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134 Cards in this Set
- Front
- Back
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The eight categories that contribute segments of information leading to the definitive or final diagnosis are
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1. Clinical
2. radiographic 3. historical 4. laboratory 5. microscopic 6. surgical 7. therapeutic 8. differential findings (p.8) |
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Clinical diagnosis suggests the strength of the diagnosis comes from...
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the clinical appearance of the lesion (pg. 8)
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Bulla
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circumscribed, elevated lesion that is more than 5mm in diameter usually contains serous fluid and looks liek a blister
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lobule
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segment or lobe that is a part of the whole, lobes sometimes appear fused together
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macule
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distinuished by a color different from that of the surrounding tissue it is flat and does not protrude above the surface of the normal tissue. Freckle if an example of a macule
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Papule
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small, circumscribed lesion usually less than 1cm in diameter that is elevated or protrues above the surgace of normal surrounding tissue.
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predunculated
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attached by a stemlike or stalk base similiar to a mushroom
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pustules
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variously size circumscribed elevations containing pus
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sessile
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base of lesion flat or braod instead of stem
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vesicle
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small, elevated lesion less than 1cm in diameter containing serous fluid
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nodule
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palpable solid lesion 1cm in diameter found in soft tissue, can occur above, level with, or beneath the skin surface
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palpation terms
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soft, firm, semifirm, fluid filled (consistancy)
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pallor
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paleness of skin or mucosal tissues
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corrugated
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wrinkled
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fissure
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cleft or groove normal or otherwise, showing prominent depth
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Coalescence
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parts of a whole join together or fuse to make one
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diffuse
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borders not well defined
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multilocular
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lesion that extends beyond the confines of one distinct area and is defined as many lobes or parts that are somewhat fused together. If it is a radiolucency, sometimes resembles soap bubbles
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What can cause root resorption?
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response to a stimuli including cyst, tumor, or trauma (ortho) p.5
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Differential diagnosis
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practitioner decides which test or procedure is required to rule out the conditions originally suspected and establish the definitive or final diagnosis p.23
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Which of the following is NOT a variant of normal?
a. fordyce granules b. melanin pigmentation c. linea alba d. none |
d. none p28
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fordyce granules
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variant of normal. clusters of ectopic sebaceous glands, yellow lobules in clusters. More than 80% of adults over 20 years of age have it. p.24
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torus palatinus
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variant of normal. exophytic growth of normal compact bone. Frequent in women p.24
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mandibular tori
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variant of normal. normal dense bone found in lingual aspect of mandible in the area of the premolars above the mylohyoid ridge. Bilateral, lobulated p. 25
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melanin pigmentation
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variant of normal. most common in dark skinned individuals p.25
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retrocuspid papilla
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variant of normal. sessile nodule on gingival margin of lingual aspect of mand cuspids p. 25
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lingual varicosities
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variant of normal. ventral and lateral surfaces of tongue. Most common in individuals older than 60 years p.26
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linea alba
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variant of normal. white line on bucca mucosa along occlusal plane. prominent in bruxers
p.26 |
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Leukoedema
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variant of normal. generalized opalescence in imparted to the buccal mucosa by leukoedema. 85% of black adults. gray white film diffused throughout buccal mucosa making it look opaque. Stretching it will show normal pigment p. 26
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Lingual Thyroid Nodule
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(benign cond of unknown cause) mass in the midline of the dorsal surface of the tongue posterior to the circumvallate papillae in the area of the foramen cecum. Sessile baseand 2-3cm in width. p. 27
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Median Rhomboid Glossitis
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(benign condition of unknown cause) flat or slightly raised oval erythematous area in the midline of the dorsal surface of the tongue, beginning at the junction of the anterios and middle thirds and extending posterior to the circumvallate papillar. No filiform papillar, p. 27
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Geographic Tongue
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(benign condition of unknown cause)
may be genetic, exacerbated by stress, diffuse areas devoid of filiform papillae surrounded by white or yellow. Periods of remission! p.28 |
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Fissured Tongue
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benign condition of unknown cause) seen in 5% of population. may be genetic, dorsal surface of the tongue deep fissures . Advise to brush the tongue and keep clean p.28
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Hairy Tongue
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benign condition of unknown cause)
Increased accumulation of keratin on the filiform papillae. Either caused by increased keratin production or decreased in desqwaumation. p.28 |
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Abfraction
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stress induced cervical lesions (abfract=to break away)
Wedge shaped lesions |
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Perimolysis
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Enamel loss on the occlusal surfaces, cause restorations to seem high.
Seen in bulimia, carbonation and swimming |
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Frictional Keratosis
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chronic mechanical irriation, thickened surface epithelium (keratin)
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Morsicatio Buccarum
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Cheek biting
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Linea Alba
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Horizontal grayish white line on bucca mucosa.
Hyperkeratonosis |
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How long should trauma return to normal?
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About two weeks
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Submucosal Hemorrhage
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reddish purple to blue-black
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Smallest bruise is called...
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Petechiae
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Intermediate bruise called
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Ecchymoses
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BIG bruise
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hematoma
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Petechiae
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nonraised, pinpoint area of submucosal bleeding
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Ecchymosis
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large, nonelevated area of submucosal bleeding
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Palatal Ecchymosis
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traumatic lesion from sexual activity
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Soft Tissue Emphysema
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air or gas in soft tissue space!
Crepitation on palpation (sounds like paper crackling) |
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Anesthetic Necrosis
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tissue die as injection site (likely to happen with 1:50,000 epi)
Typically palatal. Heal in two weeks |
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Nicotine Stomatitis
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benign thickening of the mucosa
Seen especially in pipe smokers Hard and soft palate, salivary duct orifices is seen easily |
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Smoker's Melanosis
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Anterior gingiva stained!
Benign hyperpigmentation from smoking |
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Tobacco Chewer's White Lesion
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Alteration of oral mucosa
Inflammated gingiva and recession |
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Tobacco pouch
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white pouch
Deeply fissured MAY BE PRECANCEROUS |
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TRaumatic Neuroma
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reactive hyperplasia of nerve elements dur to trauma to nerve
PAINFUL Small, smooth, pink |
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Actinic (Solar) Cheilitis
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Seen often on the lower lip
Pre-Malignant No distinct vermillian border |
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What is crevicular fluid?
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Serous exudate!
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Functions of exudate
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Dilutes bacterial toxins
Contains antibodies Inactivated toxins Provides nutrients for inflammatory cells |
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What is the primary cell of the inflammatory response?
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PMN
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What is the primary immune cell?
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Macrophage
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What are plasma cells derived from?
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B lymphocytes
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Heparin
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anti-coagulant
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Chemical Mediators
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start, enhance or ampily the inflammatory response.
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Exogenous chemical mediators
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Come from bacteria
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Endogenous chemical mediators
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Histamine, Kinins,Arachadonic acid
From OUR complement system |
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What does the complement system do?
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Mediates ascular response by histamine release
Recruits phagocytic leukocytes Opsonizes the targets of phagocytic cells = recognizes and attaches to the target Damages target cells |
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Opsonin's
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enhance phagocytosis by leukocytes. Causes OPSONIZATION
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At the site of the injury during early inflammation Kinin's do this...
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increase dilation of the vessels and permeability. Induces pain!
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Margination
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coming tinto contact with the blood vessel wall
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Pavementing (adhesion)
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sticking to the blood vessel wall (endothelial surface)
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Emigration (diapedesis)
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leaving the blood stream
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Opsonization
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recognizing and attaching to the target
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Leukocytosis
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increased # of leukocytes in the blood stream
10,000-30,000 leukocytes reponse to overwhelming injury |
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Lymphadenopathy
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swollen lymph nodes caused by
1. increased # of lymphocytes 2. LARGER lymphocytes |
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What causes fever?
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Caused by pyrogens (hypothalmic regulation)
It kills the bacteria, but too much will kill YOU |
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What is a normal WBC count?
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4000-10,000
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You see a lesion that is firm, enlarged, nontender and non moveable. What do you think?
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DANGEROUS!
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Which is pathologic?
a. Granulation tissue b. Granulomatous tissue |
B. Granulomatous tissue!
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What do you call any disease that is in bone?
a. central b. peripheral |
a. central
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What do you call any disease that is in tissue, over bone?
a. central b. peripheral |
b. peripheral
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Hyperplasia is what?
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multiplication of # of cells
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Hypertrophy
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the cells are all bigger than they are supposed to be
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What would you expect in chroinc inflammation?
A. Hypertrophy B. Hyperplasia C. Both |
C. BOTH
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What would you expect in acute inflammation?
A. Hypertrophy B. Hyperplasia C. Both |
C. Both or Either!
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What forms the scafolding for connective tissue?
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fibrinogen
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What heals first? Epithelial tissues or CT?
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same time
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What is important about day 7 after injury?
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this tissue is now sealed off and resistant to further injury. Susceptible still, but reasonable repair
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What can impair repair?
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Tobacco, alcohol, nutrition, edema, infection, removal of osteoblast layer and excessive or inadequate movement.
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Mucocele
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salivary fluid building up, most common on lower lip.
Not typically a cyst because there isn't a pathologic core |
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Ranula
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mucocele, blue due to venous blood and proximity to the surface.
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Sialolithiasis
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obstruction of salivary gland duct by salivary stone
Antibiotics and passage or removal. |
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Sialadenitis
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painful swelling in response to the stone, chronic sclerosing sialadentitis may develop
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Necrotizing Sialometaplasia
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salivary gland necrosis causing swelling and ulceration. No known cause
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Hypertrophy
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the cells are all bigger than they are supposed to be
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What would you expect in chroinc inflammation?
A. Hypertrophy B. Hyperplasia C. Both |
C. BOTH
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What would you expect in acute inflammation?
A. Hypertrophy B. Hyperplasia C. Both |
C. Both or Either!
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What forms the scafolding for connective tissue?
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fibrinogen
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What heals first? Epithelial tissues or CT?
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same time
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What is important about day 7 after injury?
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this tissue is now sealed off and resistant to further injury. Susceptible still, but reasonable repair
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What can impair repair?
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Tobacco, alcohol, nutrition, edema, infection, removal of osteoblast layer and excessive or inadequate movement.
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Mucocele
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salivary fluid building up, most common on lower lip.
Not typically a cyst because there isn't a pathologic core |
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Ranula
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mucocele, blue due to venous blood and proximity to the surface.
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Sialolithiasis
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obstruction of salivary gland duct by salivary stone
Antibiotics and passage or removal. |
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Sialadenitis
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painful swelling in response to the stone, chronic sclerosing sialadentitis may develop
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Necrotizing Sialometaplasia
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salivary gland necrosis causing swelling and ulceration. No known cause
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You see a multilocular boney thing in an xray that is pushing roots aside. Other than a cyst, what could it be?
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central giant cell granuloma
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gingival hyperplasia
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an altered tissue response due to pregnancy, puberty, phenytoin, Ca channel blockers, cyclosporine
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Chronic Hyperplastic Pulpitis
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AKA pulp polyp, overgrowth of chronically inflamed granulation tissue from a carious pulpal exposure. Usually in young children
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Choristoma
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normal tissue in an abnormal location, rare in the oral cavity
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Periapical Abcess
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pus w/CT and WBC
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Periapical granuloma
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chronic granulation tissue
(lymph, marcophages, plasma cells & dense fivrous CT) |
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Periapical cyst
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true cyst
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T or F A cystic periapical lesion will not heal from a root canal
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TRUE
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What organism tends to form tracts outside of the face from periapical abcess?
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Actinomyces
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Parulis
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abcess that perforates teh cortical plate, provides drainage
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Resorption
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we think pressure causes it
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Internal resorption treatment needed
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root canal
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T or F Dry socket has no radiographic appearance
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TRUE
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Two types of immune disorders
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1. allergies (sensitivity, hyper etc)
2. Autoimmune diseases (your body attacks itself) |
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T or F The IMMUNE response works on top of an already activated INFLAMMATORY response.
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True
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Cell mediated response dominates with what kind of lymphocytes
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T-lymphocytes
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Natural Killer cells are what type of lymphocyte?
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T-lymphocytes, they can kill without having to recognize as specific antigen
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Which Ig is found in saliva?
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IgA
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Immunity is different from inflammatory response--
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1. The immune response differs from the inflammatory
response in that it has a memory. 2. That memory allows a much faster and stronger response. 3. This increased responsiveness is known as IMMUNITY. |
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What is the difference between naturally occuring or acquired immunity (both active)?
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Natural occurring active immunity is the result of a disease caused by a microorganism from which the body has already recovered
Acquired active immunity is established by immunization. |
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What is the difference between naturally occuring passive or acquired passive immunity?
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Natural passive immunity– from mother to fetus until own system matures
Acquired passive immunity – in cases where the individual has not been previously immunized against but has been exposed to an infectious disease, antibodies from a different individual are collected and administered to provide immediate protection |
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Immunopathology
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The branch of medicine and dentistry in which the antigen has been successfully defeated and removed but the immune response, itself, malfunctions, resulting in further tissue damage.
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What are included in immunopathology?
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Hypersensitivity
Autoimmune Disease |
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What releases histamine?
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mast cells
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Factors that affect risk for hypersensitivity reaction
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Route of administration:
Topical Parenteral Presence of infection – why? Multiple allergies Clients with autoimmune disease Age - adults have had more exposures |
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After arriving at a differential diagnosis information from wihch o e of the following categories will best extablish a final or definitive diagnosis?
a. clinical b. historical c. microscopic d. radiographic e. clinical laboratory test |
c. microscopic
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The descriptive term that would best be used for a freckle is a
a. bulla b. vesicle c. lobule d. macule e. papule |
d. macule
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Which one of the following terms describes the base of a lesion that is stalklike?
a. sessile b. lobulated c. bullous d. macule e. pedunculated |
e. pedunculated
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Clinical diagnosis can be used to determine the final or definitive diagnosis of all the following except:
a. Fordyce Granules b. unerupted supernumerary teeth c. mandibular tori d. geographic tongue e. white hairy tongue |
b. unerupted supernumerary teeth
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Radiographic diagnosis would most likely be sufficient to determine the final or definitive diagnosis of
a. Internal resorption b. periapical cemento-osseous dysplasia c. odontomas d. dental caries e. all of the above |
e. all of the above
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