Oral Path Quiz 2

Front 1

what is Hyperkeratosis

Back 1

thickened keratin layer of the surface epithelium. like a calus

Front 2

Hyperorthokeratosis

Back 2

epithelium has a granular layer and the nuclei are lost in the keratin layer

Front 3

Hyperparakeratosis

Back 3

there is no granular cell layer and the epithelial nuclei are retained in the keratin layer
(remnant exists on outer)

Front 4

Spongiosis

Back 4

intercellular edema of the spinous cell layer

Front 5

Acanthosis

Back 5

thickened spinous layer. DON’T GET CONFUSED WITH ACANTHOLYASIS

Front 6

Epithelial dysplasia

Back 6

changes in size, shape and
organization of adult cells. begins in the basilar portions of the epithelium.

Front 7

Verrucous hyperplasia

Back 7

a type of papillary, exophytic proliferation of squamous epithelium “FINGERLIKE”

Front 8

Oral areas that are keratinized

Back 8

1) Hard palate
2) Gingiva
3) Alveolar mucosa
4) Dorsal tongue

Front 9

Oral areas that are non-keratinized

Back 9

1) Buccal mucosa
2) Buccal vestibule
3) Labial mucosa
4) Labial vestibule
5) Floor of mouth
6) Lateral tongue
7) Soft palate
8) Gingival sulcus

Front 10

is it oral keratinized or non keratinized that are more vulnerable to malig

Back 10

non-keratinized

Front 11

clincial features of Leukoedema? who gets it more?

Back 11

-common, painless and persistent.
considered a normal variation (not a neoplasm)
-it appears to be more prominent in blacks (70-90%) and dark-skinned
-bilateral
-buccal mucosa shows a diffuse filmy milky opalescence
-mucosa may appear somewhat folded, or wrinkled
*white appearance disappears when tissue is stretched
-may also involve floor of mouth

Front 12

etiology of leukoedema

Back 12

not know. but seen more in smokers

Front 13

histology of leukoedema

Back 13

acanthosis, parakeratosis and intracellular edema

Front 14

tx for leukoedema

Back 14

none since non malig. but should look to make sure it is not leukoplakia

Front 15

Differential diagnosis for leukoedema

Back 15

keratosis
white sponge nevus
smokeless tobacco lesions
cheek-biting lesions

Front 16

clinical features for Linea Alba

Back 16

white line along buccal mucosa in region of occlusal plane

Front 17

Histology for linea alba

Back 17

hyperorthokeratosis, intracellular edema

Front 18

etiology for linea alba

Back 18

may be due to biting buccal mucosa or negative pressure due to habits such as sucking cheeks

Front 19

clinical features for Squamous Papilloma: what is it? what does it look like? where does it usually reside? who is more at risk? what color is it?

Back 19

-exophytic (ABOVE SURFACE), “cauliflower-like” soft lesion, WHITE
-usually a few mm in diameter (0.5 cm) but up to 1.5 cm
-pedunculated or less commonly sessile
-usually found on tongue, lips, buccal mucosa, gingiva and palate (palate and uvula account for 1/3 of lesions)
-seen at any age (usually adults)
-may be white or pink (depends on amount of hyperkeratosis)

Front 20

what is the most common oral lesion

Back 20

squamous papilloma

Front 21

Etiology of squamous papilloma

Back 21

Human Papilloma Virus(HPV)- especially subtypes 6 & 11
(low virulence and infective rate)
(3 to 12 month incubation period)
- transmitted by person to person contact, etc.

Front 22

Histology of squamous papilloma

Back 22

-long thin finger-like projection of squamous epithelium
containing a thin connective tissue core
-may show hyperkeratosis

Front 23

Treatment for squamous papilloma

Back 23

1) excisional biopsy (including base of lesion)
2) recurrence and dissemination to other parts of body rare
3) malignant transformation rare
4) vaccine targeted for HPV types 6, 11, 16 and 18

Front 24

Differential diagnosis for squamous papilloma

Back 24

1) verruca vulgaris
2) verrucous carcinoma
3) condyloma acuminatum
4) verruciform xanthoma
5) etc.

Front 25

Clinical features of Verrucous Vulgaris

Back 25

1) common, painless and persistent
2) wart-like with sessile base
3) has finger-like projection
4) may be white or normal in color
5) some may show a keratin horn

Front 26

who is prone to Verrucous Vulgaris? where is it usually?

Back 26

-children and young adults
-oral lesions often seem on vermillion border, labial mucosa
and anterior tongue
-may spread to other parts of body, especially fingers (contagious)
-commonly found on hands and fingers of children

Front 27

Etiology Verrucous Vulgaris

Back 27

human papilloma virus, HPV-2, HPV-4, HPV-6 and HPV-40

Front 28

Histology Verrucous Vulgaris

Back 28

1) pointed projections from surface epithelium (FINGER LIKE PROJECTIONS. NOT PEDUNCULATED)
2) thickened keratin
3) viral inclusion may be seen in upper spinous layer
4) inflammation in connective tissue
5) MULTIPLE NOT JUST BY ITSELF

Front 29

Treatment of Verrucous Vulgaris

Back 29

excisional biopsy, laser, cryo therapy
-some disappear spontaneously (⅔ within 2 years)

Front 30

Differential Diagnosis for verrucous vulgaris

Back 30

same as squamous papilloma

Front 31

Condyloma Acuminatum also know as Venereal Wart. what is the etiology

Back 31

- Human papilloma virus group HPV-2, (HPV-6, HPV-11, HPV-16, HPV-18, HPV-53, HPV-54 and HPV 31)
- incubation period 1 to 3 months after sexual contact

Front 32

verrucous vulgaris is what kind of wart

Back 32

Common Wart

Front 33

how do ppl get Condyloma Acuminatum

Back 33

sexually transmissible and autoinoculable viral disease (STD)

Front 34

tx for condyloma acumintam

Back 34

Excisional biopsy

Front 35

what does Condyloma Acuminatum look like?

Back 35

-soft papillary nodules that proliferate rapidly in size
-white or pink
-up to 2 cm in diameter (larger than squamous papillomas)

Front 36

where can you usually see Condyloma Acuminatum.

Back 36

-anogenital skin (can occur in mouth)
-multiple, papillary masses involving tongue,buccal mucosa, palate, gingiva

Front 37

For Condyloma Acuminatum, in anogenital areas, those infected with HPV 16 and HPV 18 are associated with an increase in what?

Back 37

squamous carcinoma

Front 38

WHAT IS A KOILOCYTE?

Back 38

???

Front 39

who gets Focal Epithelial Hyperplasia (Heck's disease)

Back 39

-children (ages 3 to 18) and middle-aged adults
-1st observed on American Indians, but also ethnic groups
affected

Front 40

what does focal epithelial hyperplasia look like?

Back 40

-flattened multiple nodular lesions usually on lower
lip, but also seen on buccal mucosa, commissures, upper lip and tongue
-lesions usually 1 to 5 mm in diameter
-same color as adjacent mucosa

Front 41

Heck's disease is common in what age?

Back 41

children

Front 42

etiology of Focal Epithelial Hyperplasia

Back 42

may be of viral origin (human papillomavirus types 13 and 32)

Front 43

Histology of Heck's disease

Back 43

-acanthosis
-mitosoid cells are sometimes seen in squamous epithelium

Front 44

tx for focal epithelial hyperplasia

Back 44

none unless want to move it for aesthetic reasons

Front 45

Differential Diagnosis for heck's disease

Back 45

Squamous papilloma OR MULTI FIBROMA

Front 46

Verruciform Xanthoma looks like what?

Back 46

1) characterized by lipid-laden histiocytes beneath epithelium
2) uncommon, painless and persistent
3) usually solitary lesion up to 1.5 cm in diameter
4) sessile or pedunculated base
5) normal or reddish in color or may be hyperkeratotic
6) rough or pebbly surface

Front 47

who gets Verruciform Xanthoma

Back 47

patients over 40 years of age (1:2, M/F ratio) MORE FEMALE

Front 48

where do you see Verruciform Xanthoma

Back 48

lower alveolar ridge, palate, floor of mouth, lip, genitalia, etc.

Front 49

etiology Verruciform Xanthoma

Back 49

unknown (probably not HPV) may be an unusual response to injury

Front 50

Histology Verruciform Xanthoma

Back 50

1) verrucous hyperparakeratotic surface with elongated rete ridges
2) large swollen "foam" cells (histiocytes and xanthoma cells) in connective tissue papillae between epithelial pegs

Front 51

Treatment for Verruciform Xanthoma

Back 51

1) excisional biopsy
2) usually no recurrence
3) no malignant tranformation

Front 52

Differential Diagnosis for Verruciform Xanthoma

Back 52

1) Squamous papilloma
2) Condyloma acuminatum
3) Early carcinoma

Front 53

summary Verruciform Xanthoma

Back 53

-SOLITARY LESION,
-NOT COMMON,
-RED PEBBLE LIKE SURFACE,
-FOUND ON SKIN OR GENITALIA, -HAS FOAM CELLS (XANTHOMA CELLS-MACROPHAGES)

Front 54

summary for Focal Epithelial Hyperplasia (Heck's disease)

Back 54

-VIRAL ORIGIN,
-YOUNG PPL,
-MULTI LESIONS SEEN, -CONSIDERABLE ACANTHOSIS

Front 55

summary for Condyloma Acuminatum

Back 55

-20% OF ALL STDS DX,
-CAN AUTOINOCULATE TO OTHER PARTS OF THE BODY
-THEY TEND TO BE LARGER THAN PAPILLOMA, -CONDYLOMATAS INFECTED WITH HPV 16 AND 18 HAVE AN INCREASED RISK OF MALIG TRANSFORMATION
-VERY CONTAGIOUS

Front 56

summary for Verrucous Vulgaris

Back 56

-CAN SPREAD TO OTHER PARTS, -HPV CAUSED,
-HAS KERATIN HORN AND FINGERLIKE PROJECTIONS