Pathology Lecture 1

Question 1

What type of epithelium makes up the external lips?

Answer 1

Keratinized stratified squamous epithelium with hair follicles and glands

The external lips are protected and structured for durability.

Question 2

What characterizes the vermilion border of the lips?

Answer 2

Thin keratin, vascular, dry (no glands)

This lack of glands is why it is prone to dryness.

Question 3

What type of epithelium lines the internal lips?

Answer 3

Non-keratinized stratified squamous epithelium with minor salivary glands

Question 4

Why is the vermilion border prone to dryness?

Answer 4

Because it lacks glands!

Question 5

What type of epithelium is found in the hard palate?

Answer 5

Keratinized stratified squamous epithelium firmly attached to bone

Question 6

Why does a patient heal rapidly after biting their cheek?

Answer 6

Rich vascular supply in the buccal mucosa

Question 7

Name the types of tongue papillae and indicate which have taste buds.

Answer 7

• Filiform: No taste buds
• Fungiform: Taste buds present
• Circumvallate: Many taste buds + von Ebner’s glands

Question 8

Which tongue papillae are numerous but tasteless?

Answer 8

Filiform = Feel but no Flavor (No taste buds)

Question 9

What are the major secretions of the parotid, submandibular, and sublingual glands?

Answer 9

• Parotid: Serous only
• Submandibular: Mostly serous (mixed)
• Sublingual: Mostly mucous

Question 10

Why does mouth dryness increase with age?

Answer 10

Fatty replacement of parotid gland tissue

Question 11

What duct empties the parotid gland secretion?

Answer 11

Stensen’s duct (opens near upper 2nd molar)

Question 12

What is the diagnosis for a child with small painful oral ulcers (<5mm) that heal in a week?

Answer 12

Aphthous Ulcers (Canker Sores)

Question 13

What is the major cause of aphthous ulcers?

Answer 13

Autoimmune triggers (stress, foods, fever, IBD)

Question 14

What virus causes herpetic stomatitis?

Answer 14

HSV type 1 (oral herpes)

Question 15

What are the characteristics of herpes labialis?

Answer 15

Vesicles on lips that rupture into painful shallow ulcers, triggered by sun exposure

Question 16

What are the Triple M’s of HSV?

Answer 16

• Margination
• Molding
• Multinucleation (polykaryons)

Question 17

What type of inclusions are seen in HSV infections?

Answer 17

Cowdry Type A inclusions (acidophilic, pink inside blue nucleus)

Question 18

What is the etiology and appearance of oral candidiasis (thrush)?

Answer 18

• Etiology: Candida albicans (opportunistic infection)
• Appearance: White pseudomembrane that can be scraped off, red base underneath

Question 19

Who is at risk for oral candidiasis?

Answer 19

• AIDS patients
• Diabetics
• Broad-spectrum antibiotic users
• Steroid users

Question 20

What does Candida need to infect?

Answer 20

Immunity Cracks → Candida Attacks (needs immune suppression)

Question 21

What is the diagnosis for an HIV patient with white patches on the lateral tongue that are non-scrapable?

Answer 21

Hairy Leukoplakia (caused by EBV infection)

Question 22

Is hairy leukoplakia a precancerous lesion?

Answer 22

No, it is NOT precancerous

Question 23

What are the key microscopic features of herpes simplex virus (HSV) infection?

Answer 23

• Intraepithelial vesicle
• Ballooning degeneration
• Cowdry type A inclusions
• Multinucleation, Margination, Molding (Triple M)

Question 24

What does Cowdry Type A inclusion mean?

Answer 24

• Acidophilic (pink) nuclear inclusion inside a basophilic (blue) nucleus
• Seen in HSV and CMV infections

Question 25

What is the mnemonic for HSV histology?

Answer 25

- M: Multinucleation - M: Margination - M: Molding - C: Cowdry type A inclusions

Question 26

What is the microscopic hallmark of oral candidiasis (thrush)?

Answer 26

- Pseudohyphae attached superficially to mucosa - Fibrinosuppurative exudate - Mucosal ulceration underneath

Question 27

What condition is characterized by scrapable white plaques revealing red inflamed base under the microscope?

Answer 27

Oral Candidiasis (Thrush)

Question 28

What are the main differences between aphthous ulcers and herpes ulcers?

Answer 28

| Feature | Aphthous Ulcer | Herpes Ulcer | |:-------:|:--------------:|:------------:| | Cause | Autoimmune | HSV-1 | | Lesion | Single/small | Vesicles that rupture | | Pain | Painful | Painful | | Healing | 7-10 days | 1-3 weeks |

Question 29

In which condition are the ulcers preceded by vesicles?

Answer 29

Herpetic stomatitis (HSV infection)

Question 30

Why can't candidiasis infect healthy people easily?

Answer 30

Candida albicans is normal flora — disease only happens with immune suppression or microbiota imbalance

Question 31

What infection is associated with 'white corrugated patches' on the lateral tongue?

Answer 31

Hairy leukoplakia (caused by EBV)

Question 32

What is the difference in location between HSV-1 and HSV-2?

Answer 32

- HSV-1: Above the waist (oral infections) - HSV-2: Below the waist (genital infections)

Question 33

Is hairy leukoplakia a precancerous lesion?

Answer 33

NO. Unlike true leukoplakia, hairy leukoplakia is NOT precancerous

Question 34

Where do cold sores (herpes labialis) commonly occur?

Answer 34

- Lips (commissures) - Around the mouth - Near nasal orifices

Question 35

What is the diagnosis for an HIV patient with a white patch on the tongue that cannot be scraped off?

Answer 35

Hairy leukoplakia

Question 36

What are the major risk factors for developing oral candidiasis?

Answer 36

- AIDS - Broad-spectrum antibiotics - Corticosteroids - Diabetes mellitus - Cancer or chemotherapy

Question 37

What is the best way to prevent inhaler-induced oral candidiasis?

Answer 37

Rinse the mouth after using inhaled corticosteroids