GI

Question 1

Painful, superficial ulceration of the oral mucosa characterized by a grayish base (granulation tissue) surrounded by erythema?

Answer 1

Aphthous ulcer

Question 2

Clinical triad of Behcet’s syndrome?

Answer 2

Recurrent aphthous ulcers + genital ulcers + uveitisPatients may also present with erythema nodosum = painful, red, subcutaneous, elevated nodules, typically located over the anterior aspect of the tibia.

Question 3

Pathophysiology of Behcet’s syndrome?

Answer 3

Immune complex small vessel vasculitis

Question 4

Pathophysiology of cleft lip/palate?

Answer 4

Failure of fusion of the facial processes/prominences

Question 5

Vesicular lesions of the oral mucosa that rupture, resulting in shallow, painful red ulcers?

Answer 5

Oral herpes

Question 6

Viral cause of oral herpes?

Answer 6

HSV-1

Question 7

Oral herpes - primary infection vs. re-infection?

Answer 7

Primary infection presents with fever and lymphadenopathy, re-infection does not.

Question 8

Site of HSV-1 latency?

Answer 8

Cranial sensory ganglia (trigeminal ganglia) HSV-1 virus remains dormant in trigeminal nerve sensory ganglia until stress/sunlight/menses precipitates reactivation and re-infection.

Question 9

Bacterial cause of dental caries?

Answer 9

Streptococcus mutans

Question 10

Pathophysiology of dental caries?

Answer 10

Streptococcus mutans produces acid from sucrose fermentation, which erodes enamel.

Question 11

Inflammatory skin condition characterized by erythematous macules/papules that resemble target lesions (“bull’s eye lesions”) that can become bullous?

Answer 11

Erythema multiforme

Question 12

Erythema multiforme that involves the mouth = ?

Answer 12

Stevens-Johnson syndrome

Question 13

Melanin pigmentation present on the buccal mucosa?

Answer 13

Addison disease

Question 14

Pathophysiology of melanin pigmentation on the buccal mucosa in Addison disease?

Answer 14

Increased ACTH stimulates melanocytes

Question 15

Melanin pigmentation of the lips and oral mucosa?

Answer 15

Peutz-Jeghers syndrome

Question 16

Glossitis a/wbilateral white excrescences on the lateral border of the tongue?

Answer 16

Hairy leukoplakia (pre-AIDS defining lesion)

Question 17

Viral cause of hairy leukoplakia?

Answer 17

EBV

Question 18

Histology of leukoplakia/erythroplakia?

Answer 18

Squamous hyperplasia of the epidermis

Question 19

Which of the following 4 may progress to oral cancer? Oral candidiasis, hairy leukoplakia, leukoplakia, erythroplakia

Answer 19

Leukoplakia and erythroplakia - May progress into squamous dysplasia or invasive squamous cell carcinoma (SCC)Erythroplakia > leukoplakia re: progression to oral cancer

Question 20

Wickham striae (fine, white, lacy lesions) on the buccal mucosa?

Answer 20

Lichen planus

Question 21

Most common benign tumor in the oral cavity?

Answer 21

Squamous papilloma(Exophytic tumor with a fibrovascular core)

Question 22

Major risk factors for squamous cell carcinoma of the oral cavity?

Answer 22

Tobacco and alcohol (synergistic)HPV

Question 23

Squamous cell carcinoma of the oral cavity site of metastasis?

Answer 23

Tonsillar node (superior jugular node)

Question 24

Most common cancer of upper lip?

Answer 24

Basal cell carcinoma

Question 25

Most common cancer of lower lip?

Answer 25

Squamous cell carcinoma

Question 26

Malignancy of the oral cavity associated with UV-B light expsure?

Answer 26

Basal cell carcioma

Question 27

Malignancy of the oral cavity a/w smokeless tobacco?

Answer 27

Verrucous carcinoma 

Question 28

Major salivary glands?

Answer 28

Parotid, submandibular, and sublingual

Question 29

Mumps clinical features?

Answer 29

Bilateral parotitis Unilateral orchitis/oophoritisPancreatitisMeningoencephalitis (Sterility is rare b/c of unilateral involvement of testes/ovaries, but more common in adolescence and adulthood. Childhood mumps rarely involves testes/ovaries). 

Question 30

Laboratory finding in mumps?

Answer 30

Elevated serum amylase 2/2 parotitis and/or pancreatitis 

Question 31

Bacterial inflammation of a major salivary gland?

Answer 31

Sialdenitis

Question 32

Bacterial cause of sialdenitis?

Answer 32

Staphylococcus aureus 

Question 33

MCC sialdenitis in post-op patients?

Answer 33

Inflammation of major salivary gland 2/2 calculus (stone) obstructing the duct (sialolithiasis) 

Question 34

Clinical triad of Sjogren syndrome?

Answer 34

Keratoconjunctiva sicca (dry eyes), xerostomia (dry mouth), and an associated connective tissue disease (most often rheumatoid arthritis)

Question 35

Pathophysiology of Sjogren syndrome?

Answer 35

Autoimmune destruction of the minor salivary and lacrimal glands 

Question 36

Sjogren syndrome is a/w increased incidence of what cancer?

Answer 36

Lymphoma 

Question 37

Presents as a mobile, painless, circumscribed mass at the angle of the jaw?

Answer 37

Pleomorphic adenoma 

Question 38

Salivary gland tumors:Epithelial cells intermixed with myxomatous and cartilaginous stroma

Answer 38

Pleomorphic adenoma (mixed tumor) - BenignMost common tumor of salivary glands 

Question 39

Salivary gland tumors:Heterotopic (ectopic) salivary gland tissue trapped in a lymph node

Answer 39

Warthin tumor (papillary cystadenoma lymphomatosum) - Benign- Cystic tumor with abdundant lymphocytes and germinal centers (cystic glandular structures locayed within benign lymph node tissue). 

Question 40

Salivary gland tumors:Mixture of neoplastic squamous cells and mucus-secreting cells

Answer 40

Mucoepidermoid carcinoma - MalignantMost common malignant tumor of salivary glands

Question 41

Sign that pleomorphic adenoma has transformed into a malignant carcinoma?

Answer 41

Facial nerve involvement/damage (facial nerve runs through parotid gland)