Oral Mucosa Diseases Overview

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Questions and Answers

What is the primary characteristic of aphthous stomatitis?

Shallow, painful ulcers in the mouth (correct)

Vesicles containing clear fluid

Epithelial thickening of the mucosa

White plaques on the tongue

Which organism is predominantly responsible for oral candidiasis?

Herpes simplex virus

Streptococcus pneumoniae

Candida albicans (correct)

Staphylococcus aureus

What predisposing factors are associated with the development of aphthous stomatitis?

Poor oral hygiene

Genetic predisposition

Bacterial infections

Stress and certain foods (correct)

What percentage of leukoplakia cases may undergo malignant change?

3-6% Signup and view all the answers

Herpes infections are most commonly caused by which type of virus?

HSV-1 Signup and view all the answers

Which of the following is NOT a common site for aphthous stomatitis ulcers?

Gingiva Signup and view all the answers

What is the typical duration for the healing of herpes stomatitis vesicles?

3-4 weeks Signup and view all the answers

Which condition is primarily characterized by whitish areas on the oral mucosa?

Leukoplakia Signup and view all the answers

Which of the following microscopic features is NOT associated with leukoplakia?

Giant cells Signup and view all the answers

In which population is oral candidiasis most commonly observed?

Infants and immunocompromised individuals Signup and view all the answers

What is the most common cause of oral mucoceles?

Ductal blockage due to trauma or inflammation Signup and view all the answers

What is a typical characteristic of chronic sialadenitis?

Decreased saliva secretion Signup and view all the answers

Which condition is primarily linked to the risk of developing oral squamous cell carcinoma?

Chronic irritation from a ragged tooth Signup and view all the answers

What is the most common viral infection responsible for acute sialadenitis?

Mumps virus Signup and view all the answers

What aspect describes the microscopic appearance of well-differentiated squamous cell carcinoma?

Formation of cell nests Signup and view all the answers

What is the most common site for pleomorphic adenoma?

Parotid gland Signup and view all the answers

Which of the following salivary gland tumors shows a characteristic bilateral occurrence in 10% of cases?

Warthin tumor Signup and view all the answers

What is a distinguishing symptom of Sjögren syndrome?

Xerostomia (dry mouth) Signup and view all the answers

Which malignant salivary gland tumor is the most common?

Mucoepidermoid carcinoma Signup and view all the answers

What type of lesions characterize oral carcinoma?

Ulcerative or verrucous lesions Signup and view all the answers

Which of the following is a potential side effect of medications such as ACE inhibitors related to oral conditions?

Glossitis Signup and view all the answers

What is a primary histological feature of pleomorphic adenoma?

Epithelial structures forming ducts Signup and view all the answers

Which factor is commonly associated with the development of leukoplakia?

Alcohol abuse and tobacco smoking Signup and view all the answers

What percentage of pleomorphic adenomas undergo malignant transformation?

10% Signup and view all the answers

What is a histological feature of chronic sialadenitis associated with autoimmune conditions?

Diffuse interstitial inflammation Signup and view all the answers

Which salivary gland tumor is primarily associated with smoking?

Warthin tumor Signup and view all the answers

Which type of tumor is classified as a benign mixed tumor?

Pleomorphic adenoma Signup and view all the answers

What is the typical size of a mucoepidermoid carcinoma?

Up to 8 cm Signup and view all the answers

What is the prognosis for high-grade mucoepidermoid carcinoma in terms of recurrence?

25% recurrence rate Signup and view all the answers

Which of the following is not a characteristic of pleomorphic adenoma?

Malignant transformation in 30% of cases Signup and view all the answers

Study Notes

Oral Mucosa Diseases (OMD)

Aphthous stomatitis (ulcerative stomatitis): Small, painful sores (ulcers) commonly appearing in childhood, recurring frequently. Cause unknown; predisposing factors include stress, fever, and certain foods.
Gross: Small (less than 1 cm), painful, shallow ulcers, located on the oral mucosa and tongue.
Fate: Resolves within 7-14 days without scarring.
Herpes infections: Caused by HSV-1, rarely HSV-2. Can cause acute herpetic gingivostomatitis in children.
Gross: Vesicles containing clear fluid, typically found on lips and oral mucosa.
Microscopic: Cellular edema, intranuclear inclusion bodies, and giant cells.
Fate: Vesicles heal within 3-4 weeks.
Oral candidiasis (moniliasis, thrush): Common fungal infection in infants and individuals with impaired immunity (e.g., diabetes, neutropenia).
Caused by Candida Albicans; a normal inhabitant of the oral cavity (in 30-40% of the population).
Gross: Whitish areas on an inflamed oral mucosa.
Leukoplakia: White plaque on the oral mucosa or tongue due to epithelial thickening.
Causes: Heavy smoking, chronic friction from a ragged tooth, and alcohol abuse.
Malignant change occurs in 3-6% of cases.
Microscopic: Acanthosis (increased thickness of prickle cells), hyperkeratosis (hypertrophy of the horny layer), and potentially dysplastic changes.
Glossitis: Inflammation of the tongue, presenting as a painful tongue, changes in texture (atrophy of papillae), and/or changes in color (beefy-red).
Causes include: Anemia (iron-deficiency or pernicious), vitamin B deficiencies, and infections, certain medications (e.g., sulphanilamide, sulphathiazole, ACE inhibitors and albuterol).
Oral carcinoma (squamous cell carcinoma): Constitutes 95% of oral cancers; develops between ages 50-70.
Causes: Tobacco smoking (most common), alcohol abuse, leukoplakia, human papilloma virus (HPV) infection, chronic irritation (e.g., from a ragged tooth).
Gross appearance: Ulcerative or verrucous lesions (exophytic/raised growth), often found on the floor of the mouth, tongue, and soft palate.
Microscopic: Typical squamous cell carcinoma with variable differentiation.
Malignant cells, well-differentiated; formation of cell nests.

Salivary Gland Diseases (SGD)

Oral mucoceles: Most common salivary gland lesions, caused by ductal blockage due to trauma or inflammation.
Gross: Cyst filled with mucus, varying in size, typically affecting small glands on the lower lip.
Acute sialadenitis: Inflammation of the major salivary glands, possibly due to viral, bacterial, or autoimmune factors. Mumps is the most common viral cause, leading to parotid gland enlargement and inflammation. Bacterial sialadenitis can be secondary to ductal obstructions (like stones) or bacterial invasion.
Chronic sialadenitis: Occurs due to diminished saliva secretion and subsequent inflammation, often stemming from autoimmune disorders like Sjögren's syndrome. Symptoms include dry eyes (kerato-conjunctivitis sicca), and dry mouth (xerostomia)
Presence of diffuse inflammation and focal lymphocytic aggregates.
Salivary gland tumors: -Incidence: Substantially high incidence in parotid glands (65–80%) with (15–30% being malignant). -10% in submandibular glands (with 30–40% malignancy) and 10% in minor salivary glands.
Classification: Exhibit both benign and malignant varieties.
Pleomorphic adenoma (benign mixed salivary tumor): Benign, slow-growing, painless swelling typically in the parotid gland at the lower jaw angle.
Gross: Well-demarcated, encapsulated mass, rarely exceeding 6 cm in greatest dimension.
Microscopic: Epithelial and connective tissue components.
Warthin tumor (papillary cystadenoma lymphomatosum): Less common than pleomorphic adenoma, usually found in the parotid gland, often in smokers.
Gross: Typically small, well-circumscribed, and encapsulated. May be bilateral in 10% of cases.
Microscopic: Cystic spaces lined by two layers of cells, with notable lymphoid tissue.
Mucoepidermoid carcinoma: Common salivary gland carcinoma (15%), measuring up to 8 cm in diameter and lacking a well-defined capsule.
Microscopic: Sheets of malignant squamous cells and mucous cells filled with mucin, pushing nuclei to the periphery.
Prognosis: High grade tumors have a 25% recurrence rate; 50% 5-year survival rate.
Adenoid cystic carcinoma: Relatively uncommon, characterized by small cells with scant cytoplasm, arranging in tubular or cribriform patterns.
Prognosis: 5-year survival rate approximating 60%.
Acinic cell tumor: Relatively uncommon, making up about 3% of salivary gland tumors, mainly affecting the parotid gland.
Microscopic: Tumor cells resemble normal salivary serous acinar cells even though they are malignant.
Prognosis: 5-year survival rate close to 90%.

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Description

This quiz covers various diseases affecting the oral mucosa, including aphthous stomatitis, herpes infections, and oral candidiasis. Learn about their causes, symptoms, and treatment outcomes to enhance your understanding of these common oral conditions.