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190 Cards in this Set

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_____ is serous clear fluid filled.
Vesicle
A large vessicle a.k.a. ______.
bulla
A purulent filled papule.
pustule
An epithelial lined cavity.
cyst
An elevated solid lesion < 5 mm.
papule
An elevated solid lesion > 5 mm.
nodule
95 % of oral primary herpes is due to HSV-__ while genital herpes is caused by HSV-__.
1, 2 (linked to cervical cancer)
Herpes mode of transmission?
physical contact
Most cases of primary herpes occur btween the ages of ___ and ___.
0.5, 5
The incubation period of primary herpes is ____.
2 weeks
T/F Herpetic lesions affect both keratinized and non-keratinized mucosa.
TRUE
Herpes runs a __ to __ day course.
7 to 14
Define gingivostomatits
edematous, intense erythema and painful gingiva
A 5 year old patient presents with ulcers which show a yellow, fibrinous base with a erythematous halo. The patient also suffers from fever, headache, weight loss and swollen lymph nodes. Dx: _______.
Primary Herpes
Lab results: biopsy shows vessicles, multinucleated giant cells and PCR is positive for HSV-1 virus. Dx: ________.
Primary herpes
A patient complains of prodromal sx's including itching burning and pain 6-24 hrs prior to multiple, fragile group lesions appearing on the vermilion. According to her hx she is stressed, immunosupressed and has significant sun exposure. Dx: _____.
Secondary herpes (also found on palate or attached gingiva (masticatory mucosa))
Herpes infection of the finger either primary or secondary.
herpetic whitlow
The latent herpes virus is sequestered in the __________.
trigeminal ganglion
Primary VZV cause _______ while secondary cause _____.
chicken pox, herpes zoster (shingles)
VZV is transmitted via ______. The virus multiples in ______ and is very contagious yet self limiting.
droplet inhalation, macrophages
An 65 year old male recently treated with chemo/radioation (immunocompromised) presents with prodrome pain and paresthesia followed by a unilateral vesicular, pustular, ulcerating eruptions. Dx: _______.
Herpes zoster
_________ occurs in 15% of those affected by herpes zoster after the lesions have healed causing burning and throbbing to the previously infected area and is aggravated by light touch.
post herpetic neuralgia
________ syndrome is due to herpes zoster involvement of the facial and auditory nerves causing possible unilateral facial paralysis, vesicles of the external ear, tinnitis, deafness and vertigo.
Ramsay Hunt
Hand, foot and mouth disease is is a common childhood infection caused by the _______ virus. It is highly contagious and is spread via __________. Oral vessicles which rupture and ulerate are covered by a yellow fibrinous membrane surrounded by a red halo (herpes-like) and found on ________ tissue.
coxsackie (A16 or A10), airborne or fecal-oral, non-keratinized
A child complains of acute onset phayngitis and dysphagia in late August. A macular erythematous area preceded a vessicular eruption followed by ulceration of the posterior oral cavity (soft palate and tonsilar pillars. Dx:______.
Herpangina
Herpangina is caused by the ________ virus. It has a one week incubation and a self limiting course of _____ weeks
Coxsackie group A, 1-2 week course
Two forms of measles are ________, due to the paramyxovirus, and ________ caused by the togavirus.
Rubeola, Rubella (German measles)
Rubeola or Rubella: children-fever, rash, respiratory, photophobia
Rubeola
Rubeola or Rubella: mild symptoms, Forcheimer's sign (dark red palatal papules)
Rubella
Rubeola or Rubella: may cause congenital defects in developing fetus especially in first trimester leading to deafness (80%), heart disese and cataracts.
Rubella
Rubeola or Rubella: Koplick spots, small red macules with white necrotic centers preceding skin rash and Warthin Findlay giant cells (multinucleated giant cells in lymphoid tissue).
Rubeola
Rubeola or Rubella: complications include encephalitis, thrombocytopenic purpura, ities of immunocompromised.
Rubeola
Rubeola or Rubella: contagious from 1 week prior to rash to 5 days after, last outbreak was in the 60's
Rubella
A middle aged patient of Jewish decent presents with painful shallow ulcers leading to intraepithelial blisters on non-keratinized mucosa with a + Nikolsky's sign. According to her med hx she has an autoimmune disorder. Dx:____
pemphigus vulgaris
Pemphigus vulgaris is differentiated histologically by the presence of free floating acantholytic spinous cells in blister fluid called ______. The remaining basal cells form a ______ row due the detruction of desmoglein __, a componet of desmosomes found the _______ layer.
Tzanck cells, toombstone, 3, epithelial
Steroids are used to treat pemphigus. Consequences of using long term steroids include: osteoporosis, diabetes, problems with healing and infection including ________and ______ syndrome.
candidiasis, Cushing's
________ pemphigus is an autoimmune disease triggered by malignant or benign tumors (usually leukemia or lymphoma) resembles oral pemphigus accompanied by severe heorragic, crusted chelitis and ocular lesions (70%).
Paraneoplastic
Previously known as desquamative gingivitis ____________ is typically found in females (50-60's, 2:1) due to autoantibodies directed against basement membrane antigens causing _______ gingival bullae and vessicles rarely affecting the skin. _____ adhesions are the most significant complication leading to blindness.
Mucous membrane pemphigoid (MMP), subepithelial, ocular (symblepharon)
Histologically MMP shows _________ clefting due to autoantibodies (not found circulating) to _______________ which anchor the epithelium to subepithelial tissue. Tx is usually topical ______ placed in custom trays.
subepithelial, hemidesmosomes, corticosteroids
Bullous Pemphigoid usually have detectable circulating ________ in serum which also attack the basement membrane resulting in lessions identicle to MMP yet are also found on the ____.
autoantibodies, skin
Pemphigus or pemphigoid: tissue ab IgG, IgA and C3
pemphigoid (pemphigus shows no IgA)
Pemphigus or pemphigoid: circulating auto-IgG
pemphigus (pemphigoid no circulating)
Pemphigus or pemphigoid: target proteins Laminin 5 and BP180
Pemphigoid
Pemphigus or pemphigoid: intraepithelial vessicles
pemphigus
Pemphigus or pemphigoid: subepithelial vessicles
pemphigoid
Pemphigus or pemphigoid: sites = oral and eyes
pemphigoid
Pemphigus or pemphigoid: sites = oral and skin
pemphigus
Pemphigus or pemphigoid: prognosis = fair, significant mortality
pemphigus
Pemphigus or pemphigoid: prognosis = good
pemphigoid
____________ is an autoimmune disease showing IgA in tissues. It is associated with gluten-sensitive enteropathy of young middle aged s causing pruritic lesions of elbows shoulders and buttocks rarely found in the oral cavity
Dermatitis herpetiformis
_________ is a chronic autoimmune disease of the skin commonly affecting mucous membranes including the gingiva causing bullae then ulcers. Neutrophils and eosinophils fill the area between epithelium and CT with linear IgA deposits.
Linear IgA disease
______________ is a hereditary disease causing an attachment defect of epithelial cells to underlying CT which leads to blisters and bulla formation after minor truama.
Epidermolysis bullosa
T/F An ulcer is defined as the full thickness loss of epithelial covering; elevated margins often appear with acute ulcers.
T, F elevated margins=chronic
SCCA comprise _____% of all oral cancers.
90-95
SCCA is caused by loss of cell cycle control due to the activation of _____ and inactivation of ________ genes resulting in increased proliferation and decreased apoptosis. Increased angiogenesis and degredation of basement membrane lead to ________ and invasion.
oncogenes, tumor suppressor, metastesis
SCCA incidence is_____ cases/year. ___% die from their disease.
31,000, 25-30
List from most to least risk for SCCA: alcohol, reverse smoking, smokeless tobacco, cigar/pipe, cigarette
reverse smoking > cigar/pipe > cigarette > smokeless tobacco > alcohol (additive effect)
Smokers increase their risk of SCCA __X while heavey smoking and alcohol consumption increased the risk __X.
10, 40
Other SCCA risk factors include UV light (SCCA lower lip), _________ syndromes (Plummer-Vinson), DNA repair deficiency syndromes, HPV, candidiasis, chronic irritation and male : female ratio is _:_.
iron deficiency, 3:1 (high in African Americans)
EBV and HIV are risk factors for SCCA? T/F
False, for lymphomas
The ____________ is the most common intraoral site for SCCA which can manifest themselves as red, white, mixed or ulcerated aggressive lesions capable of metastasis to regioinal ______ ______.
lateral tongue, lymph nodes
The ____________ is the 2nd most common intraoral site for SCCA causing painless non-healing ulcers.
floor of the mouth (especially w/ smoking/drinking Hx)
Which is not an area where SCCA is normally found: buccal mucosa, gingiva, hard palate, lower lip, soft palate.
hard palate (usually adenocarcinoma)
SCCA of the gingiva can resemble localized ___________.
periodontal disease
SCCA of the lower lip is more common in males than females and is caused mainly by ______ and ______.
sun exposure, pipe smoking
T/F Usually there is an epithelial change evident due to SCCA?
TRUE
Considering all the following possibilities, which clinical presentation of SCCA is most uncommon: non-healing ulcer, exophytic mass, red, white, mixed red/white, verrucopapillary mass, submucosal/intraosseous mass.
submucosal/intraosseous mass
Which is not a warning sign for SCCA: persistant lesions with no obvious cause, isolated perio defects, tingling / numbness, unexplained cervical lymphadenopathy, dysphonia, dysphagia, dyspnea.
dyspnea in not a warning sign. Tingling/numb, lesions w/o cause are most important
T/F Histologic grading is the most important parameter for the prognosis and treatment planning of SCCA.
False, Clinical staging is most important
Staging is used to identify the extent of the disease before treatment and is based on the TNM system which stands for _____________.
Tumor size, Nodal involvement, Metastesis.
Tumors can be spread by all the following except: local extension, lymphatic spread, hematogenous spread.
all are true
T/F Posterior tumors are more prone to early metastesis.
TRUE
If a lymph node is ______ to tissue, it implies that the cancer has perforated the capsule of the lymph node resulting in a bad prognostic indicator.
fixed (along with enlarged, hard and non-tender)
T/F Improvement in early stage detection of SCCA has improved in the last 25 years.
FALSE
Treatment for SCCA includes ______, the primary modality, radiation and chemo.
surgery
External beam radiation treatment typically last ___ weeks 5 days/week using 5000 cGy to the tumor. Other forms of radiation include hyperfractional therapy (2 times/day), IMRT (intensity-modulated radiotherapy - spares normal tissue) and __________ (radioactive implants placed in tumor bed.0
5 to 6, brachytherapy
Pretreatment planes for SCCA include all the following except: indicated extractions (esp. mandibular), alveoloplasty, 14-21 day healing time prior to radiation, complete restorations, impressions for fluoride carriers, daily fluoride for 6 weeks, jaw exercises to reduce trismus.
daily fluoride should be administered for life to avoid radiation caries
Which is not a short term side effect of head and neck radiation therapy: mucositis, loss of taste, pain, radiation dermatitis, xerostomia, redness, hypersensitivity.
xerostomia is a long term side effect
Time frame for head and neck radiation: 1-2 weeks ____________, 3 weeks ___________, 4-5 weeks __________.
loss of taste + thick saliva, mucositis of pharynx, mucositis of buccal mucosa and tongue
All are long term effects fo head and neck radiation except: xerostomia, radiation caries, dysphagia, bone changes, trismus, hyperpigmentation of skin, altered development of jaw/teeth in young patients, carotid atheromas.
all are true
______________ occurs more frequently in the mandible when radiation exceeds 6500 cGy causing avascular necrosis.
Radiation osteonecrosis
Treatment for osteoradionecrosis includes surgical removal of bone and ________.
hyperbaric O2
The five year survival rate for SCCA on the lower lip is __% while the tongue is __%.
94, 48
Reasons for poor prognosis of oral SCCA are: late diagnosis, difficult anatomy and _____________, which describes the concept of the remaining tissue surrounding the SCCA had already undergone some genetic change and is more prone to developing additional cancers.
field cancerization
Clinical signs of maxillary sinus SCCA include: dull ache, referred pain to teeth, failure of an extraction site to heal, palatal ulcer and most importantly ________.
parasthesia
Traumatic ulcers are caused by al trauma, chemical/thermal burns, iatrogenically or are _________ meaning self induced. These ulcers can be difficult to differentiate from ______, for this reason if there is no obvious etiology consider an immediate biopsy.
factitial, SCCA
TUGSE is short for "traumatic ulcerative granuloma with stromal epithelia" and is used to describe _______ ulcers which usually have elevated margins with minimal pain.
chronic traumatic
________ disease is due to the traumatic ulceration to the anterior tongue of infants with natal teeth.
Riga-Fede
Which is not considered an immunologic-mediated ulcer: aphthous ulcers, erythema multiforme, lupus, rxn, contact allergies, Wegner's granulomatosis, midline lethal granuloma, cyclic neutropenia, chronic granulomatous disease.
all are immunologic
Apthous ulcers are to __________ mucosa as recurrent herpes is to _________.
non-keratinized non-attached, keratinized attached
Aphthous ulcers; major, minor or herpetiform: most common.
minor
Aphthous ulcers; major, minor or herpetiform: heal with scaring in 1-2 months
major aka Sutton's disease
Aphthous ulcers; major, minor or herpetiform: often on soft palate.
major
Aphthous ulcers; major, minor or herpetiform: TX = systemic steroids.
major
Aphthous ulcers; major, minor or herpetiform: heal without scaring in 7-10 days.
minor
Aphthous ulcers; major, minor or herpetiform: recurrent crops of very small ulcers.
herpetiform
Aphthous ulcers; major, minor or herpetiform: attached gingiva or hard palate.
none…gotcha ha!, that would be herpes
Aphthous ulcers; major, minor or herpetiform: non-keratinized unattached mucosa.
all the above
Aphthous ulcers; major, minor or herpetiform: TX = topical steroids.
minor
Aphthous ulcers; major, minor or herpetiform: pain out of proportion to size of lesion.
all the above
Which medical conditions are associated with aphthous ulcers: celiac and crohn's disease, PFAPA, behcet's, Reiter's, HIV.
all the above, HIV = large atypical ulcers
PFAPA stands for ______________.
periodic fever, aphthous stomatitis, pharyngitis and cervial adenitis. TX: corticosteroids
Behcet's disease + aphthous ulcers is characterized by recurrent aphthous ulcers plus which 2 of the following: genital ulceration, eye lesions, skin lesions, positive pathergy test.
2 of any from the list
Nick Coles presents with aphthous ulcers along with a triad of lower limb arthritis, non-specific urethritis and conjunctivitis. He also divulges that being such "p-i-m-p" left him with an STD, which likely caused the above sx's due to an abnormal response to the microbial antigen. He is likely suffering from _______.
Reiter's syndrome TX: NSAIDS
A patient presents with target-like skin lesions caused by a allergy. She is most likely suffering from ______.
Erythema multiforme
Erythema multiforme; minor, major, toxic epidermal necrolysis: aka Stevens Johnson syndrome
major
Erythema multiforme; minor, major, toxic epidermal necrolysis: most severe always triggered.
TEN
Erythema multiforme; minor, major, toxic epidermal necrolysis: skin, oral, ocular and genital lesions.
major. Hint: aka Stevens-Johnson…..genitals, they both start with juh, perv!
Erythema multiforme; minor, major, toxic epidermal necrolysis: young patients, acute onset, 2-6 weeks.
minor
Erythema multiforme; minor, major, toxic epidermal necrolysis:
requires hospitalization
Erythema multiforme; minor, major, toxic epidermal necrolysis: like a burn patient.
TEN
The most common reactions are caused by: sulfa , ______ and gold injections (arthritis).
local anesthetics
A patient presents with rapid, diffuse, painless swelling of the lips, neck and face. He must be treated quickly to avoid respiratory distress. He said he had shellfish with peanut sauce for lunch. He is most likely suffering form angioedema caused by _________.
an IgE mediated allergic response to food
Which of the following may cause contact allergies: cinnamon, denture acrylic, silver amalgam, cheap crowns, meluca oil and tartar control tooth paste.
all the above T-cell mediated response (type IV)
A patient presents with a triad of systemic inflammation (necrotizing vasculitis and granulomatous) involving the URT, kidneys and lungs. Despite his sx's you proceede with the exam and find "strawberry gingivitis." You know it's ________ but decide to refer him to a "real" doctor to do a cACNCA test so you can go to golfing that afternoon.
Wegener's granulomatosis TX: steroids
A patient presents with a destructive process of the palate and midface which perforates the nasal septum. His medical history states he has peripheral T-cell lymphoma. He is most likely suffering from a ___________. You refer this one to an OMFS and go golfing, again.
Lethal Midline Granuloma
_________ is a rare inherited dyscrasia which leaves the patient neutropenic every 21 days causing severe perio making the perio dept happy.
cyclic neutropenia
Which is not a deep fungal disease: Coccidiodomycosis, histoplasmosis, Blastomycosis, Tuberculosis, Cryptococcosis.
TB
Deep fungal infections are contracted via inhalation of spores typically causing _________ lung involvement and _______ non-healing ulcers, yet in many cases the patient may be asymptomatic.
granulomatous, chronic
A patient presents with a chronic non-healing ulcer and is otherwise asymptomatic. You find out he has been farming in the Mississippi-Ohio river valley. You suspect he is suffering from the most common fungal infection in the US ___________.
histoplasmosis
A patient presents with URTI sx's and a chronic ulcer. You find he was camping in the San Juachin Valley last month . He is most likely suffering from _______ akaValley fever.
Coccidiodomycosis
Other rare fungal infections include blastomycosis and cryptococcus, which is found in people with T-cell deficiencies specially AIDS?
cryptococcus
This fungal infection found on vegetables infects the sinuses, brain, orbit and lungs of patients with immune disorders especially diabetics. Oral manifestations include palatal perforations.
mucormycosis
This opportunistic fungal infection commonly causes allergic fungal sinusitis.
aspergillosis
Syphilis, gonorrhea or TB: Treponema pallidum
syphilis
Syphilis, gonorrhea or TB: Hutchinson's triad = interstitial keratitis, 8th nerve deafness, dental anomalies including Hutchinson's (notched) incisors and mulberry molars.
congenital syphilis
Syphilis, gonorrhea or TB: Your patient presents with generalized stomatits of the pharynx. Due to your "thorough" head and neck exam you find the patient is also suffering from dysuria and has a yellow-white-green "drip-drip-drip" discharge from his along with painful swollen testicles. He is likely suffering from _______.
gonorrhea (sx's occur 2-5 days after infeciton)
Syphilis, gonorrhea or TB: re-activation --> hemoptysis, rare oral chronic ulcers and osteomyelitis
TB
Syphilis, gonorrhea or TB: 3 stages including primary chancre, secondary mucous patches, rash and condyloma lata and tertiary gummas.
syphilis ***primary and secondary are infectious
Syphilis, gonorrhea or TB: localized lung infection aka "Ghon complex"
TB
Syphilis, gonorrhea or TB: may cause perforation of the palate and glossitis
syhilis
Syphilis, gonorrhea or TB:
Syphilis, gonorrhea or TB: causes blindness of newborns
gonorrhea
Syphilis, gonorrhea or TB: most common
TB > gonorrhea > syphilis
T/F A patient with latent TB is infectious; a patient with acitve TB should not be treated.
False; True
Mucormycosis, lethal midline granuloma and syphilis may all cause ________ of the palate.
perforation
A patient presents with a draining sinus tract on the skin. "Sulfur granules" are present in the exudate. What bacteria may be causing these sx's?
Actinomyces israelii (Actinomycosis)
While volunteering in a S. American clinic a mal-nourished patient presents with a rapidly progessing, ulcerating necrotic lesion of the lips and cheek. Surrounding gingival tissue presents as ANUG. The patient may be suffering from ________ aka cancrum oris.
Noma
An African American patient presents with an asymptomatic white opacification bilaterally on his buccal mucosa. It has a wrinkled, corrugated appearance which disappears when stretched. This is most likely _______.
leukoedema
This rare, non-treatable disease is due to an autosomal nt keratin mutation which manifests itself bilaterally and symmetrically on the buccal mucosa forming deep white folds or corrugations which are asymptomatic. Similar pathology is found on other mucosal tissues of the body such as the esophagus, anus and . Definitive dx is bade via family hx or biopsy.
WSN (white sponge nevus)
HBID, an acronym for ___________________, is an extremely rare autosomal nt disease characterized by foamy conjuctival ______ in the corner's of the eye along with white lesions of the buccal mucosa similar to white sponge nevus.
hereditary benign epithelial dyskeratosis, plaques
Eric presents with 2-3 mm white, cobblestone-like papules on his hard palate. Before giving him a hard time for how bad he smells you notice his fingernails are splintering and has hyperkeratotic papules on his face and trunk. These sx's, including bad odor, are sx's of ____________.
follicular keratosis
Which is not a hereditary white lesion: HBID, follicular keratosis, WSN, leukoedema.
leukoedema (not hereditary) rest are autosomal nt
A patient presents with a "callus" like hyperkeratosis on his edentulous ridge, lateral tongue and buccal mucosa. This is most likely a case of _________.
Frictional hyperkeratosis (increased thickness of the keratin layer)
Frictional hyperkeratosis is premalignant. T/F
FALSE, if there is no obvious etiology biopsy just in case
A former smokeless tobacco chewer presents with a persistent white lesion which was biopsied 4 weeks ago. The histo slide showed acanthosis, hyperkeratosis and "_____" formation. You inform the patient there is a ___ risk of dysplasia/malignant transformation.
chevron, small
_________ carcinoma is most diagnosed on male smokeless tobacco users > 55 years old.
Verrucous
A patient presents with a white keratinization of the palate with pinpoint red spots. He couldn't stop talking about how good pipe smoking is. He most likely has ___________ and the red pinpoint spots are ________.
nicotinic stomatitis, minor salivary duct openings
An HIV patient presents with hyperkeratotic plaque-like lesions on the lateral tongue. Upon reviewing her med hx you find she also has EBV. The histo shows nuclear viral inclusions. She is most likely suffering from _________.
oral hairy leukoplakia
T/F Oral hairy leukoplakia is caused by HIV.
False EBV, although 80% are HIV+
T/F Oral hairy leukoplakia and hairy tongue are one in the same.
FALSE
A patient presents with thick matted, brownish-white (sometimes black) dorsum of the tongue due to the overgrowth of the ______ papillae. Her hx reveals she is a smoker and is currently taking antibiotics. She may have ________.
filiform, hairy tongue
You are about to misdiagnose a patient with superficial white slough with pemphigus or pemphigoid when she tells you it started a few weeks ago when she switched tooth paste brands. You consult her to change back to the old brand because she has __________.
dentifrice-associated slough
6 months later, the same patient presents with leukoplakia of the maxillary vestibule and alveolar mucosa. She said she followed your directions and bought a different brand tooth paste called Viadent at an herbal store. You know she is suffering from ________.
Sanguniaria-related keratosis
A 40 year old male smoker presents with white patches on the mandibular and buccal mucosa that can't be rubbed off. He is likely suffering from ________ and a biopsy should be taken since ____ % eventually undergo malignant transformation due to dysplasia.
idiopathic leukoplakia, 5-15
Histological features of moderate dysplasia include: increased _:_ ratio, _______ pleomorphism and increased or abnormal ______.
N:C, nuclear, mitosis
Carcinoma-in-situ invades the basement membrane. T/F
False, however is pre invasive, full thickness dysplasia
SCCA invades the basement membrane. T/F
TRUE
Tx for idiopathic leukoplakia includes _______ for large lesions, ________ if no dsyplasia, ________ for mild dysplasia and ______ for moderate to severe along with counseling for smoking cessation .
multiple biopsies, biopsy PRN, excision, complete excision
From highest % to lowest, dysplasia risk of idiopathic leukoplakia: lower lip, tongue, floor of mouth.
floor of mouth > tongue = lower lip
Idiopathic leukoplakia: most common intraoral location.
mandibular mucosa > buccal mucosa
A 50 year old "butt" white male presents with a blurring of the vermillion and hyperkeratotic plaques on his ing, mottled lower lip. Due to sun exposure he may have ________. Due to it's severity a biopsy was taken revealing atrophic epithelium, hyperkeratosis and solar ________.
Actinic (solar) Chelitis, elastosis
T/F Actinic chelitis is a precursor to SCCA and malignantly transforms 6-10% of the time.
TRUE
A female patient presents with asymptomatic, erythematous, well-demarcated areas of papillary atrophy surrounded by yellow-white border which "migrate" with time. You reassure the patient that her condition in benign and fairly common (1-3% population). She is diagnosed by clinical findings with __________.
geographic tongue aka migratory glossitis aka erythema migrans
A middle aged partially edentulous patient presents with bilateral, interlacing white keratotic line lesions with a "wax and wane" appearance on the buccal mucosa. You also notice she has cutaneous lesions on her knees and elbows along with fingernail changes. She is likely suffering from __________, and the keratotic lines are referred to as ________.
Reticular Lichen Planus (most common form), Wickham's striae
Lichen planus is a mucocutaneous disease caused by a T-cell mediated "hypersensitivity" which causes ________ of basal epithelial cells (civatte bodies) and degradation of the cell layer. Histologically saw toothed ________ and band like infiltrates of _______ and at times hyperkeratosis are present.
apoptosis, rete pegs, lymphocytes
Oral lichen planus appears in what 3 forms. These forms may coexist. T/F
reticular (most common), plaque (normally on dorsum of tongue) and erythematous/erosive. True
Erythematous/erosive lichen planus presents as ulcerating atrophic reddened areas with fine white striae on the periphery that may also be confined to the __________. Clinically it can be confused with pemphigoid, pemphigus and oral lichen planus.
gingiva
SLE, SCLE or CCLE (discoid): scaly erythematous skin patches, no systemic involvement, non-characteristic oral appearance.
CCLE (chronic cutaneous)
SLE, SCLE or CCLE (discoid): multi-system disease, butterfly rash.
SLE
SLE, SCLE or CCLE (discoid): Women 8:1, arthritis, pulmonary, and renal problems.
SLE
SLE, SCLE or CCLE (discoid): AB prophylaxis required due to Libman-Sacks endocarditis.
SLE
SLE, SCLE or CCLE (discoid): lesions in sun exposed areas, no scarring, musculoskeletal problems.
SCLE (subactute cutaneous)
SLE, SCLE or CCLE (discoid): serum ANA and anit-double stranded DNA.
all esp. SLE
An infant presents with mildly burning white soft plaques which rub off. It appears to be fungal in origin; she may be suffering from ________.
Acute Pseudomembranous Candidiasis (Thrush)
Also known as antibiotic stomatitis this fungal disease presents as generalized red patches and depapillation of the dorsal tongue.
Acute erythematous
aka "denture sore mouth"
chronic erythematous candidiasis
Angular cheilitis occurs frequently in edentulous patients due to their loss of ___ which causes deep folds at the commissures which trap saliva, fungi and bacteria (staph aureus).
VDO
Hyperplastic tissue response to chronic candidal infection causes __________ candidiasis.
Chronic hyperplastic
Involving an area anterior to the circumvallate papilla in the shape of a rhomboid, this form of candidiasis also causes a "kissing lesion" on the ________.
Median rhomboid glossitis, hard palate
Form of candidiasis involving mucous membranes and skin.
Mucocutaneous
After a sample is scraped from the area, fixed and stained confirming the presence of fungi, which Tx should not be used to treat candidiasis: fluconazole, clotrimazole, nystatin pastilles, nystatin topical powder, penicillin.
penicillin
Mucosal burns may be thermal, chemical or electrical. At times a ____ must be placed to prevent contracture.
splint
A patient presents with pallor and stiffening of his oral mucosa which restricts him from opening. You find he runs a local Quick-E-Mart which sells paan, or betel quid. You inform the patient that his condition is precancerous and he will need to return for frequent re-evaluations because he is suffering from ____________.
Submucous Fibrosis Doh!
Fordyce granules are ectopic sebaceous glands found on the buccal mucosa; they are a variant of normal. T/F
True; True
Ectopic lymphoid tissue may be found at the floor of the mouth, ventral tongue, soft palate and palatine tonsils. The key to ruling out pathology is to see if they are _______.
bilateral
Oral lymphoepithelial cysts are submucosal masses and, as the name suggests, are a keratin-filled cysts with lymphoid tissue in the cyst wall. They are commonly found on the _______ and ______.
floor of the mouth, ventral-posterior-lateral tongue
Gingival cysts are more common in s than newborns: in s they commonly appear near the mandibular PM-canine area of attached gingiva and in newborns as single-multiple 2mm off-white nodules on the midline or other areas of the gingiva. T/F
False: True
A ______ may be found at the apex of a non-vital tooth, or less likely at the base of a periodontal pocket and is aka "gum boil."
Parulis
A lipoma is a malignant adipocyte neoplasm. T/F
False - benign