Pathology - Oral Cavity

Question 1

Main cause of tooth loss before age 35?

Answer 1

dental caries

Question 2

Morphology of dental caries?

Answer 2

demineralization (enamel and dentin) of the tooth structure

Question 3

Congenitally abnormality due to syphilis?

Answer 3

Hutchinson’s teeth

Question 4

Malformation of the roof of the mouth on the bony palate?

Answer 4

torus palatinus

Question 5

Cause of dental caries?

Answer 5

acidic metabolites of fermenting sugars by bacteria

Question 6

When is gingivitis most severe?

Answer 6

adolescence (think braces)

Question 7

Gingivitis is caused by:

Answer 7

dental plaques (biofilm) and calculus (tartar, build up of plaque)

Question 8

Treatment of gingivitis:

Answer 8

REVERSIBLE process, reduce plaque

Question 9

Periodontitis is usually caused by anaerobic organisms - which ones?

Answer 9

Aggregatibacter, Porphyromonas, Prevotella

Question 10

Which systemic diseases does periodontitis often present with?

Answer 10

AIDS, leukemia, Crohn’s, diabetes, Down’s, sarcoidosis

Question 11

General description of periodontitis:

Answer 11

Gums are far receded, teeth look very spread out

Question 12

Exceedingly painful, superficial oral mucosa ulcerations are called?

Answer 12

Apthous ulcers or canker sores

Question 13

When are apthous ulcers most common?

Answer 13

first 2 decades of life

Question 14

What diseases are apthous ulcers associated with?

Answer 14

Celiacs, Behcet, IBD

Question 15

Types of fibrous proliferative lesions?

Answer 15

Irritation fibroma (traumatic) or pyogenic granuloma (pregnancy tumor)

Question 16

Purple/red lesion found on gingiva, ulcerated, and may be common in pregnant women?

Answer 16

Pyogenic granuloma

Question 17

HSV infections often prevent with a prodrome of what?

Answer 17

Lymphadenopathy, fever, anorexia, irritability

Question 18

Morphology of HSV infection:

Answer 18

acantholysis (loss of intracellular connections)

intranucelar viral inclusions - forms multinucleat polykarons with glassy cytoplasm

Question 19

Test for diagnosis of HSV?

Answer 19

Tzank test

Question 20

Where might HSV lay latent?

Answer 20

trigeminal ganglion

Question 21

Oral changes in scarlet fever:

Answer 21

strawberry or raspberry tongue

due to group A strep

Question 22

Oral changes in measles:

Answer 22

cough, coryza, conjunctivitis, Koplik spots

Warthin-Finkelday cells

Question 23

Oral changes in mononucleosis:

Answer 23

caused by EBV

acute pharyngitis, cervical LAD, palatal petechiae

Question 24

Oral changes in erythema multiforme:

Answer 24

may follow infection, drugs, cancer (appears in mouth first)

widespread = Stevens Johnson syndrome

Question 25

Oral changes in pancytopenia:

Answer 25

Ludwigs angina = cellulitis under the chin

Question 26

What causes hairy leukoplakia and who is susceptible?

Answer 26

Caused by EBV | Immunocompromised patients at risk (post-chemo, HIV,)

Question 27

Morphology of hairy leukoplakia?

Answer 27

CANNOT be scraped off | hyperkeratosis and acanthosis with "balloon cells" in the upper spinous layer

Question 28

Leukoplakia as a precancerous lesion looks like?

Answer 28

white patch that cannot be scraped off, raised verrucous plaques, may be dysplastic 25% are premalignant

Question 29

Erythroplakia as a precancerous lesion looks like?

Answer 29

red, velvety, eroded area (depressed) risk of malignancy is much higher here

Question 30

What type of cancer makes up more than 95% of cancers in the head and neck?

Answer 30

squamous cell carcinoma

Question 31

Which strain of HPV is responsible for some SCC cancers in the head and neck?

Answer 31

HPV-16

Question 32

What is field cancerization?

Answer 32

Theory that multiple tumors may be individual primary tumors and then is why there is such a high rate of secondary tumors in classic SCC

Question 33

Which type of SCC has the better prognosis?

Answer 33

HPV-positive tumors

Question 34

Most common cause of classic SCC?

Answer 34

smoking and tobacco

Question 35

Genetic markers in classic SCC?

Answer 35

p53 pathway (genes)

Question 36

Genetic markers in HPV-positive SCC?

Answer 36

p16 expression (proteins)

Question 37

General morphology of SCC?

Answer 37

Intercellular bridges, cytokeratin positive, indurated borders

Question 38

Favored site of extension of SCC:

Answer 38

cervical lymph nodes

Question 39

Most common sites of metastasis for SCC:

Answer 39

mediastinal lymph nodes, lungs, liver, bones

Question 40

Most common age for odontogenic keratocysts?

Answer 40

10-40 years old, usually males

Question 41

If OKCs present as multiple lesions?

Answer 41

Gorlin Syndrome - needs to be evaluated for nevoid basal cell caricnoma syndrome

Question 42

What genetic mutation is present in OKCs?

Answer 42

PTCH (Patched)