Pathology of oral cavity

Question 1

One word

Single or multiple, shallow, mucosal ulcerations that are common, often recurreny and painful.

Answer 1

Aphthous ulcers (Canker sores)

Question 2

Aphthous ulcers can be associated with which disorders?

Answer 2

Immunologic disorders e.g Inflammatory bowel disease

Question 3

The Aphthous ulcers affect which patients for a long time?

Answer 3

Immunocompromised patients

Question 4

True or False
The Aphthous ulcers usually self-resolves in a week but may persists for longer especially in HIV patients

Answer 4

True

Question 5

What causes the oral herpes

Answer 5

HSV-1

Question 6

HPV-2 causes what?

Answer 6

Genital herpes

Question 7

In Children the oral herpes usually persists as what?

Answer 7

Acute herpetic gingivostomatitis (Usually 2-4 yo)

Question 8

In children the oral herpes presents with what?/ characteristics of oral herpes in children

Answer 8

Vesicles and ulceration of the oral mucosa

Question 9

In adults the oral herpes usually presents as what?

Answer 9

Acute herpes pharyngitis

Question 10

After acute infection of oral herpes what happens to virus?

Answer 10

The virus treks along regional nerves and becomes latent within local ganglia

Question 11

Reactivation of the HPV-1 results to what?

Answer 11

Reactivation results in recurrent herpetic stomatitis

Question 12

The oral herpes in immunocompromised patients can persists as what?

Answer 12

Chronic mucocutaneous infection

Question 13

The most common fungal infections of oral cavity?

Answer 13

Oral candidiasis (thrush)

Question 14

Thrush refers to what?

Answer 14

Pseudomembranous of oral candidiasis

Question 15

what is meant by pseudomembranous form of oral candidiasis?

Answer 15

Superficial gray-white inflammatory membrane composed of matted organisms in a fibrinosuppurative exudate that can be scrapped off, showing an erythematous inflammatory base

Question 16

is oral candidiasis invasive?

Answer 16

Usually not invasive except on the setting of immunosuppression

Question 17

`

Oral lesion can be seen where?

Answer 17

Blood dyscrasias

Question 18

examples where oral lesion can be seen?

Answer 18

Folic acid and vitamin B12 deficiency

Question 19

List examples of mucocutaneous disorders

Answer 19

Lichen planus, pemphigus vulgaris, systemic lupus erythematosus, chemotherapy

Question 20

List oral manifestation of systemic disorders

Answer 20

Oral lesion
Mucocutaneous diseases

Question 21

one word

This is a severe, acute streptococcal cellulitis involving the neck, tongue and back of the throat.

Answer 21

Ludwig’s angina

Question 22

Vincent’s angina is painful condition of what?

Answer 22

throat

Question 23

the vincent’s angina is characterised by ?

Answer 23

Local ulceration of tonsils, mouth and pharynx

Question 24

Causative organism of vincent’s angina

Answer 24

Vincent’s bacillus

Question 25

is diphtheria a communicable or non-communicable disease?

Answer 25

communicable disease

Question 26

diphtheria is casued by what?

Answer 26

corynebacterium diphtheriae

Question 27

Diphtheria usually occurs in children and results in the formation of what?

Answer 27

a yellowish-grey pseudomembrane in the mucosa of nasopharynx, oropharynx, tonsils, larynx and trachea

Question 28

Tonsilitis is caused by which organisms

Answer 28

Staphylococci Streptococci

Question 29

The tonsilitis that is characterised by enlargement, redness and inflammation

Answer 29

Acute tonsils

Question 30

Chronic tonsilitis is caused by what?

Answer 30

is caused by repeated attacks of acute tonsilitis in which case the tonsils are small and fibrosed

Question 31

A condition that occurs as a complication of acute tonsilitis

Answer 31

Peritonsilitis abscess (Quinsy)

Question 32

The similarities between tonsilitis and peritonsilitis abscess

Answer 32

The causative organisms staphylococci or streptococci which are associated with infection of the tonsils

Question 33

Formation of abscess in the soft tissue between posterio wall of the pharynx and the vertebral column is called what?

Answer 33

Retropharyngeal abscess

Question 34

The spectrum of squmous lesion includes?

Answer 34

Malignant Benign premalignant

Question 35

Most common benign epithelial neoplasm in the oral cavity, usually in adults

Answer 35

Squamous papilloma

Question 36

The squamous papilloma is associated with low risk HPV subtypes?

Answer 36

HPV 6 and 11

Question 37

Microscopic appearance of squamous papilloma

Answer 37

Exophytic papillary proliferation of hyperplastic stratified squamous epithelium with branching fibrovascular core. Should not have dyplasia

Question 38

The white patch or plaque that cannot be scraped off and cannot be characterised clinically or pathologically as any other disease

Answer 38

Leukoplakia

Question 39

Squmous epithelium lesion in leukoplakia is characterised by ?

Answer 39

5-25% are pregmalignant, all leukoplakia are considered premalignant until otherwise proven by histologic evaluation

Question 40

Histology of leukoplakia

Answer 40

Spectrum of epithelium change form hyperkeratosis to severe dysplasia

Question 41

red velvet area within oral cavity (+/- erosions)

Answer 41

Erythroplakia

Question 42

Histology appearance of Erythroplakia

Answer 42

Almost all display severe display, carcinoma in-situ or minimally invasive carcinoma

Question 43

Is Erythroplakia related to which lifestyle

Answer 43

Often related to tobacco use

Question 44

Squmous Cell Carcinoma account for how much?

Answer 44

95% of all head or neck

Question 45

Explain the pathogenesis of squamous cell carcinoma

Answer 45

Multifactorial, depends partly on tumour location. A growing proportion have no known risk factors

Question 46

what causes SCC in oropharynx ?

Answer 46

High risk human papillomavirus infections (HPV 16)

Question 47

what causes SCC in oral cavity?

Answer 47

Smoked tobacco, alcohol, chewing of betel quid (India and Asia)

Question 48

what causes SCC in lower lip?

Answer 48

Actinic radiation (sun exposure) and pipe smoking

Question 49

clinical features of SCC

Answer 49

Clinical features: Male preponderance. Patients with HPV-positive SCC tend to be younger and have better long term survival compared to non-HPV associated SCC. Multiple primary tumours can occur due to “field cancerisation”, often with worse outcomes, necessitating early detection

Question 50

explain the Gross appearance of SCC

Answer 50

* Gross: HPV-associated SCC tend to be easily overlooked small primary tumours but accompanied by significantly enlarged cervical lymph nodes, while non-HPV associated SCC appear as raised firm plaques or roughed areas of mucosal thickening that can enlarge to form ulcerated masses with indurated borders +/- background leukoplakia or erythroplakia

Question 51

Explain the microscopic appearance of SCC

Answer 51

Microscopy: HPV-associated SCC are non-keratinizing SCC – nests and lobules of basaloid cells which are p16 immunostain positive. Non-HPV associated SCC tend to bekeratinizing SCC that may begin as dysplastic lesions