Finals Flashcards

1
Q

Periapical abscess

A

Clinical:SPT/non-vital
Rad: widened PDL + PA RL
Hist: central core necrosis + fibrous CT w/ inflm cells
Tx: RCT/exo

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2
Q

Periapical granuloma

A

Clin: asym/ non-vital
Rad: loss of LD/ PA RL
Hist: inflm granulation tissue, dense inflm infiltrate, cholesterol clefts, extravasated RBC, hemosiderin

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3
Q

Radicular cyst

A

Clin: non-vital
Rad: loss of PDL, apical RL
Hist: non-K SSE, inflm infiltrate, cholesterol cleft, giant cells, Rushton bodies
Tx: RCT, exo

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4
Q

Acute suppurations osteomyelitis

A

Clin: mostly Md, swelling, sig sensitivity, paresthesia, lymphadenopathy, fever
Rad: ill defined RL in bone, may have RO of necrotic bone
Hist: non-vital bone, bacterial colony, inflm cells
Tx: surgical

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5
Q

Fibroepithelial Polyp

A

Clin: occurs anywhere, asym
Hist: modular mass of CT; may be inflm or hyperK
Tx: excision

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6
Q

Epulis Fissuratum

A

Clin: F>M, associated with denture; ulcerated, may have papillary component
Hist: ulcer, inflm infiltrate, hyperK, may have osseous or chondromatous hyperplasia
Tx: excision

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7
Q

Pyogenic granuloma

A

Clin: red, reactive, bleeds easily, painless; associated with pregnancy
Hist: CT, vascularized, inflm, granulation tissue, often ulcerated
Tx: excision; 15% recurrence

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8
Q

Peripheral giant cell granuloma

A

Clin: only on gingiva, nodular mass, mostly middle age female, clinical feature similar to PG
Hist: giant cells, mesenchymal cells in the background, hemorrhage, may be ulcerated, sometimes reactive bone
Tx: excision down to bone, 10% recurrence

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9
Q

Peripheral ossifying fibroma

A

Clin: only on gingiva, mostly young women, ant mx
Hist: giant cell, mineralized product
Tx: excision down to periosteum, 10% recurrence

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10
Q

Inflammatory papillary hyperplasia

A

Clin: palate, red, pain, papillary, mostly under denture
Hist: papillary projection, inflm cells, hyperplastic SSE, elongate rete ridges, hyperplastic CT,

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11
Q

Reasons for hyperplastic gingivitis

A

Hormone status, drug, calculus

Drug induced = not real hyperplasia, just more CT
- can be treated with folic acid and metronidazole+azithromycin

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12
Q

Radicular cyst

A

Clin: asym, non-vital
Rad: PA RL, common root resorption
Hist: SSE, inflm cells, Hyaline bodies
Tx: RCT, exo

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13
Q

Residual cyst

A

Everything same as radicular cyst but without teeth

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14
Q

Dentigerous cyst

A

Clin: asym
Rad: RL around crown, attached to CEJ
Hist: Fibrous CT wall, cords of odontogenic epi, thin epi cells, epi and CT interface is flat
Tx: nucleation and exo

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15
Q

Eruption cyst

A

Soft tissue counter part of dentigerous cyst

- everything is the same except no tx needed

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16
Q

Dental lamina cyst of the new born

A

Proliferating rests of serres

KERATINIZED EPI

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17
Q

OKC

A

Clin:mostly post Md, asym
Rad: Multicoluar, expansion
Hist: wavy epi, thin CT wall, flat interface between CT and epi, palisading basal cell, hyperchromatic basal cell, paraK,
Tx: excision, high recurrence

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18
Q

Goblin Golts clinical

A
Multiple OKC
Falx cerebri, bifid ribs
Eyes apart
Palmar pits on palm and soles 
Risk for basal cell carcinoma
Autosomal dominant
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19
Q

Lateral periodontal cyst

A

Clinical: asym, mostly Md PM
Rad: beside root, RL, corticated, unicystic
Hist: Glycogen rich clear cells, focal plaque on epithelium
Tx: enucleation
Note: gingival cyst of adult = soft tissue version of lateral periodontal cyst

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20
Q

COC

A

Clin: mostly anterior to 1M, asym
Rad: unilocular, RL rim with RO interior, displacement
Hist: mineralization, ghost cell; odontogenic epi similar ameloblast w/ stellate reticulum
Tx: enucleation

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21
Q

Buccal bifurcation cyst

A

Clin: buccal expansion, asym, arise when molars are erupting (young pt)
Rad: RL around molar furcation
Hist: SSE, inflm infiltrates; possible hyaline bodies, cholesterol cleft, mucous cell in epi
Tx: enucleation

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22
Q

Nasopalatine duct cyst

A

Clin: asym, near nasopalatine area
Rad: radiolucency around U1, well defined, displacement
Hist: BV,N; ciliated columnar/cuboidal/SSE
Tx: enucleation

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23
Q

Lymphoepithelial cyst

A

Clin: around Waldeyer ring or lateral tongue or FOM, yellow superficial submucosal mass, asym
Rad: none
Hist: lymphoid tissue, para-K SSE
Tx: excision

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24
Q

Dermoid cyst

A

Clin: midline soft tissue cyst, teratoma; mostly FOM
Rad: none
Hist: orthoK SSE, dermal appendages; lumen filled with keratin and sebum
Tx: excision

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25
Q

Simple bone cyst

A

Clin: mostly post MD, just cavity within bone, biopsy needed unless signs of healing
Rad: scalloped boarder, rarely any effect on surrounding structure
Hist: none
Tx: none

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26
Q

Stafne bone defect

A

Clin: under IAN; concavities in the bone surface

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27
Q

Mucous retention pseudocyst

A

Focal thickening of mucosa lining of Mx sinus
Dome-shaped, non corticated RO in sinus
Tx: none

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28
Q

Conventional ameloblastoma

A

Clin: locally aggressive, expansion; 20yo+; post Md, painless
Rad: multilocular, expansion, resorption, displacement, septa; well defined and corticated
Hist: fibrous stroma, islands of ameloblast-like lining with central stellate reticulum; palisading and reverse polarity of ameloblast-like cell, cystic degeneration
Tx: resection; 15% recurrence
Note: could be from basal cells of oral mucosa, rests of dental lamina, developing enamel organ, or lining of odontogenic cyst

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29
Q

Unicystic ameloblastoma

A

Clin: younger pt, painless
Rad: unilocular, pericoronal
Hist: fibrous stroma with odontogenic epi; lumina/intralumina/mural
Tx: local curettage and Carnoy’s solution; 10% recurrence

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30
Q

CEOT (calcifying epithelial odontogenic tumour)

A

Clin: asym, post Md
Rad: corticated, RO/RL, displacement and expansion
Hist: CALCIFICATION WITH CONCENTRIC RING; fibrous CT, INTERCELLULAR BRIDGES + AMYLOID
Tx: resection

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31
Q

AOT (adenomatoid odontogenic tumour)

A

Clin: painless
Rad: corticated, pericoronal, attaches lower to CEJ, RO/RL
Hist: duct like structure; whorled masses of spindle shaped cells; Nuclei away from central space; calcification common
Tx: resection

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32
Q

Ameloblastic fibroma

A

Clin: young male (0-20); post Md, coronal to developing tooth; asym
Rad: well defined, RL; may expand cortex and inhibit eruption
Hist: cell-rich mesenchymal tissue like dental papilla with proliferating island, odontogenic epi palisading at periphery
Tx: excision

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33
Q

Ameloblastic fibro-odontoma

A

Clin: asym, associated with unerupted tooth
Rad: basically ameloblastic fibroma with RO
Hist: AF with calcification
Tx: excision

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34
Q

Odontoma compound

A

Clin: Ant Mx, asym
Rad: corticated with RL capsule
Hist:multiple tooth shaped
Tx: excision

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35
Q

Odontoma complex

A

Clin: posterior Mx/Md
Rad: irregular masses of calcified tissue
Hist: mature tubular dentin Admixed with dental pulp and enamel matrix - no order
Tx: excision

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36
Q

Odontogenic myxoma

A

Clin:posterior Md
Rad: multilocular, tennis racquet septa; may scallop; no expansion; loosen teeth but no resorption
Hist: haphazardly arranged stellate cells
Tx: curettage or wider excision; 25% recurrence

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37
Q

Odontogenic fibroma

A

May have hard tissue

For peripheral OF, 50% recurrence

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38
Q

Cementoblastoma

A

Clin: PAIN
Rad: wheel spoke appearance of root expansion, attached to root; RO; root absorption and expansion
Hist:fusion of the lesion to root, GIANT CELLS PRESENT, sheets of mineralized material

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39
Q

Gardner syndromes SS

A

Multiple osteoma
Multiple dense bone islands
Multiple supernumerary teeth
Multiple intestinal polyps (may need prophy resection to prevent colon cancer)

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40
Q

Giant cell lesions (6)

A
Peripheral giant cell granuloma
Central giant cell granuloma 
Cherubism
Brown tumour 
Aneurysmal bone cyst 
Fibrous dysplasia
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41
Q

Central giant cell granuloma

A

Clin: red, Md before 1M, <30 yo
Rad: well defined but no cortication, multilocular with septa, expansion, displace, resorption
Hist: giant cells, blood, vascularization, granular tissue

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42
Q

Aneurysmal bone cyst

A

Clin: post Md (very rare, should be bottom of DDx)
Rad: looks like CGCG (expansion, displacement, absorption, well defined but no cortication, RL, septa)
Hist: cellular, blood filled spaces, giant cells

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43
Q

Cherubism

A

Clin: bilateral expansion, autosomal dominant, 10yo, expose inferior sclera
Rad: bilateral expansion, RL with septa, epicentre = posterior Md, displace teeth, radiographic signs persist after involution

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44
Q

Langerhan cells histiocytosis

A

Clinical: appears like parulis, Md>Mx; occurs in children
Rad: well defined periphery, ice cream scoop shaped, teeth look floating, RL; no displacement and resorption
Hist: lots of eosinophils and langerhan cells
Birbeck granules in electron microscopy

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45
Q

Fibrous dysplasia

A

Clin: young ppl, Mx expansion, can displace IAN canal upward; also displace teeth, encroachment of Mx sinus
Rad: different patterns (ground glass/cotton wool/amorphous/ orange peel)
Hist:irregularly shaped trabeculae, few OB, no OC, no OB rimming of bone
Tx: cosmetic contouring

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46
Q

Cemento-osseous dysplasia

A

Clin: middle age women, ant md, vital teeth, asym
Rad: RL -> RO; well defined rim; multilocular
Hist: irregular trabeculae, fibrous stroma; cementum-like particles
Tx: none

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47
Q

Oral Squamous papilloma

A

HPV, solitary, painless

Tx: leave it or excision

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48
Q

Verruca vulgaris

A

Wart, also HPV
Common in skin but not oral cavity
Usually children and contagious

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49
Q

Condyloma acuminatum

A

HPV 16
Genital warts, STD, multiple
Hist: koilocytes

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50
Q

Acquired melanocytic nevus

A

Mole
Common, produce melanin
Junctional/compound/intramucosal
Upward maturation

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51
Q

Schwannoma (Neurilemoma)

A

Usually uncommon but most occur on H/N; painless
Spindle cells
Antoni A (with verocay body) and Antoni B

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52
Q

Neurofibroma

A

Cafe Au lait
May be component of neurofibromatosis type 1
- common, autosomal dominant, mutation of tumour suppressor gene that codes for neurofibromin

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53
Q

Granular cell tumour

A

Clin: dorsal tongue mostly
Hist: pseudoepitheliomatous hyperplasia, granular cells

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54
Q

Hemangioma

A

Hamartomas of infancy; mostly H/N

Dx: diascopy

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55
Q

Vascular malformation - port wine stain

A

Sturge-Weber Angiomatosis
Encephalotrigeminal angiomatosis - non-hereditary developmental condition
Unilateral vascular malformation (brain and face)
- facial port wine stain, neurological complication, intra-oral involvement

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56
Q

Hereditary hemorrhagic telangiectasia

A

Autosomal dominant
Lesions on skin/oral/other mucosa (epistaxis and GI bleeding)
Arteriole venous malformation in brain/lung/liver
- pulmonary hypertension, brain abscess, portal hypertension
- biliary disease, heart failure
- problem with shunting blood

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57
Q

Lymphangioma

A

Hamartomas of lymphatic vessels

Mostly congenital and H/N

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58
Q

Difference between osteoid osteoma and osteoblastoma

A

Size (2cm cut off)
Location (OB in spine)
Pain characteristic (OO gets nocturnal pain)

59
Q

Sickle cell anemia - affect on bone

A
Marrow hyperplasia 
Osteoporosis
Thinning or cortex
Enlargement of jaws
Lack of pneumatization of paranasal sinus 
Widening of diploic of skull
60
Q

Thalassemia

A
Defect in hemoglobin synthesis 
Marrow hyperplasia
Thinning of cortex
Loss of pneumatization of sinuses
Enlargement of jaws
61
Q

Paget’s disease

A

Middle ago men
Etiology: OC abnormality
Normal Ca and PO4 but high alkaline phosphatase
Bilateral Mx expansion, teeth displacement, skull enlargement (ground glass pattern), hypercementosis, bowing of the legs
Rad: jaw enlargement, teeth separation, OC resorption/OB apposition phases
Hist: reversal lines
Complications: exo site heals slowly, osteomyelitis, osteosarcoma

62
Q

Metastatic disease (BLuKiPT)

A

Breast, lung, kidney, prostate, thyroid

63
Q

Most common location for metastatic lesion

A

Gingiva (attached)
Due to rich vasculature
Presentation: hemorrhagic, exophytic, vascularized

64
Q

Multiple Myeloma

A

Plasma cell neoplasm
Clin: uncontrolled protein synthesis, renal impairment, anemia/leukopenia/thrombocyotpenia; tongue enlargement - amyloidosis; tooth mobility
Rad: multiple punched out lesion

65
Q

Lichen planus histological feature (5)

A
HyperK
Brand like inflm infiltrate 
Liquefactive degeneration of basal cells  
Colloid bodies 
Saw-tooth rete ridges
66
Q

Erythema multiforme
Precipitating factors
Clinical features
Treatment

A

Precipitating factor: viral infection and systemic med (barbiturates, Sulfonamides, penicillin)
Clinical features: hand and feet “target” appearance; multiple ulcers, college students; self limiting
Treatment: supportive or systemic steroid

67
Q

Pemphigus vulgaris

Clinical, Hist (3),

A

Fatal if untreated; mostly adults; common in upper body
Oral lesion first to show last to go (develops faster than LP but slower than EMultiforme)
Positive Nikolsky’s sign
Hist: acantholysis, tombstone basal cell, suprabasal vesicle

68
Q

Mucous membrane pemphigoid

Clinical; comorb;tx

A

Not fatal, chronic disease
Morbidity: blindness, can’t swallow (both due to scars)
Tx: topical/systemic steroid, dapsone, surgical correction

69
Q

Epidermolysis bullosa

Clinical and oral manifestation

A

Vesicles with minor trauma -> ulcer -> scar
Subepi vesicle
Due to mutation of gene that encod basement membrane
Oral lesion: vesicle and ulcers -> heals with scarring + missing/malformed hypoplastic teeth

70
Q

Ectodermal dysplasia

A

External: fine hair, problems with sweat gland, nail, lip, supraorbital ridges
Oral: conical teeth, oligodontia or no teeth

71
Q

Histo of white lesion

A

HyperorthoK; hyperparaK, acantholysis, epi dysplasia, epi hyperplasia

72
Q

Different ways to get hyperK

A

Frictional hyperK
Tobacco pouch keratosis
Nicotine stomatitis

73
Q

Clinical features with leukoplakia

A

Increase with age, smoking

Sites: anywhere except palate

74
Q

Histo of epi dysplasia

A
Bulbous rete ridges
Loss of basal cell polarity 
Premature keratinization of spinous cells 
Increase N/C ratio
Hyperchromatism
Pleomorphism 
Mitotic figures
Large nucleolus
75
Q

Risk of malignant transformation

A
FOM
Idiopathic
Non-homogenous 
Large 
Histo: severity of dysplasia
76
Q

Risk factor for SCC

A

Demographic: male over 40
Lifestyle: smoking, drinking, betel quid
Infection: syphilis, HPV
Chronic disease: Fe deficiency anemia

77
Q

% of oral cancers are smokers?

Takes how many years of non-smoker to return risk to normal?

A

80%

10 years

78
Q

T/F: HPV is a risk factor for oropharyngeal carcinoma but not oral carcinoma

A

True

79
Q

SCC locations

A

Lateral/ventral tongue > FOM> gingiva > buccal mucosa > hard palate

80
Q

Oropharynx carcinoma location

A

Soft palate, tonsillar pillars, posterior 3rd of tongue

81
Q

Symptoms of SCC

A
Most are asymptomatic 
Loss fit of denture 
Teeth mobility 
Bleeding and pain (Referred pain)
Paraesthesia
Dysphagia
82
Q

Verrucous carcinoma

A

Well diff SCC
HyperK papillary surface
Wide and elongated rete ridges

83
Q

Actinic cheilitis

A

Clinical: degenerative condition of lower lip, caused by UV, thickened, blurred demarcation, fissuring, ulcerating
Hist: hyperkeratosis, epi hyperplasia, epi dysplasia, epi atrophy, solar elastosis, chronic inflm infiltrate

84
Q

SCC of lip

Clin and RF and Tx

A

Clin: mostly lower lip and men
RF: UV radiation, whiter skin, smoking
Hist: keratin pearl, solar elastosis, everything else the actinic cheilitis has
Tx: wedge resection, mermilionectomy

85
Q

Acute and chronic side effect of radiation

A

Acute: xerostomia, mucositis, infection, loss of taste, skin (red/burn/ulcer)
Chronic: xerostomia, radiation caries, BV damage, osteoradionecrosis, trismus

86
Q

Mucositis treatment

A

Soft diet, frequent water, baking soda rinses, topic freezing, nystatin for candida, pain med, no alcohol mouthwash

87
Q

Pre-rad dental care

A
Exo all hopeless teeth
Tx all caries
F tray 
Elim all IO trauma and infection 
SRP
OHI
88
Q

Is risk of ORN forever

A

Yes

89
Q

Mucocele

A

Clin: mostly young adults and kids, due to severance fo minor salivary gland; granulation tissue forms a wall and makes it pseudocyst; painless swelling
Hist: well-circumscribed cavity w/ mucin, neutrophil infiltrate, foamy histiocytes; sialadenitis adjacent salivary gland
Tx: excision

90
Q

Ranula

A

Mucocele in FOM
Due to sublingual gland
Called plunging/cervical ranula if mucin dissects thru mylohyoid muscle to produce neck swelling
Tx: marsupialization

91
Q

Mucus retention cyst

A

Clin: from obstruction of salivary flow, parotid often, painless swelling
Hist: SSE/columnar/squamous; oncocytic metaplasia, NO INFLM
Tx: excision + associated gland

92
Q

Sialolithiasis

A

Clin: mostly subMd gland, can form in minor glands, obstructive if in major gland; episodic pain and swelling in meal time, stone near the terminal portion; if minor gland = only swelling
Tx: milking it or surgical removal

93
Q

Bacterial sialadenitis

A

Clin: mostly parotid, mostly Staph Aureus, swelling/trismus/fever/pain; pus, periodic pain and swelling at mealtime
Hist: acute: N in ducts and acini; chronic (4): lymphocyte and plasma cell infiltrate, acinar atrophy, ductal dilation, fibrosis
Tx: ABx, rehydration, remove sialoith, surgical removal of gland

94
Q

Viral sialadenitis - Mumps

A

Clin: mostly parotid, paramyxovirus, 2-3weeks of incubation, non-specific symp+preauricular pain; usually bilateral painful swelling and worsen with talking and chewing
Tx: rest, usually complete recovery

95
Q

Sjogren syndrome

A

Clin: mostly middle age female; dry eyes/dry mouth/xerostomia/keratoconjunctiva/arthralgia/myalgia/sialography
40x risk in lymphoma
May get benign lymphoepithelial lesion - L infiltrate and destroy acini

96
Q

Pleomorphic adenoma

A

Most common
Parotid>palate>upper lip
Clin: painless firm mass; mostly moveable except palate
Hist: duct-like structure, cyst-like space, myoepithelial cell, myxoid stroma
Tx: excision; 95% cure rate; <5% malignant transformation

97
Q

Warthin tumour (papillary cystadenoma lymphomatosum)

A
Parotid tumour 
ASSOCIATED WITH SMOKING
Papillary folds, oncocytic appearance, cystic spaces, lymphocytic tissue, ductal epithelium
Inner epi: columnar 
Outer epi: basal 
Tx: excision; 95% cure; 5% recurrence
98
Q

Mucoepidermoid carcinoma

A

Clin: parotid>palate>others; most common sal malignancy; may appear bluish for mucin
Hist: goblet cells (muco); squamous cells (epi); intermediate cells; arranged in cysts or islands
Low grade: mostly cystic
High grade: mostly mitosis and pleomorphism
Tx: resection; 30-90% cure depending on grade

99
Q

Acinic cell carcinoma

A

Clin: mostly parotid, slow growing, well circumscribed, low grade
Hist: mostly solid, low grade characteristic, abundant granular eosinophilic or basophilic; sheets of cell with some ducts
Tx: resection; <20% recurrence

100
Q

Adenoid cystic carcinoma

A

Clin: any gland; parotid>subMd>palate>other; travel along NERVES - paralysis; slow growing tumour, often painful
Hist: ducts and pseudocysts, Swiss cheese appearance, perineural invasion;
Tx: resection w/ rad; good short term but poor long term survival due to perinerual invasion

101
Q

Polymorphous low grade adenocarcinoma

A

Clin: old ppl; mostly minor sal gland, mostly palate, slow growing
Hist:different growth pattern, small uniform epi cells, infiltration margin, PERINEURAL INVASION
Tx: resection

102
Q

Carcinoma ex-pleomorphic adenoma

A

Clin: mostly parotid
Hist: evidence fo pleomorphic adenoma
Tx: resection; Prog: guarded

103
Q

Different intrinsic discolouration

A

Amelogenesis imperfecta, dentinogenesis imperfecta, fluorosis,hyperbilirubinemia, ochronosis, trauma (pink,yellow,black), localized RBC destruction, resto material, med

104
Q

Hypothyroidism clinical features

A

Cold, lethargy, fatigue, weight gain, bradycardia, dry skin, dry hair, HUSKINESS OF THE VOICE, non-pitting edema, macroglossia

105
Q

Clin of hyperthyroidism

A

Anxiety, heat, sweating, ocular changes, weight loss, tachycardia

106
Q

Results of hyperPTH

A

HyperCa but hypoPO4

107
Q

Dental implication of hyperPTH

A

Brown tumour, generalized loss of LA, decreased trabecular density, bone demin with fibrous replacement, long bone fracture

108
Q

Brown tumour histology

A

Same as central giant cell granuloma

Giant cell, fibrous tissue, capillaries, RBC

109
Q

Clin of Addison’s disease

A

Not enough cortisol

Weakness, fatigue, hypotension, GI upset, anorexia, N/V, diarrhea, weight loss, HYPERPIGMENTATION

110
Q

Clinical of Cushing’ syndrome

A

Obesity, moonface, buffalo hump, hypertension, osteoporosis, DM, impaired healing, infection, depression, mood changes, cataracts

111
Q

Oral feature of sickle cell (5)

A

Reduced trabecular pattern in Md, yellowish oral mucosa, increased prevalence of osteomyelitis, prolonged paresthesia of Md nerve, pulpal necrosis

112
Q

Oral features of thalassemia

A
Large marrow space in Mx
Osteoporosis in Md
Malocclusion
Enlargement of Md and Mx -> sinus obliteration 
Obliterated pulp chamber
113
Q

Clin of aplastic anemia

A

Lower RBC/WBC, acellular bone marrow, fatty infiltration

Fatigue, weakness, pale skin, easily bruised, nose bleed, gingival bleeding, cerebral hemorrhage

114
Q

Clin of iron deficiency - oral

A

Mucosa atrophy, angular cheilitis, strophic glossitis

115
Q

clin of pernicious anemia

A

Fatigue, weakness, palpitation

Numbness, tingling of extremities, burning tongue, lip atrophy, buccal mucosa atrophy, mucosal erythema

116
Q

Oral clin of Plummer-Vinson syndrome (6)

A
Iron def causing increase SCC
Burning tongue 
Atrophic tongue 
Burning oral mucosa
Angular cheilitis
Difficult swallowing
117
Q

Threshold for neutropenia

A

1500/mm^3

118
Q

Agranulocytosis oral lesion

A

Necrotizing deep ulceration of buccal mucosa, tongue, and palate

119
Q

Cyclic neutropenia clinical

A

21 cycle of episodes, fever ,anorexia, cervical lymphadenopathy
Oral mucosal ulcer, gingival recession and tooth mobility, periodontal bone loss

120
Q

Polycythemia Vera clinical

A

Increase mass of RBC, older niggas, headache, dizziness, visual disturbances, sweating, weight loss, epigastric pain

121
Q

Clin of platelet disorder

A

Persistent bleeding
Spontaneous gingival bleeding
Petechiae
Ecchymoses (small/multiple)

122
Q

Coagulation disorder

A

Delayed bleeding
Large and solitary ecchymoses
Hematoma
Hemarthroses

123
Q

Angioedema causes (5)

A
Type 1 allergy (food/med/env/phy)
ACE inhibitor 
Defect in C1 inhibitor 
High levels of antigen antibody complex
Idiopathic
124
Q

Angioedema tx (IgE, ACE inhibitor, C1 INH)

A

IgE: antiH, epi, steroid
ACE inhibitor: only Epi; antiH and steroid aren’t effective
C1 INH: doesn’t respond to anything; C1INH concentrate, androgen, antifibrinolytic

125
Q

Virus in neural cells

A

HSV and VZV

126
Q

Virus in hematopoietic cells

A

EBV

127
Q

Primary HSV infection RF, clin, natural history

A

RF: overcrowding and bad OH
Clin: mostly asym; acute herpetic gingivostomatitis,pharyngotonsillitis; always involve the gingiva, blister arise and break early, ulcer always shallow
Natural Hx: recovery 1week and colonize trigeminal nerve
Dx: clin presentation, cytology, biopsy

128
Q

HSV secondary infection trigger, clin

A

Trigger: sunlight, old age, stress, trauma, disease, menstruation
Clin: herpes labialis, recover in 4 days; herpetic whitlow, erythema multiforme

129
Q

ZVZ primary infection clin, complications

A

Clin: kids, incubation 2wks, prodrome, pruitic exanthem, more severe if adult and secondary contacts; infectious until crusting
Complications: bacterial infection (if you scratch), Reye’s syndrome, pneumonia, encephalitis, GI complications
Chicken pox

130
Q
ZVZ recurrent (herpes zoster)(shingles)
RF, Clin
A

Dorsal spinal ganglia, involves dermatome (secondary nerve)
Increase prevalence in increasing age
RF: old age, radiation, immunosuppression, dental manipulation
Clin: prodrome, trigeminal nerve involvement, postherpetic neuraligia

131
Q

EBV

A

Mostly asym, remains in host for life
Clin: fever, malaise, enlargement of lymph node, PETECHIAE, may have enlarged spleen, could cause ORAL HAIRY LEUKOPLAKIA; associated with NASOPHARYNGEAL CARCINOMA
Dx: blood test, lymphocytosis

132
Q

HIV associated infections

A
Candidiasis 
HSV, ZVZ, EBV (oral hairy leukoplakia), HPV (chondyloma acuminatum)
Linear gingival erythema 
NUG
NUP
NUS
Kaposi’s sarcoma (multifocal neoplasm of vascular endothelial origin, nodular masses)
Non-Hodgkin lymphoma
SCC
133
Q

What to ask from HIV

A

Viral load

CD4 count

134
Q

Complication of acute rhinosinusitis

A

Orbital (diplopia, periorbital cellulitis)
Bone (osteomyelitis)
Brain (intracranial abscess, meningitis)

135
Q

Chronic rhinosinusitis Dx

A

Two of (congestion/pain/obstruction/drainage [postnasal/pus]/ smell affected) present for 8 weeks and documented inflm of paranasal sinus

136
Q

Only sinogenic (5)

A

Unilateral nasal obstruction
Unilateral nasal discharge
Pus in middle meatus
Concurrent or recent upper resp tract infection
Increased pain in vertical change in head position

137
Q

Dental only pain (5)

A
Pain w/ changing temp
Tooth mobility 
Painful fractured/carious/resto tooth
Buccal sulcus swelling beside tooth
Specific dental or periapical radiographic sign
138
Q

Pain from both dental and sinus

A
Pain with changing pressure 
Unilateral Mx pain
Sleep disturbance 
Facial swelling
Buccal sulcus swelling
139
Q

Granuloma disease

A
TB
Leprosy
Syphilis 
Histoplasmosis
Granulomatous gingivitis 
Sarcoidosis
Orofacial granulomatosis 
Crohn’s disease
140
Q

Syphilis primary - clinical

A

Single non-tender chancre (3 weeks after contact)

141
Q

Syphilis secondary clinical

A

4-10 weeks after primary chancre
- diffuse rash on palm, sole
Fever, lymphadenopathy
Heals spontaneously

142
Q

Syphilis tertiary - clinical

A

Years after primary
Inflm of aorta, heart, CNS
Gummas - white-gray rubbery nodules on bone/joint/skin
Dx: dark field microscopy
Hist: granuloma with central necrosis and rare spirochetes
Tx: penicillin IM injection

143
Q

Crohn’s disease clinical

A

Granulomatous inflm with ulceration and fissuring in GI tract