Flashcards
Pathophysiology X (100 Flash cards)
Cards in this deck (100)
- 1OsteoporosisWeak bones
Decrease in serum estrogen and calcium
older females - 2OsteosarcomaNew bone is formed
Pain, swelling, paristhesia
PDL invasion results in uniform widening
Mean age is 35; most common primary malignancy of bone in persons less than 25 yo
mandible >Max
Early lucency then opacity; trabaculae changes - 3Paget's DiseaseAdults, older than 50
Jaw: symmetrical enlargerment, dentures become too tight, diastemas and hypercemtosis may appear
Jaw fracture and osteomyelitis are late complications secondary to bone sclerosis
Lots of osteoblast and multinuc osteoclasts
Reversal line with mosaic pattern
Radographically: cotton wool appearance - 4Parulis (gum boil)Oral lesion characterized by a soft erythematous papule (red-yellow spot) that develops on the alveolar process in association with a non-vital tooth and accompanying dental abscess.
Clinical evidence of a draining fistula
Made up of inflamed granulation tissue. - 5Pemphigus VulcarisAutoimmune
*AB are directed against desmosomal protein*
Manifests as multple, painful ulcers preceded by bullae that form w/in the eptithlium
Coomon sites: lips, palate gingiva
Positive Nikolsky sign
Tx: corticosteroids or immunosuppresants - 6Periapical Cemento-ossesous DysplasiaAppices of one or more mand anterior
No sym, teeth are vital
Mid aged black women
Starts as circumscribed lucency, which gradually becomes opaque
No tx - 7Periapical/radicular Cystnonvital tooth, at apex
Most common odontogenic
Acute-abscess; chronic=granuloma
Later becomes a cyst
xray: periapical lucency w/ thin radiopque line - 8Peripheral Fibromafibrous hyperplaisa of the gingiva
Caused by trauma or chronic hyperplasia - 9Peripheral giant Cell granulomaSimilar in apperance to pyogenic granuloma but more blue
Found usually anterior to permanant molars (alveolar ridge)
Treatment with excision - 10Peutz-Jeghers SyndromeOral and paraoral: pigmented macules (brown) on lips, tongue buccal mucosa, vermilion and skin of lip
Intestinal polyposis - 11Physiologic pigmentation (racial pigmentation)Darkens w/ time; present most of a person's lifetime
Af. Amer: upper or lower lip vermillion, attached gingiva, tongue, buccal mucosa
series of splotchy brown macules - 12Pleomorphic adenomaMost common benign salivary gland tumor
Mix of more than one cell type ( epithelial and ct)
Palate is most common site for minor gland lesions - 13Primary herpetic gingivostomatitisHSV type 1
usually affects children younger than 6
Inflamed, enlarged marginal gingiva; gingival bleeding
pin point vesicles -> ulcers throughout the mouth and lips w/ sig pain
Malise
low grade fever
sore throat, lymphadenopathy
doesnt want to drink water - 14Proliferative Periostitis (Garre's)Form of chronic osteomyelitis that involves the periosteum
Usually assoc w carious molar in children
Visible swelling
Common in inferior border of posterior mandible
Lucent or mottled radiographic pattern plus concentric periosteal layering (onion skin pattern)- bands of radiopaque lines that parallel cortical surface
Tx: w tooth removal and AB - 15Pyogenic granulomaUsually on gingiva at the interdental papilla
not paniful
Grows very fast
proliferative
not a fibroma
Pregnancy turmor
P. Intermedia - 16RanulaMucous rentention cyst
Submucosal nodule resulting from blockage of salivary duct by salivary stone (sialolith)
Looks like frogs belly
Bluish
FOM
history of recurrence
Mucin will yield viscous aspirate - 17Recurrent Aphthous StomatitisSeen on moveable mucosa: uvula, labial, buccal
Recurrent type (minor and major) is *not preceded by vesicles*, white/gray with red halo
Minor heals 7-14 days without scarring, not on gingiva or hard palate, 8-10 mm
Major has scarring, can last up to 6 weeks , exceeds 1 cm
Ass. with certain HLA type
Cant treat, but can manage it with corticosteroids
Herpetiform: many small crops 2-3 mm vesicles clustered together - 18Recurrent Herpes Simplex labalisFrom nerve cells of trigeminal
ulcers on lips around skin/ vermillion
Can be on eye
avoid aspirin -> reyes syndrome and corticosterioids for eyes - 19Recurrent Intraoral HerpesHSV I
Intraoral: hard palate and gingiva, vesicles ->ulcers
triggered: stress, trauma, UV exposure
More likely in Immunocompromise - 20SarcoidosisPredominately pulmonary disease, but other organs may be affected: salivary glands and mucosa
Bilateral hilar lymphadenopathy (chest x-ray)
Cutaneous lesions
tx: corticosteriods and immunomod drugs - 21Scarlet FeverWhite coating on top of strawberry tongue
Swollen hyperplastic fungiform papillae
+ strep throat symptoms -treat w/pencillin - 22Schwannoma (neurilemoma)Benign neoplasm of Schwann's cells
Displaces the nerve but doesn't envelope it
tongue favored
solitary; not syndrome- related
Related to neurofibromatosis type 2 - 23SclerodermaAutoimmune, multiorgan disease, affects mainly women
*Fibrous of tissue* leads to organ dysfunction
Leads to restriction of orifice (trismus), uniform widening of the of the periodontal membrane, bony resorption of posterior margin of the mandibular ramus - 24Sjogren's SyndromeAutoimmune disease that affects exocrine
Dry eyes (keratoconjunctivits sicca), xerostomia
Partotid swelling
Elderly women
Secondary seen w/ other disease: lupus rhumatoid artrithis - 25Squamous Cell CarcinomaMay manifest as chronic, non painful, indurated firm, nonhealing ulcer, red or white patch, or mass
More likely in males
HIgh risk sites: FOM lateral of tongue
Least likely site: hard palate
Metastasis most likely to a lymph node
Radiographic: poorly defined lucencies w/o reactive sclertotic border - 26Squamous PapillomaBenign
White to white pink papule/ nodule
rough surface (cauliflower)
Found on facial/lingual gingiva, soft/hard palate and tongue
HPV 6 & 11 - 27Stafne bone defectDevelopmental
More in males
Asymtomatic
Teeth vital
Diagnostic well demarcated radiolucency of the mandible secondary to invagination of the lingual surface of the jaw
located in the posterior mandible below the mandibular canal - 28Stevens-Jonhson SyndromeErythema Multiform Major
Triggered by drugs
Affects eyes (conjunctiva), mouth (labial mucosa, tongue, etc.) genitalia - 29Systemic Lupus ErythmatosusAutoimmune
young adult female
butterfly rash
leads to endocarditis and glomerulonephritis
discoid/chronic (skin and oral mucosa) type v. systemic/acute (butterfly rash and organ involvement) - 30Temporomandibular disorderDeviation of jaw toward painful side upon opening
TMJ disc moves anterior and medially due to contraction of the lateral pterygoid muscle
Popping clicking indicate internal derangement with reduction
reduce opening to approx 45 mm
will get neuritis ov VII cranail nerve - 31Traumatic Bone CystRAdiolucent *dead space* (no epithelial lining) in the mandible of teenages
Some (not all)associated with jaw trauma
Undogoes sponataneous healing without treatment following exploatory surgery
Pseudocyst
Radiography: scalloped margino - 32Traumatic NeuromaTransected nerve due to trauma w/ scar tissue
leading to a painful/tender, firm nodule
Likely seen near mental foramen and tongue - 33Treacher Collins SyndromeUnderdeveloped facial bones
Ears malformed/ absent
Big mouth and small jaw (micrognathia)
Droopy eyes - 34Trigeminal NeuralgiaAge of onset usually older than 35
Trigger points - 35TuberculosisCaused by Mycobacterium tuberculosis
Oral nonhealing chronic ulcers (ulcers mimick cancer on tongue) follow lung infection
Caseating granulomas w/ multinucleated giant cells on chest- chest xray
Multidrug therapy: isoniazid, rifampin, ethambutol - 36Turner Toothhypoplasia of perm tooth
Usually just affects one tooth
due to local trauma/ infection of the developing tooth bud from the primary tooth - 37VaricesLingual and lip
Dilated veins- blue
Seen typically in the elderly
Lip varices may thrombose and subsequently calcify (i.e. phlebolith) - 38Verrucous CarcinomaWell-differentiated, slow growing form of carcinoma that infreq metastasizes
Tobacco and HPV 16 & 18 have etiologic role
Exhibits broad base verruciform architecture; lg elevated, papillary
Most common site is buccal vestibule - 39Verrucous leukoplakiaHigh risk leukoplakia. Lesions start flat but become wart-like. High risk of transformation to carcinoma.
- 40Warthin's tumorOncocytic tumor that also contains lyphoid tissue
Usually found in the partotid of older men
Occasionally bilateral
Not in the oral cavity - 41White Sponge NevusMutation of Keratin 4 or 13
Auto dominant; genodermatosis
Aysm mod extensive white folds of tissue white spongy-appearing
buccal mucosa bilaterally
No tx necessary
No eye involvement - 42XerostomiaDry mouth
Can result in retrograde infection of the glands, baldish, inflamed tongue
Saliva sub or sips of water may be needed - 43acquired melanocytic nevus -type?-Junctional type: most likely to malignant transformation (melanoma)
-Intramucosal type: most common oral type. calledintradermal type on skin
-Compound type - 44Actinic Cheilitis Tx:?Cause UV ilight (esp UVB 2900-3000nm)
-Lower lip shows epithelial atrophy and focal keratosis
Upper lip min affected
May progress to SCC (premaglignant)
Junction of lip and lip vermillion and skin become indistinct
-loss of vermillion border
- Tx: 5-fluoracil, imquimide - 45Adenoid cystic carcinomahigh-grade salivary malignancy
palate most common site
Cribriform/ swiss cheese microscopic pattern
spreads through perineural spaces - 46Adenomatoid odontogenic tumorUncommon to rare odontogenic hamartoma that contains epithelial duct-like spaces and calcified enameloid material
- Young person (child / teenager)
- 2/3 female 2/3 anterior 2/3 maxilla 2/3 over impacted crown
- Snow flake calcifications in the radiolucency surronding the crown and a portion of the impacted tooth's root
- swiss cheese
- Tx: simple enucleation - 47Allergic Gingivitis- due to flavoring agent in toothpaste, candies, and chewing gums (cinnamon)
- 48Ameloblastic fibroma- Children and teens
- mand molar
unilocular/ multilocular radiolucnecy
- slight pain and swelling, not aggressive
- ameloblastic fibro-odontoma: similar except for odontoma component - 49Ameloblastoma- 34
- histology: reverse polarization of the nuclei of the tail, columnar calles of periphery
Benign but aggressive tumor w sig recurrence
Most common in post mand but can be in the ant
Most common true odontogenic tumor
multilocular radiolucency (soap bubble)
often assoc w/ impacted tooth
reverse polarization - 50Amelogenesis Imperfecta- Affects enamel
Effects all teeth
- Enamel is usually yellow in color, reduced in vol and pitted
- dentin and pulp and shapes of root and crown are nomral
Teeth are soft, there is no increase in caries rate
tx: Full crown coverage
- X-ray: open contact
-odontodysplasia: ghost teeth, non-hereditary
- Bell stage - 51Ankyloglossia-Congenital abnormality
-Short thick frenum
tongue-tied - 52Antral Pseudocyst (Mucous Retention Pseudocyst)-Asymptomatic
-No treatment necessary
-Radiographic: slight radiopaque, dome- shape, emanating from floor of maxillary sinus
-Inverted Y - 53Aspirin BurnWhite= coagulative necrosis of the surface, not hyperkeratosis
White rubs off with difficulty, hyperkeratosis does not wipe off - 54Auriculotemporal syndrome (Frey syndrome)-Often after parotid gland surgery
-Sweating of unilateral facial skin just prior to eating (strong salivation)
-Does not affect cranial nerve VI (rather than V)
-Starch Iodine test
- Auriculotemporal nerve - 55Basal Cell Carcinoma- Low grade skin cancer (lip), rarely metasize (benign)
-Usually in sun damage skin, very rare in mucosa
Manifests as nonhealing, indurated chronic ulcer, raised margins
-Begins as pearly papule
- telangiectasia
- nose - 56Bell's Palsy- hit Parotid gland during IA
- idiopathic
- 7th nerve paralysis-> unilateral lip droop at corner, inability to close or wink eye lid
- lasts usually less than one month - 57Calcifying Odontogenic cyst (Gorlin Cyst) - location? - age? - Micro?-Anterior areas of the jaws.
-Second to third decades but can be seen at almost any age.
-XRay: unilocular radiolucency .
-1/3 of cases, an impacted tooth is involved.
-Microscopically, there are many cells that are described as "GHOST CELLS", enlarged eosinophilic epithelial cells without nuclei.
← - 58Candidiasis Pseudomembranous- opportunistic infection (affects immunocompromise, immature immune sys, use of AB)
- hyphae, spores (cytology smear)
- *white, wipeable patch* (cottage cheese) w/ *red underlying base*
- palate and buccal mucosa
- "thrush" - 59Cavernous Sinus Thrombosis- can arise from an infection
- subcutaneous abscess of the upper lip
- intrabony abscess of an anterior maxillary tooth
- valveless facial veins - 60Central Giant Cell Granuloma- intrabony
- radiolucency, sometimes loculated
- *teenagers, female*
- anterior mandible favored
- benign
- histology: fibroblasts and mutinucleated giant cells
- *brown tumor of hyperparathyroidism*: no effect on saliva production. bone destruction secondary to chronic renal disease
- TX: excision or calcitonin - 61Cervical emphysema-Introduction of air into oral soft tiss w resulting sudden painless swelling and crepitance
ex: air/water syringe - 62Cheek Nibbling- Morsicatio Buccarum
- buccal mucosa
- White, rough, tissue tags above and below the occlusal plane
- Linea alba
- other sites: lip and tongue - 63Cheilitis Glandularis-Mucous minor salivary glands of lips are inflammed
-Mucus secretion
-Premag ->SCC - 64Cherubism- auto dom cond seen in jaws of children (cease after childhood)
- symmetrical swelling of one or both jaws
- Stabilizes after puberty
- Multilocular radiolucences (soap bubble) apperance
- perivascular collagen puffing
- premature shedding of prim. teeth but delated eruption of permanent.
- No tx - 65Chronic osteomyelitis-Chronic inflammation of bone and bone marrow of the jaws
-Mild to moderate pain and possibly an exudate
-lucent or mottled radiographic pattern
tx: AB and sequesrectomy
- caused by Staph Aureus
- Pain, malaise, fever
-when pain tissue die because of loss blood supply - 66Cicatricial (mucous membrane) Pemphigoid- autoimmune
- antibody reaction at the epithelial-connective tissue (BMZ)
- vesculoerosive, ulcer
- subepithelial split at the basement membrane
- seen greater in *middle aged women*
- seen in skin and eyes
- subepithelial - 67Cleft palate-lack of fusion between palatal shelves
-Approx 1 in 2000 births
-Between lat incisor and canine
-Xray: lucent line in max occlusal film
-Cleft lip more common in male
- Cleft palate more common in female - 68Cleidocranial dysplasia-Delayed tooth eruption
-Retention of primary teeth
-Supernumerary teeth
hypoplastic/aplastic clavicles
cranial bossing
Large head
hypertelorism
-shoulder moves in, high palate - 69Condensing osteitis (sclerosing osteitis)- pulpitis, non vital tooth
- posterior mandibular tooth (1st molar)
Bone sclerosis (opacity) resulting from low-grade inflammation, usually secondary to chronic pulpitis, nonvital
opacity
- does not connect with root
Asymtomatic and found on routine examination
Tx: determining and addressing the cause, and possibly endo
- differ cementoblastoma: does not connect wth root (can see PDL) - 70Condylar hyperplasia-Irregular, elongated condyle
-Chin deviates away from affected side upon closure - 71Condyloma Acuminatum- veneral wart (STD)
- HPV 6,11
- Ventral tongue- floor of mouth
- Papillary/Cauliflower like - 72Crest syndrome- mild form of Scleroderma
- Tx: steroids
- C: Calcinosis cutis
- R: Raynaud's phenomenon
- E: Esophageal dysfunction
- S: Sclerodactyly (fingers)
- T: Telangiectasias of face, vermillion border of lip and tongue - 73Crohn's Disease-Systemic disease
-Granulomatous inflammation of GI tract
-Rectal bleeding
-Granulomatous gingivitis
-Minor aphthae - 74Dens-in-dente (dens invagnatus) location most common teeth?-Most often found in anterior jaw, esp max lateral
-invagination of inner enamel epithelium
-talon cusp: evaginatus, not inva.. - 75Dentigerous Cyst-lucency around the crown of an impacted tooth
-Third molar and canines most often affected
-Most common site: post mand
-Pericoronal radioluncency attached at CEJ of unerrupted tooth
-Epithelial lining from reduced enamel epithelium has potential to transform into ameloblastoma - 76Dentin Dysplasia-All teeth affected
roots are extremely short "rootless"
-Roots are surrounded by radiolucent granulomas or cysts that may contribute to tooth loss
-Obliterated pulps but may have residual spaces (chevrons)
-not a good candidate for restoration
-draining fistula
-mishapen teeth - 77Dentinogenesis imperfecta- All teeth are affected
teeth have yellow or opalescent color-blue/grey
extreme occ wear secondary to enamel fracture (poor dentin support)
- BWXs and PAs: short roots, bell shaped crowns w constricted cervical region and obliterated pulps and root canals
- Maybe be seen w osteogenesis imperfecta:blue sclera, multple bone fractures
tx: full crown coverage
- Type 1: osteogenesis imperfecta
- Type 2: Most common, dentin abnormality with no bone involvement
- Type 3: Brandywin type: dentin abnormalities, more variation, multiple pulp exposure - 78Denture sore mouth- chronic candidiasis
- red palate
- due to patient not removing denture
- TX: rinse mouth and soak denture in antifungal (Nystatin) - 79Denture-induced fibrous hyperplasiaFibrous hyperplasia assoc w ill fitting dentures
Usually seen in anterior labial vestibles
Papillary hyperplasia is an ex
No malignant potential - 80Dermoid cyst-Mass in midline floor of mouth if above mylohyoid muscle
-Mass in upper neck if below mylohyoid muscle
-Slightly compressible "doughy: - 81Eagle Syndrome- Elongated and/or calcification of the stylohyoid ligament
- Head and neck pain is elicited by chewing, yawning, opening mouth - 82Ectodermal (hypohydrotic) Dysplasia common type?-Hypodontia or anodontia-> alveolar bone deficiency
-hypohidrotic- common type : lack of skin appendages and hair + heat intolerance
- no sweat gland
- X-linked
- Retain primary teeth, conical shaped anterior teeth
-sparse hair - 83Eosinophilic GranulomaType of Langerhans Disease
Chronic localized form
solitary/ multiple bone lesions
young adults
- most benign form
- cupped out RL resembling periodontal disease/PA lesion, gingle/multiple well-circumscribed radiolucencies - 84Epulis Fissuratum -Tx? -similar to?-hyperplastic tissue reaction caused by an ill-fitting or overextended flange in a denture
-Tx: adjust denture border and use tissue conditioner; surgery is indicated if inadequate response
- most similar to Fibroma - 85Erythema Multiforme- Self-limiting hypersensitivity rxn that affects skin or mucosa or both
- Minor form assoc w secondary herpes simplex hypersensitivity
- Major form (stevens-johnson syndrome) often triggered by drugs
- Young adult males
- Crusted, bleeding vesicles, ulcers of vermilion of lips; intraoral sites excluding gingiva
"target, iris, or bulls-eye lesions" of the hands and feet
- also positive Nikolsky - 86ErythroplakiaRed plaque that does not wipe off
High risk, most represent dysplasia or malignancy to carcinoma
Biopsy mandatory
icisional biopsy
90% chance of being dysplasia - 87Extravasated BloodClinical - spontaneous resolve
Purpura: generalized term
Petechia: pinpoint bleeding
Ecchymosis: large area
Hematoma: large: elevated - 88Fibroma- *most common connective tissue tumor*
- reactive, not true tumor
- slow growing
- hyperplasia, not neoplasia
- firm, smooth, pink elevated papule/nodule
- common site: tongue - 89Fibrous dysplasia- Involves entire half of jaw (bilateral)
- CC: teeth do not fit
Painless swelling (cease at 20)
- affects children and typically stops growing after puberty
-RAdiographic pattern: diffuse opacity (groud-glass apperance)
McCune-Albright syndrome consists of polyostotic fibrous dysplasia; cutaneous cafe au lait macules and endocrine abnormalities, esp precocious puberty
Tx: surgical recontouring for cosmetic apperance after age 20 when stabilized - 90Florid Osseous DysplasiaExuberant form of peripical cemento ossesous dysplasia that may involve the jaw
-Multiquadrant (4 quadrants)
-Fibro-osseous intraboy lesion
-Hard product produced is avascular
- likely complication: secondary osteomyelitis
Xray: radiolucent and radiopaque
No tx - 91Focal fibrous hyperplasiaCaused by trauma or chronic irritiation
A small, solid mass on the tongue, lower lip, or the oral mucosa. - 92Fordyce granules- ectopic sebaceous glands
- enlarged papules
- seen on buccal and labial mucosa - 93Gardner Syndrome- Auto dominant
- consists of intestinal polyps, facial osteomas (epidermoid cysts), skin lesions, impacted permanent and sumpernumerary teeth and odontomas
intestinal polyps high rate of malignancy conversion - 94Garre's -age? -common location? -Xray? (similar)-Proliferative Periostitis
-Form of chronic osteomyelitis that involves the periosteum
-Usually assoc w carious molar in children
-Visible swelling
-Common in inferior border of posterior mandible
-Lucent or mottled radiographic pattern plus concentric periosteal layering (onion skin pattern)- bands of radiopaque lines that parallel cortical surface
-Tx: w tooth removal and AB
-onion skin: Garre's, Erwing sarcoma - 95Generalized gingival hyperplasia- fibrous hyperplasia caused by local factors and modified by systemic conditions
- certain drugs: Phenytoin/ Ca channel blockers may contribute to gingival hyperplasia - 96Gingival cyst of the Adult - common location?-Arises from the rest cells of the dental lamina.
-Common in the mandible near the anteriors, canines and premolars.
-Middle-aged adults are more likely to be affected.
-Swelling, elevated, fluid containing vesicle on attached facial gingiva or interdental papilla.
-soft tissue counterpart of the developmental lateral periodontal cyst. - 97Gingival hyperplasia - drugs- Benign
Neoplasm of Schwann cells
- Pseudoepithlimatous hyperplasia (microscopically mimics squamous cell carcinoma)
- Most commonly seen on dorsum of tongue
occurs on gingiva only as pedunculted mass
surgerical excision, no recurrence
- granular cell: cytoplasm - 98Hand-Schuller- Christian diseaseLangerhans cell disease
Chronic dissminated form
Triad: diabetes insipus, Exophalmos, Bone lesions
Chronic - 99Heavy Metal systemic IntoxicationLead line: blue line that parallels free marginal gingiva
- 100Hemangioma-Hamartoma
-Red to blue elevated lesions
-Blanches, compressible
-Collection of sm or lg vessels filled w red blood cells
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- Praxis Flashcards: PATHOLOGY Flashcards on Pathophysiology X (100 Flash cards), created by ACAPUN INSTITUTE on 09/07/2021.
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- ACAPUN INSTITUTE · Jul 2021
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- Jul 10, 2021
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