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Oral Medicine and Diagnosis > Diagnostic Technique > Flashcards

Diagnostic Technique Flashcards

1
Q

what is objective clinical information

A

information that can be measured or perceived by the investigating clinician - signs

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2
Q

what are examples of objective clinical info

A
  • temperature
  • size
  • color
  • duration
  • consistency
  • surface contour
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3
Q

describe subjective clinical info

A
  • patients own interpretation of a clinical circumstance - symptoms
  • relies on neurologic and psychologic experiencs
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4
Q

what are examples of subjective clinical info

A

patient awareness of presence of a lesion, pain intensity, pain quality, temperature

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5
Q

describe the differential dx

A
  • orderly sequential approach
    -gathering and analyzing data
  • knowledge and experience enable recognition of abnormal findings
  • include and/or exclude disease processes based on an educated assessment of the process
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6
Q

what data do you gather for the diff dx

A
  • history
  • clinical findings- specific/unique signs and symptoms
  • lab data
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7
Q

what are the ways to clinically describe something

A
  • single vs multiple (aka systemic)
  • location
  • relative proximity to adjacent structures
  • size in dimension (mm)
  • outline- well demarcated vs diffuse
  • color- red, white, mixed, pigmented
  • consistency- firm, flaccid, compressible
  • intensity- mild, moderate, intensity, striated, lacy
  • base and surface
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8
Q

what are the ways you can describe the surface of a lesino

A
  • smooth
  • corrugated
    -eroded
  • raised
  • depressed
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9
Q

what are the ways you can describe the base of a lesion

A
  • pedunculated
    -sessile
  • nodular
  • dome-shaped
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10
Q

what is diascopy

A

compressing tissue with a glass slide to determine vascular nature of a lesion

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11
Q

describe what palpation is

A

feel and press a lesion to yield information about texture, consistency, temperature and function

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12
Q

what is probing

A

palpation with an instrument

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13
Q

what instruments are used to probe

A
  • perio probe
  • caries explorer
  • needle tip
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14
Q

what is percussion

A

striking tissues with fingers or an instrument and listening to resulting pressure changes in the tissues

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15
Q

what might percussion might tell you

A

ankylosis

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16
Q

what is aspiration

A

withdrawal of fluids from a body cavity

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17
Q

what is an example of aspiration

A

needle aspiration of cysts, vascular tumors, purulent swellings

18
Q

what is auscultation

A

listening for sounds within the body

19
Q

what are the diagnostic lab tests for oral lesions

A
  • biopsy
  • immunofluorescence
  • exfoliative cytology
20
Q

what are the types of biopsy

A

incisional
- excisional
- aspirational
- needle

21
Q

what are the indications for a biopsy

A
  • lesion with less than or equal to 14 day duration
  • unusual location
  • unusual appearance
  • suspicion of neoplasia
  • any excised tissue
  • confirm the dx of systemic disease
22
Q

what would cause suspicion of neoplasia

A
  • persistent ulceration
  • persistent erythroplasia
  • induration
  • fixation
  • chronicity
  • lymphadenopathy
  • unexplained leukoplakia
23
Q

what are the other names for needle biopsy

A
  • fine needle aspiration (FNA)
  • fine needle aspiration and cytology (FNAC)
24
Q

what are the indications for needle biopsy

A
  • to determine the cause of tissue enlargement
  • to distinguish between benign and malignant processes
  • to stage metastatic cancer
25
Q

what are the indications for oral exfoliative cytology

A
  • innocuous lesion
  • suspicious lesion with negative biopsy
  • patient refuses biopsy
  • follow up of treated malignancy
  • lesion where patient is a poor risk for surgery
26
Q

what are the limitations to needle biopsy

A
  • more technique sensitive with additional preservatives and lab processing
  • does not localize cells to affected tissues
  • appositional information to adjacent tissues is lost
27
Q

what are the contraindications for oral exfoliative cytology

A
  • keratotic or crusty mucosa
  • red, vesicular or velvety mucosa
  • submucosal swelling with normal mucosa
  • suspicion of malignancy
28
Q

what are the indications for culture and sensitivity testing

A
  • life threatening infection
  • unsuccessful previous antibiotic therapy
  • immunosuppressed patient
29
Q

why is culture and sensitivity testing use limited in dentistry

A
  • difficult for anaerobic conditions
  • turnover time too long; best attempt trial therapies of certain antibiotics as results may occur quicker than the time interval of the test
30
Q

what do oral cancer screening aids do

A
  • assist in the detection of early potentially malignant mucosal changes that are difficult to discern by visual inspection alone
  • non invasively asses the malignant potential of a mucosal abnormality
31
Q

what is the goal of tissue autofluorescense imaging

A

increase the ability to distinguish the lesional mucosal and healthy mucosa

32
Q

describe the sensitivity and specficity in tissue autofluorescence imaging

A
  • high sensitivity but low specificity in distinguishing premalignant and chronic inflammatory lesions
  • high sensitivity and specificity in identifying areas on dysplasia and invasive cancer that extends beyond the clinically evident lesion
33
Q

describe the light that is seen in autofluoirescence

A
  • we see 500-600nm
  • blue light of the scope is 400-460 nm
  • UV is less than 400nm
34
Q

what are the endogenous fluorescing products in autofluorescence

A

tryptophan, porphyrins, collagen, elastin, flavins, NADH, and fluorophores

35
Q

what are the epithelial fluoresencing compounds in autofluorescence and what does it excite at

A
  • FAD (flavin adenine dinucleotide) excites at 515nm
  • NADH (nicotinamide adenine dinucleotide) excites at 450 nm
36
Q

what are the commerically available devices for visualization of oral tissue autofluorescence

A
  • identafi 3000
  • VELScope
  • VELScope Vx
  • DOE Dental Oral Exam System
37
Q

what does dysplasia show on autofluorescence

A

decreased levels of normal autofluorescence

38
Q

what is an excisional biopsy

A

where the entire lesion is removed

39
Q

what is an incisional biopsy

A

only removing a portion of the lesion

40
Q

what type of biopsy is a suture pull

A

incisional

41
Q
A

Oral Medicine and Diagnosis (5 decks)

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