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61 Cards in this Set
- Front
- Back
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Periodontitis
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Loss of periodontal ligament attachment and alveolar bone
May lead to tooth loss Related to shift in bacterial flora |
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Periodontal (gum) disease can manifest as a component of diseases like
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HIV / AIDS
Leukemia Diabetes mellitus |
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Periodontal (gum) disease Etiologic factor
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Infective endocarditis
Pulmonary and brain abscesses Low birth weight |
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oral cavity Fibroma
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Buccal mucosa or lateral border of tongue
Nodular mass of fibrous tissue covered by squamous epithelium |
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Pyogenic granuloma
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Vascular pedunculated lesion
Often in pregnant women (pregnancy tumor) Usually undergoes spontaneous regression |
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Aphthous ulcer (canker sore)
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Superficial ulceration of oral mucosa
Rimmed by zone of erythema Single or multiple Can be painful, recurrent |
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Rubeola (measles
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Koplik spots
Small, red, irregularly-shaped lesions with blue-white centers |
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Candida albicans
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Oral thrush
HIV / AIDS Diabetes mellitus Transplant recipients Chemotherapy |
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During a physical examination, you inspect a patient’s oral cavity and identify a white lesion involving the buccal mucosa. In order to help you narrow the differential diagnosis, the item in your armamentarium that you should use next is a
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Tongue blade
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Scarlet fever
oral changes |
Fiery red tongue with prominent papillae (raspberry tongue); white-coated tongue through which hyperemic papillae project (strawberry tongue)
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Measles
oral changes |
Spotty enanthema in the oral cavity often precedes the skin rash; ulcerations on the buccal mucosa about Stensen duct produce Koplik spots
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Diphtheria
oral changes |
Characteristic dirty white, fibrinosuppurative, tough, inflammatory membrane over the tonsils and retropharynx
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Human immunodeficiency virus
oral changes |
Predisposition to opportunistic oral infections, particularly herpesvirus, Candida, and other fungi; oral lesions of Kaposi sarcoma and hairy leukoplakia
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Pemphigus
oral changes |
Vesicles and bullae prone to rupture, leaving hyperemic erosions covered with exudates
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Erythema multiforme
oral changes |
Maculopapular, vesiculobullous eruption that sometimes follows an infection elsewhere, ingestion of drugs, development of cancer, or a collagen vascular disease; when it involves the lips and oral mucosa, it is referred to as Stevens-Johnson syndrome
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Leukemia
oral changes |
Leukemic infiltration and enlargement of the gingivae, often with accompanying periodontitis
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Pregnancy
oral changes |
A friable, red, pyogenic granuloma protruding from the gingiva (“pregnancy tumor”)
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Rendu-Osler-Weber syndrome
oral changes |
A friable, red, pyogenic granuloma protruding from the gingiva (“pregnancy tumor”)
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Addison disease, hemochromatosis, fibrous dysplasia of bone (Albright syndrome), and Peutz-Jegher syndrome (gastrointestinal polyposis) oral changes
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Melanotic pigmentation
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Precancerous lesions
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Erythroplakia
Leukoplakia |
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Leukoplakia
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White patch or plaque
Cannot be scraped off Cannot be characterized as any other disease |
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Erythroplakia
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Red, flat, velvety
Usually represents markedly atypical epithelium with a high risk of malignant transformation |
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Squamous cell carcinoma Pathogenesis
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Chronic abuse of tobacco and alcohol
HPV Inherited genomic instability UV radiation Betel quid |
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Periapical (radicular) cyst
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Pulpal inflammation
Pulp death (non-vital tooth) Secondary to dental caries or trauma |
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Residual cyst
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Cyst remaining after removal of associated tooth
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Developmental odontogenic cyst
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Dentigerous cyst
Keratocystic odontogenic tumor (KCOT) / odontogenic keratocyst (OKC) |
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Dentigerous cyst
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Around crown of unerupted tooth
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Keratocystic odontogenic tumor (KCOT) / odontogenic keratocyst (OKC)
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Locally aggressive
High recurrence rate If multiple, evaluate for nevoid basal cell carcinoma (Gorlin) syndrome |
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Odontogenic tumors
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Ameloblastoma
Commonly cystic Slow growing Locally invasive |
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Upper airways Inflammatory / reactive lesions
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Infectious rhinitis
Allergic rhinitis Chronic rhinitis Acute sinusitis Chronic (rhino)sinusitis Pharyngitis and tonsillitis (sore throat) Laryngitis |
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Infectious rhinitis (common cold)
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Usually viral etiology
Adenoviruses Echoviruses Rhinoviruses Can involve nose, pharynx, tonsils |
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Infectious rhinitis (common cold)
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Secondary bacterial infection may occur
Enhances inflammatory reaction Mucopurulent or suppurative exudates Infection usually clears within 7 days |
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Allergic rhinitis (hay fever)
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Type I hypersensitivity reaction to an allergen
Mucosal edema, redness, mucus secretion Eosinophilic infiltrates |
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Chronic rhinitis
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Sequel to recurrent infectious or allergic rhinitis
Superimposed bacterial infection Mucosal desquamation or ulceration |
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Acute sinusitis
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Usually preceded by rhinitis
May arise from dental infection extending through floor of sinus Impaired sinus drainage due to edematous mucosa |
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Chronic (rhino)sinusitis
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Arises from persistent / recurrent acute sinusitis
Usually bacterial infection by oral flora Serious infection may occur May be fungal and necrotizing Can involve and penetrate surrounding bone |
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Pharyngitis and tonsillitis (sore throat)
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Usually viral origin
Bacterial involvement may be primary or secondary |
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Laryngitis
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Usually occurs along with generalized URI
May occur with GERD Associated exudation and edema Hoarseness Obstruction |
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Laryngitis
May be severe in children Laryngoepiglottitis |
Medical emergency
Potentially lethal Thumb sign |
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Laryngotracheobronchitis (croup)
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Barking cough
Inspiratory stridor Steeple sign |
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Neoplasms
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Nasopharyngeal angiofibroma
Sinonasal (Schneiderian) papilloma Squamous papilloma Laryngeal carcinoma |
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Nasopharyngeal angiofibroma
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Adolescent males
Tends to bleed profusely |
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Sinonasal (Schneiderian) papilloma
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Exophytic
Cylindrical Inverted → High rate of recurrence Locally aggressive |
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Squamous papilloma
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Usually single in adults
May be multiple Papillomatosis Associated with HPV types 6 and 11 |
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Laryngeal carcinoma
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Nearly all (about 95%) are squamous cell carcinomas
Irreversible event in the hyperplasia-dysplasia-carcinoma sequence |
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Laryngeal carcinoma
Multiple risk factors |
Alcohol
Smoking HPV |
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Otitis media
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Pseudomonas aeruginosa
Diabetic patients May be aggressive, necrotizing, and destructive Staphylococcus aureus Fungus |
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ear neoplasm
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Most involve pinna
Basal cell carcinoma → Squamous cell carcinoma Associated with sun exposure Those elsewhere in the ear are rare |
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Branchial (cleft) cyst
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Superior lateral aspect of neck along sternocleidomastoid muscle
Thought to arise from second branchial arch remnants Most commonly observed in young adults |
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Thyroglossal duct cyst
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In midline of superior anterior neck
Arises from remnants of developmental tract of thyroid |
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Paraganglioma
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In proximity of larger vessels (carotid body tumor)
Associated with sympathetic and parasympathetic nervous systems |
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Paraganglioma histo
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Nests of round / oval neuroendocrine cells (zellballen) surrounded by spindle-shaped sustentacular cells
Variable clinical behavior |
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Xerostomia (dry mouth
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Decrease in production of saliva
High incidence Common side effect of many medications and related also to Radiation therapy Sjögren syndrome |
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Mucocele
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Results from blockage or rupture of duct
Saliva leakage into surrounding stroma Most often found on lower lip Trauma is most common cause |
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Sialadenitis
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Various etiologies
Viral Mumps Often affects parotid Other salivary glands may be impacted HIV |
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Sialadenitis
Various etiologies |
Obstruction due to stone formation (sialolithiasis)
Impacted food debris Edema around duct orifice following injury |
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Pleomorphic adenoma (mixed tumor)
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Most common salivary gland neoplasm
Most appear in parotid |
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Warthin tumor (papillary cystadenoma lymphomatosum)
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Seen almost exclusively in parotid
More common in males Associated with smoking |
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Mucoepidermoid carcinoma
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Most common primary malignant salivary gland tumor
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Adenoid cystic carcinoma
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Slow but relentless growth
5-year survival rate about 65% 15-year survival rate about 15% |
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Adenoid cystic carcinoma
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On average, those arising in minor salivary glands have a poorer prognosis than those arising in the parotids
Perineural invasion (and pain) common |
