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81 Cards in this Set
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Gingival problems that look like lichen planus (other DD, but focus on the reddened tissue
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ELP
BMMO PV Toothpaste Idiosyncrasy |
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BMMP aka ?
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Cycatricial pemphigoid or sub epithelial cleft
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Least common of the Lichen planus appearance
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Pemphigus vulgaris (also most serious)
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PV starts where?
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oral cavity--> massive skin involvement
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PV unique characteristics?
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Intra epithelial vesicle formation with Zank cells
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What is toothpast idiosyncrasy common with?
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plaque reduction, flavored, or whitening toothpastes
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Lichen planus located on what part of the mouth?
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Gingiva (can strictly be here in women). can be anywhere!
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LP is difficult to distinguish from?
How differentiate them? |
BMMP
History (b/c no symptoms) |
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LP treatment?
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steroids: beta-methazone, topical (not systemic b/c it kills all living things, just like Monday lectures)
if use systemic, use burst therapy (10 days or less) |
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LP that is white?
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Erosive LP
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To Diagnose LP cannot use just____?
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histiology b/c it is non specific with necrotic cells
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To Dx LP can use what and how it works?
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Direct immunofluorescene: does something special, basement membrane and lights up to to anit fibrinogen
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BMMP differs from LP because (clinical difference)
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limited to gingiva.
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BMMP clinical signs?
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Ulceration, red gingiva, cyclicly gets worse/better,
OCULAR involvement |
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How diagnose?
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Immunofluorescence: stays positive for 4 other IG that LP does not, but will not stain + for antifibrinogen
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Pemphigus has
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sluffing of skin
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Diagnose with?
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indirect IF: looks like monkey serum (what ever that means). also has tissue and circulating antibodies that differ from BMMP and LP.
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in early stages pemphigus does
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cycles better/worse
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Pemphigus location
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any oral location and can get to skin--> 3rd degree like burns-->death.
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Palatal lesions DD
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1. Abscess, 2. Fibroma, 3. Salivay gland tumor, 4. KS, 5. Nasopalitine duct cyst, 6. Minor salivay gland cyst
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how rule out Palatal abscess?
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if it is in the midline
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fibroma looks like?
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leaf
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KS originally found in?
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Old Jewish men.
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Mucocole most commonly found in?
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Posterior palate
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Salivary duct cyst most commonly found in/
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posterior palate
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Adenocystic carcinoma usually has _____ involvement?
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neural
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Pleomorphic adenoma origin/
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different tissues from different origins
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KS can affect?
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skin, oral cavity and many other sites
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Oral hairy leukoplakia is caused by?
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EBV
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3 homosexual diseases from that original study done somewhere?
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KS, Neumocystis pnemonia, oral candidiasis (these came together to be known as the AIDS syndrome).
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KS and oral hairy luekoplakia found where? color?
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side of tongue as white lesion
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White lesions DD
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1. genodermatosis
Leukoplakias 3. Dermatoses Inflamations |
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Genodermatosis origin?
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genetic
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Genodermatosis how diagnose?
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stretch it out and disappears (10-90% of pts... just to give you a specific stat to go with)
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Leukoplakias are caused by
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sun, smoke, tobacco
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Dermatosis associated with what disease?
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Lupus
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Color of candidiasis?
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white, red or ANYTHING
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Types of gingival enlargment (DD)
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1. Hyperplastic gingiva, 2. drug-related hyperplasia, 3. Gingivalfibromatosis
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what drugs can cause hyperplasia of the gingiva?
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dylantin , Ca channel blockers, Cyclosporin
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Most pts with gingival inflammation also have?
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bad oral hygiene
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Characteristic of gingival fibromatosis?
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teeth are completely covered, usually in the posterior ( but this can happen to edentulous pt)
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Tx. of gingival fibromatosis?
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chop it off every 10 years (how long it takes to cover teeth again)... I mean chop-it-off-ectomy for more $$$!
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Wegeners(?) is a
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lymphoma causing gingival hyperplasia (very uncommon, will never encounter, but you must know what it is so that when you are ectomying it you can know to make lateral instead of horizontal incisions)
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Hyperplasia can be caused by lack of ___ vitamin? who gets this?
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Pirates. ARRRRRR
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Leukemia has a worse prognosis in (adults or children)
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adults
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If you have a mixed lesion on x-ray, how do you know if it is neoplastic or not?
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if it is expanding then it is neoplatic
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DD for Mixed lesion (8)?
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1. Developing tooth, 2. Cemento-osseous dysplasia (PA, focal, Florid), 3. Odontoma, 4. Central ossifying fibroma, 5. CEOT, 6. COC (gorlin), 7.Ostioid, 8. Cementoblastoma,
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Cemento-osseous dysplasia does/does not have expansion?
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No
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Most common RO mass over tooth is ?
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odontoma
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COF does/does not have expansion?
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does!
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CEOT looks like?
aka? |
driven snow or fine multilocularity (like lichen planus on x-ray)
odontogenic tumor, pinborg, |
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COC aka?
occurs with____? |
gorlin
odontoma (20%) |
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Ostioid osteoma/osteoblastoma difference?
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Ostioid responds to asparin, osteoblastoma does not. and something about size, like 2cm, but I did not get which is smaller and which is bigger
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Cementoblastoma location?
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1Molar or PMs
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does the Pinborg have intracellular dysplasting? atypical mytotic figures?
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no.
no. |
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What does the pinborg tumor have?
how know it is there? |
Amyloid (a pritein molecule) that has unknown structure
special stain (apple green with polarized light) |
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How differentiate all these multilocular z-rays?
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histo! Yeaaahhhhh!
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Something about listigang rings
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Chemists name, crystalization, most not malignant, and are insignificant ( but very important to know)
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is scleraderma a problem in Ok?
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no, it is relatively rare, 1/several 100k except in Choctaw where 1/5 have it due to some FRENCH CANADIAN trappers (it is always the french or the canadian's fault, darn them) French have bad genes
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If widening PDL, mobile teeth, DD?
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Must keep these 3:
Scleroderma, Ostiosercoma, Chondrosarcoma (unless it is just one side of tooth???) |
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how differentiate between PA cemento-dysplasia and abcess?
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Abcess is usually 1 tooth, non vital tooth (can have pain due to expansion)
PA is vital, assymptomatic |
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How does focal differ from other cemento-dysplasias?
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focal is not associated with the teeth, located post (PA is anterior), can overlap teeth, can be bilateral
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Who gets focal Cemento-dysplasias?
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black women
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Herpetic gingivostomatitis? primary vs secondary?
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Secondary has symptoms
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How do the herpetic gingivostomatitis symptoms differ from the zoster symptoms?
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Zoster is moer systemic
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Herpangina caused by?
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coxsaki viru (intra viruses), all given number instead of names
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Hand-foot-and-mouth disease can be a ___virus family
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intra (coxaki) (same strain can cause herpangina)
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Herpangina lesions locations?
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soft palate and other places
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Primary varicella-zoster is
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chicke pox
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Secondary varicella zoster is
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shingles (or zoster)
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if ulcerations in the mouth and they are only on fixed tissue think
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recurrent herpes
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DD for nonfebrile-associated vesicular eruptions (4)
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1. Recurrent herpes stomatitis (short), 2. Recurrent herpes labialis (short), 3. Contact vesicular stomatitis (non herpes), 4. Impetigo (non herpes)
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what % of pts with primary herpes will get secondary?
if they have herpes 2? |
40-45% with 1-2 breakouts a year
90% wtih recurrences 1-2X mo |
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What % of primary herpes are assymptomatic?
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90%
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What % of pts with primary herpes, if they go out in the su, will get secondary herpes?
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25%
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DD for teeth floating in air (5)?
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1. Chronic periodontitis, 2. diagetic periodontitis, 3. Histocytosis X, 4. Cyclic Neutropenia, 5. Leukemia
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Chronic periodontitis should not be seen in
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young children
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Histocytis X aka?
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Langerhan's histiocytossi
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If histo shows sheet of histiocytes, what do you do to confirm Dx?
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do EM and look for birback granules or tennis raquet stuff (EM not used, now use Immuno peroxidase test)
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prognosis for melanoma?
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less than 6 mo
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Brown, gray or black lesions DD?
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racial pigmentation, Amalgam tattoo, Hairy tongue, Melanocytic, macule/nevus/melanoma, Smokers melanosis
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