Robbins

Question 1

is caused by focal demineralization of tooth structure (enamel and dentin) by acidic products of bacterial sugar fermentation

Answer 1

dental carries

Question 2

inflammation of the oral mucosa surrounding the teeth, caused by accumulation of dental plaque and calculus

Answer 2

gingivitis

Question 3

is an inflammatory process that affects the supporting structures of the teeth (ligaments), alveolar bone, and cementum

Answer 3

Periodontitis

Question 4

a submucosal nodular mass of fibrous connective tissue stroma that occurs primarily on the buccal mucosa along the bite line or the gingiva

Answer 4

irritation fibroma

Question 5

typically found on the gingiva of children, young adults, and pregnant women. This exophytic inflammatory lesion is red to purple in color and frequently ulcerated. Histologically, they are a highly vascularized proliferation of organizing granulation tissue.

Answer 5

pyogenic granulomas

Question 6

red, ulcerated, nodular lesions of the gingiva that arise from a long-standing pyogenic granuloma, while others develop de novo from cells of the periodontal ligament, complete surgical excision down to the periosteum is required

Answer 6

Peripheral ossifying fibroma

Question 7

oral cavity lesion that contains aggregates of multinucleate, foreign body–like giant cells separated by a fibroangiomatous stroma

Answer 7

Peripheral giant cell granuloma

Question 8

The pseudomembranous form of oral candidiasis is called

Answer 8

thrush

Question 9

a distinctive oral lesion on the lateral border of the tongue caused by EBV

Answer 9

Hairy Leukoplakia

Question 10

T/F until proven otherwise by histologic evaluation, all leukoplakias must be considered precancerous

Answer 10

true

Question 11

a possibly precancerous lesion which is red, velvety, possibly eroded area within the oral cavity that usually remains level with or may be slightly depressed relative to the surrounding mucosa

Answer 11

erythroplakia

Question 12

Approximately 95% of cancers of the head and neck are _____, with the remainder largely consisting of ____

Answer 12

SCCs, adenocarcinomas of salivary origin

Question 13

primary cause of SCC of the oropharynx

Answer 13

HPV infection

Question 14

oropharyngeal carcinoma

prognosis is better in
hpv related scc or “classic” scc?

Answer 14

hpv related

Question 15

postulates that multiple individual primary tumors develop independently in the upper aerodigestive tract as a result of years of mucosal exposure to carcinogens

Answer 15

field cancerization

Question 16

T/F second primary tumors in the oropharyngeal classic scca have the highest rate among all malignancies and commonly have good prognosis

Answer 16

False, they are usually fatal

Question 17

mutations in these 3 genes are drivers of cancer development

Answer 17

TP53, CDKN2A, PIK3CA

Question 18

hpv oncoproteins and the proteins they inactivate

Answer 18

E6 - p53
E7 - RB

Question 19

classic hpv neg scca vs hpv-assoc scca:

favored locations are the ventral surface of the tongue, floor of the mouth, lower lip, soft palate, and gingiva

Answer 19

classic

Question 20

classic hpv neg scca vs hpv-assoc scca:

tend to develop without a readily identified premalignant (i.e., dysplastic) component

Answer 20

hpv-assoc

Question 21

oropharyngeal:

classic hpv neg scca vs hpv-assoc scca:

appear as raised, firm, pearly plaques or irregular, roughened, or verrucous areas of mucosal thickening

Answer 21

classic

Question 22

oropharyngeal carcinoma

classic hpv neg scca vs hpv-assoc scca:

are most often nonkeratinizing neoplasms arising in the reticulated epithelium of the tonsillar crypts within the lingual tonsils, base of tongue, soft palate, and pharynx

Answer 22

hpv-assoc

Question 23

oropharyngeal carcinoma

classic hpv neg scca vs hpv-assoc scca:

typically preceded by premalignant lesions, such as leukoplakia and erythroplakia

Answer 23

classic

Question 24

oropharyngeal cancer

classic hpv neg scca vs hpv-assoc scca:

present as small primary tumors that lack obvious surface mucosal lesions but are accompanied by significant cervical lymphadenopathy

Answer 24

hpv assoc

Question 25

The histology of this invasive oropharyngeal tumor is characterized by the proliferation of nests and lobules of nonkeratinizing and basaloid cells

Answer 25

HPV-associated SCC

Question 26

Immunohistochemical detection of strong ____ protein expression can serve as a marker for HPV-associated SCC

Answer 26

p16

Question 27

originates around the crown of an unerupted tooth as a result of fluid accumulation between the developing tooth and the dental follicle. Histologically, they are lined by a thin layer of stratified squamous epithelium, and there is frequently a dense chronic inflammatory cell infiltrate in surrounding connective tissue

Answer 27

dentigerous cyst

Question 28

well-defined unilocular or multilocular radiolucencies with a lining consisting of a thin layer of keratinized stratified squamous epithelium with a prominent basal cell layer and a corrugated epithelial surface. it is locally aggressive

Answer 28

keratocystic odontogenic tumor

Question 29

keratocystic odontogenic tumor is usually solitary so multiple cysts should be evaluated for this syndrome

Answer 29

nevoid basal cell carcinoma (Gorlin syndrome)

Question 30

mutations associated with nevoid basal cell carcinoma syndrome (Gorlin syndrome)

Answer 30

PTCH (Patched), chromosome 9q22

Question 31

common inflammatory lesion found at the tooth apex. The cysts develop as a result of long- standing inflammation of the tooth (pulpitis), often secondary to advanced carious lesions or local trauma. Over time, granulation tissue may develop, with subsequent epithelialization that results in a cyst

Answer 31

radicular cyst

Question 32

two most common and clinically significant odontogenic tumors

Answer 32

odontoma and ameloblastoma

Question 33

most common odontogenic tumor, arises from epithelium and is associated with extensive enamel and dentin deposition. These lesions probably represent hamartomas rather than true neoplasms and are cured by local excision.

Answer 33

odontoma

Question 34

arises from odontogenic epithelium and does not display ectomesenchymal differentiation. It is cystic, slow growing, and locally invasive with a typically indolent course. Treatment requires wide surgical resection to prevent recurrence.

Answer 34

ameloblastoma

Question 35

T/F most people with nasal polyps are atopic

Answer 35

false, only 0.5% of atopic people have nasal polyps

Question 36

a benign, highly vascular tumor that arises within the fibrovascular stroma of the posterolateral wall of the roof of the nasal cavity and occurs almost exclusively in adolescent males who are often fair-skinned and red headed

Answer 36

nasopharyngeal angiofibroma

Question 37

mutation present in the majority of nasopharyngeal angiofibromas

Answer 37

CTNNB1 (beta-catenin)

Question 38

Sinonasal papilloma occurs in 3 forms: in descending order of frequency

Answer 38

exophytic endophytic (inverted) oncocytic

Question 39

Most endophytic sinonasal papillomas have mutations in _____ the remaining harbor _____

Answer 39

EGFR, HPV DNA, 6 and 11

Question 40

Sinonasal papilloma is a benign neoplasm arising from the

Answer 40

respiratory or Schneiderian mucosa lining the nasal cavity and paranasal sinuses

Question 41

arise from neuroectodermal olfactory cells within the mucosa, particularly in the superior aspect of the nasal cavity are small, blue, round cell neoplasms typically composed of well-circumscribed nests and lobules of cells separated by fibrovascular stroma

Answer 41

Olfactory Neuroblastoma (Esthesioneuroblastoma)

Question 42

carcinoma uniformly associated with translocations that fuse genes encoding chimeric proteins composed of a chromatin regulator, and a portion of a “chromatin reader” protein, usually BRD4.

Answer 42

NUT midline carcinoma

Question 43

T/F nasopharyngeal carcinoma is characterized by a distinctive geographic distribution, a close anatomic relationship to lymphoid tissue, and an association with EBV infection

Answer 43

T

Question 44

3 patterns of nasopharyngeal carcinoma

Answer 44

keratinizing non-keratinizing basaloid

Question 45

three principal factors that influence development of nasopharyngeal carcinomas are

Answer 45

heredity age EBV infection

Question 46

refers to laryngotracheobronchitis in children that produces a characteristic inspiratory stridor due to airway narrowing

Answer 46

croup

Question 47

develop in the vocal cords often in smokers/ those who strain their voice often, covered by squamous epithelium that may become keratotic, hyperplastic, or even slightly dysplastic overlying a loose myxoid connective tissue core. The latter may be variably fibrotic, fibrinous, or highly vascularized

Answer 47

Reactive Nodules (bilateral) Polyps (unilateral)

Question 48

mutiple laryngeal lesions in children which are caused by HPV types 6 and 11 acquired via the maternal birth canal

Answer 48

juvenile laryngeal papillomatosis

Question 49

T/F Nondysplastic hyperplasias in the larynx have almost no potential for malignant transformation

Answer 49

True

Question 50

most common risk factor for laryngeal carcinoma

Answer 50

tobacco smoke

Question 51

these ear cysts are typically 1 to 4 cm in diameter, lined by keratinizing squamous or metaplastic mucus-secreting epithelium, and filled with amorphous, keratinous debris

Answer 51

cholesteatoma

Question 52

refers to abnormal bone deposition in the middle ear about the rim of the oval window into which the footplate of the stapes fits

Answer 52

Otosclerosis

Question 53

benign lesions usually appear on the upper lateral aspect of the neck along the sternocleidomastoid muscle, lined by stratified squamous or pseudostratified columnar epithelium. The fibrous cyst walls typically contain lymphoid tissue with prominent germinal centers. Cyst contents may be clear and watery or mucinous and may also contain desquamated cells and granular cellular debris

Answer 53

branchial cysts

Question 54

lined by stratified squamous epithelium when located near the base of the tongue or by pseudostratified columnar epithelium in lower locations The fibrous cyst wall often includes lymphoid aggregates or thyroid remnants.

Answer 54

thyroglossal duct cyst

Question 55

also called carotid body tumors

Answer 55

paraganglioma

Question 56

occur frequently in both hereditary and spontaneous paragangliomas

Answer 56

loss-of-function mutations in genes encoding succinate dehydrogenase (SDH) subunits

Question 57

Nests (zellballen) of round to oval chief cells with abundant, clear or granular, eosinophilic cytoplasm and uniform, round to ovoid, sometimes vesicular, nuclei are surrounded by delicate vascular septae

Answer 57

paraganglioma

Question 58

The supporting network of spindle-shaped stromal cells in paragangliomas, collectively called ________, are positive for S-100 protein

Answer 58

sustentacular cells

Question 59

paragangliomas that occur with the adrenal (pheochromocytomas) are associated with the familial _____

Answer 59

MEN2

Question 60

paragangliomas that occur in association with hereditary paraganglioma syndromes (PGL1-4, SDH deficient), usually involve the _____

Answer 60

head and neck

Question 61

T/F Paragangliomas with succinate dehydrogenase A (SDHA) mutations are associated with the highest rates of metastasis (30% to 50%)

Answer 61

False, succinate dehydrogenase B (SDHB)

Question 62

Hereditary head and neck paragangliomas are associated with____ mutations, occur at younger ages, are often multiple, and can be malignant

Answer 62

succinate dehydrogenase gene mutations

Question 63

are these glands mostly serous, mucinous, or mixed? parotid submandibular sublingual

Answer 63

parotid - serous submandibular - mixed, mostly serous sublingual - mixed, mostly mucous

Question 64

most prevalent form of sialadenitis

Answer 64

mucocele

Question 65

most common viral cause of sialadenitis

Answer 65

mumps

Question 66

most often found on the lower lip as the result of trauma, occur at all ages, and present as fluctuant lower lip swellings with a blue translucent hue. They are pseudocysts lined by inflammatory granulation tissue or fibrous connective tissue and filled with mucin and inflammatory cells, particularly macrophages

Answer 66

mucocele

Question 67

____ are epithelial-lined cysts that arise when the duct of the sublingual gland has been damaged

Answer 67

ranula

Question 68

T/F the malignant potential of salivary gland tumors is inversely proportional to gland size, with smaller glands harboring greater numbers of cancers

Answer 68

True

Question 69

the most common salivary gland neoplasm

Answer 69

Pleomorphic adenoma (PA)

Question 70

PA are most commonly seen in the _____ gland

Answer 70

parotid

Question 71

Many cases of PA are associated with chromosomal rearrangements that induce overexpression of

Answer 71

PLAG1

Question 72

In PA cases that lack PLAG overexpression mutations of ____ are usually present

Answer 72

HMGA2

Question 73

The dominant histologic feature of this salivary tumor is morphologic heterogeneity. The epithelial elements resembling ductal cells or myoepithelial cells are arranged as ducts, acini, irregular tubules, strands, or sheets of cells. and are typically dispersed within a background of loose myxoid and hyaline tissue containing islands of cartilage and, rarely, foci of bone

Answer 73

pleomorphic adenoma

Question 74

second most common salivary gland neoplasm that arises almost exclusively in the parotid gland

Answer 74

warthin tumor

Question 75

risk for development of a warthin tumor are increased by 8 fold in

Answer 75

smokers

Question 76

round to oval encapsulated mass with a lining that is composed of a double layer of oncocytic cells; the innermost layer is columnar, while cuboidal cells occupy the outer layer, usually in a lymphoid stroma

Answer 76

warthin tumor

Question 77

most common primary malignant tumor of salivary glands

Answer 77

Mucoepidermoid carcinoma

Question 78

fusion protein that is believed to play a key role in the genesis of mucoepidermoid carcinoma

Answer 78

CRTC1-MAML2

Question 79

this salivary tumor demonstrates cords, sheets, or cystic configurations of squamous, mucous, or intermediate cells that have squamous features and small to large mucus-filled vacuoles

Answer 79

mucoepidermoid carcinoma

Question 80

small, poorly encapsulated, infiltrative, gray-pink lesions composed of small cells with dark, compact nuclei and scant cytoplasm.The tumor cells are organized in a cribriform growth pattern that resembles swiss cheese.The spaces between the tumor cells are often filled with hyaline material thought to represent excess basement membrane

Answer 80

adenoid cystic carcinoma

Question 81

gene rearrangement present in a subset of adenoid cystic carcinomas

Answer 81

MYB-NFIB

Question 82

T/F Adenoid cystic carcinomas arising in the parotid tend to have a poorer prognosis than those arising in the minor salivary glands

Answer 82

False, poorer prognosis if in minor salivary glands

Question 83

The cytoplasm of cells of acinic cell carcinomas contain purple granules called

Answer 83

zymogen granules

Question 84

Eosinophilic, granular to vacuolated cytoplasm with no zymogen granules. Tubular, papillary and cystic growth. Sometimes has distinctive eosinophilic secretions in lumina.

Answer 84

secretory carcinoma

Question 85

fusion gene associated with secretory carcinoma

Answer 85

ETV6-NTRK3

Question 86

Solid, trabecular, or tubular growth Perpendicular basal cells on outside of nests Epithelial cells on inside of nests pleomorphic adenoma without the stroma

Answer 86

basal cell adenoma / monomorphic adenoma

Question 87

translocations common in acinic cell carcinomas

Answer 87

NR4A3 translocations