• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/116

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

116 Cards in this Set

  • Front
  • Back
secondary or metastatic stage of syphillus
- maxulo papular rash
- oral lesions known as mucous patches that are painless, grayish and white plaques
tertiary syphilis
gummas are characteristic lesions and are areas of granulomatous inflammation

- intraorally gummaas are most commonly noted on the tongue and palate.
- appear as a firm nodular mass which may lead to perforation of the palatal vault and lead to a hole in the palate into the nasal cavity.
congenital syphilis before two years of life
- may include bilateral symmetric mucous patches, snuffles (profuse nasal discharge containing large amounts of treponoma)
- osteochondritis or periostitis in the long bones (seen in 75-100% of children)
MOTH EATEN appearance of bones at the distal ends.
- can completely repair in one year.

- fissures develop on the lips, nares and anus.
- Rhagades - cluster of scars radiating around the mouth

- mucous membranes - white mucous patches may be found on any of the membranes.
late manifestations of congenital syphilis
- hutchinsons teeth - notch appearance on biting edges of upper central incisors.

- interstitial keratisis - most common late lesion - GROUND glass appearance
- bony changes include sclerosing lesions, saber shin,
FRONTAL BOSSING
GUMMATOUS or destructive lesions in long bone.
hutchinsons triad
- combo of tooth abnormalities, nerve deafness and blindness is known as hutchinsons triad.
two tests to test for congenital syphilis
- immunoglobin M immunoblotting and

- PCR
actinomycosis
- subacute to chronic infection
- caused by filamentous gram positive anaerobic to microaerophilic bacteria that are NOT acid fast.

- characterized by contiguous spread, supparative and granulomatous infl. reaction and formation of multiple abscesses and sinus tracts that discharge sulfur granules.

- most common clinical forms of this are cervicofacial, thoracic and abdominal. in women pelvic actinomycosis is common.
cervicofacial am
- caused by actinomyces israelii
- normally present in tonsillar crypts, carious teeth and calculus deposits.
- traumatic incidents like extraction, pa infection following an open pulpitis or pericornitis around a partially impacted tooth.
- infection normally follows oral surgery
- initial stages are characterized by soft tissue swelling in the perimandibular area.

- direct spread into adjacent tissues occurs and fistulas may form that discharge purulent material that discharge yellow.
mycosis
adfadsf
mycosis (fungal infections)
- candidiasis
- histoplasmosis
- coccidiomycosis
- cryptococcosis
- blastomycosis
- aspergillosis
- zygomycosis
candidiasis
- candidosis, monoliasis, thrush

- is caused by candida albicans and presented as: yeast (spor, pseudohyphae or long and branching hyphae

- the hyphal form is usually present when organisms are isolated from an infections process.
candidiasis general info.
- infection of the skin or mucous membrane with any species of candida, but chiefly candida albicans.

- usually localized in the skin, nails, mouth, vagina, vulva, bronchii, or lungs but may invade the blood stream.

- occurs commonly as a secondary infection ass. with immune system compromise.

- newborn infants may contract through passege in the birth canal.
basic types of candidiasis in the oral cavity
- acute pseudomembranous candidiasis (thrush)

- atrophic (erythematous) candidiasis

- chronic hyperplastic candidiasis (candidal leukoplakia)
factors predisposing oral tissues to candidiasis
- acidic saliva, xerostomia, nocturnal denture wearing, heavy smoking, blood group o individuals, immunologic disorders, antibiotic therapy, steroid therapy, iron, folic acid and vitamin deficiences.
thrush (acute pesudomembranous candidiasis) thruch
- a clinicla form of C. albicans infection that consists of white, creamy, loose patches of desquamative epithelium

- containing numerous matted mycelia over an erythematous mucosa that is easily removed.

- common in patients with more severe predisposing factors.
atrophic (erythematous) candidiasis
- clinical form of c. albicans infection in which the mucosa is thinnned, smooth and bright red with symptoms of burning and increased sensitivity.

- commonly found on the palate under a denture but also on the tongue and other mucosal surfaces.
chronic hyperplastic candidiasis
- clinical form of c. albicans infection consisting of white plaques or papules againsta an erythematous background.

- containing hyphae in the parakeratin layer of the thickened epithelium.
oral lesions ass. with candida albicans
- angular chelitis
- median rhomboid glossitis
- chronic mucocutaneous candidiasis
angular cheilitis (perleche)
- bilateral fissureof the corners of the mouth common in pt. with c albicans infections

- often requires tx. with antifungals
median rhomboid glossitis
- asymptomatic, elongated erythematous patch of atrophic mucosa of the mid dorsal surface of the tongue due to a chronic c. albicans infection.
chronic mucocutaneous candidiasis
- condition in which persistent and refractory candidasis occurs on the musous membranes, skin and nails of the affected patients

- most patients exhibit defects in their endocrine or immune system.
tx. in candidiasis
- topical or systemic antifungal medications
- elimination of the predisposing factors.
coccidioidomycosis
- chronic lung infection due to inhalation of spores of coccidioides immitis common in the san joaquin valley of california that may have ass. chronic ulcers in the mouth resembling a malignancy.
cryptococcus
- chronic infection of the lungs ass. with bird droppings. can spread to CNS. oral chronic ulcers primarily occur in immunocompromised patients and are best treated with amph. b.
mucormycosis: rhinocerebral zygomycosis
- background; fungi are ubiquitous in the natural world, often found in ass. with plants, mammals andinsects.

- accordingly, humans are continually exposed to multiple genera of fungi via various routes, including the resp. and gi routes, which allow the possiblity of colonization.

- depending on the interaction between host mucosal defence mechanisms and fungal virulence factors, colonization may be transient or persistent.
aspergillosis
- infection commonly located in the lungs of immunocompromised patients and occasionally occuring as a destructive lesion of the maxillary sinuses

- best treated in the oral area with surgical debridement followed by amphotericin B and fluconazole fungicides and with mgmt. of the predisposing condition.
north american blastomycosis
- an uncommon, rarely symptomatic, chronic lung infection due to inhalation of spores of blastomyces dermattides.
- has ass. skin lesions and occasional chronic oral ulcers that resemble malignancy and are best treated with amphotericin B.
types of viruses
- dna virus (uses nuclear DNA for replication)

- RNA virus - (remains in cytoplasm)
latency
- prolonged stage of some viral infections in which the viral core is integrated within cellular components, but its presence is not detectable clinically or with the use of lab methods.
viral infections
- herpes virus
- coxsackie virus
- toga virus
- paramyxovirus
- human pappiloma viruses
- retroviruses.
herpes virus
- herpes simplex virus
- vz
- epstein barr
- cytomegalovirus
herpes viruses
- neurotropic ( HSV 1 and 2 and VZV)

- lymphotrophic - ebv, CMV

- all herpetic viruses are capable of replicating in epithelial cells.
herpes simplex virus
- type 1 - oral lesions
- type 2 - genital lesions
herpes simplex infections
- acute primary herpetic gingivostomatitis
- secondary or recurrent HSV infections
- herpetic whitlow
acute primary herpetic gingivostomatitis
- uncommon initial herpes simplex infection in which multiple shallow ulcers form.

- are present throughout both the keratinized and gland bearing intraoral surfaces.

- accompanied by systemic symptoms of fever, lymphadenopathy and myalgia.
;rimary herpetic stomatitis
- usually occurs in young children
- pt. has no neutralizing antibodies
- child becomes very ill.
recurrent herpes labialis
- episodic occurences of a cluster of vesicles and shallow ulcers localized to the lateral aspects of the lips.

- in pt. with latent herpes simplex infections dormant in ganglia that innervates the lips.

- lesions are triggered by a number of internal or external factors.
triggering factors for clinical manifestation of recurrent herpes
- emotional stress, trauma, cold, sunlight, gi upset, fever, menstrual cycle, immunes suppression
herpetic whitlow
- an intense painful infection of skin folds around the fingernails.

- caused by a direct contact with an active lesion.
type 2 herpes simplex genital herpies
sick
neonatal herpes simplex virus
- infants bonrn to mothers with genital herpes
- involves skin, eyes, central nervous system, and internal organ.
- treated with iv injection of acyclovir and supportive care.
tx. of herpes simplex
- palliative and supportive like soothing rinses and analgesics

- anti viral agents like acyclovir for immunocompromised patients and genital infections.
herpes zoster virus
- primary lesion is varicella or chicken pox followed by a period of latency
- during latency the virus resides in regional ganglia
secondary lesions result from decreased immunity and secondary lesions may occur colled herpes zoster
primary varicella zoster lesion
- acquired during childhood
- produces a maculo papular rash of the skin.

- malaise, fever and minor lesions throughout the oral cavity.

- contracted through close contact with other infected individuals.
herpes zoster (shingles )
- regional occurnece of the vzv

- appears as vesicular eruptions of skin or mucosa
- distinctive unilateral pattern
- severe pain
- pain persists for prolonged periods after lesions heal. (post herpetic neuralgia)
zoster shingles clinical signs
- first sign is pain/ tenderness and erythematous rash.
- followed by blisters/ vesicles for 4-5 days
- becomes encrusted
- heals in 1-2 weeks
- post herpetic neuralgia.
tx. of herpes zoster
- admin. of acyclovir within 72 hours after onset of the rash.
- oral steroid to relieve the pain and post herpetic neuralgia
- narcotics for post herpetic neuralgia.
epstein barr virus
- ebv is a gamma herpes virus
- infects mainly b Lymphocytes
- remains latent after primary infection.
primary diseases
- infectious mononucleosis
- chronic ebv infection
- x linked lymphoproliferative syndrome

- reactivation syndrome
- lympho proliferative disorders in immunocompromised patients
- burkitt lymphoma
- nasopharyngeal carcinoma
- hairy leukoplakia.
diseases caused by EBV
- mononucleosis
- hairy leukoplakia
- immunoproliferative lesions and burkitt lymphoma
- nasopharyngeal carcinoma
infectious mononucleosis
- large lymphocytes with large nuclei.
- by means of lymphocytes ebv can gain passage to the epithelial cells of the oropharynx.
- detectable antibody (IgM) to virus.
lymphocyte description in infectious mononucleosus
- large and non neoplastic with a large purple core in histo analysis.
tx. of infectious mononucleosis
- analgesics
- rest
- don't need to isolate the patient.
chronic ebv infection
- seen in adults adolescents and children.
- profound debilitatieve fatigue ass. wtih low grade or subjective fever, sore throat.
- weakness, myalgia, arthralgia, headache, confusion and sleep disturbance.
x linked lympho proliferateive syndrome (duncans disease)
- rare x linked recessive disorder in which affected individuals develop a fatal primary infection when exposed to EBV.
lymphoproliferative disorders in immunocompromised patients
- immunosuppressed pt. may develop a polyclonal proliferation of EBV transformed B cells.
burkitts lymphoma
- form of lymphoma first described in equatorial africa that is ass. with ebv.

- has a predilection for the jaws of children.

STARRY SKY APPEARANCE histologically.
with macrophages and tumor cells present.
nasopharyngeal carcinoma
- aggressive form of SCC in the nasopharynx
- having varying levels of differentiation.
- often first discovered as a metastatic lesion in a lateral neck lymph node.
- undifferentiated forms of this tumor are ass. with EBV.
hairy leukoplakia
- vertically corrugated, slightly elevated WHITE surface alteration of the LATERAL or VENTRAL tongue margin.

- does not wipe off and can't be seen at other oral sites, usually in conjunction with tongue lesions.
- treated with chemotherapy
coxsackie virus
- part of picornavirus (includes common cold virus) family.
- RNA virus
- 2 types - A (affecting oral region) and B affecting epithelial tissue of oropharynx.
lesions ass. with coxsackie viruses
- herpangina
- hand, foot and mouth diseases
- acute lymphonodular pharyngitis.
herpangina
- non treatable mild infection caused by a mixture of cox. a viruses
- localized to the post. soft palate and nasopharynx.
- consist of multiple small shallow ulcers resembling a herpetic infection that lasts for approx. one week.
hand foot and mouth disease
- a highly contagious systemic infection of cx a virus

- limited duration in which vesicular eruptions occur in the palms of hands, soles of feet, and mucosa of ant. part of the mouth.
hand foot and mouth gen. info.
- incubation period of 3-5 days
- dispersed vesicles, 5-10 in number.
- 2-6 mm in diameter surrounded by red halo.
- rupture quickly, leaving painful ulcers.
- present for 5-8 days.
- vesicles found intra dermally, consisting of epidermal exocytosis, spongiosis, and individual cell necrosis.
acute lymphonodular pharyngitis
- localized infection of cox a virus
- consisting of yellow or white papules surrounding an erythematous zone confined to the lymphoid tissues.
- post. soft palate and nasopharynx that lasts from 1-2 weeks.
togavirus (rubella)
german measles
- systemic viral infection
- begins in resp. tract and moves to circ. system.
- produces a papular skin rash, fever and malaise that lasts for 1-2 weeks.

- capable of producing congenital defects during pregnancy.
paramyxovirus
- measles (rubeola)
- mumps (epidermic parotitis)
measles (rubeola)
- highly contagious systemic viral infection
- crontracted through the resp. system and spread through the circ. system.
- predilection for skin blood vessels that produce a skin rash.
- sometimes pneumonia and encephalitis.
spots in measles
KOPLICK SPOTS - typically involve the buccal and labial mucosa.
- irregular patchy, erythema with a central, minute bluish white specks with the appearance of a grains of salts.
mumps
- acute viral illness
- until recently only thought to affect armies during times of mobilization
- incubation period is 14-18 days (range of 14-25 days)
- the prodromal symptoms are non specific, and include myalgia, anorexia, malasie, headache and low grade fever.
mumps - epidemic parotitis
- localized viral infection contracted through the resp. system.
- primarily affects one or more major salivary glands.
- swelling and pain
- occasionally affects other organs; and produces fever and malaise.
mumps continued
- parotid gland involvement (parotitis)
- common 90% bilateral
- painful due to the stretching of the parotid capsule
- lasts for 3-4 days
- displaces the ear lobe due to involvement of the tail of the parotid gland.
- may even cause trismus in extreme instances
- may cause the skin overlying the parotid gland to be warm and flushed BUT ther is NO rash.
mumps cont.
- clinical swelling of the submand. glnds is much less frequent ( 10%)
- symptomatic sublingual gland involvement is uncommon.

- can involve a wide range of different tusses and organs.
- meningitis is common, but is typically mild
- orchitis - may dev. 4-5 days after the parotitis.
- generally only occurs in post pubertal males and rarely causes sterility.
serious complications of mumps include
- deafness
- encephalitis

mumps is a self limiting disease in most cases.
- no specific anti viral therapy mgmt. is supportive.
human papilloma virus (HPV)
- part of DNA papovavirus family
- there are 100 HPV subtypes
- tropism for epithilial cells
- are found in normal mucosa in a late stage, and in benign and malignant lesions.
HPV in benign oral lesions
- squamous papilloma (hpv 6 and 11)
- verruca vulgaris ( HPV 2 and 4)
- condyloma acuminatum (hpv 6 and 11)
- focal epithelial hyperplasia ( HPV 13 and 32)
squamous papilloma
- papillary focal epithelial hyperplasia common in the post. aspect of the mouth, containing koilocytic cells and HPV 6 and 11
papilloma
- benign epithelial enlargement that is ass. with human papilloma virus infection.
- firm, nonpainful, and pedunculated
- rough white cauliflower or warty surface with numerous fingerlike projections.
- arises from surface of sse, is exophytic and it does not invade underlying tissues.

- excisional biopsy including the base of the lesion is the tx.

- recurrence is unlikely.
mumps - epidemic parotitis
- localized viral infection contracted through the resp. system.
- swelling and pain
- primarily affects one or more major salivary gland.
mumps epidemic parotitis
- can involve a wide range of different tissues and organs
- meningitis is common but mild usually.
- orchitis - may develop 4-5 days after the parotitis. rarely causes steriolity.
papilloma
- a benign epithelial enlargement ass. with HPV infection.
- firm, nonpainful and pedunculated
- rough white cauliflower or warty surface with numberous fingerlike processes.
veruca vulgaris (wart)
- papillary focal epithelial hyperplasia commonly containing koilocytic cells of HPV 2 or HPV 6
- commonly occurs on hands and ant. aspect of mouth of kids.
veruca vulgaris cont.
- asymptomatic, exophytic and broad base.
- surface is white rough and warty
- may be solitary or multiple
- may spread to other body surfaces via autoinoculation.
- sometimes spontaneously resolve.
- usually treated by liquid nitrogen, chemical agents or surgical excision.

- ORAL verruca are treated by excisional biopsy.
condyloma acuminatum
- multiple papillary or sessile focal areas of epithelial hyperplasia
- genital and oral mucosa that contain koilocytes and HPV 6- HPV 11

- hard to get rid of.
statistics on HPV infection
- 20% of women are infected with HPV.

- cervical cancer is the second leading cause of cancer among women.

95% of cervical cancers contain HPV DNA
transmission of HPV
- similar to other diseases regarding other venereal diseases.

- high correlation, therefore between number of sex partneers and risk of infection.
condyloma accuminatum
- warty soft tissue enlargemet caused by HPV
- sexually transmitted and most common in the anogenital region.
- often has multiple lesions.
- TREATED BY SURGICAL EXCISION
- pat. sexual partner should also be treated.
focal epithelial hyperplasia (multifocal epithelial hyperplasia, heck disease)
- multiple papillary or sessile areas of epithelial hyperplasia of the oral mucosa.
- in young patients of specific pop. isolates that frequently regress spontan.

- the epithelium is extensively acanthotic and contains koilocytes and HPV 13 and HPV 32.
focal epithelial hyperplasia exceptions
- characterized by acanthosis, with the presence of mitosoid cells which presumably reflect the presence of the causative virus.
retrovirus
HIV causes aids -
- the virus can enter the body through the lining of the vagina, vulva, penis, rectum or mouth during sex.

- may also be spread through infected blood
aids transmission to babies
- about 1/4 to 1/3 of all women infected with HIV and untreated will pass the disease on to their children.

- can also be spread through the breast milk.

- mother should be on AZT therapy to reduce transmission problems.
early symptoms of HIV infection
- fever, headache, tiredness and enlarged lymph nodes.
cdc's def. of aids
- hiv infected people who have fewer than 200 CD4 positive T cells per cubic millimeter of blood. (healthy adults usually have CD4 positive counts of more than 1000)
- 26 clinical conditions that affect people with adva nced HIV disease. most are opportunistic infections.
symptoms of opportunistic infections common in people with aids include...
coughing and shortness of breath.
how to diagnose HIV
two tests
1. Elisa
2. western blot
elisa test
- enzyme linked immuno sorbent assay.. is a relatively inexpensive and very accurate test (though not 100 percent)

- in this test (generally the first test performed) a blood sample is taken and spun at high speeds allowing serum to seperate from blood.

- then a reagent is added that changes color to indicate HIV infection.
western blot test
- confirms the elisa test findings if they are positive.. because it is expensive.
infections and neoplastic lesions ass. with aids
- pneumocystis carinnii pneumonia
- cryptosporidiosis
- toxoplasmosis
- cerebral meningitis
- kaposi sarcoma
- non hodgkins lymphoma.
- generalized herpes simplex/ vzv infections
- cmv retinitis
- candidiasis
common oral lesions in patiens with AIDS
- candidiasis
- intraoral
- esophogeal
- hairy leukoplakia
- diffuse herpes simplex gingivostomatitis
- diffuse varicella zoster lesions
- kaposi sarcoma
- non hodgkin lymphoma
- hiv gingivitis / periodontitis
- acute nonspecific ulcers
- chronic ulcers
- cryptococcus neoformans
- histoplasma capsulatum
- cmv
- herpes simplex
kaposi sarcoma
- macular or nodular vasc. lesions occuring singularly or in multiples on the mucosa and skin of HIV infected patients; lesions consiste of proliferating atypical endothelial cells and indicate that the patient has aids.
tx. of HIV infection
- RT inhibitors - interrrupts early stage of the virus making copies of itself.

- included in this class of drugs are AZT

- may slow the spread of HIV in the body and slow the start of opportunistic infections.

- second class is known as protease inhibitors ... interupt virus replication at a later stage in their life cycle. all end in - vir.
features of benign tumors
- slow growth , encapsulated , well defined, non ulcerated, no metastasis.
malignant tumors
- differ from benign tumors in 4 different ways
1. structure
2. rate of growth
3. invasive growth
4. metastasis
- metastasis is a unique feature of malignant tumors.
features of malignant tumors
- list on slide 10 of epithel.
experimental carcinogenesis
- initiation - alteration in genome occurs
- promotion - event that causes proliferation of the tranformed cell, giving rise to a neoplasm.

- progression - new genetic mutation occurs with dev. of sub clones of neoplastic cells.
histological chanegs in malignant neoplasm
- pleomorhism - variation in cell and nuclear size and shape.
- hyperchromatism - inc. nuclear DNA

- abnormal mitosis
- increased mitosis
- anaplasia - loss of morphologic evidence of maturation.
epithelial disorders (lesions of oral epithelium)
- benign epithelial tumors
- benign pigmented lesions
- epithelial hyperplasia/ atrophy/ dysplasia and malignant epithelial tumors and melanoma.
benign epithelial lesions
- squamous papilloma
- keratoacanthoma
papilloma
- slow growing caused by HPV 6 and 11
- no potential for malignancy and removed by local excision.
other HPV related epithelial lesions caused by different subtypes of the virus ...
- verrucous vulgaris
venereal wart (condyloma accuminatum)
- focal epithelial hyperplasia
focal epithelial hyperplasia
ass. with HPV
keratoacanthoma
- benign endophytic epithelial growth
- appearing as a well circumscribed keratin filled crater
- on sun exposed skin
- often mistaken for squamous cell carcinoma.
- surgical tx.
benign pigmented lesions
- melanotic macules
- smokers melanosis
- nevi
- intramucosal (intradermal) nevus
- junctional nevus
- compound nevus
- blue nevus
melanotic macules
- physilogic or reactive small, flat brown areas of the mucosal surface
- caused by an increase in the production of melanin granules
- not in the number of melanocytes.
nevi
- benign, exophytic, usually pigmented congenital lesion of the skin or mucosa.
- composed of focal collections (nests) of rounded melanocytes (nevus cells)
- surgical excision of oral nevi.
nevus: birth mark, mole
- dependingon location of the nevus cells, specific lesions are classified.

- intradermal (intramucosal)
- junctional
- compound
- a macular form, usually of the hard palate and composed of fusiform cells, is termed blue nevus.