Oral Path CUdental exam 2

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Numerous small spaces are to ________ hemangiomas while large capillary spaces are to _________ hemangiomas.: capillary, cavernous
A 1 year old patient presents with a superficial raised red mass of the buccal mucosa. The mother indicates that it was present at birth but has grown considerably in the last 4 months. The lesion blanches while performing a diascopy and there is no brui: congenital hemangiomas
A Port Wine stain is an example of a congenital vascular malformation; it will eventually involute due to capillary dissolution. T/F: True; False - they have no capillaries and do not involute
A patient presents with slight facial asymetry due to a red mass of his buccal mucosa. He admits it was present at birth and hasn't grown much. Radiographs show a "sunburst" appearce while a bruit sound is made upon auscultation. You suspect th: congenital vascular malformation
A patient presents with autosomal nt, abnormal vascular dialations of terminal vessels on her lip, tongue and extremities. She complains of recent nose bleeds and is being treated for iron deficiency anemia due to GI lesions. She is likely suffering from: Hereditary Hemorrhagic Telangiectasia (HHT)
AKA encephalotrigeminal angiomatosis, 10% of those affected with this disease present with a Port wine stain along with vascular malformations of the leptomeninges possibly causing seizures.: Sturge Weber Syndrome
An abnormal blue vascular dialation frequently found on the ventral tongue or lower lip is called a _____.: varix
Pyogenic granulomas are pus producing granulomatous inflamation tissue. T/F: False, they are hyperplastic granulation tissue cuased by trauma, foreign material or calculus
T/F Pyogenic granulomas are found exclusively on gingival tissue?: False, predominantly gingiva yet may be found on other traumatized soft tissue
Pyogenic granulomas present durring pregnancy are also called _______ and should be excised after birth due to the high rate of recurrance. A pyogenic granuloma in an extraction socket is also referred to as a ____________.: pregnancy tumor, epulis granulomatosa
__________ are found exclusively on the gingiva, usually due to trauma/irritation between the molars and incisors, and may "cup out" underlying bone. Multinucleated giant cells are found histologically.: Peripheral giant cell granuloma
An eight year old child presents with tonsillitis and pharyngitis due to a Group A strep infection. He has a red facial rash and "strawberry tongue," he is likely suffering from ________.: Scarlet fever
______ refers to a red neoplastic patch on oral mucous membranes but does not indicate a particular dx. Once biopsied, 90% show severe dysplasia or SCCA microscopically.: Erythroplakia - usually found on floor of mouth or retromolar area of s, less common than leukoplakia
An AIDS patient, with a mustache, presents with an HHV-8 related malignant proliferation of endothelial cells (hypercellular spindle cells with ill-defined vasculature and extravasated RBCs) on his hard palate. The lesion appears nodular/exophytic and re: Kaposi's sarcoma.
A red smooth tongue, burning sensation and angular chelitis may be due to which of the following: Vit B deficiency, pernicious anemia, Fe deficiency.: All the above
A Northern European female presents with Fe deficiency anemia, red smooth tongue, an oral burning sensation and angular chelitis. Reviewing her med hx you find she has _______ predisposing her to oral/esophageal cancer.: Plummer Vinson Syndrome
A post-menopausal women presents with burning of the mouth and other intra-oral tissues in which no identifiable cause can be found. She may be suffering from ____________.: Burning mouth syndrome
A 12 year old male presents with firey red gingiva, atrophic tongue, angular cheilitis and burning mouth. He has no systemic complaints other than constipation due to swallowing the two packs of cinnamon gum he chews a day. He is most likely suffering fr: plasma cell gingivitis aka allergic gingivostomatitis (also caused by dentifrice)
Pinpoint hemorrhages are also referred to as ______.: petechiae
Purpura are larger/smaller than petechiae?: larger
An echymosis is > _ cm.: 2
Define hematoma.: accumulation of blood in tissue forming a mass
A 22 year old female presents with an extravascular red lesion on the junction of her soft and hard palate. She "swears" she got it from sucking too hard on a straw on a date with Adam last night. This may be caused which of the following: fell: All the above
Petechiae/ecchymosis, gingival enlargement/hemorrhage (spontaneous), loose teeth and mucosla ulcers are all oral manifestation most commonly caused by _______ leukemia.: Monocytic
_________ are melanin producing cells which reside in the _______ cell layer. ________ processes deliver pigment to surrounding keratinocytes and macrophages. The amount of pigment is influenced by sunlight, ________ and genetics.: Melanocytes, basal, dendritic, hormones
Similar to melanocytes these cells contain tyrosinase which converts tyrosine to melanin; however they do not have dendritic processes. These cells have a rounded cytoplasm and can migrate into submucosa where they tend to retain melanosomes.: Nevus cells
A patient presents with pigmentation of the buccal mucosa. Reviewing his hx you notice his upper denture teeth were not off-set enough facially causing him to bite his cheek; they were adjusted a few weeks ago fixing the problem. These pigmented areas ar: postinflammatory pigmentation (also found around the borders of lichen planus)
Physiologic pigmentation is due to an increased # of melanocytes. T/F: False, increased melanin and normal # of melanocytes commonly on gingiva
A 45 year old female smoker presents with irregularly shaped brown macules of her facial gingiva. She may have smokers _______, due to stimulation of melanocytes by smoking.: smokers melanosis
A patient presents with a round, flat, well defined, uniformly pigmented lesion of the lower lip. A biopsy shows increased melanin deposition in the basal layer and normal #'s of melanocytes. This may be an _______.: Oral meloanotic macule, aka focal melanosis.
Periorifacial and hand freckling, GI polyps and an increased risk for malignant tumors (pancrease, GI, breast, ovary) are signs of ___________ syndrome. Oral signs may manifest first.: Peutz-Jeghers
A patient presents with oral melanotic macules and bronzing of the skin due to increased ACTH/MSH caused by hypoadrenocorticism. Med hx reveals this patient has _______ disease.: Addison's
A patient presents with uniformly light brown, sharpley defined, oval shaped patches of skin called __________ macules. This could be caused by 2 diseases. If 6 or more patches are found along with axillary freckling (from the California sun) and 2+ neur: café-au-lait, neurofibromatosis (NF1), McCune-Albright Syndrome (MAS)
An infant presents with a darkly pigmented mass of the anterior maxilla. Radiographs show an ill-defined radiolucency and vanillylmandelic (VMA) acid is present in the urine. #1 on the differential dx would be a rare _________.: Melanotic Neuroectodermal tumor of infancy
Nevus is a name for any skin mark. A "mole' is an example of a _______ nevus.: Melanocytic
A patient presents with a blue elevated pigmentation about 0.5 cm in diameter on the palate. A biopsy is taken to rule out a melanoma and reveals nests (clusters or theques) of nevus cells in the CT. This patient had a benign __________.: oral melanocytic nevus (intramucosal) *malignant transformation unlikely but can mimic melanoma
All oral nevi should be excised. T/F: TRUE
Which nevus; junctional, intramucosal, compound, blue: most common intraoral nevus with nests of nevus cells in CT.: intramucosal
Which nevus; juncional, intramucosal, compound, blue: spindle shaped nevus cells deep in CT, second most common intraoral nevus.: blue nevus
Which nevus; juncional, intramucosal, compound, blue: nevus cell nests at the CT-epithelial interface.: junctional
Which nevus; junctional, intramucosal, compound, blue: nevus cell nests in both CT and CT-epithelium interface.: compound
A 35 year old black male presents ith an acquired, benign, dark pigmentation of the buccal mucosa. He says it grew rapidly and is several cm in diameter. It is most likely an oral ________.: melanoacanthoma
_______ are rare (1/500K) malignant tumors of melanin-producing cells (nests) usually of the palate or gingiva more commonly found in African Americans and Asians.: Melanoma
Which is not a warining sign of a melanoma: asymetry in shape, irregular/notched borders, mottled color, >6mm diameter, "benign appearing.": all are warning signs abc's advanced lesions
Lateral growth is to _______ melanoma as verticle growth is to _______ melanoma.: in situ, invasive
Oral melanoma prognosis is poor, worse than that of cutaneous melanoma. The 5 yr survival rate is __ to __%.: 10-20%
_________ is the most common pigmentation of the oral mucosa.: Amalgam tattoo
Minocycline, amino-quinolones, amiodarone and AZT may cause -induced pigmentations. Which stains underlying alveolar bone?: Minocycline (acne rx)
Which heavy metal does not cause staining: Arsenic, Metallica, bismuth, cis-Pt, Pb, Hg? Where do they occur?: all cause staining along the gingival margin
Round, pink surface projections are to _______ as spiked, white surface projections are to ________.: papillomas, verruca vulgaris
________ is the most common oral papillary lesion; it is usually <1cm, has a pink/pebbley appearance with HPV infected cells (koilocytic cells - nuclear pyknosis/optically clear). It is commonly found on the _________.: oral squamous papilloma, palate/uvula (soft palate)
A patient presents with a small, round, white, spike-like lesion of the buccal mucosa. He may be suffering from verrucous _______.: vulgaris (not verrucous carcinoma which is shaggy/exophytic/blunt pushing margins usually due to tobacco)
Dysplastic oral warts are exclusively found in ___ patients.: HIV
A 72 year old male presents with multiple, clustered, red, edematous rounded projections of the palatal vault. He claims to have left his denture in the past 12 years and recently was forced to remove it due to discomfort. He is most likely suffering fro: inflamatory papillary hyperplasia, candidia
A 26 year old female presents with a soft, red, like mass of the buccal mucosa. The patient has a history of contracting STD's. The mass is most likely a _________ found in secondary ________.: condyloma latum, syphilis
An HIV+ 28 year old male patient presents with a mass multiple oral warts which have coalesced into a soft broad-based pink exophytic growth. He says his "buddy" has a similar looking lesion on his anogenital region - ooh! ____________ is at th: condyloma acuminatum
A patient presents with asymptomatic, clustered (or discrete) papules of the lips similar in color to the surrounding skin. His chief complaint is to have them removed for cosmetic reasons. You diagnose him with ______.: focal epithelial hyperplasia (Heck's disease)
A patient calls and complains of a small red macule which rapidly (4-8 wks) became a firm nodule with a central crater of keratin on the sun-exposed border of her lip. She comes in for a biopsy although it may have eventually resolved with scaring. The b: Keratoacanthoma
A 56 year old male presents with a slow growing, shaggy-white-exophytic mass of the mandibular buccal mucosa. The biopsy reveals blunt broad epithelial margins pushing into the submucosa and superficial verrucous hyperkeratosis. The patient has a history: verrucous carcinoma (not verucous vulgaris = white spikey wart)
A 34 year old male presents with "snail tract" pustules on erythematous,"cobblestone-like" oral mucosa. His medical hx reveals he has an inflamatory bowel disease. He may be suffering from ________.: Pyostomatitis vegetans
__________ is a white-pink, well-circumscribed granular/papillary surface lesion which can be elevated or depressed with foamy cells in the CT papilae.: Verruciform xanthoma (foamy)
Benign reactive hyperplasia's generally painless, occur secondary to ______ and chronic over-exuberant ______.: injury, repair
A 16 year old female presents with a small, fixed, firm, pink, pedunculated gingival mass anterior to her first molar. It is most likely a ________.: peripheral (gingival) fibroma
Of the 4 types of peripheral fibromas: gingival, ossifying, odontogenic and giant cell, which shows large stellate sometimes multinucleated fibroblasts?: giant cell fibroma; giant cells = fibroblasts (not to be confused with giant cell granuloma)
__________ are asymptomatic nodules <5mm found lingual to the mandibular canines. They are sometimes mistaken for papilomas, common in young patients and disappear with age.: Retrocuspid papilla
Which of the following cause gingival hyperplasia: hyperplastic response to local factors such as plaque and calculus, hormonal changes such as pregnancy, , dyscrasias.: all the above
Matt presents with a well-circumscribed, fixed, slow growing pink polyp of his lower lip mucosa. His constant lower lip biting causes this traumatic lesion.: traumatic fibroma
A 69 year old patient presents with a fibrous CT proliferation of the vestibular mucosa due to an overextended/poorly fitting denture flange. He most likely has ________ which must be surgically excised and the denture corrected.: epulis fissuratum
________ is a benign, fast growing, <5cm nodular lesion, more commonly found in the extremities, which is composed of fibro-myofibroblasts and is often mistaken for a malignancy.: Nodular fasciitis
A patient presents with a slow growing, non-encapsulated, submucosal mass of the palate. The biopsy shows stellate and spindled fibroblasts in a myxoid stroma. He may have a _______.: soft tissue myxoma
A 17 year old male presents with recurrent epistaxis, nasal obstruction and a mass within the nasopharynx causing inferior displacement of the soft palate. You reassure the patient it is benign yet has a 50% chance of recurrence after being excised. He i: nasopharyngeal angiofibroma
An presents with nasal obstruction, pain and recurrent epistaxis. He may be suffering from an __________.: olfactory neuroblastoma
A benign neoplasm of adipose tissue causing yellow, slow growing, encapsulated, spongy/compressible mass which can be submucosal or exophytic is called a ______.: lipoma
__________ are asymptomatic, may be solitary or multiple, firm, slow-growing nodules which are fixed to the surface and also to deep structures. Elongated wavy nuclei with occasional axons are found microscopically.: Neurofibromas
A patient presents with a firm lump on the tongue. Histologically spindle cells form antoni A = palisades/swirls around ______ bodies and antoni B = _______ cells in a light fibrillar matrix. These are classic histological findings of a ___________.: Verocay, spindle, Schwannoma
____________ may occur when a nerve is severed leading to a firm, slow-growing, neural " - " scaring mass of "nerves gone wild." The _______ is the most common site.: Traumatic neuroma, mental foramen
Sx's of ______ include: mucosal neuromas, pheochromocytomas of the adrenal (50%) medullary thyroid carcinomas (90%), a marfanoid "Mohammad Al-Haji like" build, narrow face and everted eye lids.: Men 2B (III)
A patient presents with a solitary, dome shaped asymptomatic neural proliferation of the skin of the nose. A biopsy is taken and interlacing fascicles of spindle cells, with no varocay bodies, are present. The lesion must be excised. This patient likely: palisaded encapsulated neuroma (90% occurrence on nose or cheeks)
A female patient presents with a sessile, firm pinkish-yellow submucosal mass on the dorsum of the tongue. The biopsy reveals pseudocarcinomatous hyperplasia. Dx _________.: Granular cell tumor (may be multifocal, benign neoplasm)
An infant female presents with a pedunculated, fixed, nonulcerated mass of the maxillary gingiva. Histo shows large cells with no pseudocarcinomatous hyperplasia. The mass may be a ____________.: congenital epulis of the newborn
An encapsulated neoplasm of smooth muscle.: Leiomyoma
A neoplasm of striated muscle.: Rhabdomyoma (clinically similar to a neural tumor)
T/F Myositis ossificans is, as the name states, an ossifying inflammatory response occurring exclusively localized usually due to trauma.: False - may be localized/generalized

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