ORAL PATH & ORAL MEDICINE II NEET MDS INICET MDS Quick Revision WE ARE WITH YOU

this is dr madhuri from team mds conquer we will see the glance of over medicine and pathology subject in this video so here the clinical pictures are given here if you see this is the retrognathia glossoptosis and because of this glossoptosis there is an airway obstruction so these three features if you combine it comes out of which syndrome that is peri robin syndrome and you can also see here the patient of perry robinson syndrome will have a board like faces and this is because of retrognathia and this is because of mainly because of the retrognathia and if you take this patient's which of perry robinson syndrome will also have cleft palate okay so the important features of perry robin syndrome includes bought phase retrognathia airway obstruction and the glossoprosis so there is a very robin sequence okay we'll see the syndromes which comes under this peri robin sequence peri robin sequence is nothing but a isolated clinical feature that means the patient will have a glossoptosis or a cleft palate or only cleft palate or abstraction along with the cleft palate so it is an isolated phenomenon ok so this isolated phenomenon can be seen in other syndromes also like stickler syndrome willow cardio facial syndrome treacher colin syndrome and fetal alcohol syndrome okay remember peri robin sequence okay see the terminology sequence is also seen in other syndromes like stickler syndrome willow cardio facial syndrome treacher colon syndrome and fetal alcohol syndrome so the syndrome given here is a clinical feature of you can if you see this clinical picture so this is a picture of treacher choline syndrome okay and the important uh point you have to note in rachel colin syndrome is fish face okay bird-like faces is perry robin syndrome whereas fish like face is the tricera colon syndrome and one more important point you have to note here is collaborate okay collaborative eye also belongs to treacher collins syndrome and in these patients will have a ear mall formations okay the there is no up complete absence of ear or a partial development of liver you complete absence of ear or a partial absence of ear and only a one your earlobe can be can also be seen okay so ear defects and the fish face belongs to tresor colon syndrome and you have to remember the facial or a clinical appearance of this syndromes also which they can be asked as a clinical based question or a picture based question coming here this is a parry robbins rambok syndrome if you see here this face cut also relate with the scleroderma okay there is a terminology called as encomptisable okay which is mostly called as localized or linear scleroderma okay so if they ask about a syndrome which is related to the linear scleroderma or a localized scleroderma then your answer will be of your parry romberg syndrome okay so this is the facial appearance of a parry romberg syndrome only important point here that is it relates with the scleroderma and the term which is related to related to both this is and copdy sabor so we have seen board like fishes and fish like faces now we'll see the frog like face okay frog like phase belongs to krausen syndrome okay krausen syndrome is a craniosynostosis okay remember the terminology craniosynostosis belongs to krausen syndrome and here the patient will have a frog like face or a flower leaf skull on the radiograph okay so two things three things here craniosynostosis frock phase and the clower leaf phase belongs to krausen syndrome then coming to the malcus and rosenthal syndrome so what are the features you can see here in this clinical pictures one is the fissure tongue okay so this is the fissure tongue and you can see this killitis granulomatosa and along with this you can see that kelitos granulomatosa or swelling of that leaves and along with this pulse unilateral palsy okay so all these things belongs to marcus and rosenthal syndrome only the important thing is fish your tongue so the tongue appearance in the malcus and rosenthal syndrome is fissured tongue okay so identify this tongue picture clinical picture you can see here this is called as hairy tongue and in the hairy tongue you have to remember the philly form papillae okay so in the hairy tongue the filliform papillae will be elongated or hypertrophied so they can ask you regarding the papilla okay so in the hairy tongue the filiform papilla will be elongated or hypertrophy one more important tongue feature here microglossia okay so everyone knows that microglossia is in back with with man syndrome sarah so there are other three syndromes given here along with this back with whitman syndrome where you will see the macroglossia the other three syndromes include down syndrome taller syndrome and bahamal syndrome so you have to remember these four syndromes okay so where do you see microglossia that is back with windman syndrome down syndrome taller syndrome and the bahamal syndrome so in these four syndromes you can see the macroglossia okay there are two type of teeth that is natural teeth and the neonatal teeth okay what are the natural teeth which are present at the birth okay so the natural teeth of the teeth which are present at the birth if you take the neo natal teeth the teeth present in first month of birth that is within 30 days they are called as neonatal teeth so in this slide they have given three type of disorders and or syndromes which where we will see the needle or a neonatal tooth they include rigafide disease halaman strife syndrome and alice van gravel syndrome so in these three syndromes you can see the presence of natural teeth the this is a very important point so in these three things you will see the presence of natural teeth that is regarded disease halaman steve syndrome and alice van gravel syndrome here the classification of cyst are given so this classification is based on tissue of origin okay so they can ask that cyst which they can ask you in multiple option questions like which are derived from the rest of molasses that is periapical system the residual cyst and which sister derived from the reduced enamel epithelium that is done desert assist and the eruption cyst and there are a few cysts which are derived from the dental lamina or rest of service so this is include odentogenic keratosis gingival cyst of newborn gingival cyst of adult lateral periodontal cyst and the glandular orientogenic cyst okay so they remember these things which are derived from the rest of molasses which are reduced enamel epithelium derivatives and which are the derivatives of rests of ceres coming to the federal cyst okay here i have given a list of cysts which are called as fissural cysts okay we'll see them so a median anterior maxillary or a nasopalatine cyst median palatal cyst globular maxillary cyst median mandibular cyst and the nasolar or nasolabial cyst so all the cysts are the fiscal cyst okay so remember these names median anterior or maxillary nasopalatin median palatal globular maxillary median mandibular nasal allele or nasolabial cyst belongs to the fiscal cyst so important definition regarding amyloblastoma okay you can remember the short term like unicef if you see that is unicellular this is according to the robinsons classification of amiloblastoma this definition was given so it is a unicellular it is a non-functional it is intermittent in growth it is clinically persistent and it is anatomically benign okay so amyloblastoma unicellular non-functional intermittent in growth clinically persistent and anatomically benign so you have to remember this phi terminologies regarding the amyloplasty mind which is according to robinson classification and histologically actually there are six common varieties of amyloblastoma so other than this six common varieties there are also three rare varieties histologically okay we'll see the common varieties common varieties includes follicular plexiform acanthomatous granular cell in granular cells you will see the lysosomes okay then basal cell and desmoplastic so this follicular plexiform acanthomatous granular cell basal cell and snowplastic belong to the common histological varieties of amyloblastoma whereas rare varieties includes clear cell papillae ferrous and kerato-amyloblastoma so please do remember these three histological varieties which are the rare varieties of amyloblastoma coming to the two-thirds tumor so they can ask like which is a two-thirds tumor so that is nothing but a adenomatoid or endogenic tumor avoti is also called as two-third tumor why because two important reasons is two third of this cases appears in anterior maxilla and two third of the cases are associated with impacted canine okay so because of these two important reasons it is called as two thirds tumor that is two-thirds associated with anterior maxilla and two-thirds of cases are associated with the impacted canine we'll see few features which are not seen in squamous or endogenic tumor okay so as they have given like famous most of the students think they have uh features which are related to epithelium dysplasia okay but we i am giving a list of four very important features and they can ask you in statements okay the four statements given the four features given here are not a feature of squamous or dendrogenic tumor okay so they can ask you like a true false base questions so squamous or dendrogenic tumor do not have pleomorphism it doesn't have nuclear hyperchromatism it doesn't have mitotic activity and it doesn't have the epithelial pulse so remember they do not have priomaphism they do not have the nuclear chromatism and they do not have the mitotic activity and they do not have the epithelial pulse so remember these four features are very important which are not seen in squamous or dendrogenic tumor there are three features given that is oral a patient comes to you and he has a oral liken plan is plus hypotension plus diabetes mellitus okay if you see these three triad there is a diagnosis there can be a diagnosis for this three triode okay that diagnosis is nothing but a greenspun syndrome so the greenspan syndrome triad will be of your oral icon plan is hypertension and the diabetes mellitus so identify this syndrome this is syndrome or a disorder it is nothing but a clinocranial dysplasia so the most characteristic feature is hypoplastic clavicles and they can bring their shoulders too close okay so hypoplastic clavicles hypo clavicles or even in few cases the clavicle is absent okay so this is seen in cledo cranial dysplasia or disorders and here the important gene is your cbf a1 gene remember cba fa1 gene is associated with your clidocranial dysplasia so what here this is a macula okay so this is a feature of hereditary hemorrhagic telangiectasia okay the what is that feature this is a cherry red macule on the skin with a crushed spider appearance remember this statement cherry red macular on the skin with a crust spider appearance is a feature of hereditary hemorrhagic telangiectasia you can see this is a red michael cherry red molecule and one most thing is given here that is a herald patch okay where is the the herald patch is a feature of patriotism rosia okay in patriasis rosia you can see the herald patch it is a very important feature and this is also a red molecule remember two things here one cherry red macules crushed spiderweb appearance with is seen in hereditary hemorrhagic telangiectasia whereas this red molecule which appears in the form of a patch that is nothing but herald patch is seen in vitriolis rosia so what can you suspect in this patient you can see in this patient there is a period pigmentation or a freckle type of appearance okay perioral pigmentation of freckle type of appearance over the perioral region so in these patients what can you suspect you can suspect a huge jog syndrome okay in this patients you can suspect a pure jogger syndrome so if the patients comes with perioral pigmentation you can directly or you can advise the patient to take a endoscopy because even this patient will have a polyphosis endoscopy of intestine okay so the features important in your jogger syndrome are perioral pigmentation plus an intestinal polyposis okay what is this lesion which mimics the carcinoma so that is necrotizing cylometaplasia it is a salivary gland disorder and it mostly mimics the salivary it mostly mimics the squamous cell carcinoma okay and this ah necrotizing cell metablasia may develop more during even the palatal injections also that is forceful or a traumatized or a pressurized palatal injections it can cause the necrosis over the region so loss of blood supply and it results in the necrotizing xylometaplasia which sometimes makes the square muscle carcinoma and one more thing there will be you can also suspect a i mean like you can see the deep dd that is differential diagnosis for this palatal necrosis or perforation those are deep fungal infections and one more important here is syphilis okay so syphilis d fungal infections and necrotizing cylomatoplasia make and calls the necrosis of the palette necrotic lesion of the palate so what is the gold standard diagnosis for the jochran syndrome that is lip biopsy lower lip biopsy is a gold standard diagnostic test for the jogger syndrome remember this is a very important point that is gold standard for the diagnostic test for the jagran syndrome is lip biopsy here a classification of candidiasis is given so in this classification the very important things are candida associated lesions okay what are the candida associated lesions they are dengue stomatitis angular kilitas median rhomboid glossitis that is dangerous stomatitis angular kilitis and the median rhomboid glossities are the candida associated lesions there are two lesions here asked here one is a kissing lesion and one is a kissing this is okay what is a clinical picture given here it is a kissing lesion so in this clinical picture is nothing but a multifocal candidiasis is associated with kissing lesion why because the patient might develop a candidiasis on the tongue and if the tongue touches the palate on palette also it the same the lesion may develop so hence it is called as a kissing lesion and there is a one more term called as a kissing disease what is kissing disease it is infectious mononucleosis okay so kissing disease is a infectious mononucleosis caused by epstein-barr virus so you have to remember kissing lesion is candidiasis whereas kissing diseases infectious mononucleosis which is caused by epstein-barr virus coming to the densest stomatitis there are three this is a clinic picture based question so here there are three types of uh candidiasis include on the dangerous dermatitis so the first one is the patient will have a arithmetis region only on few focal areas of the palate or the allele ridge okay so if you take the type 2 densest dermatitis the patient will have the erythematos region over the complete allele ridge but if you take the type 3 the patient will have a erythematous region and also the granular type of lesions granular lesions all over the palate okay so the type 1 only focal type 2 allele rich type 3 entire palette and you even you can see the granular growths also and one more important thing that is snail track ulcer if you see this is a snail track type of ulcer where it does it seem it is seen in the secondary syphilis so don't confuse if they ask about the single track ulcer it is seen in the secondary syphilis one more thing hpv 16 okay hpv 16 is more important because it is a high risk type of papilloma virus and most commonly involved in the carcinoma so hpv 16 is a very important number because it is a high risk and also associated with most of the oral carcinomas what is this see the you have to concentrate on the clinical picture that is this is a horrible hairy leukoplakia and caused by epstein-barr virus and it also associated with hiv so they can ask you are they present in the form of a clinical picture so concentrate on the clinical picture which occurs mostly in the literal border of the tongue and it associated with the hiv and caused by the epstein-barr virus it is oral hairy leukoplakia so this is the classification of hiv infection there are three groups that is group one two and three group one and two given here the lesions which are strongly associated with the hiv infection which includes candidiasis hairy leukoplakia kaposi sarcoma non-hodgkin's lymphoma and periodontal diseases so these are the lesions which are strongly associated with the hiv infection but if you take the group 2 they are less commonly associated with the hiv infection that includes bacterial infections melanotic hyperpigmentation and necrotizing ulcerative stomatitis okay group 2 less commonly whereas group 1 lesions strongly associated with hiv infection and here the lesions which are seen in hiv infection that is bacterial infections drug reactions lycanoid reaction epithelid angiomatosis fungal infections other than candidiasis neurological disturbances and recurrent after stomatitis okay so all these things are lesions which are seen in hiv infection so first one is strongly associated second the group two is less commonly associated and third will be seen in hiv infection what is this alarm clock headache okay alarm clock headache is seen in spino palatine and due to which ah nerve damage there is a paraximal crying during eating okay so the paraxial crying during eating it is due to the damage of facial know this is very important because of that this damage there is a paraximal crying now this is a what sign and and which in seen in which syndrome so this is called as a sternberg sign okay remember sternbox sign and it is seen in marfan syndrome and this is also a clinical picture based question that is this is a sternberg sign which is seen in mafan syndrome so this is a clinical based question so you have to identify the syndrome based upon the facial features and it is very easy that is downs syndrome so this is a down syndrome patient and here even this patient is a down's syndrome even this patient also has a downs syndrome so this is a direct question they can ask to identify the syndrome so based on the facial features you have to identify the syndrome and you can see here there is a frontal bossing and in some patients there will be of a hypoplastic maxillary mandible again you have to mix these clinical features that is the more important thing you have to note here is the multiple oral papillomatous lesions okay multiple oral papillomatic lesions and you can see vats or the skin manifestations along with the patient may complain of a uterine cancer array breast cancer so the multiple one important is this the multiple oral papillomas and the patient may have a complaint of a breast cancer or uterine cancer then your diagnosis will be cowed and syndrome so they can ask you like this combination type of questions also with which is only diagram based okay so you have to know the each and every feature at least the important features of syndromes and what is this clinical picture so lion like faces it is seen in pages this is okay so initially we have red bird like faces fish like faces frog like faces now the lion like faces it is seen in pages this is so remember these faces what is this appearance of the mucosa you can see here this is a cobblestone appearance okay cobblestone appearance of mucosa where do you see this cobblestone appearance one important thing is crohn's disease okay and the second more thing is hex disease okay so in the crohn's disease and the hex disease and also in the pios tomatitis vegetans okay so crons hex disease and piopsomatitis vegetans you will see the cobblestone appearance of the over mucosa so remember these three points and also the picture and based upon this can you diagnose the syndrome that is nothing but phrase syndrome how can you diagnose this as a phrase syndrome if you see here the patient has a sweating over here and that to the gauss statory sweating that near the ear and also you can see the flushing okay so the flushing and the gauss stator sweating is associated with the phrase syndrome okay now we'll diagnose few cases with their clinical features or clinical presentation so here a patient i have written only important points or hints for the diagnosis okay the patient complains of a swelling in the floor of the mouth is the first point and that swelling is in six months and that patient has pain and that pain increases while eating okay and the fourth one on palpation it is tender and hard okay the swelling in the floor of the mouth since six months pain increases while eating and palpation it is tender and hot okay so with all these things if the floor of the mouth so you can think of few lesions like a granular but okay so you can remove these two lesions okay why because on palpation it is tender and hard okay whereas granular and lipoma will be soft and non tender mostly they will be soft and non tender okay so there is only one one thing here that is silo lip okay relate to these points silo lit is can be seen in the floor of the mouth which is mostly because of that submandibular silolith and it will it can present since many days like a chronic salidinite and they have give the patient had presented with it so we will so the patient has a swelling in the floor of the mouth okay since six months so i have given only important hints for the diagnosis okay so the patient complains of a swelling in the floor of the mouth that is first hint second will be it's a chronic lesion that is in six months thought is pain increases while eating and the fourth thing is palpation it is tender and hot okay so here the swelling in the floor of the mouth what can you expect in this floor of the mouth usually regular cases you can go for the granular or a lipoma or a silo liquid so but in palpation i have given that is tender and hard right so you can you have to eliminate the options granules and lipoma these both are soft in consistency and non tender mostly they are soft in consistency and non tender and if you take the pain increases while eating okay see silo lithius then hard inconsistency and floor of the mouth yes it can present in the floor of the mouth because of that submandibular lesion or if it involves a submandibular gland and it can present from six months yes it can present from six months like a chronic silentinitis and one more important feature is pain increases while eating so all these four features are related to your silo lip so the patient has pain since six months right so this is in six months and the patient has pain while eating increases while eating so you can go for chronic cy ladinitis may be because patient is developing the bacterial infection because of this silo lithius okay so chronic salidinite is secondary to silo lithius can be your provisional diagnosis next one the patient has it is a 22 year female that is young female complain missing teeth on examination the patient has space hair periorbital pigmentation radio salivation and opg multiple missing teeth okay the positive findings here are space hair and reduce salivation so with these things along with missing teeth you can go for your provisional diagnosis as ectodermal dysplasia because the patient has the reduced elevation and decreased number of teeth and also the decreased number of health that is ectodermal structures are this plastic here so you can go with the provisional diagnosis ectodermal dysplasia and here the case the patient is a 40 years male and he has radiotherapy completed 15 days back and in this patient oral mucosa is ulcerative and very tender okay in which cases you can see oral mucous are very on ulceratives and tendons maybe you can see in infectious conditions or you can see in autoimmune conditions like our erosion lichen planus or a pam figures so in these infectious conditions or most commonly or a autoimmune conditions you can see the ulcerative or a tender oral mucosa and even but here there is a hint given that is radiotherapy so the patient had underwent radiotherapy so in these type of patients the patient can develop radiation mucositis so you can eliminate these two and you can go with radiation mucositis with this positive finding that is radiotherapy so in the diagnosis provisional diagnosis will be radiation mucositis