Oral Path 2

Front 1

Orthokeratinized where?

Back 1

(Thick - no nuclei)
Hard palate
Gingiva
Alveolar mucosa
Dorsal tongue

Front 2

Parakeratinized

Back 2

(Thick - flattening nuclei) (only keratin in the oral cavity)

Gingiva

Alveolar mucosa

Dorsal Tongue

Front 3

Nonkeratinized (thick)

Back 3

(thick)

Buccal Mucosa

Buccal vestibule

Labial mucosa

Labial Vestibule

Front 4

Nonkeratinized (thin)

Back 4

(thin)

Floor of the mouth

Ventral tongue

Lateral tongue

Soft Palate

Gingival sulcus

Front 5

Hyperplasia

Back 5

thickened from extra numbers of cells

Front 6

Acanthosis

Back 6

thickened from excess spinous layer

Front 7

Pseudoepitheliomatous hyperplasia

Back 7

benign, strong proliferation that looks like it’s invading, i.e. “fake cancer” appearance

Front 8

Acantholysis

Back 8

blister formation within epithelium, e.g. pemphigus

Front 9

Dysplasia

Back 9

atypical, cancer-like cells

Front 10

Dyskeratosis

Back 10

premature keratin formation, i.e. epithelial pearls – sing of precancerous region.

Front 11

Spongiosis

Back 11

degenerative shrinkage of epithelial cells, leaving open spaces between them
-- Basket-weave change (looks like side of woven basket)

Front 12

Bullous

Back 12

blister formation

Front 13

Verruciform

Back 13

long, pointed chevron-like surface projections

Front 14

Hypoplasia

Back 14

thinned from decreased number of cell layers

Front 15

Intracellular edema

Back 15

enlarged cells with clear, pale cytosol

Front 16

Atrophy

Back 16

thinned from decreased size of each cell

Front 17

Exuberant scar tissue

May develop from pyogenic granuloma

may be pigmented (Reactive melanosis of epithelium)

Maybe: frictional keratosis

Back 17

Irritation Fibroma

Front 18

Most common soft tissue mass

(3rd mucosal lesion)

Back 18

Irritation Fibroma

Front 19

Irritation Fibroma treatment

Back 19

full size 6 months

does not go away

conservative excision

Front 20

Irritation Fibroma histology

Back 20

pink - excessive connective tissue

Epithelium often atrophic

Front 21

Grows under denture, flat,

6th most common mucosal lesion

Back 21

Leaf-Shaped Fibroma

Front 22

Not related to trauma, but looks like one.

Back 22

Giant Cell Fibroma

Front 23

Large, stellate (star shaped), subepithelial fibroblasts

Back 23

Giant Cell Fibroma

Front 24

Retrocuspid Papilla

location, what cells?

Back 24

In children,behind MN cuspids, Same giant fibroblasts as giant cell fibroma

Front 25

repeating trauma from denture flange

11th most common oral lesion

Back 25

Epulis Fissuratum

Front 26

papillary hyperplasia along edges

inflammatory papillary hyperplasia

pseudoepitheliomatous hyperplasia

Can look like: Squamous cell carcinoma

Back 26

Epulis Fissuratum

Front 27

which diseases have pseudoepitheliomatous hyperplasia

and look like squamous cell carcinoma on histo

Back 27

Epulis Fissuratum

&

Inflammatory Papillary Hyperplasia

Front 28

hard palate, denture, continues indefinitely, dual treatment

Back 28

Inflammatory Papillary Hyperplasia

Front 29

2/3 -3/4 on gingiva

Young adults

2:1 F

loose MYXOMATOUS connective tissue

Back 29

Oral Focal Mucinosis

Front 30

Pyogenic Granuloma location?

pus?

is it granuloma?

Back 30

Gingiva (75%)

Not an infection, no pus but called “pyogenic”

Not granuloma

Front 31

Lobular (locular) capillary hemangioma (another name)

Back 31

Pyogenic Granuloma

Front 32

When touch bleed easily, fragile

Back 32

Pyogenic Granuloma

Front 33

Pyogenic Granuloma

Special Variants

Back 33

Pregnancy tumor - poor oral hygiene

Epulis granulomatosum - extraction socket

Parulis (gum boil) - dental fistla (can have pus)

Front 34

more acute inflammatory products

Back 34

Neutrophils

Front 35

chronic inflammatory products

Back 35

Lymphocytes

Front 36

Peripheral Ossifying Fibroma, comes from where

Back 36

From periodontal fibers

Front 37

only in Gingival papilla

Back 37

Peripheral Ossifying Fibroma

Front 38

Maybe cementoid globules

Few cementoblasts

Almost no cementocytes

Back 38

Peripheral Ossifying Fibroma

Front 39

May show radiopacities

may spread teeth apart

may occure in edentulous

Back 39

Peripheral Ossifying Fibroma

Front 40

Peripheral Ossifying Fibroma treatment

Back 40

Conservative surgical excision

With curettage of base 15% recurrance

Front 41

Gingiva only (alveolar mucosa) in older

Back 41

Peripheral Giant Cell Granuloma

Front 42

Multinucleated giant cells

Extravasated erythrocytes

Back 42

Peripheral Giant Cell Granuloma

Front 43

Saucerization (cup out underlying bone)

Back 43

Peripheral Giant Cell Granuloma

Front 44

Peripheral Giant Cell Granuloma in socket called

Back 44

epulis granulomatosum

Front 45

Peripheral Giant Cell Granuloma if large or multiple recurring

Back 45

brown tumor of hyperparathyroidism

Front 46

Peripheral Giant Cell Granuloma treatment

Back 46

Conservative surgical excision 10% recur

Front 47

Most common soft tissue tumor in the body, but uncommon in mouth

Back 47

Lipoma

Front 48

Sessile, yellowish mass Very soft, encapsulated

Back 48

Lipoma

Front 49

Benign neoplasm of fat cells, buccal location

Back 49

Lipoma

Front 50

Reactive proliferation of neural tissue -- After nerve injury

Back 50

Traumatic Neuroma

Front 51

Mental foramen location

Back 51

Traumatic Neuroma

Front 52

streaming fascicles of spindle Schwann cells forming Verocay bodies (line against line)

Back 52

Schwannoma

Front 53

most common peripheral nerve tumor

Back 53

Neurofibroma

Front 54

Benign neoplasm of Schwann cells -- & perineural fibroblasts

Back 54

Neurofibroma

Front 55

spindle-shaped cells (C shape nuclei)

Back 55

Neurofibroma

Front 56

NF1 gene on chromosome 17

Back 56

Neurofibromatosis

Front 57

Neurofibromatosis prevelance in oral %

Back 57

oral lesions 75%

Front 58

Café au lait spots (2 diseases)

Back 58

Neurofibromatosis &

Jaffe-Lichtenstein syndrome

McCune-Albright syndrome

Front 59

Lisch nodules (brown spots on iris)

Back 59

Neurofibromatosis

Front 60

Neurofibromatosis, chance of malignant development

Back 60

5-10% chance of malignant development

Front 61

Neurofibrosarcoma, survival

Back 61

5 year survival 50% malignant

preipheral nerve dysplastic spindle cells

Front 62

HPV types 6 and 11

Back 62

Squamous Papilloma

Front 63

HPV # cause cancer and # that do not

Back 63

16 and 18 cause cancer6 and 11 do not

Front 64

HPV type 2, 4, 6, 40

Back 64

Verruca Vulgaris

Front 65

Squamous Papilloma HPV types

Back 65

6 and 11

Front 66

Verruca Vulgaris HPV types

Back 66

2, 4, 6, 40

Front 67

Verruca Vulgaris treatment

Back 67

topical salicylic acid, lactic acidexcision for atypical only

Front 68

Condyloma Acuminatum HPV types

Back 68

HPV types 2, 6, 11, 53 & 54

Front 69

HPV types 2, 6, 11, 53 & 54STD

Back 69

Condyloma Acuminatum

Front 70

Condyloma Acuminatum treatment

Back 70

surgical NO LASER (airborn spread)

Front 71

HPV 13 & 32

Back 71

Multifocal Epithelial Hyperplasia; Heck’s Disease

Front 72

Multifocal Epithelial Hyperplasia; Heck’s Disease

Back 72

HPV 13 & 32

Front 73

Heck’s Disease treatment

Back 73

Spontaneous regression reportedaesthetic excision

Front 74

Pox virus

Back 74

Molluscum Conatgiosum

Front 75

Sharing clothes, wrestlers, communal bathing

Back 75

Molluscum Conatgiosum

Front 76

Molluscum Conatgiosum treatment

Back 76

spontaneous remission

Front 77

Last on Diagnosis, older males

Back 77

Warty Dyskeratoma

Front 78

sun exposed. "stuck on" look

Back 78

Seborrheic Keratosis

Front 79

Not dependent on sun exposure

vermilion lip,

soft palate

2:1 Males

Back 79

Oral Melanotic Macule

Front 80

Black female, buccal, rapid increase in size

Back 80

Oral Melanoacanthoma

Front 81

Male 70%, older, most common oral lesion

Back 81

Leukoplakia

Front 82

Leukoplakia, most common location, % of oral floor dysplastic

Back 82

70% vermilion border

90% of oral floor dysplastic or cancer

Front 83

Leukoplakia top 3 differentials

Back 83

1. Hyperkeratosis2. Dysplasia3. Squamous Cell CA

Front 84

Leukoplakia treatment

Back 84

1. check if wipes off

2. remove etiology

3. 2 weeks check and biopsy if left

Front 85

dysplasia, histo

Back 85

multinucleiation

Very large nuclei

Front 86

mild dysplasia treatment

Back 86

stop habitclose followup

Front 87

Moderate and severe dysplasia treatment

Back 87

remove remaining lesion and follow up

Front 88

Red patch that cannot be clinically or pathologically diagnosed as any other condition

Back 88

Erythroplakia

Front 89

Almost All erythroplakias demonstrate

Back 89

significant epithelial dysplasia,

carcinoma in situ,

or invasive squamous cell carcinoma

Front 90

erythroplakias is ___ in 90%

Back 90

severe dysplasia

Front 91

erythroplakia location (3)

Back 91

Floor of mouth

tongue

soft palate

Front 92

Benign neoplasm of osteoblasts

Bone production

Back 92

Osteoblastoma

Front 93

Pain not relieved by aspirin

Back 93

Osteoblastoma

Front 94

Immature (woven bone)

NOT ATTACHED TO ROOT

Back 94

Osteoblastoma

Front 95

Osteoblastic rimming of bone

Osteoblasts scattered throughout the background fibrous stroma

Back 95

Osteoblastoma

Front 96

center has plexus of nerves

Osteoblastic rimming of bone (sim to osteoblastoma)

Osteoblasts scattered throughout the background fibrous stroma

Back 96

osteoid osteoma

Front 97

caused by cumulative UV,

10% transform to SCCA

50% white adults

Back 97

Actinic Keratosis

Front 98

A plaque on the skin of the face with a rough, sandpaper-like surface

Back 98

Actinic Keratosis

Front 99

premalignant alteration of the lower lip vermilion 10:1 Males

Back 99

Actinic Cheilosis

Front 100

Benign epithelial neoplasm that primarily occurs on sun-exposed skin

Back 100

Keratoacanthoma

Front 101

“Self Healing Cancer”

Back 101

Keratoacanthoma

Front 102

genodermatosis (inherited genetic skin conditions)Autosomal dominant (AD)

Back 102

White Sponge Nevus & HBID

Front 103

White Sponge Nevus defect in what

Back 103

Defect in keratin formation -- Keratin 4 (spinous layer) -- Keratin 13 (spinous layer)

Front 104

Intracellular edema Perinuclear condensation

Back 104

White Sponge Nevus

Front 105

White Sponge Nevus treatment

Back 105

no treatment needed

Front 106

Looks like Hereditary Benign Intraepithelial Dyskeratotsis (HBID

Back 106

White Sponge Nevus

Front 107

eye involvment - plaque

Back 107

HBID; Witkop-von Sallmann Syndrome

Front 108

Buccal mucosae, bilaterally

Back 108

White Sponge Nevus & HBID

Front 109

Autoimmune attack (T-cells) --

Against basement membrane

Back 109

Lichen Planus (LP)

Front 110

Association with hepatitis C

Back 110

Lichen Planus (LP)

Front 111

Wickham’s striae

Back 111

Lichen Planus (LP)

Front 112

Most common form of oral LP, bilateral

Back 112

Reticular Lichen Planus (LP)

Front 113

Lichen Planus (LP) treatment

Back 113

erosive - topical

reduce stress

antifungal

monitor

Front 114

Clinical similarity to erosive LP

Back 114

Graft versus host disease (GVHD)

Front 115

Ulcers are generally surrounded by patchy zones of erythema and streaky keratosis that somewhat resemble lichen planus

Back 115

Chronic Ulcerative Stomatitis

Front 116

Clinical similarity to ELP

Back 116

Chronic Ulcerative Stomatitis

Front 117

The most frequently mutated gene in human oral cancer is

Back 117

the p53 tumor suppressor gene

Front 118

Betel/Areca nut

Back 118

greater risk of cancer

Front 119

HPV SCC originating mostly in what tissue

Back 119

50% originating in the oropharynx

Front 120

90% of cervical cancers are related to

Back 120

HPV

Front 121

Oral cancer statisticsM:F%, age AA vs White

Back 121

75% in males6th most common cancer in malesAfricanA middle ageWhite older age

Front 122

Most likely place for oral cancer

Back 122

LOWER LIP, lateral/ventral borders of the tongue, Anterior floor of the mouth, tonsillar pillars, and lateral soft palate

Front 123

Squamous Cell Carcinoma (SCCA)

gender and age

Back 123

M>65

Front 124

Squamous Cell Carcinoma (SCCA) treatment

Back 124

Wide (radical) surgical excision, radiation therapy, or a combination

Front 125

Verrucous Carcinoma

gender and age

habit

Back 125

M >

55

where chewing tobacco

Front 126

Verrucous Carcinoma histologic changes 4 steps

Back 126

hyperkeratosis -> Verrucous keratosis -> verrucous carcinoma -> squamous cell carcinoma

Front 127

Snuff dipper’s cancer

Back 127

Verrucous Carcinoma

Front 128

Most common skin cancer, most common of all cancers

Back 128

Basal Cell Carcinoma

Front 129

focal ulceration, 80% head and neck, vermillion of the lip

Back 129

Basal Cell Carcinoma

Front 130

3rd most common cancer

Back 130

Melanoma

Front 131

Malignancy of melanocytes

Back 131

Melanoma

Front 132

ABCDE of what disease

and what is it

Back 132

Melanoma

Asymmetry, Border irregularity, Color variegation, Diameter greater than 6 mm, Evolving

Front 133

Central Ossifying Fibroma location

Back 133

MN molar/premolar

Front 134

Central Ossifying Fibroma etiology

Back 134

benign neoplasm of osteoblasts or cementoblasts

Front 135

Central Ossifying Fibroma capsul/rim?,

push teeth?

Back 135

Encapsulated/rim yes, Unilocular, push roots aside or resorb roots

Front 136

Two types of calcified tissue in Central Ossifying Fibroma

Back 136

Psammomatoid type (more common), Trabecular type

Front 137

Hyperparathyroidism-jaw tumor syndrome (4)

Back 137

-- Parathyroid adenoma/carcinoma

-- Central ossifying fibroma

-- Renal cysts

-- Wilms’ tumor (kidney)

Front 138

Juvenile Aggressive Ossifying Fibroma two types

Back 138

trabecular/psammomatoid

Front 139

Ewing’s Sarcoma

Back 139

White young males, MN post

Front 140

Metastasis to the Jaws from where

Back 140

Usually from:

-- Breast

-- Prostate

-- Colon

-- Lung

Front 141

3 malignant bone tumors

Back 141

Osteosarcoma,

Chondrosarcoma,

Ewing sarcoma

Front 142

Cell of Origin osteocyte (bone tumor)

Back 142

Osteoma

Front 143

Cell of Origin endothelial cell (bone tumor)

Back 143

Hemangioma, Intraosseous

Front 144

Cell of Origin Primitive neuroectodermal cell, (bone tumor)

Back 144

Ewing sarcoma

Front 145

F>>M, middle aged, third molars and retromolar areas

Back 145

Focal Osteoporotic Marrow Defect

Front 146

Focal Osteoporotic Marrow Defect treatment

Back 146

None, unless painful

Front 147

Idiopathic Osteosclerosis location

Back 147

MN 1st molar/premolar

Front 148

Idiopathic Osteosclerosis capsul

Back 148

Not encapsulated

Front 149

Idiopathic Osteosclerosis treatment

Back 149

Not needed, remains indefinitely

Front 150

Bone slowly “dissolves"

Back 150

Massive Osteolysis (Vanishing Bone Disease)

Front 151

Massive Osteolysis treatment

Back 151

none is effective (ususally curettage tried)

Front 152

F<30, MN anterior

Back 152

Central Giant Cell Granuloma

Front 153

May expand or perforate cortex, resorb roots, push teeth, thin rim

Back 153

Central Giant Cell Granuloma

Front 154

Central Giant Cell Granuloma treatment

Back 154

Surgical curettage, Corticosteroid injections, Calcitonin injections

Front 155

Brown Tumor

Back 155

Hyperparathyroidism

Front 156

Defective gene on chromosome 16, bilateral

Back 156

Cherubism

Front 157

Eosinophilic cuffing

Back 157

Cherubism

Front 158

Enlarges until puberty, then “burns out”

Back 158

Cherubism

Front 159

May develop central giant cell granuloma

Back 159

Cherubism

Front 160

Abnormal bone = immature, fibrosis of marrow spaces Postzygotic mutation of GNAS 1 gene Just in one bone

Back 160

Fibrous Dysplasia of Bone

Front 161

Ground-glass radiopacity

Back 161

Fibrous Dysplasia of Bone

Front 162

Fibrous Dysplasia of Bone treatment

Back 162

“burns out” with adulthood, surgical recontouring

Front 163

Monostotic fibrous dysplasia, differentiate from another

Back 163

One bone involved -- 85% of cases

Front 164

Polyostotic fibrous dysplasia, differentiate from another

Back 164

Multiple bones involved -- Jaffe-Lichtenstein syndrome -- McCune-Albright syndrom

Front 165

Hockey stick deformity of hip Café au lait spots Hyperthyroidism

Back 165

McCune-Albright syndrome

Front 166

Actually empty cavity (Hollow marrow space) M <25

Back 166

Traumatic Bone Cyst

Front 167

scalloped between roots (xray)

Back 167

Traumatic Bone Cyst

Front 168

Traumatic Bone Cyst treatment

Back 168

curretage, hemorrhage, new bone 6 months

Front 169

Benign neoplasm of bone

Back 169

Osteoma

Front 170

Multiple osteomas of flat bones (face)

Back 170

Gardner Syndrome

Front 171

Adenomatous intestinal polyposis

-- Risk of adenocarcinoma

Back 171

Gardner Syndrome

Front 172

Epidermoid cysts of skin

Desmoid tumors of skin

Back 172

Gardner Syndrome

Front 173

Night pain relieved by aspirin

Back 173

Osteoid Osteoma