Oral Pathology Test 2
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| what are Premalignant lesions? | epithelial dysplasia (abnormal cells before they are cancerous, if they leave the epithelium they are caner)
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| what is Leukoplakia? | white plaque which will not rub off and which cannot be diagnosed as a specific disease (always premalignant)
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| what is Frictional keratosis? | physiologic reaction to physical irritation, not pre-malignant
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| what is the primary etiology of most leukoplakia? | tobacco
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| what is Stomatitis nicotina? | keratotic palate with red dots- not premalignant
pipe smokers, inflamed salivary glands
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| what is the mouth lined with? | stratified squamous epithelium
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| what is Hyperparakeratosis? | increased amount of parakeratin on surface of epithelium (no dysplasia)
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| what is Hyperorthokeratosis | increased amount of orthokeratin on the surface of epithelium (no dysplasia)
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| what is most Orthokeratin | most mature type of epithelium with no nucleus in it
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| what is Acanthosis | increase in thickness of epithelium
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| what is Epithelial dysplasia | process the epithelium goes through prior to becoming malignant as determined by cytologic alterations of the cells
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| what is Carcinoma in Situ | worse case for a pre-malignant cell before it becomes cancerous, cells are malignant but still in the epithelium
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| what are the high risk sites for oral cancer? | Floor of the mouth/ventral tongue
Lateral border of tongue
Lower lip (actinic keratosis)
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| What makes it a non-homogenous leukoplakia? | Areas of redness, ulceration, pebbly, bumpy verrucous areas
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| is Size a predictor of dysplasia? | NO
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| what is Erythroplakia? | red plaque which cannot be diagnosed as any specific disease or condition (always pre-malignant)
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| what is the cancer that arises in the oral cavity called? | Squamous cell carcinoma
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| what ages are affected by oral cancer? | Peak age incidence is 50-70 years
increasing in age of 70 year olds and 40 year olds
women are at higher risker at developing at a younger age
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| do people who smoke cigars or pipes have a decrease incidence of oral cancer? | no, decreased incidence of lung cancer
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| what is the risk for alcohol abusers when compared to smoking? | Risk is greater than 2 pack per day for smokers
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| what constitutes alcohol abuse? | A total of 6 alcohol equivalents per day
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| how much are alcohol equivalents? | One shot (1.5 OZ) hard liquor
One glass (6 OZ) wine
One glass/can (12 OZ) beer
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| Heavy smoking and minimum drinking has an increase of what for oral cancer | X8
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| Heavy drinking and minimum smoking has an increase of what for oral cancer? | x23
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| what are the Factors that degrade the immune system lead to increased cancer incidence | Aging: immune system becomes degraded
Chronic nutritional deficiency
Disease states
Therapeutic intervention
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| what are the genetic defects associated with oral cancer? | Basal cell nevus syndrome
Gardner’s syndrome
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| Only ?% of US adults can correctly identify an early warning sign of oral cancer | 25%
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| Only ?% of US adults know the risk of alcohol abuse | 13%
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| Only ?% of US adults have had an oral cancer exam | 14%
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| what does an ulcer look like? | Often with a raised, rolled border
Often with a very deep, central crater
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| what are the sites that are immune to oral cancer? | Dorsum of the tongue is very rarely affected
Anterior portion of the hard palate is relatively immune
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| what causes Impetigo? (organisms) | streptococcus pyogenes and Staphylococcus aureus
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| what does impetigo look like? | Vesicles that rupture leaving amber-colored crusts
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| if left untreated, strep throat can progress to what? | scarlet fever, rheumatic fever
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| what does scarlet fever look like? | Skin rash, palatal petechiae, “strawberry tongue”
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| what does Rheumatic fever involve? | Affects heart, joints (Rheumatoid arthritis), central nervous system
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| what organism causes tuberculosis? | Mycobacterium tuberculosis
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| what does scrofula mean? | Lymph node involvement
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| where is tuberculosis found in the oral cavity? | Tongue and palate have ulcerations
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| what is Actinomyces israelii? | Normal inhabitants of oral cavity, only becomes a disease if it is allowed to grow in an area with a history of surgery
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| what does Actinomyces israelii look like? | yellow “sulphur granules”
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| what organism causes syphilis? | Treponema Pallidum
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| what is the incidence of syphilis in the united states? | In the united states there is a 100X incidence compared to the rest of the world
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| What are the stages of syphilis? | primary:chancre
secondary: mucous patch generally on hands and feet
latent: nothing
tertiary: gumma
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| what is gumma in tertiary stage of syphilis characterized by? | Chronic inflammation that destroys tissue
Atrophic glossitis: dorsal tongue covered by white film (syphilitic leukoplakia)
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| what is the Hutchinson Triad in congenital syphilis? | Screwdriver shaped “Hutchinson’s incisors”
Mulberry molars
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| what is Pericoronitis? | Inflammation of the mucosa around the crown of a partially erupted or impacted tooth
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| what is Chronic sclerosing osteomyelitis? | bone becomes dense in certain areas
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| what are the Predisposing conditions for candidias? | Antibiotic therapy
Cancer chemotherapy
Corticosteroid therapy
Dentures
Diabetes mellitus
Pregnancy
Iron deficiency
Newborns
Advanced malignancy
Xerostomia
Other immunocompromised states (HIV/AIDS
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| what are the conditions of Pseudomembranous candidiasis? | can be wiped off, burning sensation or metallic taste
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| what is Chronic atrophic candidiasis? | Denture stomatitis, follows the outline of the prosthesis, red lesion
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| what is the Only fungal organism associated with pre-malignancy | Chronic hyperplastic
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| what is Median rhomboid glossitis | Erythematous, rhomboid (diamond shaped) area at midline of dorsal tongue
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| what type of virus is the human papiloma virus? | DNA virus
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| what are the three most common forms of human papiloma virus? | Verruca vulgaris, Papilloma, Condyloma acuminatum
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| what type of virus is the Condyloma acuminatum | STD
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| what virus is associated with the common wart? | human papilloma virus, verruca vulgaris
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| what are Koilocytes | HPV viral alteration, clearing out of cytoplasm
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| what do Papillomas look like? | White/red/normal color “cauliflower” shaped exophytic nodule
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| what do Condyloma acuminatum look like | Pink exophytic mass with short, blunted surface projections
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| what population is Heck’s disease most found in | in Native Americans and Eskimos
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| HHV 1 usually causes... | oral lesions
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| HHV 2 usually causes... | genital lesions
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