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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
How do you treat Candidiasis?
Anti-fungal medicine
26
What is a troches
Medicine delivery that is time released like a life saver
27
What is Nicotine Stomatitis
White hyperkeratotic palate secondary to smoking, usually a pipe or cigar. Likely related to the heat
28
Who typically gets Nicotine Stomatitis
Males over 45
29
What should you document from your H&N exam if everything is normal?
Just that you did complete a head and neck exam and everything was normal!
30
What should you chart if you discover a lesion that is a variant of normal?
Details about the lesion and what exactly the variation is
31
What should you chart if you discover an abnormal lesion
Chart findings and then follow the protocol set forth in your standards of care documentation
32
Why might this course's Top 30 data be skewed?
Because in 1986 in Minnesota, the ethnic majority was scandanavian. And there are many more women in the study than men
33
What is leukoplakia technically?
Hyperkeratosis
34
Why is the gingiva/mucosa pink?
Because you are seeing the vasculature through a translucent membrane (epithelium)
35
When might materia alba NOT be a white lesion?
When the patient has stained it with coffee, tea, smoke, etc.
36
What might the lesion of a microwave burn look like?
A white center (scab/necrotic tissue) with a red halo (rubor/healing tissues)
37
What is the chemical name of acid? What is its pH
Acetyl salicylic Acid | pH = 2
38
What can you recommend to someone who overdoes it owhen using listerine?
If they feel they must use it all of the time, at least dilute it to a 50:50 mix
39
Besides dessication, how else might a cotton roll cause harm if left in contact with the epithelium for too long?
The cotton can take up toxins and transfer them to the epithelium
40
What is the most common fungal infection of the oral cavity?
Candidiasis
41
What oral infection used to be treated in infants with a purple dye called phenyl thaline?
Thrush (Candidiasis in infants)
42
What is the microbe associated with Candidiasis/Thrush?
Candida albicans
43
What are the two forms in which you can find C. albicans
Spore vs. Hyphae
44
What common treatment for Asthma can actually cause a Candidiasis infection?
Inhalers
45
What percent of the population has candida albicans in their mouth all the time?
1/3-1/2; but we don't get sick because it is the spore form
46
What are the major predisposing factors for C. albicans infection?
``` Immune Status: AIDS Malignancy Suppression Medications Abx Steroids (e.g. Inhaler) Partial and Complete Dentures ```
47
Microscopically, what diagnostic indicators are we looking for to confirm a C. albicans infection?
Branching hyphae
48
In what clinical situation will it be more likely to find red candida vs. white?
Under dentures
49
For this course's purposes, what drug name would you prescribe to a patient with C. albicans?
Simply antifungal (not a pharm course)
50
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?
``` Cream = Water Based Ointment = Oil Based ``` Ointment would be better because the solution would not dissolve into the water based saliva
51
What common while removable lesion can show up as a white line on the buccal mucosa at about the level of the occlusal plane?
Linea alba
52
What causes Linea alba?
it is hyperkeratosis from chewing/friction of the cheeks
53
What is the treatment for Linea alba?
No treatment recommended
54
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?
leukoedema
55
Describe what leukoedema looks like? What is the treatment?
Bilateral While/Milky White Opalescence NO TREATMENT
56
How would you know that a leukoedema lesion is fluid filled?
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
Why is nicotine stomatitis a very misleading term?
Because it is neither a lesion related to nicotine nor an inflammation of the mouth
58
What causes nicotine stomatitis?
The heat induced destruction of soft tissue on the palate....often seen in pipe and cigar smokers because they don't inhale
59
What is the most common demographic for nicotine stomatitis/smokers palate?
Men over 45
60
What are the "volcano tipped" papules sometimes seen in nicotine stomatitis?
Inflammed salivary glands
61
What can you tell about an edentulous patient who has nicotine stomatitis on his/her palate?
That they don't wear their dentures very often
62
What is the presentation of Oral Hairy Leukoplakia?
Bilaterally on the lateral borders of the tongue
63
What virus and condition is Oral Hairy Leukoplakia associated with?
EBV in AIDS patients
64
Why is Oral Hairy leukoplakia white?
Candida is growing on the ends of the hyperkeratotic folds
65
how does tobacco pouch keratosis present?
White lesions form where dippers keep their pouch. White is hyperkeratosis
66
After 20-40 years, what is the most likely form of cancer to develop out of a dipping habit?
verracous (wart like) carcinoma
67
What while oral lesion can be described as a chronic mucocutaneous disease?
lichen planus`(cutaneous because it's often seen as a skin lesion).
68
What are the four P's of lichen planus?
Purple Pruritic Polygonal Papules
69
Who gets lichen planus more often, women or men?
Women 3:2
70
What age group most often gets lichen planus
Middle aged adults
71
What oral lesion is associated with striae of wickham?
Lichen planus
72
Why don't we have a cure for lichen planus?
Because we don't really know what causes it
73
When can lichen planus turn very painful?
When it ulcerates
74
What are the two classifications of ORAL lichen planus
Reticular (net-like) and Erosive
75
What is the most obvious differentiating factor to decide between reticular and erosive?
``` Painful (erosive/ulcerative) Non Painful (Reticular/Striae) ```
76
What other oral lesions must you rule out before deciding on a lichen planus diagnosis?
Lichenoid Drug Rxns
77
Can you (a dentist) definitively determine if it is a drug rxn or lichen planus?
No. They are identical histologically. You must work with an MD
78
What oral lesion is associated with saw tooth rete pegs prior to ulceration?
Lichen planus
79
Why is it important to watch leukoplakia very carefully for 2 weeks?
Because it could be indicative of cancer
80
What type of cancer is associated with leukoplakia?
Invasive SCC
81
What could be indicative of carcinoma in situ (in terms of leukoplakia?
Jumbled up epithelium layers
82
What is the abnormal cellular growth progression of leukoplakia?
Molecular change within DNA Dysplasia Carcinoma in Situ Invasive SCC (Broken through basement membrane)
83
What is the most important factor in a leukoplakia prognosis?
How early in the progression the lesion was discovered?
84
If after two weeks you tell the patient to just "keep an eye on it" what are the chances leukoplakia will turn malignant?
4%
85
Why is leukoplakia considered a pre-malignant lesion?
Because by the time it is found, it has already reached the dysplasia stage (or worse) 25% of the time
86
What is the etiology of leukoplakia?
``` Tobacco Friction Alchohol UV Rays Microbes Sanguinaria ```
87
What part of the leukoplakia lesion should be biopsied?
The worst looking part

D2: 622 Oral Pathology (36 decks)

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