Oral Pathology Test 3
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where are minor salivary glands not found? | gingiva
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what are the three disease of benign soft tissue neoplasms? | papilloma
verruca vulgaris
condyloma acuminatum
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what is the most common soft tissue mass in the soft palate? | papilloma
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what does pedunculated mean? | big head, small neck
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what does sessile mean? | bread base, small head
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where is papilla found? | tongue, lips, soft palate
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what is verruca vulgaris? | common wart
white painless nodule with papillary projections, common on the skin
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how does a person get verruca vulgaris? | same person from the skin to the mouth
autoinoculation
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condyloma acuminatum is also known as | veneral wart, sexually transmitted disease
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how does condyloma acuminatum present? | sessile, pink, contender mass
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what is the unique feature of canalicular adenoma? | predisposition to occur in the upper lip 75% of the cases
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what are two most common tumors that occur in the upper lip? | pleomorphic adenoma
canalicular adenoma
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if the person is 60 years or older, the person with the lump in the upper lip typically has | canalicular adenoma
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if the person is younger than 40 years old, the person with the lump in the upper lip typically has... | pleomorphic adenoma
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where does pleomorhpic adenoma mostly occur? | major gland (parotid gland) than minor gland
palate is the most common site in the mouth
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what is the most common salivary neoplasm? including both benign and malignant | pleomorhpuc adenoma
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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
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what is the most common mesenchymal neoplasm? | Lipoma
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where does Lipoma most commonly occur? | trunk and extremities
will float if placed in tube of water
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what is the most common type of peripheral nerve neoplasm? | neurofibroma
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how do you diagnose a Schwannoma? | encapsulated, antoni A and antoni B tissue
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what are the components of neurofibromatosis? | cafe au lait macules, axillary freckling (Crowe's sign), Lisch nodules in iris
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what is a leimyoma? | neoplasm of smooth muscle
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what is rhabdomyoma? | neoplasm of skeletal muscles
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what are the most common sites for granular cell tumor to occur? | tongue, bucal mucosa
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where does congenital epulis or congenital granular cell lesion occur and on who mostly? | female babies on maxillary alveolar ridge
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osteoblasts are... | bone forming cells
secrete collagen material that becomes the matrix that calcifies
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osteoclasts are.... | bone breaking down cells, resorbing the bone
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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)
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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
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intramembranous bone formation | bone is laid down between two sheets of soft tissue
flat bones in our body, skull, jaws, wrists, ankles, spines
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what are the metabolic disease of bone formation | rickets, scurvy, hyperparathyroidism
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what are the idiopathic disease of bone formation | pager's disease
fibrous dysplasia
aneurysmal bone cyst
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what is the most common of the inherited bone diseases? | osteogenesis imperfecta
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what is osteogenesis imperfecta caused by? | defect in osteoblastic activity, they can produce collagen but the collagen they produce is defective collagen
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what are the associated features of osteogenesis imperfecta? | dentinogenesis imperfecta, blue sclera, hearing loss, joint hyperflexiility
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what is the exact opposite of osteogenesis imperfecta? | osteopetrosis (bones are too dense)
osteogenesis imperfecta (bones are too weak
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where is the defect in osteopetrosis? | osteoclastic cells or bone remodeling cells which results in a marked increase in bone density
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what are the two types of osteopetrosis? | infantile autosomal recessive (more severe)
adult autosomal dominant form
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what happens in achondroplasia? | defect in endochondral bone formation, have problems with long bones in the body, membranous bones form normally
autosomal dominant
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what is the normal appearance of someone with achondroplasia? | dwarfism, leg bones and vertebrae are shorter than normal
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what is cleidocranial dysplasia a defect in? | intramembranous bone production
bones won't fuse with surround bone, delayed closure of suture lines
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what does cleidocranial dysplasia look like? | elongated neck with stooped shoulders, large head
multiple impacted and supernumerary teeth, high arched palate, often clefted
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what is craniofacial dysplasia? | defect in membranous bone metabolism
intramembranous bones fuse too soon or too early
exophthalmos or bug eyes,divergent strabismus
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what are the oral craniofacial dysplasia oral manifestation? | midface deficiency, mandibular pseudoprognathism, high arched palate
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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
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what is Rickets associated with? | deficiency in vitamin D during infancy
retards growth, bowing of the legs
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what is vitamin D associated with in bone | Allowing calcium to be deposited on the bone matrix
defective mineralization of osteoid matrix
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what is vitamin C deficiency associated with? | diets lacking in fresh fruits and vegetables
results in inadequate collagen synthesis
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what causes hyperparathyroidism? | excessive production of parathromone by the parathyroid glands
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what are the two types of hyperparathyroid? | primary: adenoma most often
secondary: kidney disease
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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
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what is seen in the jaws with hyperparatyroidism? | multiple radiolucencies in the jaws
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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
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what is the laboratory findings in hyperparathyroidism? | elevated serum Ca+2
decreased serum PO4-3
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what is the other name of Paget's disease? | osteitis deformans
causes defamation and weakening of bones
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what are the symptoms of Paget's disease? | due to incoordination of bone deposition and bone resorption result is distortion and weakening of bones
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what causes Paget's disease? | slow virus of paramyxovirus group
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what are the clinical manifestation of Paget's disease? | continuing enlargement over a prolonged period (hat size increase)
complain of bone pain
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what are the oral manifestation of Paget's disease? | enlargement of maxilla, opening of diastema
cotton wool appearance and hypercementosis on roots of teeth
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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
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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
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what is the characteristic facial presentation? | elevation of eye, depression of commissure
obliteration of the nasolabial fold
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what is most commonly affected in fibrous dysplasia? | posterior maxilla
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if you see ground glass quality in x-rays, what can diseases can you conclude? | hyperparathyroidism or fibrous dysplasia
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how does aneurysmal bone cyst look like on an x-ray? | blow out lesion "fire cracker"
unilocular or multilocular lucency
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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
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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
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what is characteristic of a radiograph of a person with chronic osteomyelitis? | increase density of surrounding bone
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what does focal schelerosing osteomyelitis present as? | focal area of increased bone density, bone scar
one of the most common radiographic consults sent
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if an inflammation is NOT associated with a tooth on a radiograph what is it most likely? | focal osteosclerosis
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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
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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
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how does bisphosphonate induced osteonecrosis happen? | drugs inhibit action of osteoclasts, also effects angiogenesis and osteblasts
drug half life is 15 years or greater
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what is the synonym for alveolar osteitis? | dry socket, post extraction complication
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where does alveolar osteitis usually occur? | mandibular third molars, most commonly in women
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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
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what is osteoradionecrosis always seen with? | radiation therapy, radiation permanently damages the bone by destroying blood vessels in the area
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what population do we typically see periapical cemental dysplasia in? | middle aged black females
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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
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what population does florid cement osseous dysplasia typically affect? | middle age, black females
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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
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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
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what population does Langerhan's cell disease typically effect? | younger patients, 50% are under the age of 10
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what is the classic presentation of Langerhan's cell disease in radiographs? | teeth floating in air
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where is traumatic bone cyst located? | radiolucent area in the mandible usually found on routine radiographic exam
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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
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what is the surgical findings of traumatic bone cyst? | an empty hole in the bone, little to no tissue recovered
not expanding lesions
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what is central giant cell granulomas? | expansions of the alveolus, multilocular appearance
rarely seen posteriorly
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what are exostosis? | torus palatinus
torus mandibularis
buccal area of maxillary or mandibular alveolar ridge most common site, often bilateral
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where are torus palatinus always located? | located in the midline of the hard palate
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where do torus mandibularis typically occur? | lingual premolar area of the mandible
usually bilateral
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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
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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
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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
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what is the size and symptoms of osteoblastoma? | larger in size
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how do you tell the difference between osteosarcoma and chondrosarcoma? | have to look at it under a microscope
mixed lucent opaque lesions
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what is the classic radiographic appearance of osteosarcoma and chondrosarcoma | sun ray appearance
bone production above alveolar crest
spiked root appearance
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what are endocrine glands? | produce hormones that are secreted directly into the bloodstream with no duct system present, exert effects on the entire body
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what causes hyper function of endocrine system? | proliferation of endocrine tissue (neoplasia or hyperplasia)
loss of negative feedback signal
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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
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what hormones are secreted by the posterior lobe of the pituitary gland | ADH and oxytocin
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what happens in hyper function of growth hormone in pituitary gland? | giantism (excess growth hormone before puberty)
acromegaly (excess growth hormone after puberty)
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what are the oral manifestations of giantism? | macrodontia, mandibular enlargement with prognathism
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what are the oral manifestations of acromegaly? | enlargement of the skull and jaws
mandibular prognathism, often anterior open bite
development of diastemas, macroglossia
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what happens in hypo function of growth hormone? | dwarfism (normal proportions maintained)
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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
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what is caused by hyper function of thyroid hormone? | Grave's disease, toxic multi nodular goiter
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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
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what is the major potential complication of dental treatment with hyperthyroidism? | thyroid storm (hyperthyriodism)
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what is caused by hypothyroidism? | cretinism or congenital hypothyroidsim (occurs at young age)
myxedema (adult onset)
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what are the classic signs of hypothyroidism? | fluid retention in body, crenated tongue
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what are the oral manifestations of myxedema? | enlarged tongue, lingual thyroid nodule
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what does the parathyroid gland control? | calcium levels in the blood, nerve function
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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
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what are the oral manifestations of hypoparathyroidism? | transient problem
partial anodontia (failure of formation), malformed or hypo plastic teeth
increased susceptibility to candidiasis
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what happens when there is adrenal cortical hyper function | cushing's syndrome
"moon face" with decreased mobility of tongue and muscle mastication
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what happens when there is hypo function of the adrenal cortical hormones | Waterhouse Friderichsen's disease- death within 3 days
Addison's Disease
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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
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what is the most common cancer? | basal cell carcinoma
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what does basal cell carcinoma look like? | nonhealing ulcers, often rolled bordered
firm and fixed, grows very slowly, raised nodules with depressed centers
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where is the most common location for adencarcinomas intraorally? | posterior lateral border of the hard palate
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what do we call a sarcoma of fibrous tissue? | fibrosarcoma
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what do we call a sarcoma of fat tissue | liposarcoma
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what do we call a sarcoma of blood vessels | angiosarcoma
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what is Kaposi's sarcoma? | in people with AIDS or immunosupression
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what do we call a sarcoma in the smooth muscle? | leiomyosarcoma
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what do we call a sarcoma in the skeletal muscle? | rhabdomyosarcoma
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what do malignant lymphomas look like | multifocal, painless, firm and rubbery
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what are the two types of lymphoma? | Hodgkin's Disease: grows in the lymph nodes, cured with radiation
Non Hodgkin's: grows anywhere
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what is the most common disease inside your jaw? | metastasic disease
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