
What are fordyce granules?
* Ectopic sebaceous glands * Development stimulated at puberty
73
fordyce granules
74
fordyce granules
75
What is the differntial diagnosis for this...
squamous cell carcinoma arepo leukoplakia actinic cheilitis
76
What is actinic cheilitis?
- lips that have sun damage - potentially premalignant condition
77
What is a leukoplakia?
A white patch or plaque that can’t be characterized clinically or pathologically as any other disease.
78
What IS NOT a leukoplakia (never ever)?
pseudomembranous candidiasis leukoedema smoker's keratosis
79
What is the differential diagnosis for this?
hyperplastic candidiasis squamous cell carcinoma hyperkeratosis from trauma leukoplakia
80
What is the best clinical diagnosis for this?
chronic mucosal chewing Morsicatio Buccarum
81
What is a erythroplakia?
A red patch or plaque that can’t be characterized clinically or pathologically as any other disease
82
What is never a erythroplakia (NEVER EVER)?
medial rhomboid glossitis
83
What is the differential diagnosis for this...
epithelial dysplasia squamous cell carcinoma carcinoma in situ
84
What is a differential diagnosis for this...
Addison's disease smokers melanosis pterts yager
85
What is an oral melanotic macule?
* Focal increase in melanin * Normal number of melanocytes * Lower lip vermillion most common
86
What are the clinical types of lichen planus?
* Reticular lichen planus * Erosive lichen planus
87
What is reticular lichen planus?
* Bilateral asymptomatic white lesions of posterior buccal mucosa (Wickham striae) * Also papules and plaques
88
erosive lichen planus
89
What are the other names of geographic tongue?
* Benign Migratory Glossitis * Erythema Areata Migrans * Stomatitis Areata Migrans * Wandering Rash of the Tongue
90
What are the characteristics of geographic tongue?
* Cause unknown – Hypersensitivity to environmental factor ? * Common at tip and lateral border * Red – Multiple erythematous zones – Atrophy of filliform papillae * White * Elevated, yellow-white, serpiginous border
91
geographic tongue
92
What is the histology of geographic tongue?
* Psoriasiform mucositis – Resembles psoriasis * Exocytosis of neutrophils into epithelium * Munro microabscesses

Pathology 2 (5 decks)

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