D3 Oral Path Test 2

Front 1

Which age group does chronic hyperplastic pulpitis normally affect?

Back 1

children and young adults

Front 2

Name 3 common causes of pulpal calcifications.

Back 2

age, irritation and trauma

Front 3

Which type of pulpal calcification is due to an epitheliomesenchymal interaction during root formation?

Back 3

denticle

Front 4

Where are denticles often found?

Back 4

root canal or pulp chamber adjacent to furcation area

Front 5

Pulp stones form within which part of the pulp?

Back 5

coronal portion

Front 6

Which type of pulpal calcification forms around a central nidus?

Back 6

pulp stone

Front 7

Where are diffuse linear calcifications found?

Back 7

pulp chamber and canal

Front 8

Name 4 disorders pulpal calcifications can be found with.

Back 8

dentin dysplasia type II, Ehler-Danlos syndrome, pulpal dysplasia, and tumoral calcinosis

Front 9

What is the most common clinical symptom of a periapical granuloma?

Back 9

usually asymptomatic

Front 10

What percent of apical inflammatory lesions become periapical granulomas?

Back 10

75%

Front 11

Name 5 histological features seen with a periapical granuloma.

Back 11

Russell bodies, Pyronine bodies, cholesterol clefts, extravasated blood, and hemosiderin pigmentation

Front 12

What kind of pulpal disease might leave a fibrous scar?

Back 12

periapical granuloma

Front 13

Periapical cysts usually arise from __. Are the more common in the maxilla or mandible?

Back 13

epithelial rests of Malassez; maxilla

Front 14

What is the common cause of residual periapical cysts?

Back 14

periapical inflammatory tissue from not curetting after tooth extraction

Front 15

Periapical cysts are line by __.

Back 15

SSE

Front 16

Name 3 histological features of periapical cysts.

Back 16

Rushton bodies, dystrophic calcifications and cholesterol clefts

Front 17

A periapical abscess starts as __. What are 2 radiographical features?

Back 17

acue apical peridontitis; thickened PDL or lucency

Front 18

Which way will an abscess often perforate and why?

Back 18

buccall bone because it is thinner

Front 19

Which teeth with abscess will drain lingually?

Back 19

max LI, palatal roots of max molars, and mand. 2nd and 3rd molars

Front 20

Which muscle blocks the spread of an abscess towards the facial for posterior teeth?

Back 20

buccinator

Front 21

Signs and symptoms of an abscess diminish within what amount of time if localized?

Back 21

48 hours

Front 22

Ludwig's angina typically arise from infection of which teeth? What % of the time?

Back 22

lower molars; 70%

Front 23

Cavernous sinus thrombosis typically arises from infection of which teeth? It perforates the buccal cortical plate and extends into the __, __, or __ reaching the __.

Back 23

max premolars and molars; maxillary sinus, PP space, or infratemporal fossa; orbit

Front 24

Respiratory obstruction takes place if what space is involved with Ludwig's angina?

Back 24

lateral pharyngeal

Front 25

What is the treatment for Ludwig's angina? Cavernous sinus thrombosis?

Back 25

maintain airway and antibiotic therapy with penicillin preferred and aminoglycosides for resistant strains; high dose antibiotics and corticosteroids along with extraction of offending tooth

Front 26

Is osteomyelitis more common in males or females? Maxilla or mandible?

Back 26

males; mandible

Front 27

What is the treatment for acute osteomyelitis? Chronic?

Back 27

antibiotics and drainage; surgical intervention with IV antibiotics

Front 28

When does diffuse sclerosing osteomyelitis often occur?

Back 28

during adulthood

Front 29

What age group is focal sclerosing osteomyelitis typically seen in? Which teeth?

Back 29

children and young adults; mand. premolars and molars

Front 30

If condensing osteomyelitis persists after resolution of the inflammatory focus it is called a __.

Back 30

bone scar

Front 31

What is the mean age group affected by proliferative periostitis? What is another term for the disease? Which teeth are most often affected?

Back 31

13 years old; Garre's osteomyelitis; mand. premolar and molar

Front 32

The pain from alveolar osteitis is due to __.

Back 32

kinins

Front 33

Signs and symptoms of alveolar osteitis may last how many days? What is the antibiotic of choice for prevention?

Back 33

10 to 14; tetracycline

Front 34

What 2 organisms have long been known to cause NUG? What recent organisms? What is the main predisposing factor? What age group is most affected?

Back 34

fusobacterium nuleatum and berrelia vincentii; prevotella intermedia and pathogen-related oral spirochetes; stress; young and middle aged adults

Front 35

What is the treatment for NUG?

Back 35

debridement, chlorhexidine rinses and antibiotic therapy

Front 36

What are the 3 categories of plasma cell gingivitis? There is a dense plasma cell infiltrate of which mucosal layer? Treatment?

Back 36

allergic, neoplastic and idiopathic; lamina propria; dietary history, allergy testing and topical or sytemic corticosteroids

Front 37

Which 2 periodontal diseases are diagnosed through exclusion?

Back 37

granulomatous gingivitis and aggressive periodontitis

Front 38

Name 2 diseases that must be excluded before diagnosing granulomatous gingivitis? When in life does it mostly occur? What is the common clinical finding?

Back 38

Chrohn's disease and Wegener's granulomatosis; adulthood; red or red-white macules of the interdental papillae

Front 39

What are the 2 final diagnoses that might be reached for granulomatous gingivitis and tell the treatment for each?

Back 39

foreign body granuloma in which the foreign material must be excised or localized orofacial granulomatosis treated by intralesional or systemic corticosteroids

Front 40

Which periodontal disease is most often used as a clinical term to describe a pt. with chronic vesiculoerosive process?

Back 40

desquamative gingivitis

Front 41

Desquamative gingivitis is usually a manifestation of which 2 disease most commonly? Where in the mouth is it limited to? What age and sex group does it mostly affect? Facial or lingual affected more?

Back 41

lichen planus and cicatricial pemphigoid; the gingiva; older than 40 and females; facial

Front 42

What periodontal disease is Nikolsky's sign associated with?

Back 42

desquamative gingivitis

Front 43

What must be done before determining diagnosis of desquamative gingivitis? Treatment?

Back 43

biopsy followed by immunofluorescence; corticosteroids

Front 44

What is most known drug for causing gingival hyperplasia? Name 2 others.

Back 44

phenytoin; calcium channel blockers and cyclosporine

Front 45

Is gingival hyperplasia from phenytoin mostly seen in what age group? Dihydropyridines? Cyclosporine? Enlargement starts after how many months of drug use?

Back 45

young; middle-aged and elderly; any age; 1-3 months

Front 46

Name 4 syndromes gingival fibromatosis is associated with. When in life does it usually begin? Affect maxilla or mandible more? Thicker on facial or palatal? It is correlated with __.

Back 46

hypertrichosis, epilepsy, hypothyroidism, and growth hormone deficiency; before age 20; maxilla; palatal; eruption of teeth

Front 47

What is aggressive periodontitis correlated with? What are the 3 most common pathogens?

Back 47

immunodeficiency; A.a., prevotella intermedia and porphyromonas gingivalis

Front 48

Localized aggressive perio occurs around what age? Localized around which teeth? Give the 3 specific features.

Back 48

11-13 yrs; incisors and first molars; circumpubertal onset, robust serum antibody response, and attachment loss localized to first molars and incisors and involving no more than 2 teeth other than the previously lister

Front 49

Give 4 specific features of generalized aggressive perio?

Back 49

usually affects people under age 30, poor serum antibody response, pronounced destruction of periodntal attachment and alveolar bone, and must affect at least 3 teeth other than incisors and first molars

Front 50

What must be done to confirm diagnosis of aggressive perio? Treatment?

Back 50

biopsy; antibiotic therapy followed by removal of local factors and inflamed periodontal tissues 2 days later, chlorhexidine rinses and a 3 month recall system

Front 51

Papillon-Lefevre syndrome is due to a mutation of __. What is the primary pathogen? Name the 3 most common clinical features. The skin lesions respond to which medicine? Skin symptoms become evident by what age?

Back 51

cathepsin C; A.a.; palmar/plantar keratosis, progressive periodontitis, and "floating teeth" on a radiograph; retinoids; within first 3 years

Front 52

Which 2 bacteria are responsible for impetigo? It is most common in __, __, and __ and arises in areas of __. What is the treatment for the bullous form? Non-bullous form?

Back 52

staph aureus and strep pyogenes; children with poor hygiene, crowded living conditions and hot and humid climates; trauma, topical antibiotics for the non-bullous form and systemic antibiotics for the bullous form;

Front 53

Which disease is described as having vesicles or bullae that rupture leaving an amber or honey colored crust?

Back 53

impetigo

Front 54

What are the 3 choice antibiotics for impetigo?

Back 54

clindamycin, cephalexin and dicloxacillin

Front 55

Strep tonsillitis and pharyngitis are commonly caused by __ but also __, __, and __. The viral infections commonly cause which 3 symptoms? If ot managed correctly there is a risk for __, __, or __.

Back 55

group A beta-hemolytic strep, adeno, entero, and Epstein-Barr viruses; rhinitis, laryngitis, and bronchitis; scarlet fever, rheumatic fever, or glomerulonephritis

Front 56

Group A beta-hemolytic strep are most sensitive to which antibiotic?

Back 56

penicillin

Front 57

What is the predisposer to tonsillolithiasis? Where on a pan will it be seen? What is the treatment if it is superficial? Deeper?

Back 57

recurrent tonsillar inflammation; midway up the ascending ramus; enucleation; surgical excision

Front 58

Syphilis is more common in which gender?

Back 58

males

Front 59

When is the primary stage of syphilis evident? Secondary? How long does the latent period last? What % progress to the tertiary stage?

Back 59

2-3 weeks after inoculation (resolves in 3-8 weeks); 4-10 weeks; 1-30 years; 30%

Front 60

In what stages can a mother transmit syphilis? What stages show oral changes?

Back 60

1st, 2nd and latent; any stage

Front 61

Name 5 common findings seen in secondary syphilis.

Back 61

maculopapular rash, lues maligna, mucous patches, split papules, and condyloma lata

Front 62

Name 4 findings seen in lues maligna.

Back 62

fever, headache, myalgia, and necrotic ulcerations of skin and mouth

Front 63

Name 3 finding seen in tertiary syphilis.

Back 63

gumma formation, leutic glossitis and palatal perforation

Front 64

Name the 3 symptoms seen in Hutchinson's triad.

Back 64

Hutchinson's teeth, interstitial keratitis, and 8th nerve deafness

Front 65

Name 2 serological tests used to diagnose syphilis and what stages they are good for. Fluroescent tests and what stages they are good for.

Back 65

VDRL and RPR are good during the 1st and 2nd stages; FTA-ABS and TPHA are good for life once the chancre develops

Front 66

What is the treatment of choice for syphilis?

Back 66

penicillin followed by tetracycline

Front 67

What % of TB pts progress to active disease and what is it usually due to? What is skin involvement with TB termed? TB from drinking contaminated milk termed?

Back 67

5% due to immunocompromise; lupus vulgaris; scrofula

Front 68

Where are TB oral lesions mostly seen? It is histologically demonstrated through which method?

Back 68

tongue; acid-fast stain

Front 69

Explain the treatment for TB.

Back 69

isoniazid + rifampin for 9 months or isoniazid, rifampin, and pyrazinamide for 2 months followed by isoniazid and rifampin for 4 months; streptomycin and ehtambutol are also used

Front 70

Sulfur granules are common to which disease?

Back 70

actinomycosis

Front 71

What are the 3 most common sites for actinomycosis?

Back 71

cervicofacial, amdominal and thoracic

Front 72

Actinomycosis is associated with __. Which area is most often involved? How are acute infections treated? Chronic?

Back 72

local trauma; area overlying the angle of the mandible; removal of infection followed by 2-3 week course of penicillin; 6 weeks-12 months cycle of penicillin

Front 73

What is the infectious agent is cat scratch disease? How is it diagnosed? Treated?

Back 73

bartonela henselae; a fluroescent antibody test; resolved itself in 4 months but is also sensitive to erythromycin and tetracycline

Front 74

Which sinus relies solely on cilia?

Back 74

maxillary

Front 75

What is the most common predisposing factor for sinusitis? Name 3 causative organisms. How long must it last before being considered chronic?

Back 75

recent upper respiratory viral infection; strep pneumonia, haemophilus influenzae, and moraxella catarrhalis; at least 3 months

Front 76

How is acute sinusitis treated? Chronic?

Back 76

amoxicillin; surgery

Front 77

What % of humans carry candida albicans? What 3 factors determine whether an infection exists?

Back 77

30-50%host immune status, oral mucosal environment, and the virulence of the candida strain involved

Front 78

Acute pseudomembranous candidiasis is also known as __. The white plaques consist of __. What 3 locations is it commonly found?

Back 78

thrush; hyphae; buccal mucosa, palate and tongue

Front 79

Name the 4 forms of the erythematous for of candidiasis.

Back 79

acute atrophic, central papillary atrophy , denture stomatitis and chronic multifocal

Front 80

Acute atrophic erythematous candidiasis is also known as __ and is due to __ and characterized by __ and __.

Back 80

antibiotic sore mouth; broad spectrum antibiotics; burning sensation and loss of filiform papillae on tongue

Front 81

Central papillary atrophy from erythematous candidiasis is also referred to as __ and is due to __. What age group does it affect more?

Back 81

median rhomboid glossitis; chronic candidiasis; children

Front 82

What organism is also commonly involved in chronic multifocal erythematous candidiasis?

Back 82

staph aureus

Front 83

Denture stomatitis is also known as __.

Back 83

chronic atrophic stomatitis

Front 84

Which type of candidiasis cannot be wiped off?

Back 84

chronic hyperplastic form

Front 85

Chronic hyperplastic candidiasis is also known as __. It is often seen where? Which disease can it not be distinguished from?

Back 85

candidal leukoplakia; anterior buccal mucosa; leukoplakia

Front 86

The mucocutaneous form of candidiasis also can develop __ abnormalities and __.

Back 86

endocrine and iron deficiency anemia

Front 87

Candidal hyphae never penetrate deeper than the __ layer.

Back 87

keratin

Front 88

What method is used to diagnose candidiasis?

Back 88

exfoliative cytology

Front 89

Which drugs used to treat candidiasis are not absorbed systemically?

Back 89

nystatin and clotrimazole

Front 90

What is the disadvantage of nystatin and clotrimazole?

Back 90

daily dosing schedule; nystatin also tastes bitter

Front 91

Which drugs used to treat candidiasis requires an acidic stomach environment?

Back 91

ketoconazole

Front 92

Give the disadvantages of ketoconazole. What drugs should it not be given with and why?

Back 92

hepatotoxicity and drug interactions; terfenadine and erythromycin b/c it may cause cardiac arrhythmias

Front 93

What is the drug of choice for life threatening fungal infections?

Back 93

IV amphotericin B

Front 94

What is the disadvantage of amphotericin B?

Back 94

nephrotoxicity

Front 95

Which drug is used to treat histoplasmosis and blastomycosis?

Back 95

itraconazole

Front 96

What is the most common systemic fungal infection in the US?

Back 96

histoplasmosis

Front 97

What are the clinical symptoms of acute histo and how long do they last? Chronic?

Back 97

acute is similar to the flu and lasts about 2 weeks; chronic form is similar to TB

Front 98

What is the treatment for acute histo? Chronic? Disseminated?

Back 98

acute is supportive care; chronic is itraconazole, ketoconazole or amphotericin B; disemminated is IV amphotericin B

Front 99

Which gender does blastomycosis affect more?

Back 99

males

Front 100

The acute form of blasto resembles __ while the chronic resembles __. Which type is more common? The skins lesions resemble __ thereby requiring __ for diagnosis.

Back 100

pneumonia; TB; chronic; squamous cell carcinoma; biopsy

Front 101

Pseuodoepitheliomatous hyperplasia is a common feature of __.

Back 101

blastomycosis

Front 102

What is the most accurate technique for diagnosing blasto?

Back 102

culture

Front 103

What is the most common treatment for blasto? What is the treatment for acute? Chronic?

Back 103

most dont require treatment; acute reuqires amphotericin B; chronic requires itraconazole, ketoconazole or amphotericin B

Front 104

Coccidioidomycosis is endemic to __. It may produce a hypersensitivity reaction termed __ which is a combo of coccidioid and __. Skin lesions are most common in __. Less sever cases are treated with __ and __.

Back 104

desert in SW US; Valley Fever; erythema nodosum; nasolabial foldketoconazole and fluconazole

Front 105

Which organism is found in the gut of a pigeon?

Back 105

cryptocrosis neoformans

Front 106

Cryptococcosis affects __ almost exclusively.

Back 106

immunosuppressed

Front 107

What is the most common life threatening fugal infection in AIDs patients?

Back 107

cryptococcosis

Front 108

Which fungus is unique in having a yeast form in both soil and in humans?

Back 108

crypto

Front 109

Crypto primarily infects the _ but the disseminated form affects the __, __, __ and __.

Back 109

lungs; meninges, skin, bone and prostate gland

Front 110

Yeasts with a clear halo are characteristic of __.

Back 110

crypto

Front 111

Crypto is treated how?

Back 111

amphotericin B plus flucytosine; or fluconazole or itraconazole

Front 112

Name 3 genera of molds seen with zygomycosis. It is most common in which people? What is the form seen in the oral cavity?

Back 112

Absidia, mucor or rhizopus (RAM); severe diabetic and immunocompromised; rhizocerebral zygomycosis

Front 113

Which fungal infection has a preference for invasion of small blood vessel?

Back 113

zygomycosis