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Gastrointestinal System > Oral Cavity Pathology > Flashcards

Oral Cavity Pathology Flashcards

1
Q

Name the most important microbiota of the mouth

A
  • Anaerobic bacteria
    • Peptostreptococcus
    • Fusobacterium
    • Prevotella
    • Actinomyces
  • Streptococcus viridans
  • Streptococcus mutans
  • Candida albicans
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2
Q
  • Pseudocyst of minor salivary gland origin
  • Formed when salivary duct is blocked or ruptured (usually secondary to trauma such as biting lip or cheek)
  • Causes secretions to dissect into the soft tissues surrounding the gland with pooling of mucus
  • Typically presents as painless swelling of lower lip/buccal mucosa
  • May resolve spontaneously or may have to excise (with the involved salivary gland to prevent recurrence)
A

Mucocele

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3
Q
  • Etiologies:
    • Mumps
    • Duct obstruction (sialolithiasis)
      • Often S. aureus
      • Dehydration increases risk
    • Sjogren’s syndrome
  • Firmness, pain, swelling
  • MC involves either parotid or submandibular gland
A

Sialadenitis

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4
Q
  • Relatively uncommon and slow-growing but aggressive, propensity for perineural invasion
  • Poor long-term prognosis with risk of distant metastasis, even many years later
A

Adenoid cystic carcinoma

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5
Q

Parotid tumors drain into ___ first then to ___

A
  1. Intraparotid lymph nodes
  2. Upper cervical lymph nodes
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6
Q
  • MC due to S. pyogenes (GAS)
  • Potential for RF
  • Complication of acute illness
    • Peritonsillar abscess
    • Lemierre’s syndrome (Fusobacterium necrophorum)
A

Bacterial pharyngitis

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7
Q
  • Melanin pigmentation of lips and oral mucosa + hamartomatous polyps of GI tract
  • Autosomal dominant; de novo cases can develop
A

Peutz-Jeghers syndrome

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8
Q
  • Produces a gray-blue line along the junction of the teeth and gum
A

Lead poisoning

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9
Q
  • Due to Rhinovirus, Adenovirus, Coronavirus, and others
  • Presents as sore throat
  • Erythema and edema of pharynx, +/- exudate
A

Viral pharyngitis

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10
Q
  • Due to failure of the 2nd branchial cleft to involute during development
  • Entrapped remnant forms a cyst in the lateral neck anterior to the SCM
  • Presents in late childhood to early adulthood
  • Many asymptomatic but can become enlarged and inflamed; may even develop draining sinus tract to pharynx or skin
A

Branchial cleft cyst

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11
Q
  • Due to EBV
  • Painless, white plaque-like lesion on lateral tongue
  • Cannot be scraped off
  • Patients typically immunosuppressed
A

Oral hairy leukoplakia

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12
Q
  • Not a specific diagnosis
  • Clinical term used to describe a “white plaque”
  • Can not be scraped off, asymptomatic
  • Risk (low) of dysplasia/malignancy
  • MC associated with tobacco
A

Leukoplakia

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13
Q
  • Usually infected during childhood (HSV1)
  • Recurrent painful (and contagious) vesicular lesions of oral mucosa, gingiva, lips (herpes labialis)
  • Vesicles reupture quickly leaving shallow ulcers
  • Heal spontaneously in 1-2 weeks without scarring
  • Virus remains latent in trigeminal ganglia
  • May have prodromal symptoms of itching and burning prior to reactivation
  • Triggers for reactivation: sunlight, cold, trauma, stress, or immunosuppression
A

Herpetic gingivostomatitis

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14
Q
  • Asians > whites > blacks
  • Due to failure of palatal shelves to fuse
A

Cleft palate

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15
Q
  • Mildly painful, shallow, yellow ulcers surrounded by red halos
  • Oral ulcers on lips, buccal mucosa, tongue, or soft palate
  • Rash also involves hands, feet, and sometimes the buttocks
  • Mouth and throat pain, throat pain, +/- low grade fever
  • Coxsackivirus
A

Hand foot and mouth disease

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16
Q
  • 2nd MC benign salivary gland neoplasm
  • Arises in parotid only
  • M>F
  • Marked associated with smoking
  • No malignant change
  • Histology: Double layer of palisading neoplastic columnar and cuboidal epithelial cells resting on a dense lymphoid stoma (sometimes with GCs)
A

Warthin tumor

17
Q

Drug-Induced Gingival Overgrowth

Associations include: ___, ___, ___

A
  1. Phenytoin
  2. Cyclosporine
  3. CCBs
18
Q
  • Malignancy neoplasm of endothelial cells
  • Associated with HHV-8
  • Mucous membrane involvement common; also skin, viscera (GI tract)
  • Types
    • AIDS-associated
    • Transplant-associated
    • Classic (sporadic)
    • Endemic African
A

Kaposi sarcoma

19
Q
  • Infection of the submandibular sace usually arising from a dental infection
  • May spread rapidly to involve surrounding soft tissue and skin
  • Usually polymicrobial (anaerobic and aerobic)
  • Risk of airway obstruction due to edema
  • Typical presentation
    • Fever
    • Dysarthria (difficulty with speech)
    • Mouth pain
    • Drooling
    • Dysphagia
      *
A

Ludwig’s angina

20
Q
  • MC primary malignant tumor of salivary glands
  • Most (60-70%) parotid
  • Low, intermediate, and high grade based on the degree of anaplasia
  • Clinical course and prognosis depend on grade
  • Admixture of 3 cells types
    • Mucocytes
    • Epidermoid cells
    • Intermediate cells
A

Mucoepidermoid carcinoma

21
Q

Enlargement of the tongue

Associations:

  • Hypothyroidism
  • Amyloidosis
  • Acromegaly
  • Neoplastic infiltration
A

Macroglossia

22
Q
  • Single or multiple small (few mm) painful ulcers usually involving the inner lip or tongue
  • Typically arise in kids/adolescents and often recur, becoming less frequent in adulthood
  • Lesions spontaneously resolve in 1-2 weeks
  • Cause uncertain; may be allergic or autoimmune
A

Aphthous ulcers (canker sores)

23
Q
  • Autoimmune destruction of lacrimal and salivary glands
  • Usually seen in middle-aged females
  • Clinical
    • Dry eyes
    • Dry mouth
  • Anti-Ro (SS-A) and Anti-La (SS-B) autoantibodies
  • Diagnosis: Lip biopsy, serology
  • Increased risk of dental caries, lymphoma
A

Sjogren syndrome

24
Q
  • Oranism that produces acid that leads to loss of tooth enamel and ultimately dental caries
  • Fluoridation of water sources helps prevent
A

Streptococcus mutans

25
Q
  • Salivary duct stone
  • Can cause duct obstruction
  • Risk factors
    • Dehydration
    • Meds that decrease amount of saliva
  • Complications: Sialadenitis
  • MC in Wharton duct
A

Sialolithiasis

26
Q
  • Risk factors
    • Immunosuppresion
    • Broad spectrum antibiotic use (altered normal flora)
  • Clinical
    • White, curd-like discharge on red background involving the oral mucosa
    • Can be scraped off but may bleed
  • Symptoms
    • Dysphagia
    • Mouth soreness
    • Pain
A

Oropharyngeal candidiasis (thrush)

27
Q
  • Excess fluoride consumption early in life can cause hypomineralization of dental enamel
  • Thought to be a direct effect on the rate of mineral formation resulting in disruption of the enamel
  • White to brown tooth discoloration
A

Fluorosis

28
Q
  • Exhibits epithelial and mesenchymal differentiation
  • MC benign salivary gland neoplasm
  • MC in middle-aged adults (F>M)
  • Radiation exposure increases risk
  • Risk of recurrence if not completely excised
  • Low risk malignant transformation
  • Painless, slow-growing, mobile mass
A

Pleomorphic adenoma

29
Q
  • Asians > whites > blacks
  • Due to failure of fusion of maxillary and medial nasal processes
A

Cleft lip

30
Q
  • Adrenocortical insufficiency leads to increased production of pro-opiomelanocortin (a prohormone that is cleaved into ACTH, MSH, and others)
  • The elevates MSH results in increased melanin synthesis, causing hyperpigmentation on buccal mucosa
A

Addison’s disease

31
Q
  • Usually on gingiva, may be on lips, buccal mucosa, tongue
  • AKA “pregnancy tumor” because occsationally occurs during pregnancy
  • Histologically comprised of a lobular proliferation of capillary-sized vessels “lobular capillary hemangioma”
A

Pyogenic granuloma

32
Q
  • Clinical term for “red plaque”
  • More likely dysplastic/malignanct than leukoplakia
  • Red because of subepithelial vascular dilation
  • Tobacco major risk factor
A

Erythroplakia

33
Q
  • Mucosal breach (dental infection or trauma) → introduces organism to mucosa → infection → abscesses and draining sinus tracts (“lumpy jaw”)
  • Sulfur granules (yellow aggregates of pus + Actinomyces)
  • Adults males with poor oral hygiene at greatest risk
  • Other risk factors
    • DM
    • Immunosuppresion
    • Malnutrition
A

Cervicofacial actinomycosis

34
Q
  • MC malignant neoplasm of oral cavity
  • Risk factors
    • Tobacco (all types)
    • ALcohol
    • HPV (particularly HPV-16)
    • Sunlight (lower lip)
  • Sites in descending order:
    1. Lower lip (vermilion border)
    2. Floor of mouth
    3. Lateral border of tongue
A

Squamous cell carcinoma

35
Q
  • Benign, tumor of the oral cavity
  • Located in mandible
  • Arises from odontogenic epithelium
  • Radiographically: Radiolycency of bone → “soap bubble” appearance
  • Locally invasive, does not metastasize
A

Ameloblastoma

36
Q
  • Usually children
  • Presentation
    • Acute onset fever (102-104)
    • Oropharyngeal lesions (MC in soft palate) begin as papules → vesicles → rupture leaving yellow/gray ulcers
  • Recovery within a few days
  • Coxsackievirus A
A

Gastrointestinal System (13 decks)

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