80 Questions
What is the main characteristic of the epithelial surface of the hard palate, gingiva, and some regions of the dorsum of the tongue?
Keratinized stratified squamous epithelium
What is the name of the condition characterized by the formation of stones in the salivary ducts?
Sialolithiasis
What is the primary site of attack in Sjogren syndrome?
Lacrimal glands
What is the type of epithelium present on the lips, buccal mucosa, and alveolar mucosa?
Nonkeratinized stratified squamous epithelium
What is the diagnosis of Sjogren syndrome based on?
All of the above
What is the name of the tumor that affects the mouth?
Pleomorphic adenoma
What is the name of the condition characterized by a white patch on the oral mucosa?
Leukoplakia
What is the name of the condition characterized by cancer of the oral cavity?
Oral cancer
What is the likely diagnosis for a 50-year-old male with a twenty-year history of gastro-oesophageal reflux symptoms?
Gastro-oesophageal reflux disease
What is the treatment provided to the 50-year-old male with gastro-oesophageal reflux symptoms?
Proton-pump inhibitor
What is the characteristic feature of Zenker diverticulum?
Outpouching above upper oesophageal sphincter
What is the condition associated with repetitive distal oesophageal contractions?
Diffuse oesophageal spasm
What is the characteristic feature of Oesophageal mucosal web?
Mucosal semi-circumferential protrusion
What is the condition associated with mucosal/submucosal circumferential protrusion?
Oesophageal (Schatzki) ring
What is the likely cause of the child's oesophagus being almost completely occluded?
Food impaction
What is the diagnosis for the 30-year-old man with sudden onset of hematemesis after consuming large amounts of alcohol?
Mallory-Weiss tear
What is the most common type of oesophageal cancer worldwide?
Squamous Cell Carcinoma
What is the main characteristic of Barrett's oesophagus?
A metaplastic, columnar, glandular, intestine-like mucosa
What is a complication of gastro-oesophageal reflux disease (GORD)?
Oesophageal stricture
What is a risk factor for Squamous Cell Carcinoma Oesophagus (SCC)?
All of the above
What is the diagnosis for a 32-year-old man with difficulty swallowing, regurgitation of food, and manometric studies showing a complete absence of peristalsis?
Achalasia
What is a cause of lower oesophageal sphincter (LES) incompetence?
All of the above
What is a complication of Barrett's oesophagus?
All of the above
What is a normal characteristic of the oesophagus?
Stratified squamous epithelium
What is a risk factor for gastric cancer?
Smoking
Which type of gastric cancer is associated with environmental factors?
Intestinal type
What is the term for the left supraclavicular lymph node metastasis?
Virchow node
What is the characteristic of diffuse gastric adenocarcinoma?
Absence of cell cohesion
What is the term for the periumbilical lymph node metastasis?
Sister Mary Joseph node
Which of the following is a route of spread of gastric cancer?
Hematogenous spread
What is the term for the direct seeding of the pouch of Douglas?
Blumer shelf
Which of the following is a type of gastric cancer?
Gastric adenocarcinoma
What is the characteristic of Hyperchromatism?
Abnormal nuclear staining
What is the result of Dysplasia++ plus invasion?
Cancer
What is the characteristic of Anaplasia?
Lack of differentiation
What is the diagnosis of the patient with difficulty swallowing food and blurred vision?
Sjogren syndrome
What is the microscopic feature of salivary gland biopsy in Sjogren syndrome?
Lymphocytes
What is the result of Hyperkeratosis of oral epithelium?
Dysplasia of oral epithelium
What is the characteristic of Dysplasia of oral epithelium?
Increased and abnormal mitotic activity
What is the final step in the development of oral squamous cell carcinoma?
Oral squamous cell carcinoma
What is the primary characteristic of Sjogren syndrome?
Chronic autoimmune disease attacking lacrimal and salivary glands
What is the term for the formation of stones in the salivary ducts?
Sialolithiasis
What is the characteristic of the epithelial surface of the hard palate, gingiva, and some regions of the dorsum of the tongue?
Keratinized
What is the diagnosis of a patient with a white patch on the oral mucosa?
Leukoplakia
What is the name of the tumor that affects the mouth?
Pleomorphic adenoma
What is the diagnosis of a patient with chronic inflammation of the stomach lining?
Gastritis
What is the diagnosis of a patient with difficulty swallowing food and blurred vision?
Sjogren syndrome
What is the characteristic feature of oral cancer?
Uncontrolled growth and spread of abnormal cells
What is the likely diagnosis for a patient with difficulty swallowing and regurgitation of food, and manometric studies showing a complete absence of peristalsis?
Achalasia
What is the likely diagnosis for a 58-year-old woman with a history of alcoholic cirrhosis who presents with vomiting blood and experiencing bloody stools?
Gastric varices
What is a complication of gastro-oesophageal reflux disease (GORD)?
All of the above
What is the most appropriate clinical condition for a patient with a feature of mucosal semi-circumferential protrusion?
Oesophageal mucosal web
What is a risk factor for Squamous Cell Carcinoma Oesophagus (SCC)?
All of the above
What is the treatment provided to a 50-year-old male with a twenty-year history of gastro-oesophageal reflux symptoms?
Proton-pump inhibitor
What is the characteristic feature of Barrett's oesophagus?
Metaplastic, columnar, glandular, intestine-like mucosa with brush border and goblet cells
What is the cause of lower oesophageal sphincter (LES) incompetence?
All of the above
What is the likely diagnosis for a 30-year-old man with sudden onset of hematemesis after consuming large amounts of alcohol?
Mallory-Weiss tear
What is the diagnosis for a newborn boy who regurgitates at every feeding?
Normal physiological reflux
What is the characteristic feature of a Zenker diverticulum?
Outpouching above upper oesophageal sphincter
What is the condition associated with repetitive distal oesophageal contractions?
Diffuse oesophageal spasm
What is a complication of Barrett's oesophagus?
All of the above
What is the likely cause of the child's oesophagus being almost completely occluded?
Foreign body obstruction
What is the most common type of oesophageal cancer worldwide?
Squamous Cell Carcinoma Oesophagus (SCC)
What is the condition associated with mucosal/submucosal circumferential protrusion?
Oesophageal (Schatzki) ring
What is the most common risk factor for gastric cancer?
Helicobacter pylori infection
Which type of gastric cancer is associated with mutations in E-cadherin?
Diffuse type
What is the term for the periumbilical lymph node metastasis?
Sister Mary Joseph node
What is the characteristic of the intestinal type of gastric cancer?
Characterized by cohesive neoplastic cells
What is the route of spread of gastric cancer to the left supraclavicular lymph node?
Lymphangitic spread
Which of the following is a type of gastric cancer that is associated with environmental factors?
Intestinal type
What is the term for the direct seeding of the pouch of Douglas?
Blumer shelf
What is the characteristic of the diffuse type of gastric cancer?
Characterized by absence of cell cohesion
What is the characteristic of Moderate Dysplasia in oral epithelium?
Increased nuclear cytoplasmic ratio
What is the final step in the development of oral squamous cell carcinoma from Normal oral epithelium?
Dysplasia++ plus invasion
What is the characteristic of Severe Dysplasia/Carcinoma in situ in oral epithelium?
Pleomorphism
What is the diagnosis of a patient with difficulty swallowing food and blurred vision, and positive anti SS-A and anti SS-B antibodies?
Sjogren syndrome
What is the microscopic feature of salivary gland biopsy in Sjogren syndrome?
Lymphocytes
What is the result of Hyperkeratosis of oral epithelium?
Leukoplakia
What is the characteristic of Dysplasia of oral epithelium?
Increased nuclear cytoplasmic ratio
What is the result of Dysplasia++ plus invasion?
Cancer
Study Notes
Upper Gastrointestinal Tract
Mouth
- Oral mucosa composed of stratified squamous epithelium, present on lips, buccal mucosa, alveolar mucosa, soft palate, underside of the tongue, and floor of the mouth
- Epithelial surface of hard palate, gingiva, and some regions of specialized mucosa on the dorsum of the tongue
- Sjogren syndrome: a chronic inflammatory autoimmune disease that mainly attacks lacrimal and salivary glands
- Leukoplakia: a condition characterized by hyperkeratosis of oral epithelium
- Oral cancer: can arise from oral squamous epithelium, with risk factors including tobacco, alcohol, and HPV
- Development of oral squamous cell carcinoma:
- Normal oral epithelium → Hyperkeratosis of oral epithelium → Dysplasia of oral epithelium → Oral squamous cell carcinoma
Sialolithiasis
- Formation of stones in salivary ducts
Oesophagus
- Congenital and acquired diseases of the oesophagus
- Neoplasms: oesophageal cancer can be classified into two main types, squamous cell carcinoma (SCC) and adenocarcinoma
- Squamous cell carcinoma:
- Most common type of oesophageal cancer worldwide
- Occurs in the upper/middle part of the oesophagus
- Risk factors: alcohol, tobacco, caustic injury, achalasia, radiation exposure, and carcinogen (acetyl aldehyde)
- Adenocarcinoma:
- Metaplastic, columnar, glandular, intestine-like mucosa with brush border and goblet cells replaces normal stratified squamous epithelium of the distal esophagus
- Dysplasia in Barrett's oesophagus can progress to adenocarcinoma
- Oesophageal obstruction:
- Diffuse oesophageal spasm: repetitive distal oesophageal contractions
- Zenker diverticulum: outpouching above upper oesophageal sphincter
- Oesophageal mucosal web: mucosal semi-circumferential protrusion
- Oesophageal (Schatzki) ring: mucosal/submucosal circumferential protrusion
- Barrett's oesophagus:
- A metaplastic, columnar, glandular, intestine-like mucosa with brush border and goblet cells replaces normal stratified squamous epithelium of the distal esophagus
- Dysplasia in Barrett's oesophagus can progress to adenocarcinoma
Stomach
- Gastritis
- Peptic ulcer disease
- Neoplasms: gastric adenocarcinoma, gastric lymphomas, carcinoid tumors, and gastrointestinal stromal tumor
- Gastric cancer:
- Risk factors: Helicobacter pylori infection, autoimmune atrophic gastritis, smoking, diet (smoked, dried, and preserved food), gastric polyps, and genetic factors
- Histological types:
- Gastric adenocarcinoma
- Gastric lymphomas
- Carcinoid tumors
- Gastrointestinal stromal tumor
- Lauren's classification:
- Intestinal type: common, affects older people, associated with environmental factors, and characterized by cohesive neoplastic cells that form glandlike tubular structures
- Diffuse type: not common, affects young people, associated with mutations in E-cadherin, and characterized by absence of cell cohesion
- Routes of spread:
- Local invasion of adjacent structures
- Hematogenous spread
- Lymphangitic spread
- Peritoneal spread
Sjogren Syndrome
- Chronic autoimmune inflammatory disorder characterized by diminished lacrimal and salivary gland function with resultant dryness of the eyes and mouth
- Diagnosis: detection of autoantibodies (anti-SSA/Ro, ANA) and salivary gland biopsy
- Features:
- Bilateral enlargement of the salivary glands
- Dryness of the eyes and mouth
- Positive anti-SSA and anti-SS-B antibodies
Upper Gastrointestinal Tract
Mouth
- Oral mucosa composed of stratified squamous epithelium, present on lips, buccal mucosa, alveolar mucosa, soft palate, underside of the tongue, and floor of the mouth
- Epithelial surface of hard palate, gingiva, and some regions of specialized mucosa on the dorsum of the tongue
- Sjogren syndrome: a chronic inflammatory autoimmune disease that mainly attacks lacrimal and salivary glands
- Leukoplakia: a condition characterized by hyperkeratosis of oral epithelium
- Oral cancer: can arise from oral squamous epithelium, with risk factors including tobacco, alcohol, and HPV
- Development of oral squamous cell carcinoma:
- Normal oral epithelium → Hyperkeratosis of oral epithelium → Dysplasia of oral epithelium → Oral squamous cell carcinoma
Sialolithiasis
- Formation of stones in salivary ducts
Oesophagus
- Congenital and acquired diseases of the oesophagus
- Neoplasms: oesophageal cancer can be classified into two main types, squamous cell carcinoma (SCC) and adenocarcinoma
- Squamous cell carcinoma:
- Most common type of oesophageal cancer worldwide
- Occurs in the upper/middle part of the oesophagus
- Risk factors: alcohol, tobacco, caustic injury, achalasia, radiation exposure, and carcinogen (acetyl aldehyde)
- Adenocarcinoma:
- Metaplastic, columnar, glandular, intestine-like mucosa with brush border and goblet cells replaces normal stratified squamous epithelium of the distal esophagus
- Dysplasia in Barrett's oesophagus can progress to adenocarcinoma
- Oesophageal obstruction:
- Diffuse oesophageal spasm: repetitive distal oesophageal contractions
- Zenker diverticulum: outpouching above upper oesophageal sphincter
- Oesophageal mucosal web: mucosal semi-circumferential protrusion
- Oesophageal (Schatzki) ring: mucosal/submucosal circumferential protrusion
- Barrett's oesophagus:
- A metaplastic, columnar, glandular, intestine-like mucosa with brush border and goblet cells replaces normal stratified squamous epithelium of the distal esophagus
- Dysplasia in Barrett's oesophagus can progress to adenocarcinoma
Stomach
- Gastritis
- Peptic ulcer disease
- Neoplasms: gastric adenocarcinoma, gastric lymphomas, carcinoid tumors, and gastrointestinal stromal tumor
- Gastric cancer:
- Risk factors: Helicobacter pylori infection, autoimmune atrophic gastritis, smoking, diet (smoked, dried, and preserved food), gastric polyps, and genetic factors
- Histological types:
- Gastric adenocarcinoma
- Gastric lymphomas
- Carcinoid tumors
- Gastrointestinal stromal tumor
- Lauren's classification:
- Intestinal type: common, affects older people, associated with environmental factors, and characterized by cohesive neoplastic cells that form glandlike tubular structures
- Diffuse type: not common, affects young people, associated with mutations in E-cadherin, and characterized by absence of cell cohesion
- Routes of spread:
- Local invasion of adjacent structures
- Hematogenous spread
- Lymphangitic spread
- Peritoneal spread
Sjogren Syndrome
- Chronic autoimmune inflammatory disorder characterized by diminished lacrimal and salivary gland function with resultant dryness of the eyes and mouth
- Diagnosis: detection of autoantibodies (anti-SSA/Ro, ANA) and salivary gland biopsy
- Features:
- Bilateral enlargement of the salivary glands
- Dryness of the eyes and mouth
- Positive anti-SSA and anti-SS-B antibodies
This quiz covers the anatomy and diseases of the mouth, including the oral mucosa, Sjogren syndrome, and leukoplakia.
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