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52 Cards in this Set

  • Front
  • Back
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 _______.
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.
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.
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
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.
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.
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, SCLE or CCLE (discoid): Women 8:1, arthritis, pulmonary, and renal problems.
SLE, SCLE or CCLE (discoid): AB prophylaxis required due to Libman-Sacks endocarditis.
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).
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.
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.
Mucosal burns may be thermal, chemical or electrical. At times a ____ must be placed to prevent contracture.
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 _______.
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."
A lipoma is a malignant adipocyte neoplasm. T/F
False - benign