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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
ELP
BMMO
PV
Toothpaste Idiosyncrasy
BMMP aka ?
Cycatricial pemphigoid or sub epithelial cleft
Least common of the Lichen planus appearance
Pemphigus vulgaris (also most serious)
PV starts where?
oral cavity--> massive skin involvement
PV unique characteristics?
Intra epithelial vesicle formation with Zank cells
What is toothpast idiosyncrasy common with?
plaque reduction, flavored, or whitening toothpastes
Lichen planus located on what part of the mouth?
Gingiva (can strictly be here in women). can be anywhere!
LP is difficult to distinguish from?

How differentiate them?
BMMP

History (b/c no symptoms)
LP treatment?
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)
LP that is white?
Erosive LP
To Diagnose LP cannot use just____?
histiology b/c it is non specific with necrotic cells
To Dx LP can use what and how it works?
Direct immunofluorescene: does something special, basement membrane and lights up to to anit fibrinogen
BMMP differs from LP because (clinical difference)
limited to gingiva.
BMMP clinical signs?
Ulceration, red gingiva, cyclicly gets worse/better,
OCULAR involvement
How diagnose?
Immunofluorescence: stays positive for 4 other IG that LP does not, but will not stain + for antifibrinogen
Pemphigus has
sluffing of skin
Diagnose with?
indirect IF: looks like monkey serum (what ever that means). also has tissue and circulating antibodies that differ from BMMP and LP.
in early stages pemphigus does
cycles better/worse
Pemphigus location
any oral location and can get to skin--> 3rd degree like burns-->death.
Palatal lesions DD
1. Abscess, 2. Fibroma, 3. Salivay gland tumor, 4. KS, 5. Nasopalitine duct cyst, 6. Minor salivay gland cyst
how rule out Palatal abscess?
if it is in the midline
fibroma looks like?
leaf
KS originally found in?
Old Jewish men.
Mucocole most commonly found in?
Posterior palate
Salivary duct cyst most commonly found in/
posterior palate
Adenocystic carcinoma usually has _____ involvement?
neural
Pleomorphic adenoma origin/
different tissues from different origins
KS can affect?
skin, oral cavity and many other sites
Oral hairy leukoplakia is caused by?
EBV
3 homosexual diseases from that original study done somewhere?
KS, Neumocystis pnemonia, oral candidiasis (these came together to be known as the AIDS syndrome).
KS and oral hairy luekoplakia found where? color?
side of tongue as white lesion
White lesions DD
1. genodermatosis
Leukoplakias
3. Dermatoses
Inflamations
Genodermatosis origin?
genetic
Genodermatosis how diagnose?
stretch it out and disappears (10-90% of pts... just to give you a specific stat to go with)
Leukoplakias are caused by
sun, smoke, tobacco
Dermatosis associated with what disease?
Lupus
Color of candidiasis?
white, red or ANYTHING
Types of gingival enlargment (DD)
1. Hyperplastic gingiva, 2. drug-related hyperplasia, 3. Gingivalfibromatosis
what drugs can cause hyperplasia of the gingiva?
dylantin , Ca channel blockers, Cyclosporin
Most pts with gingival inflammation also have?
bad oral hygiene
Characteristic of gingival fibromatosis?
teeth are completely covered, usually in the posterior ( but this can happen to edentulous pt)
Tx. of gingival fibromatosis?
chop it off every 10 years (how long it takes to cover teeth again)... I mean chop-it-off-ectomy for more $$$!
Wegeners(?) is a
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)
Hyperplasia can be caused by lack of ___ vitamin? who gets this?
Pirates. ARRRRRR
Leukemia has a worse prognosis in (adults or children)
adults
If you have a mixed lesion on x-ray, how do you know if it is neoplastic or not?
if it is expanding then it is neoplatic
DD for Mixed lesion (8)?
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,
Cemento-osseous dysplasia does/does not have expansion?
No
Most common RO mass over tooth is ?
odontoma
COF does/does not have expansion?
does!
CEOT looks like?

aka?
driven snow or fine multilocularity (like lichen planus on x-ray)

odontogenic tumor, pinborg,
COC aka?

occurs with____?
gorlin

odontoma (20%)
Ostioid osteoma/osteoblastoma difference?
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
Cementoblastoma location?
1Molar or PMs
does the Pinborg have intracellular dysplasting? atypical mytotic figures?
no.

no.
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)
How differentiate all these multilocular z-rays?
histo! Yeaaahhhhh!
Something about listigang rings
Chemists name, crystalization, most not malignant, and are insignificant ( but very important to know)
is scleraderma a problem in Ok?
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
If widening PDL, mobile teeth, DD?
Must keep these 3:
Scleroderma, Ostiosercoma, Chondrosarcoma
(unless it is just one side of tooth???)
how differentiate between PA cemento-dysplasia and abcess?
Abcess is usually 1 tooth, non vital tooth (can have pain due to expansion)
PA is vital, assymptomatic
How does focal differ from other cemento-dysplasias?
focal is not associated with the teeth, located post (PA is anterior), can overlap teeth, can be bilateral
Who gets focal Cemento-dysplasias?
black women
Herpetic gingivostomatitis? primary vs secondary?
Secondary has symptoms
How do the herpetic gingivostomatitis symptoms differ from the zoster symptoms?
Zoster is moer systemic
Herpangina caused by?
coxsaki viru (intra viruses), all given number instead of names
Hand-foot-and-mouth disease can be a ___virus family
intra (coxaki) (same strain can cause herpangina)
Herpangina lesions locations?
soft palate and other places
Primary varicella-zoster is
chicke pox
Secondary varicella zoster is
shingles (or zoster)
if ulcerations in the mouth and they are only on fixed tissue think
recurrent herpes
DD for nonfebrile-associated vesicular eruptions (4)
1. Recurrent herpes stomatitis (short), 2. Recurrent herpes labialis (short), 3. Contact vesicular stomatitis (non herpes), 4. Impetigo (non herpes)
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
What % of primary herpes are assymptomatic?
90%
What % of pts with primary herpes, if they go out in the su, will get secondary herpes?
25%
DD for teeth floating in air (5)?
1. Chronic periodontitis, 2. diagetic periodontitis, 3. Histocytosis X, 4. Cyclic Neutropenia, 5. Leukemia
Chronic periodontitis should not be seen in
young children
Histocytis X aka?
Langerhan's histiocytossi
If histo shows sheet of histiocytes, what do you do to confirm Dx?
do EM and look for birback granules or tennis raquet stuff (EM not used, now use Immuno peroxidase test)
prognosis for melanoma?
less than 6 mo
Brown, gray or black lesions DD?
racial pigmentation, Amalgam tattoo, Hairy tongue, Melanocytic, macule/nevus/melanoma, Smokers melanosis