Oral Pathology Quiz
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Questions and Answers

What is the primary cause of morsicatio mucosae oris?

  • Viral infections
  • Genetic factors
  • Allergic reactions
  • Biting or nibbling habits (correct)

What is a characteristic feature of the lesions observed in morsicatio?

  • White to red-white plaque with a rough appearance (correct)
  • Hemorrhagic ulcerations
  • Red and well-defined borders
  • Smooth and shiny surface

What treatment option is suggested if morsicatio does not resolve spontaneously?

  • Application of a steroid ointment
  • Surgical excision
  • Application of a keratolytic agent (correct)
  • Antibiotic therapy

Which of the following is a key diagnostic criterion for white sponge nevus?

<p>Positive family history (A)</p> Signup and view all the answers

What appearance characterizes white sponge nevus lesions?

<p>Thickened, folded, or corrugated lesions (A)</p> Signup and view all the answers

What distinguishes median rhomboid glossitis from other oral lesions?

<p>A flat, red area devoid of papillae (C)</p> Signup and view all the answers

What is the primary method used to identify candidal hyphae in laboratory investigations?

<p>Gram-stain and PAS stain (A)</p> Signup and view all the answers

How is white sponge nevus typically treated if it causes discomfort?

<p>Surgical excision and grafting (D)</p> Signup and view all the answers

Which factor does NOT contribute to neonatal thrush?

<p>Use of broad-spectrum antibiotics (A)</p> Signup and view all the answers

Which anatomical site is most commonly affected by morsicatio linguarum?

<p>The lateral borders of the tongue (B)</p> Signup and view all the answers

What is the recommended duration for continuing Nystatin treatment after the clinical infection has disappeared?

<p>7 days (A)</p> Signup and view all the answers

What serious side effect can result from prolonged use of Amphotericin B?

<p>Nausea and vomiting (D)</p> Signup and view all the answers

For which condition is Miconazole contraindicated?

<p>Liver diseases (A), Pregnancy (B)</p> Signup and view all the answers

Which of these is an antifungal treatment that can also cause thrombophlebitis as a side effect?

<p>Amphotericin B (A)</p> Signup and view all the answers

What form of Nystatin is recommended for application to affected areas?

<p>Topical cream (B)</p> Signup and view all the answers

When should Antifungal therapy be initiated for oro-pharyngeal candidiasis?

<p>Upon diagnosis (C)</p> Signup and view all the answers

What is the main causative microorganism associated with denture stomatitis?

<p>C. albicans (A)</p> Signup and view all the answers

Which type of denture stomatitis is characterized by a granular mucosa?

<p>Type III (A)</p> Signup and view all the answers

What is the recommended treatment for denture stomatitis involving topical antifungal medication?

<p>Applying miconazole gel three times daily (C)</p> Signup and view all the answers

What should be done if a patient shows no response to initial treatment for denture stomatitis?

<p>Inspect and treat underlying conditions (C)</p> Signup and view all the answers

How long should a patient refrain from wearing their denture during the initial treatment phase?

<p>1-2 weeks (C)</p> Signup and view all the answers

What type of chronic candidiasis is characterized by a white patch that cannot be removed by scraping?

<p>Chronic hyperplastic candidiasis (A)</p> Signup and view all the answers

Which bacteria are commonly involved in the microflora associated with denture stomatitis?

<p>Various genera including Streptococcus, Lactobacillus, and Actinomyces (B)</p> Signup and view all the answers

Where is chronic hyperplastic candidiasis most commonly found?

<p>Buccal mucosa and commissural mucosa (A)</p> Signup and view all the answers

What is the primary treatment approach for leukodema?

<p>Reassurance (D)</p> Signup and view all the answers

Which clinical test can help confirm the diagnosis of leukodema?

<p>Stretching test (D)</p> Signup and view all the answers

What is a distinguishing feature of Fordyce’s granules?

<p>They represent ectopic sebaceous glands. (B)</p> Signup and view all the answers

What causes the appearance of linea alba?

<p>Pressure or frictional irritation (C)</p> Signup and view all the answers

In which demographic are Fordyce's granules most commonly found?

<p>Elder patients (C)</p> Signup and view all the answers

What could be a differential diagnosis for leukodema?

<p>Lichen planus (A)</p> Signup and view all the answers

Which of the following describes the typical appearance of linea alba?

<p>Horizontal white line on the buccal mucosa (D)</p> Signup and view all the answers

What is a common feature of leukodema regarding its appearance?

<p>It presents bilaterally on the mucosa. (D)</p> Signup and view all the answers

What is a characteristic appearance of MRG on the tongue?

<p>Depapillated red area (C)</p> Signup and view all the answers

What is the primary treatment when candidal hyphae are detected in an MRG lesion?

<p>Topical antifungal medication (D)</p> Signup and view all the answers

Which of the following is NOT a common cause of traumatic keratosis?

<p>Frequent smoking (B)</p> Signup and view all the answers

What indicates the presence of nicotinic stomatitis in a patient?

<p>Grayish-white thickened palate (C)</p> Signup and view all the answers

What is the recommended action for a patient diagnosed with nicotinic stomatitis?

<p>Stop smoking (A)</p> Signup and view all the answers

What is a potential appearance of papillary hyperplasia of the palate?

<p>White umbilicated nodules (B)</p> Signup and view all the answers

Which diagnostic method is MOST important for confirming the presence of candidal infection in a lesion?

<p>Swab and culture (D)</p> Signup and view all the answers

What condition is associated with the appearance of white umbilicated nodules on the palate?

<p>Nicotinic stomatitis (D)</p> Signup and view all the answers

What is the primary treatment for mucocutaneous candidiasis (MCC)?

<p>Systemic antifungals given for several months (A)</p> Signup and view all the answers

Which type of candidiasis is characterized by lesions appearing as thick white plaques that cannot be scraped off?

<p>Chronic mucocutaneous candidiasis (C)</p> Signup and view all the answers

What is the role of a biopsy in diagnosing oral lesions?

<p>To confirm the diagnosis and differentiate from similar conditions (A)</p> Signup and view all the answers

Which antibiotic is noted for treating syphilis?

<p>Penicillin (D)</p> Signup and view all the answers

What distinguishes tertiary syphilis as a premalignant condition?

<p>Development of syphilitic leukoplakia on the tongue (C)</p> Signup and view all the answers

Flashcards

Leukodema

A variation of normal oral mucosa appearing as a greyish-white milky film on the buccal mucosa and soft palate, especially in dark-skinned individuals and heavy smokers.

Fordyce's Granules

Ectopic sebaceous glands commonly seen as soft, asymptomatic yellowish-creamy spots on the buccal mucosa and lips.

Linea Alba

A horizontal white line on the buccal mucosa at the level of the occlusal plane, often associated with pressure or friction caused by teeth or habits like sucking.

Burning Mouth Syndrome

A condition causing burning sensation on the tongue and oral mucosa. Often triggered by certain foods or drinks.

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Stomatitis

Localized inflammation of the oral mucosa, often accompanied by redness, swelling, and pain. It is often caused by irritation, infection, or allergic reaction.

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Lichen Planus

A widespread inflammatory disease of the oral mucosa, characterized by white lacy patches. Often associated with immune reactions.

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Lupus Erythematosus

A chronic inflammatory disease that can affect various parts of the body, including the skin and oral mucosa.

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Psoriasis

A chronic skin condition causing silvery-white scales on red patches. It can also affect the oral mucosa.

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What is Morsicatio?

Habitual biting or nibbling of the oral mucosa, often affecting the tongue, cheeks, or lips. It can be associated with stress or psychological issues and may result in white to red-white plaques with a rough texture.

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What is White Sponge Nevus?

A developmental keratotic lesion inherited as an autosomal dominant trait, causing thickened, white, folded, or corrugated lesions on oral and other mucosal surfaces.

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What is Median Rhomboid Glossitis?

A diamond-shaped or rounded area of depapillation in the midline of the tongue, located at the junction of the anterior and posterior tongue.

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What is Tretinoin® or Retinol?

A keratolytic agent used to treat Morsicatio when it doesn't disappear on its own. It helps to remove the thickened keratin layer.

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What is reassurance in treating Morsicatio?

A simple treatment option for Morsicatio, involving reassurance and encouraging the patient to break the biting habit.

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What is a Bite Plate or Habit Breaker?

A mechanical device designed to prevent biting and help break the habit. It can be used to treat Morsicatio.

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How is the biting habit stopped for Morsicatio?

A treatment option for Morsicatio, requiring the patient to abstain from the biting habit, allowing the lesion to heal naturally.

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How is White Sponge Nevus removed?

Surgical removal of a white sponge nevus lesion, often due to extreme discomfort or cosmetic concerns.

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Median Rhomboid Glossitis (MRG)

A red, depapillated (lacking papillae) area on the tongue, sometimes white or nodular. It may be associated with Candida (yeast) infection. While it was once thought to be a developmental remnant, it is now more commonly linked to Candida.

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Traumatic Keratosis (Frictional Keratosis)

A thickened, whitish area of oral mucosa caused by irritation from a specific source, such as dentures, braces, or rough edges of teeth. It resolves when the irritant is removed.

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Nicotinic Stomatitis (Stomatitis Nicotina)

A specific lesion on the palate of heavy smokers, characterized by grayish-white, thickened, and sometimes fissured (cracked) mucosa. White nodules with red centers around minor salivary gland openings are common due to heat and tar deposits.

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Papillary Hyperplasia of the Palate

A condition affecting the palate in denture wearers, especially with ill-fitting dentures. It presents as an overgrowth of papillae (bumps) on the palate, typically appearing as a bumpy, uneven surface.

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Clinical Appearance in MRG Diagnosis

A common clinical approach to diagnose Median Rhomboid Glossitis. It involves observing the visual appearance of the lesion.

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Biopsy in MRG Diagnosis

A common diagnostic method used to rule out carcinoma in a suspected case of Median Rhomboid Glossitis.

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Topical Antifungal Medication for MRG

A typical treatment for Median Rhomboid Glossitis when Candida is detected.

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Removal of Irritant for Traumatic Keratosis

A key step in treating Traumatic Keratosis once the irritant is removed.

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Oral Candidiasis (Thrush)

A fungal infection of the mouth, often presenting as white patches on the tongue and inner cheeks. Common in newborns and immunocompromised individuals.

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Nystatin

A common antifungal medication used to treat oral candidiasis. Available in various forms: lozenges, suspension, and cream.

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Nystatin Oral Gel (Mundgel®)

The oral gel form of Nystatin, applied directly to the affected areas to treat oral candidiasis.

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Miconazole (Daktarin®)

A topical antifungal medication used to treat oral candidiasis, available as an oral gel.

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Amphotericin B (Fungizone®)

A potent antifungal medication used to treat severe oral candidiasis, available in oral suspension and lozenge forms.

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Amphotericin B Oral Suspension

The oral suspension form of Amphotericin B, taken orally to treat oral candidiasis.

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Amphotericin B Side Effects

Potential side effects of Amphotericin B, such as nausea, vomiting, fever, and kidney problems, especially when used for extended periods in severe cases.

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Addressing Systemic Background

A method to treat oral candidiasis by addressing underlying causes such as weakened immune system, diabetes, or antibiotic use.

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What is Mucocutaneous Candidiasis (MCC)?

A condition characterized by candidiasis affecting the mouth, nails, skin, and other mucosal surfaces. Oral lesions appear as thick, white plaques that cannot be scraped off.

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What is Familial MCC?

A type of MCC where candidiasis mainly affects the family members and tends to be limited or localized.

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What is Diffused MCC?

A type of MCC that spreads widely and involves granuloma formation, which is a type of cluster of immune cells.

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How does syphilis affect the tongue?

Syphilis can affect the tongue, causing a precancerous lesion called "syphilitic leukoplakia". The tongue may also become thinner and smoother, a condition known as "atrophic glossitis".

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How is syphilis treated?

Treatment of syphilis usually involves antibiotics, particularly penicillin. Other effective antibiotics include tetracycline and erythromycin.

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Denture Stomatitis

An inflammation of the oral mucosa caused by wearing dentures, primarily due to Candida albicans infection and trauma from dentures.

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Type I Denture Stomatitis

A type of denture stomatitis limited to minor red spots caused by denture pressure or irritation.

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Type II Denture Stomatitis

A more severe type of denture stomatitis affecting a large area of the mouth.

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Type III Denture Stomatitis

The most severe type of denture stomatitis with red spots and a grainy surface.

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Candida albicans

The most common cause of denture stomatitis, a yeast-like fungus often found in the mouth.

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Denture Soaking

A treatment for denture stomatitis involving soaking the denture in a bleach solution to eliminate Candida albicans.

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Topical Antifungal

A treatment for denture stomatitis involving applying miconazole gel to the denture, wearing it for a short time, then cleaning and reapplying.

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Chronic Hyperplastic Candidiasis (Candidal Leukoplakia)

A chronic form of candidiasis characterized by white patches that can't be removed.

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Buccal Mucosa

A common location for chronic hyperplastic candidiasis, affecting the inside of the cheek and nearby area.

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Study Notes

Oral Mucosa Lesions

  • Macule: A change in skin/mucosa color, non-elevated, non-palpable, typically less than 1 cm in diameter. Examples include melanotic macules.
  • Patch: A large macule, equal to or larger than 1 cm in diameter, may have surface changes like scales or wrinkles, yet still not palpable.
  • Papule: A circumscribed, solid elevation, varying in size from pinhead to less than 1 cm.
  • Plaque: A broad papule or confluent papules, equal to or larger than 1 cm, wider than deep.
  • Nodule: A palpable, spherical or dome-shaped lesion less than 1 cm in diameter, either endophytic (deeper in tissue) or exophytic (projecting above). Examples include fibromas.
  • Tumor: Similar to a nodule but larger than 1 cm.
  • Blister (Vesicle): A small, circumscribed, fluid-filled, epidermal or mucosal elevation generally less than 1 cm in diameter, containing serous fluid.
  • Bulla: A large blister, rounded or irregularly shaped containing clear serous or purulent fluid, larger than 1 cm.
  • Pustule: A small elevation with cloudy/purulent material (pus), typically yellowish, white, or red.
  • Telangiectasia: Enlarged superficial blood vessels, visible as "spider veins".
  • Purpura: Reddish-to-purple discolorations caused by blood leaking into tissue; do not blanch with pressure. Types include petechiae (<0.3 cm), purpura (0.4-0.9 cm), and ecchymosis (>1 cm).
  • Scale: Dry or greasy laminated keratin masses, representing thickened stratum corneum.
  • Crust: Dried sebum, pus, or blood mixed with epithelial and/or bacterial debris.

Oral Mucosa Lesions: White appearance

  • Increased epithelial thickness: Increased thickness of epithelium covering mucosal areas.
  • Abnormal keratinization: Abnormal keratinization of non-keratinized epithelial surfaces (metaplasia).
  • Hyperkeratosis: Increased keratin production.
  • Fluid imbibition: Fluid (water/saliva) absorption by the upper mucosa layer.
  • Tissue necrosis: Tissue death.

Oral Mucosa Lesions: Red appearance

  • Epithelial thinning: Epithelial thinning due to erosion or atrophy.
  • Reduced keratinization: Reduced epithelial keratinization.
  • Abnormal cell turnover: Abnormal cell turnover during healing.
  • Blood leakage: Blood leakage into surrounding tissue due to trauma.
  • Vasodilation: Vasodilation (increased blood vessel size).
  • Tumor (neoplasm): Blood vessel proliferation related to a tumor.
  • Dysplasia (pre-malignant/malignant): A pre-cancerous or cancerous condition.

Oral Mucosa Lesions: Classification

  • Normal variation: Includes leukoplakia, linea alba, Fordyce's granules, morsicatio.
  • Developmental: Includes white spongy nevus, median rhomboid glossitis.
  • Traumatic: Includes traumatic keratosis, nicotinic stomatitis, papillary hyperplasia of the palate.
  • Infective: Includes candidiasis, syphilis, measles, or rubella.
  • Blood dyscrasia: Includes anemia and Plummer-Vinson syndrome.
  • Vitamin A deficiency
  • Drugs: Chemical burns, drug reactions (lichenoid, stomatitis venenata, medicamentosa).
  • Dermatological: Lichen planus, lupus erythematosus, psoriasis.
  • Premalignant: Leukoplakia, erythroplakia, submucous fibrosis.
  • Malignant: Squamous cell carcinoma.
  • Miscellaneous: Oral skin graft, coated tongue, geographic tongue.

Other Conditions (e.g., Leukodema, Fordyce Granules, Linea Alba, Morsicatio)

  • Leukodema: Greyish-white milky film on buccal mucosa and soft palate, especially in dark-skinned people and heavy smokers.
  • Fordyce's granules: Ectopic sebaceous glands on buccal mucosa and lips, appearing as yellowish-creamy spots.
  • Linea alba: Horizontal white line on buccal mucosa, caused by pressure or frictional irritation.
  • Morsicatio: Biting/nibbling of the oral mucosa, leading to a white plaque/patch.

Candidiasis (Oral Fungal Infections)

  • Candidiasis: Most common oral fungal infections in humans, can be caused by Candida albicans.
  • Associated factors: Acidic saliva, xerostomia, denture use, smoking, malnutrition, antibiotic/steroid use, or compromised immune systems.

Pseudomembranous Candidiasis (Thrush)

  • Clinical presentation: Creamy white patches that can be scraped off, leaving raw mucosa. Commonly found on palate, buccal mucosa, and tongue. Burning sensation, abnormal taste observed.
  • Diagnosis: Symptoms, clinical findings, and laboratory investigations (e.g., swab culture on Sabouraud dextrose agar, PAS stain, and Gram stain).

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Description

Test your knowledge on oral pathology with our quiz that covers various conditions such as morsicatio mucosae oris, white sponge nevus, and candidal infections. You will explore diagnostic criteria, treatment options, and characteristic features of these oral lesions. Perfect for dental students and professionals looking to refresh their understanding of oral health issues.

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