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AU'18 Oral Path II > HPV-Related Cancers - part I > Flashcards

HPV-Related Cancers - part I Flashcards

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1
Q

human papilloma viruses (HPV’s) are a group of how many related viruses?

A

more than 130

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2
Q

T/F: all HPV types are sexually transmitted

A

false, some types are not sexually transmitted

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3
Q

which HPV types cause squamous papillomas?

A

HPV 6, 11

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4
Q

which HPV type causes non-genital warts?

A

HPV 2

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5
Q

which HPV types causes venereal warts (condyloma acuminatum)?

A

HPV 6, 11

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6
Q

which HPV types have a low risk for cancer?

A

HPV 2, 6, 11

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7
Q

which HPV types have a high risk for cancer?

A

HPV 16, 18, 31, 33

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8
Q

which HPV type causes verruca vulgaris?

A

HPV 2

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9
Q

which HPV types are sexually transmitted?

A

HPV 6, 11, 16, 18

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10
Q

who is affected by squamous papilloma?

A

any age

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11
Q

squamous papilloma can affect any location but what are the common intraoral sites?

A
  1. tongue
  2. uvula
  3. soft palate
  4. lip
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12
Q

what is the most common soft tissue mass arising from the soft palate?

A

squamous papilloma

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13
Q

clinical features of squamous papilloma

A
  1. usually solitary
  2. usually pedunculated, but can be sessile
  3. exophytic with fingerlike projections giving a “cauliflower” or “wart-like” appearance
  4. projections can be pointed or blunted
  5. soft
  6. painless
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14
Q

squamous papilloma has low what?

A

low infectivity, low virulence

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15
Q

color of squamous papilloma depends on what?

A

amount of keratin

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16
Q

tx of squamous papilloma

A

conservative excision

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17
Q

T/F: recurrence of squamous papilloma is common

A

false, unlikely

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18
Q

T/F: spontaneous remission of sqamous papilloma is possible

A

true

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19
Q

verruca vulgaris is a dermatologic term for what?

A

common wart

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20
Q

is verruca vulgaris contagious?

A

yes

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21
Q

how is verruca vulgaris contagious?

A

via self-inoculation

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22
Q

who does verruca vulgaris affect?

A

any age especially children

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23
Q

where is verruca vulgaris extremely common?

A

on skin especially hand

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24
Q

where is verruca vulgaris is infrequently located?

A

on oral mucosa

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25
clinical features of verruca vulgaris
1. pedunculated or sessile 2. painless papule(s) 3. papillary projections or rough surface
26
where does verruca vulgaris typically appear intraorally?
1. vermilion border 2. labial mucosa 3. anterior tongue
27
tx for verruca vulgaris on skin
1. topical therapies | 2. surgery
28
tx for verruca vulgaris intraorally
1. surgery 2. laser 3. cryotherapy 4. electrosurgery
29
can verruca vulgaris recur?
yes
30
is spontaneous remission possible for verruca vulgaris?
yes
31
what is the most common sexually transmitted infection in the US?
HPV
32
more than 40 HPV types spread through what?
direct sexual contact
33
T/F: some HPV types can be spread by close skin-to-skin contact
true
34
condyloma acuminatum has what type of risk?
low
35
T/F: although condyloma acuminatum is considered low risk, it is possible to have co-infection with high risk type
true
36
which HPV types are considered high risk and are implicated in cancers?
HPV 16 and HPV 18
37
clinical features of venereal warts (condyloma acuminatum)
1. contagious 2. sessile, pink 3. short, blunted 4. non-tender, exophytic 5. larger than papillomas (~1 cm but up to 3 cm) 6. often multiples
38
where can venereal warts (condyloma acuminatum) occur?
1. anogenital region 2. mouth 3. larynx
39
all ages can be affected by venereal warts (condyloma acuminatum) but who is most affected?
teenagers, young adults
40
where intraorally does venereal warts (condyloma acuminatum) usually affect?
1. labial mucosa 2. lingual frenum 3. soft palate
41
tx of venereal warts (condyloma acuminatum)
1. excision 2. cryotherapy 3. laser
42
what is the concern about using lasers to tx venereal warts (condyloma acuminatum)?
airborne virus
43
what is used to tx anogenital venereal warts (condyloma acuminatum)?
topical agents
44
anogenital condylomata infected with HPV 16, 18 have a higher risk for malignant transformation to what?
SCC
45
T/F: oral condyloma has shown to have a higher risk for malignant transformation to SCC when infected with HPV 16, 18
false
46
when are virtually all sexually active individuals exposed to HPV?
by early 20's
47
what is the prevalence of any GENITAL HPV in American adults aged 18-59 according to the CDC?
~45%
48
how does HPV enter epithelial cells?
via mucosa and skin
49
what type of cells does HPV infect?
basal cells
50
what is an HPV infection?
terminal differentiation infected keratinocytes
51
what does an HPV infection comprise of?
1. viral shedding | 2. mutations leading to pre-cancerous then cancerous transformation
52
T/F: most HPV infections are asymptomatic and resolve spontaneously
true
53
over 90% of HPV infections are cleared by the body within how many years?
2-3 years
54
T/F: some cells infected with HPV may remain latent for decades
true
55
how can some infected cells remain latent for decades?
1. low level replication 2. minimal viral protein expression 3. lack of immune clearance
56
how long can a persistent HPV infection last?
up to 20 years
57
as infected cells grow, what occurs?
mutations occur leading to pre-cancerous then cancerous transformation
58
how does high-risk HPV types cause cancer?
high-risk HPV types make proteins E6, E7 and L1, L2
59
what does E6, E7 allow?
cell to grow in uncontrolled manner and avoid cell death
60
what does L1, L2 comprise?
comprise the virus capsid (shell) required for virus transmission, spread and survival
61
which proteins causes the virus assembly and release?
L1, L2, E4
62
which proteins causes cell proliferation and high level episomal replication occur?
E1, E2, E4, E5, E6, E7
63
which proteins causes latent infection and low evel episomal replication occur?
E1, E2
64
a persistent infection may be a result of what?
infected cells are not destroyed
65
T/F: shed epithelial cells in oral rinses can be used to identify a latent infection
false, cannot
66
shed epithelial cells in oral rinses cannot discriminate between what?
an oral and oropharyngeal infection
67
what percent of oropharyngeal cancer is caused by HPV?
~70%
68
what percent of cervical cancer is caused by HPV?
~70%
69
what percent of anal cancer is caused by HPV?
~95%
70
what percent of vaginal cancer is caused by HPV?
~65%
71
what percent of vulvar cancer is caused by HPV?
~50%
72
what percent of penile cancer is caused by HPV?
~35%
73
oral and oropharyngeal cancer are both what?
head and neck squamous cell carcinomas (HNSCC)
74
where is oral squamous cell carcinoma (OSCC) typically occur?
anterior to tonsillar pillars
75
what percent of oral squamous cell carcinoma (OSCC) are HPV-related?
<5%
76
T/F: there is consistent evidence that HPV is a risk factor for OSCC
false
77
where does oropharyngeal squamous cell carcinoma (OPSCC) typically occur?
1. base of tongue 2. soft palate 3. palatine tonsils 4. pharyngeal wall

AU'18 Oral Path II (31 decks)

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