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pathology exam 2 Flashcards

1
Q

Dissolution of intercellular bridges of the prickle cell layer of epithelium

A

acantholysis

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2
Q

a hypersensitive state acquired through exposure to an allergen

A

allergy

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3
Q

allergic reaction causing the release of vasoactive substances such as histamine; causes respiratory distress

A

anaphylaxis

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4
Q

protein molecule (immunoglobin) produced by plasma cells and reacts with a specific antigen

A

antibody

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5
Q

any substance that can induce a specific immune response

A

antigen

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6
Q

antibody that reacts against an antigenic constituent of a persons own body

A

autoantibody

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7
Q

disease characterized by injury of ones own tissues caused by a cell mediated or humoral response

A

autoimmune disease

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8
Q

B cell; lymphatic tissue that matures into plasma cells which produce antibodies

A

b lymphocyte

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9
Q

immunity predominated by T lymphocytes

A

cell mediated immunity

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10
Q

tumor-like mass of inflammatory tissue of macrophages surrounded by lymphocytes

A

granuloma

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11
Q

disease characterized by the formation of granulomas

A

granulomatous disease

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12
Q

immunity predominated by antibodies

A

humoral immunity

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13
Q

State of altered reactivity whereby the body reacts to foreign agents with exaggerated immune response

A

hypersensitivity

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14
Q

combo of antibody and antigen

A

immune complex

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15
Q

dry eyes

A

xeropthalmia

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16
Q

deficiency of the immune response resulting from hypoactivity or decreased numbers of lymphoid cells

A

immunodeficiency

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17
Q

cell characteristic of lupus erythematosus and other autoimmune diseases

A

LE cell

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18
Q

tissue composed of lymphocytes and a meshwork of CT

A

lymphoid tissue

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19
Q

large mononuclear phagocyte that assists in an immune response

A

macrophage

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20
Q

mucosal inflammation

A

mucositis

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21
Q

the superficial layer of epithelium sloughs off when firm, sliding manual pressure is applied

A

nicolskys sign

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22
Q

disease caused by a microorganism that does not ordinarily cause a disease but becomes pathogenic under certain circumstances

A

opportunistic infection

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23
Q

administered by injection

A

parenteral

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24
Q

pruritis

A

itching

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25
Q

microorganism that causes disease

A

pathogenic microogranism

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26
Q

protein (IgM) that is detected in serum associated with rheumatoid arthritis

A

rheumatoid factor

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27
Q

T cell) matures in thymus and helps with cell mediated immunity

A

t lymphocyte

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28
Q

lymph organ in chest that produces T lymphocytes

A

thymus

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29
Q

infection (herpes) that involves the distal phalanx of a finger

A

whitlow

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30
Q

Immune response defends the body against injury, particularly from foreign substances
such as microorganisms

A
  • the immune response has the capacity to remember and responds more quickly when a substance enters the body a 2nd time
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31
Q

antigens* Cells involved in the immune response:

A

foreign substances against which the immune system defends the body

  • mainly proteins
  • often microorganisms and their toxins
    i. autoimmune disease – occurs as a result of part of an individuals own body becomes antigens
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32
Q
  • Cells involved in the immune response:
A
  • B lymphocytes (B cells) – Eosinophils
  • T lymphocytes (T cells) – Mast Cells
  • Macrophages – Natural Killer (NK) Cells
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33
Q

lymphocytes

A

the 1 WBC’s involved in immune response

  • they recognize/respond to antigens
  • NK cell – viral infections
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34
Q

from stem cells in bone marrow

- they mature in lymphatic tissue (lymph nodes)

A

b lymphocytes

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35
Q

2 types of b lymphocytes

A
  • 2 types:
    i. plasms cell produces specific antibody needed to fight the antigen
    1. antibody also called – immunoglobulins – specific – IgG, IgM, IgE, Ig A, IgD (GAMED)
    2. antibody combines with antigen – immune complex
    a. antigen – antibody complex – renders the antigen inactive
    b. antibody titer – lab test to determine the level of a specific antibody in the blood
    3. B memory cell – 2nd type of B lymphocyte
    a. Retains the memory of previously encountered antigen and the duplicates
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36
Q

t cells

A

i. T – lymphocytes – thymus
1. T – helper cells – increase the functioning of B -lymphocytes and enhances the antibody response
2. T – suppressor cells – suppress the functioning of the B lymphocytes and T-Killer cells that are active in surveillance against virally infected cells or tumor cells

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37
Q
  • change monocytes to macrophages
    - inhibit migration of macrophages so they
    stay in needed area
  • activate macrophages
  • enhance ability of macrophages to destroy
    foreign cells (phagocytosis)
A

lymphocytes produce lymphokines:

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38
Q

stimulates WBC’s population growth

A

interleukins

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39
Q

destruction of fibroblasts

A

lymphotoxin

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40
Q

antiviral activities

A

interferon

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41
Q

phagocytosis

  • link between the inflammatory and immune responses
  • can act as antigen – presenting cells
A

macrophages

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42
Q

divisions of immune responce

A

1) Humoral response – involves the production of antibodies (B lymphocytes 1)
2) Cell – mediated immune response (CMI) – T lymphocytes and macrophages

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43
Q

the increased responsiveness that results from the retained memory of
an already encountered antigen

A

immunity

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44
Q

can occur naturally or can be acquired

  • via vaccination
  • “immunization”
    i. sometimes requires a booster (example – tetanis)
A

active immunity

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45
Q

using antibodie produced by another person to protect an
individual from infectious disease
- antibody from another passes through the placenta to a developing fetus
- bone marrow transplant

A

passive immunity

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46
Q
  • the study of immune reactions involved in disease
A

immunopathology

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47
Q

allergic reactions with exaggerated responses and tissue destruction

A

hypersensititvity

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48
Q

type 1 of hypersensitivy

A
  1. type I (Anaphylaxis)
    a. occurs immediately after exposure to a previously encountered antigen. (Penicillin)
    b. IgE causes mast cells to release Histamine
    c. can be life threatening because patient may not be able to breath
    d. examples: hayfever, Asthma
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49
Q

type 2 h

A

Cytotoxic)

a. antibody combines with an antigen bound to the surface of tissue cells
b. incompatible blood transfusions
c. Rhesus incompatibility (Rh) – mother’s antibodies cross the placenta and destroy the newborn’s RBC’s
d. example: autoimmune hemolytic anemia

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50
Q

type 3 h

A

(immune complex)

a. immune complexes are formed between microorganisms and antibody in circulating blood
b. causes phagocytosis/death of the neutrophils with the release of lysosomal enzymes causing tissue destruction
c. example: systemic lupus erythematosus

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51
Q

type 4 h

A

cell-mediated)

a. “delayed hypersensitivity” – cell-mediated response
b. tuberculin test (PPD) [Mantoux]
i. skin reaction occurs if the individual tested has previously been exposed to the organism causing TB
c. responsible for the rejection of tissue grafts/transplanted organs

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52
Q

hypersensitivity to drugs

A
  • drugs can act as antigens
  • patients with multiple allergies are more likely to have allergic reactions to drugs
  • causes a type I allergy
  • anaphylaxis, urticaria (hives), and angioedema
  • systemic anaphylaxis can be fatal
  • PENICILLIN – 300 deaths/year in US
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53
Q

type of immunopathologic condition that involves a deficiency in
number, function, or interrelationships of the involved WBC’s and their products
- AIDS

A

immunodeficiency

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54
Q

apthous ulcers

A

canker sores or aphthous stomatitis

i. painful oral ulcers for which the cause remains unclear
ii. frequently recur
iii. 3 types of aphthous – minor, major, and herpetiform
iv. aphthous ulcers are most common type of ulcer – 20% of population
v. more common in females
vi. trauma is most common precipitating factor in development of aphthous ulcers
vii. stress also associated

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55
Q

i. systemic diseases associated with aphthous ulcers:

A
  1. Behcet’s syndrome
  2. Crohn’s disease
  3. Ulcerative colitis
  4. Cyclic neutropenia
  5. Sprue (gluten intolerance)
  6. Intestinal lymphoma
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56
Q
    • MINOR APHTHOUS ULCERS
A
  • most common type
  • discrete round to oval ulcers that are up to 1cm in diameter surfaced by a yellowish-white fibrin covering surrounded by a halo of erythema
  • ulcers occur on movable mucosa, tongue, and soft palate
  • more common in anterior part of the mouth
  • begins with a prodromal period of 1-2 days – burning, itching, soreness
  • painful
  • single or multiple lesions
  • heal spontaneously in 7-10 days
  • treat symptomatically – Tylenol, anesthetics (topical), some topical steroids (lidex) [pallative]
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57
Q
  • MAJOR APHTHOUS
A
  • larger than 1cm in diameter and are deeper and last longer than minor
  • painful
  • occur in posterior part of the mouth
  • may require biopsy for dx
  • several weeks to heal with scarring
  • some require systemic steroids
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58
Q
  • HERPETIFORM APHTHOUS
A
  • very tiny (1 – 2 mm)
  • resemble ulcers caused by the herpes simplex virus
  • painful and develop anywhere in oral cavity usually grouped
    • ulcers from herpes simplex appears on mucosa fixed to bone – palate and gingival
      i. “Bound down mucosa”
  • hard to distinguish from 1 herpes
    i. way to distinguish is that with 1 herpes – fever, malaise, fiery red gingiva
    ii. 1 herpes does not respond to topical application of liquid tetracycline
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59
Q

URTICARIA/ANGIODEMA

A
  • both are similar lesions
  • urticaria – “hives” appears as multiple areas of well-demarcated swellings associated with itching (pruritus)
    i. caused by localized areas of vascular permeability in superficial CT beneath epithelium
  • angioedema – diffuse swelling of tissues caused by permeability of deeper blood vessels but no itching
    i. usually the lips are affected
  • Tx includes use of Antihistamines (Benadryl-diphenhydramine)
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60
Q

CONTACT MUCOSITIS/DERMATITIS

A
  • lesions resulting from the direct contact of an allergen with the skin or mucosa
  • cell –mediated immunity – Type IV hypersensitivity
  • mucositis – mucosa becomes erythematous/edematous accompanied by burning/itching
  • dermatitis – erythematous, swelled and becomes encrusted with scaly, white epidermis
  • most common cause – latex; but can be caused by other things to: local anesthetics, acrylic, metals
  • Tx – topical/systemic corticosteroids
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61
Q

FIXED DRUG ERUPTIONS

A
  • lesions that appear in the same site each time a drug is introduced
  • subside when drug is removed
  • single or multiple slightly raised reddish patches or clusters of macules on skin
  • pain & itching
  • Type III hypersensitivity
  • Tx – discontinue use of drug after it’s been identified
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62
Q

ERYTHEMA MULTIFORME

A
  • acute, self-limited disease affecting the skin and mucous membrane
  • occurs in young adults and affects men more commonly than women
  • characteristic skin lesion – “Bull’s eye or target” – concentric rings of erythema alternating with normal skin color
  • can affect oral cavity with or without the skin – oral – ulcers
  • ulcers on lateral borders of tongue; crusted and bleeding lips
  • explosive onset
  • most severe form of erythema multiforme is called Stevens-Johnson syndrome
    i. mucosal lesions more extensive and painful; genital mucosa/mucosa of eyes; lips generally encrusted/bloody
    ii. eye lesions can lead to blindness
  • some possible causes: herpes simplex, TB, histoplasmosis, drugs – barbiturates and sulfonamides
  • Tx – topical corticosteroids; systemic steroids
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63
Q

LICHEN PLANUS

A
  • benign, chronic disease affecting the skin and oral mucosa
  • characteristic pattern of interconnecting lines (striae) resembling the pattern of the plant lichen as it grows on rocks and trees (lace appearance)
    i. striae called – Wickham’s striae
    ii. located on buccal mucosa – usually bi-lateral
  • lichen planus common in middle age with slight female predominance
  • if the epithelium separates from the CT and erosions, bullae, or ulcers form its called erosive and/or bullous lichen planus
  • desquamative gingivitis can be caused by lichen planus
  • skin lesions of lichen planus – 2 – 4 mm papules located: lumbar region, flexor surfaces of wrist, anterior surface of ankles
  • dx made upon clinical appearance and histologic appearance of biopsy
  • chronic disease that is treated symptomatically
  • Tx with topical corticosteroids
  • Suggested that patients with lichen planus are more at risk to develop Squamous Cell Carcinoma
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64
Q

REITER’S SYNDROME

A
  • triad of arthritis, urethritis, and conjunctivitis
  • unknown cause
  • antigenic marker HLA-B27 present suggestive of genetic influence
  • more prevalent in men than women
  • develops 1 – 4 weeks after venereal or GI infection
  • radrographically – periosteal proliferation on heels, ankles, metatarsals, phalanges, knee, and elbows
  • aphthous-like ulcers, erythematous lesions, and geographic tongue-like lesions in oral cavity
  • lasts from weeks – months
  • Tx with ASA (aspirin) or NSAIDS (non-steroidial anti-inflammatory drugs)
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65
Q

HISTIOCYTOSIS X

A
  • also called Langerhans cell granulomatosis
  • 3 entities grouped under this:
    i. LETTERER-SIWE DISEASE
    1. acute fulminating disorder affecting children younger than 3 years
    2. resembles a lymphoma – rapid and fatal
    3. some times responds to chemotherapy
    ii. HAND-SCHÜLLER –CHRISTIAN DISEASE
    1. children less than 5 years
    2. classic triad in 25% of patients:
    a. single-multiple “punched-out” (RL) in skull
    b. unilateral or bilateral exophthalmos
    c. diabetes insipidus
    3. oral manifestations – sore mouth, halitosis, gingivitis, loose teeth, non-healing extraction sites, appearance of advanced periodisease
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66
Q

i. EOSINOPHILIC GRANULOMA

A
  1. older children/adults
  2. males
  3. skull/mandible involved
  4. lesion resembles periodontal disease or PA inflammation or as a well-circumscribed (RL) with or without sclerotic borders
  5. Tx – conservative surgical excision and radiation
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67
Q

AUTOIMMUNE DISEASE AFFECTING ORAL CAVITY

A
  • these diseases causes tissue damage because the immune system treats the person’s own cell’s and tissues as antigens
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68
Q

SJÖGREN’S SYNDROME

A
  • affects salivary and lacrimal glands – xerostomia/xerophthalmia
  • eye damage occurring in Sjögren syndrome is called keratoconjunctivitis sicca
  • specific cause is unknown
  • 50% have other autoimmune diseases – rheumatoid arthritis/systemic lupus
  • 1 - without another autoimmune disease
  • 2 - with another autoimmune disease
  • major/minor salivary glands involved – 50% have Parotid enlargement
  • eye involvement can create photophobia – abnormal visual intolerance to light
  • 20% of patients also have Raynaud’s phenomenon – disorder affecting the fingers and toes
  • 90% have a positive reaction to rheumatoid factor – an antibody to IgG
  • lab abnormalities include:
    i. mild anemia
    ii. () WBC count
    iii. elevated erythrocyte sedimentation rate
    iv. diffuse elevation of serum immunoglobulins
  • dx made when 2 of the 3 components are present: xerostomia, rheumatoid arthritis, or keratoconjunctivitis sicca
  • also susceptible to lymphoma
  • Tx symptomatically
    i. NSAIDS (ibuprofen, ketoprofen, naproxen sodium)
    ii. Corticosteroids (prednisone)
    iii. Saliva substitutes
    iv. Sugarless gum
    v. Pilocarpine – used to increase salivary flow
69
Q

SYSTEMIC LUPUS ERYTHEMATOSUS

A
  • acute/chronic inflammatory autoimmune disease of unknown cause
  • affects women 8 times more than men
  • 3 times more frequently in black women
  • syndrome that includes a wide spectrum of disease activity and signs and symptoms ranging from skin lesions (discoid lupus) to wide spread, debilitating, life threatening disease with multiple organ involvement
  • both cellular and humoral immunity are impaired
  • 85% of individuals have skin lesions
  • classic “Butterfly” rash occurs across the bridge of the nose, and some lesions on the fingertips
  • skin lesions tend to worsen when exposed to sunlight
  • arthritis/myositis can occur
  • psychoses/depression are signs of CNS involvement – seizures can be present
  • pericarditis, cardiac arrhythmias, & endocarditis may be seen late in the disease
  • kidney involvement
  • dx based on classic multiorgan involvement and presence of antinuclear antibodies in serum
  • Tx’s
    i. ASA/NSAIDS for mild symptoms
    ii. Hydroxychloroquine (anitmalarial)
    iii. Corticosteroids with azathioprine & cyclophosphamide
    iv. Excellent prognosis with mild symptoms, but can be fatal
    v. Kidney failure is cause of death in SLE
    vi. SBE prophylaxis recommended (sub-acute bacterioendocarditis)
70
Q

PEMPHIGUS VULGARIS

A
  • severe, progressive autoimmune disease affecting the skin and mucous membranes
  • characterized by intraepithelial blister formation that results from breakdown of the cellular adhesion between epithelial cells – known as Acantholysis
  • most frequently seen type of pemphigus
  • 3 types of pemphigus: vegetans, foliaceus, and erythematosus
  • oral lesions appear as shallow ulcers to fragile vesicles or bullae
  • characterized by Nikolsky’s sign – sloughing with finger pressure
  • Dx made by biopsy/microscopic examination and direct or indirect immunofluorescence
  • Tx: high dose corticosteroids, methotrexate
  • Can also have lupus, rheumatoid arthritis, and Sjögrens Syndrome at same time
71
Q

CICATRICIAL PEMPHIGOID

A

“benign mucous membrane pemphigoid” – BMMP

  • chronic autoimmune disease affecting oral mucosa, conjunctiva, genital mucosa, and skin (requires referral to multiple specialists)
  • heals with some scarring
  • lesions occur as a result of cleavage of epithelium from underlying CT (acantholysis)
  • most common site is gingiva
    i. appearance from erythema to ulceration and involves both free/attached gingival
    ii. gingival lesions termed – desquamative gingivitis
  • Dx made by biopsy/histologic examination
    i. Direct immunofluorescence shows a linear pattern at basement membrane
  • Tx: topical/systemic corticosteroids
  • Eye damage is possible – can lead to blindness
72
Q

BULLOUS PEMPHIGOID

A
  • very similar to BMMP with incidence occurring in older patients > 60 years
  • Tx – NSAIDS – corticosteroids
73
Q

BEHÇET’S SYNDROME

A
  • chronic recurrent autoimmune disease consisting 1 of oral ulcers, genital ulcers, and ocular inflammation
  • around 30 years old
  • oral ulcers very similar to aphthous ulcers
  • painful
  • genital ulcers are small and located on scrotum or base of penis labia majora
  • skin lesions are papular and pustulate and occur on the trunk and limbs
  • Dx: 2 of 3 need to be present [oral, genital, ocular]
    i. Pustule developing after needle puncture is highly suggestive of Behçet’s
  • Tx: systemic/topical corticosteroids
74
Q

INFECTIOUS DISEASES

A
  • most common affecting tissues of the oral cavity: Bacterial, fungal, and viral infections
  • opportunistic infection – changes that affect the oral flora so that organisms that are usually nonpathogenic are able to cause disease
    i. changes include:
    1. decreased salivary flow
    2. ABC (antibiotic) administration
    3. immune system alterations
  • routes of transfer:
    i. via air by dust or H2O droplets
    ii. intimate or direct contact
    iii. hands/objects
    iv. blood or body fluids
75
Q

BACTERIAL INFECTIONS

A
  • Tuberculosis (TB)
    i. Infectious chronic granulomatous disease caused by Mycobacterium tuberculosis
    ii. 1 infection of the lungs
    iii. signs/symptoms: fever, chills, fatigue, malaise, weight loss, and persistent cough
    iv. miliary TB – when kidneys and liver become involved
    v. scrofula – involvement of the submandibular and cervical lymph nodes – swelled
    vi. oral lesions are rare but do occur as ulcers on tongue/soft palate
    vii. oral lesions are dx on biopsy
    viii. skin test to determine if person has been exposed/infected is Mantoux test
    1. antigen purified protein derivative (PPD) is injected into skin – if previously exposed a (+) reaction occurs – type IV hypersensitivity reaction
    2. if (+) then chest x-ray to determine if active disease present
    ix. USE universal precautions
    x. Tx: combination medications – isoniazid (INH) and rifampin and pyrazinamide
    1. months to years
76
Q

ACTINOMYCOSIS

A
  • infection caused by a filamentous bacterium Actinomyces israelii
  • formation of abscesses that tend to drain by the formation of sinus tracts
  • the colonies or organisms appear in the pus as tiny bright yellow grains – sulfur granules
  • often preceded by tooth extraction or abrasion of the mucosa
  • Tx: high dose ABC’s for long-term period
77
Q

syphilis

A
  • caused by the spirochete Treponema pallidum
  • transmitted by direct contact – sexual, also blood transfusion or transplacental inoculation
  • organism dies quickly when exposed to air and changes in temperature
  • signs/symptoms:
    i. primary (1) – oral lesion is a chancre – highly infectious and forms at site where spirochete enters the body
    ii. secondary (2) – about 6 weeks after 1 lesion appears
    1. diffuse eruptions of skin and mucous membranes
    2. oral lesion – mucous patch – multiple, painless, grayish-white plaques covering ulcerated mucosa
    3. most infectious
    iii. tertiary (3) – occur years after initial infection if treatment has not been given
    1. lesions involves the cardiovascular/CNS systems
    2. gumma – firm mass that eventually becomes an ulcer found on tongue and palate
    a. a destructive lesion that can perforate the palatal bone
78
Q

i. can be transmitted from infected mother to the fetus by crossing placental barrier
ii. causes serious/irreversible damage to the child (facial/dental abnormalities)
1. Hutchinson’s incisors and Mulberry molars
- Dx of skin lesions by dark-field examination to ID spirochetes
i. Blood work more accurate: VDRL (Venereal Disease Research Laboratory) test, FTA-ABS (fluorescent treponemal antibody absorption) test
- Tx: with PENICILLIN

A

congenital syphilis

79
Q

ACUTE NECROTIZING ULCERATIVE GINGIVITIS (ANUG)

A
  • painful erythematous gingivitis in which there is necrosis of the interdental papillae
  • caused by a fusiform bacillus and spirochete (Borrelia vincentii)
  • gingival painful and erythematous – foul (fetid) odor
  • cratering of interdental papillae
  • Tx: débridement and ABC therapy – tetracycline
80
Q

PERICORONITIS

A
  • inflammation of mucosa around the crown of a partially erupted, impacted tooth
  • most common with mand. 3rd molar
  • operculum – soft tissue flap covering partial eruption
  • Tx: débridement, irrigation, ABC use, EXTRACTION
81
Q

ACUTE OSTEOMYELITIS

A
  • acute inflammation of the bone and bone marrow
  • most commonly a result of the extension of a PA abscess
  • microscopic exam reveals:
    i. nonviable bone
    ii. necrotic debris
    iii. acute inflammation
    iv. bacterial colonies in marrow spaces
  • Tx: drainage and ABC therapy
82
Q

CHRONIC OSTEOMYELITIS

A
  • long standing inflammation of bone
  • due to:
    i. inadequately treated Acute Osteo
    ii. Paget’s Disease
    iii. Sickle cell disease
    iv. Bone irradiation
  • bone is painful and swollen
  • radiographically – diffuse, irregular (RL)
  • chronic sclerosing osteomyelitis – when lesion becomes (RO)
  • Dx based on biopsy
  • Tx:
    i. Débridement and ABC Tx
    ii. Some cases require hyperbaric O2
83
Q

fungal infections

A
  • CANDIDIASIS
    i. Also called “thrush”
    ii. Occurs as an overgrowth of the yeast-like fungus Candida Albicans
    iii. Most common oral fungal infection
    iv. Causes:
    1. ABC Tx
    2. Chemotherapy
    3. Corticosteroid
    4. Dentures
    5. Diabetes
    6. HIV
    7. Xerostomia
    8. Infancy
  • presents as an erythematous lesion with a white surface that is easily revived by rubbing with a 2x2
  • commonly Tx: NYSTATIN
  • TYPES:
    i. Pseudomembranous Candidiasis
    ii. Erythematous Candidiasis (Acute Atrophic)
    iii. Chronic Atrophic Candidiasis
    1. most common type affecting oral mucosa
    2. also known as Denture Stomatitis – associated with denture or partial
    iv. Chronic Hyperplastic Candidiasis
    1. white lesion that does not wipe off
    v. Angular Cheilitis
    1. erythema/fissuring at labial commissures
    2. nutritional deficiency as well
    vi. Chronic Mucocutaneous Candidiasis
    1. severe form occurring in patients who are severely immunocompromised (HIV)
    2. chronic oral and genital mucosal candidiasis
84
Q

deep fungal infections

A
  • histoplasmosis, coccidioidomycosis, blastomycosis, and cryptococcosis
    i. all characterized by 1 involvement of the lungs
  • oral lesions are chronic, non healing ulcers that can resemble Squamous cell
  • Tx: antifungals – amphotericin B or ketoconazole
85
Q
  • rare fungal disease
  • inhabitant organism from soil
  • occurs in diabetic/debilitated patients
  • involves nasal cavity, max. sinus, hard palate
A

mucormycosis

86
Q
  1. papillary oral lesion caused by a papilloma virus
  2. oral lesions are less common than skin lesions
  3. lips are one of the most common intraoral sites
  4. white, papillary, exophytic lesion resembling a papilloma
  5. biopsy
  6. Tx: excision of lesion surgically
A

papillomavirus

verruca vulgaris

87
Q
  1. a benign papillary lesion that is caused by another papillomavirus
  2. transmitted by sexual contact
  3. more common in anogenital region, transmitted to oral cavity via oral sex
  4. lesions on tongue, buccal mucosa, palate, gingival, and alveolar ridge
  5. pink in color
  6. Tx: surgical excision
A

condyloma acuminatum

88
Q
  1. characterized by presence of multiple whitish to pink nodules distributed throughout oral mucosa
  2. most common in children
  3. asymptomatic and usually resolve on their own
A

focal epithelial hyperplasia

89
Q

HERPES SIMPLEX INFECTION

A
  • 2 forms: Type 1 and Type 2
    i. Type 1 – oral lesions
    ii. Type 2 – genital lesions
  • one of a group of viruses called herpes viruses
    i. others are:
    1. varicella-zoster virus
    2. Epstein-Barr virus
    3. cytomegalovirus
90
Q
  • 1 Herpetic Gingivostomatitis
A

i. painful, erythematous, and swollen gingival and multiple tiny vesicles on perioral skin, vermilion border of lip, and oral mucosa – form ulcers
ii. fever, malaise, lymphadenopathy
iii. children ages 6 months – 6 years
iv. lesions heal in 1 – 2 weeks

91
Q
  • Recurrent Herpes Simplex
A

i. Virus tends to persist in latent state – trigeminal ganglion – recurrence
ii. 1/3 – ½ population
iii. herpes labialis – most common recurrent infection – vermilion border of lip
1. “cold sore” or “fever blister”
iv. certain triggers – sunlight, menstruation, fatigue, fever, stress
v. bound down mucosa (palate/gingival)
vi. recurrent herpes simplex appears as painful crops of tiny vesicles or ulcers that can coalesce to form a single ulcer
vii. usually prodromal symptoms: burning, itching, tingling
viii. lesions heal 1 – 2 weeks
ix. * more contagious in vesicle stage
x. can affect fingers – herpetic whitlow
xi. can also affect the eyes
xii. Tx: Acyclovir, symptomatic Tx

92
Q

VARICELLA-ZOSTER VIRUS

A
  • causes both chicken pox and shingles
  • chicken pox – highly contagious disease causing vesicular/pustular eruptions of the skin/mucous membrane
    i. headache, fever, and malaise
    ii. usually children
    iii. 2 – 3 weeks
  • Herpes Zoster – unilateral, painful eruption of vesicles along the distribution of a sensory nerve
    i. Adults
    ii. Occurs with immunodeficiencies and Hodgkin’s disease and Leukemia
    iii. Affects branches of Trigeminal – V1, V2 or V3
    iv. Oral lesions unilateral
    v. Lasts for several weeks
    vi. Transmitted by contaminated droplets
    vii. Tx: symptomatically; some corticosteroids
93
Q

COXSACKIEVIRUS

A
  • named after the town in New York
  • HERPANGINA
    i. Vesicles appear on the soft palate
    ii. Fever, malaise, sore throat, and difficulty swallowing (dysphagia)
  • HAND-FOOT-AND - MOUTH DISEASE
    i. Epidemics in children less than 5 years
    ii. Oral lesions with macules or papules on skin of feet, toes, hands and fingers
    iii. Resolves within 2 weeks
    iv. Usually no Tx
94
Q

i. Highly contagious disease – for paramyxovirus

ii. Koplik’s spots – small erythematous macules with white necrotic centers

A

measles

95
Q

i. Viral infection of parotid gland – paramyxovirus

A

MUMPS

96
Q

i. Infectious mononucleosis, nasopharyngeal carcinoma, Burkitt’s lymphoma, and hairy leukoplakia
ii. Mono – sore throat, fever, lymphadenopathy, enlarged spleen, malaise, fatigue
1. palatal petechiae
2. “kissing disease”

A

EPSTEIN BARR

97
Q

irregular, corrugated, white lesion most commonly occurring on lateral border of the tongue
i. Immunocompromised patients – HIV

A

HAIRY LEUOPLAKIA

98
Q

tongue tied”; high lingual frenum close to the tip of the tongue

A

anklyoglossia

99
Q

– a tooth that is fused to the bone; usually primary teeth

A

ankylosed tooth

100
Q

CONGENITAL ABSENSE OF TEETH

A

ANADONTIA

101
Q

maked deviation from the normal

A

anomaly

102
Q

– site of union of two corresponding parts; corner of the lips (libial commissure)

A

commissure

103
Q

condition where two teeth are joined by cementum

A

concrescense

104
Q

present and existing from birth

A

congenial

105
Q

– cavity lined by epithelium and enclosed in CT capsule

A

cyst

106
Q

tooth within a tooth”; enamel invaginates into the dentin

A

dens in dente

107
Q

the formation of dentin

A

dentinogeneisis

108
Q

distinguishing one thing from another

A

differentiation

109
Q

union of two adjacent tooth germs

A

fusion

110
Q

tooth germ tries to divide itself

A

geminaion

111
Q

partial anodontia; loss or lack of some teeth

A

hypodontia

112
Q

teeth cannot erupt into the oral cavity

A

impacted teeth

113
Q

abnormally large teeth

A

macrodontia

114
Q

abnormally small teeth

A

microdontia

115
Q

small solid mass detected through palpation

A

nodule

116
Q

preference

A

predilection

117
Q

caused by an abnormality in the genetic make-up transmitted from parent to offspring through the egg or sperm

A

inherited disorders

118
Q

one that is present at birth

A

congenital disorder

119
Q

primitive oral cavity

A

stomodeum

120
Q

tooth development – 5th week of embryonic life

A

odontogensis

121
Q

the formation of dentin

A

dentinogenesis

122
Q

the formation of enamel

A

amelogeneisis

123
Q

the formation of cementum

A

cementogenesis

124
Q

extensive adhesion of the tongue to the floor of the mouth

- “tongue-tied”

A

anklyglossia

125
Q

– surgical removal of a portion of a frenum

A

frenectomy

126
Q

epithelium – lined blind tracts located at the corners of the mouth

A

commissural lip pits

127
Q

abnormal pathologic sac or cavity lined by epithelium and enclosed in a CT capsule

A

cyst

128
Q

most common cyst is a

A

radicular cyst

129
Q

related to tooth development

A

odontogenic

130
Q

not related to tooth development

A

nonodontogenic

131
Q

– cysts occurring within the bone

A

intrassoeous cysts

132
Q

cysts that occur in soft tissue

A

extraosseous cysts

133
Q

forms around the crown of an unerupted or developing tooth

i. most common location – impacted 3rd molar
ii. radiographically – well-defined, unilocular (RL) around crown of an unerupted or impacted tooth
iii. Tx: removal
- eruption cyst – in soft tissue

A

follicular cyst

134
Q

in soft tissue around the crown of an erupting tooth

i. eruption hematoma – when lesion is filled with blood
ii. Tx: none usually

A

eruption cyst

135
Q

develops in place of a tooth
i. most common place – 3rd molar region
ii. history that the tooth was never present
iii. young adults
iv. radiographically – well defined (RL) that can be unilocular or multilocular
v. biopsy to rule out OKC or lateral periodontal cyst
vi. Tx: surgical removal of lesion
qpri

A

primordial cyst

136
Q

unique histologic appearance that frequently recurs

i. most common 3rd molar region
ii. radiographically – well-defined multilocular (RL) lesion
iii. expansive lesion that can displace and resorb teeth
iv. Tx: surgical excision with curettage

A

odontogenic keratocyst OKC

137
Q

i. LPC – most often seen in mand. cuspid/premolar area
1. unilocular or multilocular (RL) lesion located on lateral aspect of a tooth root
ii. GC – located in soft tissue adjacent to LPC
iii. More often in males
iv. Asymptomatic
v. Tx: both removed surgically

A

lateral periodontal cyst/ gingival cyst

138
Q 
ocated within the nasopalatine canal
i.	Associated with incisive foramen/papillae
ii.	Males, 40 – 60 years
iii.	Teeth are vital
iv.	Well-defined (RL)
v.	Tx:  excision
q
A

nasopalatine duct cyst

139
Q

well-defined unilocular (RL) located in midline of hard palate
i. Tx: excise

A

median palatine cyst

140
Q

well-defined pear-shaped (RL) formed between the roots of max. lateral incisor/canine

i. Teeth are vital
ii. Tx: excise

A

globuloaxillary cyst

141
Q

rare lesion, located in midline of mandible

i. Well-defined (RL) below apices of incisors
ii. Tx: excise

A

median mandibular cyst

142
Q

soft tissue cyst with no alveolar bone involvement

i. Adults 40 – 50 years olf
ii. Females 4x more likely
iii. * expansion or swelling in mucolabial fold in area of max. canine/floor of nose
iv. Tx: surgical excision

A

nasolabial cyst

143
Q

raised nodule in the skin of face or neck

i. Thought to originate from epithelium of hair follicle
ii. Tx: excise

A

EPIDERMAL CYST

144
Q

DERMOID CYST/BENIGN CYSTIC TERATOMA

A
  • dermoid – developmental cyst often present at birth or noted in young children
    i. found in anterior floor of mouth – tongue displacement – doughy
  • b.c.t. – resembles a dermoid cyst but teeth, bone, muscle, and nerve tissue may be found in wall of the lesion
  • Tx: removal
145
Q

most commonly found in the major salivary glands

  • pinkish-yellow raised nodule located in floor of mouth or lateral borders of the tongue
  • Tx: surgical excision
A

lymphoepithelial cyst

146
Q

Stafne’s bone cyst”

  • well-defined (RL) in posterior region of mandible
  • Tx: none
A

static bone cyst

147
Q

from foramen caecum to thyroid gland below hyoid

  • young 10 – 30 years
  • females
  • presents as a smooth bulge or swelling in area of midline of neck
  • Tx: complete excision of cyst/tract + part of hyoid bone
A

thyroglossal tract cyst

148
Q

Traumatic bone cyst”

  • young – males
  • well-defined (RL) that has scalloping around the roots of teeth
  • void within bone that fills up in 6 months – 1 year
A

simple bone cyst

149
Q

Vascular Lesion”

  • pseudocyst of blood filled spaces
  • multilocular “soap bubble”
  • less than 30 years – females
  • previous history of trauma
  • ASPIRATE
    • surgical removal – excessive bleeding
A

aneurysmal bone cyst

150
Q

congenital lack of teeth

i. Total anodontia is rare but is associated with ectodermal dysplasia

A

anadontia

151
Q

lack of one or more teeth

i. Most common missing is 3rd molar, Max. lateral, Mand. 2nd premolar

A

hypdontia

152
Q

extra teeth

i. Most common – mesiodens – located in midline between centrals
ii. Distomolar – located to distal of 3rd molar
iii. Paramolar – located buccal

A

supernumerary teeth

153
Q

maller than normal

i. Usually more common with one tooth – max. lateral – peg lateral

A

microdontia

154
Q

larger than normal

i. Facial hemihypertrophy – enlargement of half the head with enlargement of the teeth on that side

A

macrodontia

155
Q

union of two separate teeth

i. 1 crown, 2 roots

A

fusion

156
Q

two adjacent teeth are united by cementum

A

concrescense

157
Q

small spherical nodule of enamel located in trifurcation area

A

enamel pearl

158
Q

accessory cusp located in the area of the cingulum

i. Removed some times – interferes with occlusion

A

talon cusp

159
Q

“bull teeth” – long pulp chamber and short roots

i. Radiographic appearance

A

taurodontism

160
Q

enamel invaginates into the crown of a tooth

i. Most common – max. lateral
ii. Vulnerable to caries, pulpal infection, and necrosis
iii. Filling or Endo

A

dens in dente

161
Q

extra root

i. “bitruncated root”
ii. most commonly single rooted teeth – Canines and mand.PM

A

Supernumerary roots

162
Q

incomplete or defective formation of enamel

i. Factors causing:
1. Amelogenesis Imperfecta – inherited enamel hypoplasia
2. Febril illnesses (measles, chickenpox)
3. Vitamin deficiency
4. Local infection of 1 tooth – Turner’s tooth
5. Fluoride – Enamel Fluorosis – mottled enamel
6. Congenital Syphilis – Hutchinson’s Incisors or Mulberry Molar
7. Birth Injury

A

enamel hypoplasia

163
Q

enamel doesn’t motive and calcify – chalky-white

A

enamel hypcalcifation

164
Q

endogenous or intrinsic staining

A

tetracycline staining

165
Q

“Ghost teeth”

i. Very thin enamel/dentin
ii. Extremely large pulp chambers
iii. Extraction

A

regional odontodysplasia

166
Q

can’t erupt due to physical obstruction

  • most common – 3rd molars
    i. most common position for impaction – Mesioangular
  • classifications of impactions:
    i. Mesioangular
    ii. Distoangular
    iii. Vertical
    iv. Horizontal
A

impacted teeth

167
Q

tooth lies partly in bone/soft tissue

A

partial impaction

168
Q

no eruption forces allowing eruption

  • most common – 3rd molars
    i. most common position for impaction – Mesioangular
  • classifications of impactions:
    i. Mesioangular
    ii. Distoangular
    iii. Vertical
    iv. Horizontal
A

embedded teeth

169
Q

Ankylosis”

- 1 teeth in which bone has fused to roots

A

ankylosed teeth

pathology exxam 2 (1 decks)

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