Final

Question 1

What is the 1 way to definitively diagnosis cancer

Answer 1

Biospy

Question 2

What are the conditions that can be treated with oral bisphosphonates

Answer 2

Pagets ds and osteoporosis

Question 3

What are the conditions that can be treated with IV bisphosphonates

Answer 3

Osteoporosis and bone metastases

Question 4

What is the length of time where lower instances of BRONJ would occur?

Answer 4

18 months

Question 5

What is the transplant that will be most likely to result in Graft vs host ds

Answer 5

Allogenic (different donor to host but are a match)

Question 6

What is autologous

Answer 6

The pts own bone marrow or stem cells are removed and preserved for transplantation

Question 7

What is allogenic

Answer 7

Bone marrow or stem cells from a HLA (human leukocyte antigen) matched individual are used for transplantation. Still risk for rejection

Question 8

What is syngeneic

Answer 8

Bone marrow or stem cells from an identical twin are used for transplantation

Question 9

What are the medications used to treat different opportunistic infections? Viral?

Answer 9

Acyclovir and famciclovir

Question 10

What are the medications used to treat different opportunistic infections? Bacterial?

Question 11

What are the medications used to treat different opportunistic infections? Fungal?

Answer 11

Nystatin and fluconazol

Question 12

What is the platelet threshold when invasive procedures should be avoided?

Answer 12

> 75,000 mm3 for chemo pts

Question 13

What is the absolute neutrophil count threshold when invasive procedures should be avoided?

Answer 13

ANC > 1000 mm3 for chemo pts

Question 14

What is nadir and when does it occur

Answer 14

When a pt is at their lowest blood counts
Low blood counts 7-14 days after chemo
Bc of this the best time to tx them is right before their next round of chemo. Do procedures day 28 for tx every month.

Question 15

What is the recommended hyperbaric oxygen regiment for pts that are to have ext or other osseous surgeries

Answer 15

If the pt receives radiation over 50 gy they are at risk of osteroradionecrosis so 20 dives before ext and extraction following with 10 dives after.
Only used once in a lifetime, not for every procedure

Question 16

what are ways that pts with xerostomia can reduce their caries risk

Answer 16

Drink lots of water
salivary substitutes
sugar free or xylitol gum
sialogogues
minimize carbs and alcohol
use alcohol free mouth rinse

Question 17

What are the indications for extracting teeth prior to radiation

Answer 17

Non-restorable caries or high caries rate
per pocketing >5mm
Furcation involvement
impacted teeth

Question 18

What is the the threshold of radiation when taste is lost?

Answer 18

60 gy

Question 19

what is the threshold of radiation when osteoradionecosis is likely to occur

Answer 19

50 gy

Question 20

what is the threshold of radiation when hypofunction of the salivary glands is likely to occur

Answer 20

25 gy

Question 21

what are the 5 R’s of fractionation

Answer 21

Repair
Redistribution
Repopulation
Reoxygenation
Radiosensitivity

Question 22

What are the differences btw fixed beam radiation and intensity modulated radiation therapy

Answer 22

Fixed beam is all the tissues btw the portals receives the same dose
Intensity modulated radiation therapy is constantly moving beams that administers different amounts of radiation to the tissues, so tumor receives highest amount, minimal amounts of radiation to vital structures

Question 23

What are the types of HPV associated with oropharyngeal cancer

Answer 23

16 and 18

Question 24

What are the structures considered in the oral cavity

Answer 24

Gingiva
floor of mouth
anterior portion of tongue
buccal mucosa
hard palate
teeth

Question 25

What are the structures considered in the oropharynx

Answer 25

Soft palate Tonsils (lingual and palatine) Base of tongue Pharynx (later and posterior

Question 26

What are the risk factors for oral cancer

Answer 26

``` HPV Smoking Alcohol Smokeless tobacco Marijuna Betel quid Chronic irritation ```

Question 27

What is the percent of head and neck cancers make up compared to all cancers?

Answer 27

3%

Question 28

What radiographic method uses a radio tracer (18 F-fluorodeoxyglucose) to detect tumors?

Answer 28

PET scan

Question 29

What is the criteria for stage 1 cancer?

Answer 29

``` Localized stage cancer 2 cm or less in greatest dimension Has not grown deeply into nearby tissues Has not spread into lymph or other parts 5-yr SR = 85% ```

Question 30

What is the criteria for stage 2 cancer?

Answer 30

Early locally advanced 2-4 cm or less in the greatest dimension Has not grown deeply into nearby tissues Has not spread into lymph or other parts 5-yr SR = 66%

Question 31

What is the criteria for stage 3 cancer?

Answer 31

``` Late locally advanced Larger than 4cm across Has not grown deeply Cancer cells ARE PRESENT in 1 lymph, which is located on the same side of the head or neck as the primary tumor and is smaller than 3cm across 5-yr SR = 35-45% ```

Question 32

What is the criteria for stage 4 cancer?

Answer 32

Metastasized Cancer has reached an advanced stage and has distant metastasis 5-yr SR = 9%

Question 33

Define Occult metastasis

Answer 33

Non-detectable metastasis

Question 34

What is the percent reduction in SR of pts with lymph node metastasis with squamous cell carcinoma

Answer 34

50%. it cuts it in half

Question 35

Define tumor grading

Answer 35

Look at the tumor cell differentiation and rate of growth under microscopic examination. The pathologist carries out the description of a tumor based on how abnormal the tumor cells are. Grading helps the pathologist determine if there is a degree of dysplastic changes in the tumor and how quickly it is likely to grow

Question 36

What are the TNM classifications

Answer 36

``` T = size and depth of primary tumor N = whether the cancer has spread to the lymph nodes M = whether the cancer has spread to another part of the body ```

Question 37

What are the T's | TX, T0, Tis, T1, 2, 3, 4

Answer 37

``` TX = tumor cannot be assessed T0 = no evidence of tumor Tis = carcinoma in situ T1 = tumor 2cm or less 2 = tumor > 2 cm but < 4 cm 3 = Tumor > 4cm 4 = Tumor invades deep adjacent structures ```

Question 38

What are the N's | N0, N1, N2a, N2b, N2c, N3

Answer 38

``` N0 = No palpable nodes N1 = Single ipsilateral node 6cm ```

Question 39

What is the percent of oral cancers that are squamous cell carcinomas?

Answer 39

90%

Question 40

Identify the clinical signs that would indicate a biopsy is needed

Answer 40

``` Intense whiteness Redness/ulceration bleeding Granular or verruciform surface Exophytic growth Mass formation, induration ```

Question 41

What is the dye commonly used to ID dysplastic tissue

Answer 41

Toludine blue

Question 42

What are the M's | MX, M0, M1

Answer 42

``` MX = distant metastasis cannot be assessed M0 = no distant metastasis M1 = Distant metastasis ```