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Oral Path Exam 3
Oral Pathology Test 3
| Question | Answer |
|---|---|
| where are minor salivary glands not found? | gingiva |
| what are the three disease of benign soft tissue neoplasms? | papilloma verruca vulgaris condyloma acuminatum |
| what is the most common soft tissue mass in the soft palate? | papilloma |
| what does pedunculated mean? | big head, small neck |
| what does sessile mean? | bread base, small head |
| where is papilla found? | tongue, lips, soft palate |
| what is verruca vulgaris? | common wart white painless nodule with papillary projections, common on the skin |
| how does a person get verruca vulgaris? | same person from the skin to the mouth autoinoculation |
| condyloma acuminatum is also known as | veneral wart, sexually transmitted disease |
| how does condyloma acuminatum present? | sessile, pink, contender mass |
| what is the unique feature of canalicular adenoma? | predisposition to occur in the upper lip 75% of the cases |
| what are two most common tumors that occur in the upper lip? | pleomorphic adenoma canalicular adenoma |
| if the person is 60 years or older, the person with the lump in the upper lip typically has | canalicular adenoma |
| if the person is younger than 40 years old, the person with the lump in the upper lip typically has... | pleomorphic adenoma |
| where does pleomorhpic adenoma mostly occur? | major gland (parotid gland) than minor gland palate is the most common site in the mouth |
| what is the most common salivary neoplasm? including both benign and malignant | pleomorhpuc adenoma |
| where is war thin tumor or papillary cyst adenoma lymphomatous? | almost exclusively found in the parotid gland second most common benign parotid tumor, may occur bilaterally |
| what is the most common mesenchymal neoplasm? | Lipoma |
| where does Lipoma most commonly occur? | trunk and extremities will float if placed in tube of water |
| what is the most common type of peripheral nerve neoplasm? | neurofibroma |
| how do you diagnose a Schwannoma? | encapsulated, antoni A and antoni B tissue |
| what are the components of neurofibromatosis? | cafe au lait macules, axillary freckling (Crowe's sign), Lisch nodules in iris |
| what is a leimyoma? | neoplasm of smooth muscle |
| what is rhabdomyoma? | neoplasm of skeletal muscles |
| what are the most common sites for granular cell tumor to occur? | tongue, bucal mucosa |
| where does congenital epulis or congenital granular cell lesion occur and on who mostly? | female babies on maxillary alveolar ridge |
| osteoblasts are... | bone forming cells secrete collagen material that becomes the matrix that calcifies |
| osteoclasts are.... | bone breaking down cells, resorbing the bone |
| osteocytes are... | matrix material laid down by osteoblasts calcifies and the cell is trapped cells inside the bone that interpret the stress we place on the bone (signaling system) |
| endochondral bone formation | bones that form from a preexisting collagen model osteosteoblasts lay down the matrix on preexisting cartilage model long tubular bones of the body, arms/legs/ribs |
| intramembranous bone formation | bone is laid down between two sheets of soft tissue flat bones in our body, skull, jaws, wrists, ankles, spines |
| what are the metabolic disease of bone formation | rickets, scurvy, hyperparathyroidism |
| what are the idiopathic disease of bone formation | pager's disease fibrous dysplasia aneurysmal bone cyst |
| what is the most common of the inherited bone diseases? | osteogenesis imperfecta |
| what is osteogenesis imperfecta caused by? | defect in osteoblastic activity, they can produce collagen but the collagen they produce is defective collagen |
| what are the associated features of osteogenesis imperfecta? | dentinogenesis imperfecta, blue sclera, hearing loss, joint hyperflexiility |
| what is the exact opposite of osteogenesis imperfecta? | osteopetrosis (bones are too dense) osteogenesis imperfecta (bones are too weak |
| where is the defect in osteopetrosis? | osteoclastic cells or bone remodeling cells which results in a marked increase in bone density |
| what are the two types of osteopetrosis? | infantile autosomal recessive (more severe) adult autosomal dominant form |
| what happens in achondroplasia? | defect in endochondral bone formation, have problems with long bones in the body, membranous bones form normally autosomal dominant |
| what is the normal appearance of someone with achondroplasia? | dwarfism, leg bones and vertebrae are shorter than normal |
| what is cleidocranial dysplasia a defect in? | intramembranous bone production bones won't fuse with surround bone, delayed closure of suture lines |
| what does cleidocranial dysplasia look like? | elongated neck with stooped shoulders, large head multiple impacted and supernumerary teeth, high arched palate, often clefted |
| what is craniofacial dysplasia? | defect in membranous bone metabolism intramembranous bones fuse too soon or too early exophthalmos or bug eyes,divergent strabismus |
| what are the oral craniofacial dysplasia oral manifestation? | midface deficiency, mandibular pseudoprognathism, high arched palate |
| what is the only area of the oral cavity that is involved in cherubim? | the jaws, multilocular radiolucent lesions alveolar bone enlargement, impacted teeth and malocclusion |
| what is Rickets associated with? | deficiency in vitamin D during infancy retards growth, bowing of the legs |
| what is vitamin D associated with in bone | Allowing calcium to be deposited on the bone matrix defective mineralization of osteoid matrix |
| what is vitamin C deficiency associated with? | diets lacking in fresh fruits and vegetables results in inadequate collagen synthesis |
| what causes hyperparathyroidism? | excessive production of parathromone by the parathyroid glands |
| what are the two types of hyperparathyroid? | primary: adenoma most often secondary: kidney disease |
| what is parath hormone responsible for? | maintain normal calcium level in your bone can increase calcium absorption through your gut makes the kidneys kick out phosphate |
| what is seen in the jaws with hyperparatyroidism? | multiple radiolucencies in the jaws |
| what are the clinical features of hyperparathyroidism? | moans: mental confusion strones: kidney, salivary, other bones: loss of lamina dura, trabecular pattern, brown tumors, ground glass appearance abdominal groans: duodenal ulcers |
| what is the laboratory findings in hyperparathyroidism? | elevated serum Ca+2 decreased serum PO4-3 |
| what is the other name of Paget's disease? | osteitis deformans causes defamation and weakening of bones |
| what are the symptoms of Paget's disease? | due to incoordination of bone deposition and bone resorption result is distortion and weakening of bones |
| what causes Paget's disease? | slow virus of paramyxovirus group |
| what are the clinical manifestation of Paget's disease? | continuing enlargement over a prolonged period (hat size increase) complain of bone pain |
| what are the oral manifestation of Paget's disease? | enlargement of maxilla, opening of diastema cotton wool appearance and hypercementosis on roots of teeth |
| what are the three types of fibrous dysplasia? | monostotic fibrous dysplasia: one bone affected, adults over the age of 30 polyostotic fibrous dysplasia: multiple bones affected but not connected, younger teenagers and children Albright's syndrome: multiple bones affected, cafe au lait pigmentations |
| what is cranifacial fibrous dysplasia | commonly in the head and neck multiple bones, contiguous bones or bones close to one another age is older teenagers and young adults under age of 30 |
| what is the characteristic facial presentation? | elevation of eye, depression of commissure obliteration of the nasolabial fold |
| what is most commonly affected in fibrous dysplasia? | posterior maxilla |
| if you see ground glass quality in x-rays, what can diseases can you conclude? | hyperparathyroidism or fibrous dysplasia |
| how does aneurysmal bone cyst look like on an x-ray? | blow out lesion "fire cracker" unilocular or multilocular lucency |
| what are the symptoms of acute osteomyelitis? | pain usually accompanies, less than 1 month in duration lymph node swelling and elevated white blood cell count |
| what is a characteristic presentation of a person with chronic osteomyelitis? | multiple extractions with out relief of pain may or may not be swelling or pain |
| what is characteristic of a radiograph of a person with chronic osteomyelitis? | increase density of surrounding bone |
| what does focal schelerosing osteomyelitis present as? | focal area of increased bone density, bone scar one of the most common radiographic consults sent |
| if an inflammation is NOT associated with a tooth on a radiograph what is it most likely? | focal osteosclerosis |
| if an inflammation of bone on a radiograph is associated with an apex of a tooth what is it most likely | condensing osteitis tooth may be non vital, if vital probably has something that contributes to pulpal inflammation widening of PDL space |
| where is osteomyelitis with proliferative periostitis or Garre's osteomyelitis located ? | inflammation just below the periosteum, bony hard swelling associated with onion skin pattern radiographically egg shell bone |
| how does bisphosphonate induced osteonecrosis happen? | drugs inhibit action of osteoclasts, also effects angiogenesis and osteblasts drug half life is 15 years or greater |
| what is the synonym for alveolar osteitis? | dry socket, post extraction complication |
| where does alveolar osteitis usually occur? | mandibular third molars, most commonly in women |
| what causes alveolar osteitis? | loss or breakdown of the blood clot in the socket, exposed bone visible without soft tissue covering, produces severe pain and foul odor |
| what is osteoradionecrosis always seen with? | radiation therapy, radiation permanently damages the bone by destroying blood vessels in the area |
| what population do we typically see periapical cemental dysplasia in? | middle aged black females |
| what part of the mouth is most affected in periapical cemental dysplasia | anterior mandible, painless and discovered on routine radiograph with vital teeth late stages have opaque with a thin lucent rim |
| what population does florid cement osseous dysplasia typically affect? | middle age, black females |
| what part of the mouth is most affected in florid cement osseous dysplasia typically effect? | multiple posterior quadrants, usually painless and often discovered on routine radiograph, mixture of lucent and opaque presence |
| what is unique about focal cement osseous dysplasia? | does not affect classic population (middle age black females) females still predominate, mandible usually site(premolar and 1st molar), no expansion seen |
| what population does Langerhan's cell disease typically effect? | younger patients, 50% are under the age of 10 |
| what is the classic presentation of Langerhan's cell disease in radiographs? | teeth floating in air |
| where is traumatic bone cyst located? | radiolucent area in the mandible usually found on routine radiographic exam |
| who typically gets traumatic bone cysts and what does it look like? | typically teenagers or early 20's scalloping of the lesion up between tooth roots |
| what is the surgical findings of traumatic bone cyst? | an empty hole in the bone, little to no tissue recovered not expanding lesions |
| what is central giant cell granulomas? | expansions of the alveolus, multilocular appearance rarely seen posteriorly |
| what are exostosis? | torus palatinus torus mandibularis buccal area of maxillary or mandibular alveolar ridge most common site, often bilateral |
| where are torus palatinus always located? | located in the midline of the hard palate |
| where do torus mandibularis typically occur? | lingual premolar area of the mandible usually bilateral |
| what is the difference between osteomas and exostosis? | osteomas can be found in other parts of the body where exostosis are only found in the oral cavity osteomas have different radiographic appearance sometimes |
| what is Gardner's syndrome? | autosomal dominant disorder, passed from parent to child multiple osteomas (forehead and jaws or angle area of mandible) supernumerary teeth often, cysts in the skin polp contributes to colon cancer |
| what is the size and symptoms of osteoid osteomas? | small lesions pain that the patient can isolate to a single area, point tenderness that corresponds to radiograph has pain at night |
| what is the size and symptoms of osteoblastoma? | larger in size |
| how do you tell the difference between osteosarcoma and chondrosarcoma? | have to look at it under a microscope mixed lucent opaque lesions |
| what is the classic radiographic appearance of osteosarcoma and chondrosarcoma | sun ray appearance bone production above alveolar crest spiked root appearance |
| what are endocrine glands? | produce hormones that are secreted directly into the bloodstream with no duct system present, exert effects on the entire body |
| what causes hyper function of endocrine system? | proliferation of endocrine tissue (neoplasia or hyperplasia) loss of negative feedback signal |
| what causes hypo function of the endocrine system? | destruction of the endocrine tissue by inflammatory infections, infarction or surgical procedures loss of the positive stimulating signal |
| what hormones are secreted by the posterior lobe of the pituitary gland | ADH and oxytocin |
| what happens in hyper function of growth hormone in pituitary gland? | giantism (excess growth hormone before puberty) acromegaly (excess growth hormone after puberty) |
| what are the oral manifestations of giantism? | macrodontia, mandibular enlargement with prognathism |
| what are the oral manifestations of acromegaly? | enlargement of the skull and jaws mandibular prognathism, often anterior open bite development of diastemas, macroglossia |
| what happens in hypo function of growth hormone? | dwarfism (normal proportions maintained) |
| what are the oral manifestations of dwarfism? | delayed eruption, prolonged retention of deciduous teeth microdontia, failure of development of third molars crowding teeth and malocclusion |
| what is caused by hyper function of thyroid hormone? | Grave's disease, toxic multi nodular goiter |
| what are the oral manifestations of Grave's disease? | mass in anterior of the neck, often U shaped glossopyrosis or burning tongue tremor of the tongue |
| what is the major potential complication of dental treatment with hyperthyroidism? | thyroid storm (hyperthyriodism) |
| what is caused by hypothyroidism? | cretinism or congenital hypothyroidsim (occurs at young age) myxedema (adult onset) |
| what are the classic signs of hypothyroidism? | fluid retention in body, crenated tongue |
| what are the oral manifestations of myxedema? | enlarged tongue, lingual thyroid nodule |
| what does the parathyroid gland control? | calcium levels in the blood, nerve function |
| what are the oral manifestations of hyperparathyroidism? | radiolucent lesions in the jaws, loss of normal trabecular pattern and lamina dura looks like ground glass, brown lesions |
| what are the oral manifestations of hypoparathyroidism? | transient problem partial anodontia (failure of formation), malformed or hypo plastic teeth increased susceptibility to candidiasis |
| what happens when there is adrenal cortical hyper function | cushing's syndrome "moon face" with decreased mobility of tongue and muscle mastication |
| what happens when there is hypo function of the adrenal cortical hormones | Waterhouse Friderichsen's disease- death within 3 days Addison's Disease |
| what are the oral manifestations of Addison's disease? | can't produce significant quantities of steroid hormones bronzing of the skin and face, macular pigmented lesions on the oral mucosa |
| what is the most common cancer? | basal cell carcinoma |
| what does basal cell carcinoma look like? | nonhealing ulcers, often rolled bordered firm and fixed, grows very slowly, raised nodules with depressed centers |
| where is the most common location for adencarcinomas intraorally? | posterior lateral border of the hard palate |
| what do we call a sarcoma of fibrous tissue? | fibrosarcoma |
| what do we call a sarcoma of fat tissue | liposarcoma |
| what do we call a sarcoma of blood vessels | angiosarcoma |
| what is Kaposi's sarcoma? | in people with AIDS or immunosupression |
| what do we call a sarcoma in the smooth muscle? | leiomyosarcoma |
| what do we call a sarcoma in the skeletal muscle? | rhabdomyosarcoma |
| what do malignant lymphomas look like | multifocal, painless, firm and rubbery |
| what are the two types of lymphoma? | Hodgkin's Disease: grows in the lymph nodes, cured with radiation Non Hodgkin's: grows anywhere |
| what is the most common disease inside your jaw? | metastasic disease |
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