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D2: 622 Oral Pathology > 01: Top 30 Lecture > Flashcards

01: Top 30 Lecture Flashcards

1
Q

What are the 3 results for a region during a Head and Neck Exam

A

Normal
Variant of Normal
Abnormal

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2
Q

Once you find the pathology what are the “Sieve” indicators related to the patient

A

Age
Gender
Race

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3
Q

Once you find the pathology what are the “Sieve” indicator related to the pathology itself

A 
Color
Size
Location
Morphology
Radiographic
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4
Q

What color is leukoplakia

A

White

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5
Q

leukoplakia is a clinical term, so what does it mean?

A

A white lesion in the oral cavity only

It doesn’t not rub off

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6
Q

Why are white lesions white?

A

Because there is something blocking out the redness of the underlying vascular tissue

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7
Q

What types of things could be blocking the view of the vascular tissue?

A 
Keratin
Microbial colony
Scar tissue
Necrosis
etc.
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8
Q

What White Lesions can be wiped off?

A 
Materia Alba
White coated tongue
Burn (Thermal, Electrical, etc.)
Pseudomembranous candidiasis
Tooth Paste
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9
Q

What is materia alba

A

It is basically dental plaque that isn’t on the tooth

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10
Q

What is white coated tongue

A

Basically materia alba on the tongue
Asymptomatic
Can be brushed/scraped from the tongue

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11
Q

What are most oral burns caused by

A

Microwaved food

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12
Q

Why are burns white

A

White area is a scab that can be pulled off, bright red on periphery is healing tissues.

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13
Q

How do electrical burns differ from other oral burns

A

They often come from kids biting electrical cords

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14
Q

Why do some people get aspirin burns in the mouth?

A

People get a toothache and they have been told that if they put an aspirin next to the tooth it would work better than swallowing it

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15
Q

Why does aspirin cause an acid burn

A

Aspirin has a pH of 2

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16
Q

What is the treatment of an aspirin burn

A

Discontinuance of ASA

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17
Q

What other chemicals can cause “Aspirin” burns

A

Hydrogen peroxide
Silver nitrate
Phenol
some Endo Materials

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18
Q

How does toothpaste/mouthwash overdose cause a white lesion

A

Chronic overuse of some toothpaste can cause acid burn

Listerine is up to 25% alcohol that is also able to burn tissues

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19
Q

How can a cotton roll burn develop?

A

The cotton over time dessicated the epithelium and killed it by drying

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20
Q

What is thrush

A

Oral candidiasis in babies

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21
Q

Which is infective, candida spores or hyphae

A

Hyphae

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22
Q

What are the other forms and presentations of candidiasis

A

White Pseudomembranous
Thrush
Angular Chelitis

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23
Q

What is angular chelitis

A

Candidiasis on the corner of the mouth

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24
Q

What is Central Papillary Atrophy of the Tongue

A

Candidiasis on the part of the tongue that is not self cleansing

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25
Q

How do you treat Candidiasis?

A

Anti-fungal medicine

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26
Q

What is a troches

A

Medicine delivery that is time released like a life saver

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27
Q

What is Nicotine Stomatitis

A

White hyperkeratotic palate secondary to smoking, usually a pipe or cigar. Likely related to the heat

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28
Q

Who typically gets Nicotine Stomatitis

A

Males over 45

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29
Q

What should you document from your H&N exam if everything is normal?

A

Just that you did complete a head and neck exam and everything was normal!

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30
Q

What should you chart if you discover a lesion that is a variant of normal?

A

Details about the lesion and what exactly the variation is

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31
Q

What should you chart if you discover an abnormal lesion

A

Chart findings and then follow the protocol set forth in your standards of care documentation

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32
Q

Why might this course’s Top 30 data be skewed?

A

Because in 1986 in Minnesota, the ethnic majority was scandanavian. And there are many more women in the study than men

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33
Q

What is leukoplakia technically?

A

Hyperkeratosis

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34
Q

Why is the gingiva/mucosa pink?

A

Because you are seeing the vasculature through a translucent membrane (epithelium)

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35
Q

When might materia alba NOT be a white lesion?

A

When the patient has stained it with coffee, tea, smoke, etc.

36
Q

What might the lesion of a microwave burn look like?

A

A white center (scab/necrotic tissue) with a red halo (rubor/healing tissues)

37
Q

What is the chemical name of acid? What is its pH

A

Acetyl salicylic Acid

pH = 2

38
Q

What can you recommend to someone who overdoes it owhen using listerine?

A

If they feel they must use it all of the time, at least dilute it to a 50:50 mix

39
Q

Besides dessication, how else might a cotton roll cause harm if left in contact with the epithelium for too long?

A

The cotton can take up toxins and transfer them to the epithelium

40
Q

What is the most common fungal infection of the oral cavity?

A

Candidiasis

41
Q

What oral infection used to be treated in infants with a purple dye called phenyl thaline?

A

Thrush (Candidiasis in infants)

42
Q

What is the microbe associated with Candidiasis/Thrush?

A

Candida albicans

43
Q

What are the two forms in which you can find C. albicans

A

Spore vs. Hyphae

44
Q

What common treatment for Asthma can actually cause a Candidiasis infection?

A

Inhalers

45
Q

What percent of the population has candida albicans in their mouth all the time?

A

1/3-1/2; but we don’t get sick because it is the spore form

46
Q

What are the major predisposing factors for C. albicans infection?

A 
Immune Status:
  AIDS
  Malignancy
  Suppression
  Medications
    Abx
    Steroids (e.g. Inhaler)
  Partial and Complete Dentures
47
Q

Microscopically, what diagnostic indicators are we looking for to confirm a C. albicans infection?

A

Branching hyphae

48
Q

In what clinical situation will it be more likely to find red candida vs. white?

A

Under dentures

49
Q

For this course’s purposes, what drug name would you prescribe to a patient with C. albicans?

A

Simply antifungal (not a pharm course)

50
Q

What is the difference between a cream and an ointment? Which would be a better choice to treat candida on the dorsum of the tongue?

A 
Cream = Water Based
Ointment = Oil Based

Ointment would be better because the solution would not dissolve into the water based saliva

51
Q

What common while removable lesion can show up as a white line on the buccal mucosa at about the level of the occlusal plane?

A

Linea alba

52
Q

What causes Linea alba?

A

it is hyperkeratosis from chewing/friction of the cheeks

53
Q

What is the treatment for Linea alba?

A

No treatment recommended

54
Q

Considering it is present in 70-80% of the ethnic group, African Americans might say that it is abnormal not to have this white, removable lesion?

A

leukoedema

55
Q

Describe what leukoedema looks like? What is the treatment?

A

Bilateral
While/Milky White Opalescence
NO TREATMENT

56
Q

How would you know that a leukoedema lesion is fluid filled?

A

If you put tension on the lesion the fluid will run out and the mucosa will appear normal. Once the tension is released, the fluid will return

57
Q

Why is nicotine stomatitis a very misleading term?

A

Because it is neither a lesion related to nicotine nor an inflammation of the mouth

58
Q

What causes nicotine stomatitis?

A

The heat induced destruction of soft tissue on the palate….often seen in pipe and cigar smokers because they don’t inhale

59
Q

What is the most common demographic for nicotine stomatitis/smokers palate?

A

Men over 45

60
Q

What are the “volcano tipped” papules sometimes seen in nicotine stomatitis?

A

Inflammed salivary glands

61
Q

What can you tell about an edentulous patient who has nicotine stomatitis on his/her palate?

A

That they don’t wear their dentures very often

62
Q

What is the presentation of Oral Hairy Leukoplakia?

A

Bilaterally on the lateral borders of the tongue

63
Q

What virus and condition is Oral Hairy Leukoplakia associated with?

A

EBV in AIDS patients

64
Q

Why is Oral Hairy leukoplakia white?

A

Candida is growing on the ends of the hyperkeratotic folds

65
Q

how does tobacco pouch keratosis present?

A

White lesions form where dippers keep their pouch. White is hyperkeratosis

66
Q

After 20-40 years, what is the most likely form of cancer to develop out of a dipping habit?

A

verracous (wart like) carcinoma

67
Q

What while oral lesion can be described as a chronic mucocutaneous disease?

A

lichen planus`(cutaneous because it’s often seen as a skin lesion).

68
Q

What are the four P’s of lichen planus?

A

Purple
Pruritic
Polygonal
Papules

69
Q

Who gets lichen planus more often, women or men?

A

Women 3:2

70
Q

What age group most often gets lichen planus

A

Middle aged adults

71
Q

What oral lesion is associated with striae of wickham?

A

Lichen planus

72
Q

Why don’t we have a cure for lichen planus?

A

Because we don’t really know what causes it

73
Q

When can lichen planus turn very painful?

A

When it ulcerates

74
Q

What are the two classifications of ORAL lichen planus

A

Reticular (net-like) and Erosive

75
Q

What is the most obvious differentiating factor to decide between reticular and erosive?

A 
Painful (erosive/ulcerative)
Non Painful (Reticular/Striae)
76
Q

What other oral lesions must you rule out before deciding on a lichen planus diagnosis?

A

Lichenoid Drug Rxns

77
Q

Can you (a dentist) definitively determine if it is a drug rxn or lichen planus?

A

No. They are identical histologically. You must work with an MD

78
Q

What oral lesion is associated with saw tooth rete pegs prior to ulceration?

A

Lichen planus

79
Q

Why is it important to watch leukoplakia very carefully for 2 weeks?

A

Because it could be indicative of cancer

80
Q

What type of cancer is associated with leukoplakia?

A

Invasive SCC

81
Q

What could be indicative of carcinoma in situ (in terms of leukoplakia?

A

Jumbled up epithelium layers

82
Q

What is the abnormal cellular growth progression of leukoplakia?

A

Molecular change within DNA
Dysplasia
Carcinoma in Situ
Invasive SCC (Broken through basement membrane)

83
Q

What is the most important factor in a leukoplakia prognosis?

A

How early in the progression the lesion was discovered?

84
Q

If after two weeks you tell the patient to just “keep an eye on it” what are the chances leukoplakia will turn malignant?

A

4%

85
Q

Why is leukoplakia considered a pre-malignant lesion?

A

Because by the time it is found, it has already reached the dysplasia stage (or worse) 25% of the time

86
Q

What is the etiology of leukoplakia?

A 
Tobacco
Friction
Alchohol
UV Rays
Microbes
Sanguinaria
87
Q

What part of the leukoplakia lesion should be biopsied?

A

The worst looking part

D2: 622 Oral Pathology (36 decks)

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