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Oral Oncology > Final > Flashcards

Final Flashcards

1
Q

What is the 1 way to definitively diagnosis cancer

A

Biospy

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2
Q

What are the conditions that can be treated with oral bisphosphonates

A

Pagets ds and osteoporosis

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3
Q

What are the conditions that can be treated with IV bisphosphonates

A

Osteoporosis and bone metastases

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4
Q

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

A

18 months

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5
Q

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

A

Allogenic (different donor to host but are a match)

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6
Q

What is autologous

A

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

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7
Q

What is allogenic

A

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

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8
Q

What is syngeneic

A

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

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9
Q

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

A

Acyclovir and famciclovir

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10
Q

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

A
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11
Q

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

A

Nystatin and fluconazol

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12
Q

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

A

> 75,000 mm3 for chemo pts

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13
Q

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

A

ANC > 1000 mm3 for chemo pts

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14
Q

What is nadir and when does it occur

A

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.

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15
Q

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

A

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

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16
Q

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

A 
Drink lots of water
salivary substitutes
sugar free or xylitol gum
sialogogues
minimize carbs and alcohol
use alcohol free mouth rinse
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17
Q

What are the indications for extracting teeth prior to radiation

A

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

18
Q

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

A

60 gy

19
Q

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

A

50 gy

20
Q

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

A

25 gy

21
Q

what are the 5 R’s of fractionation

A 
Repair
Redistribution
Repopulation
Reoxygenation
Radiosensitivity
22
Q

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

A

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

23
Q

What are the types of HPV associated with oropharyngeal cancer

A

16 and 18

24
Q

What are the structures considered in the oral cavity

A 
Gingiva
floor of mouth
anterior portion of tongue
buccal mucosa
hard palate
teeth
25
Q

What are the structures considered in the oropharynx

A

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

26
Q

What are the risk factors for oral cancer

A 
HPV
Smoking
Alcohol
Smokeless tobacco
Marijuna
Betel quid
Chronic irritation
27
Q

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

A

3%

28
Q

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

A

PET scan

29
Q

What is the criteria for stage 1 cancer?

A 
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%
30
Q

What is the criteria for stage 2 cancer?

A

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%

31
Q

What is the criteria for stage 3 cancer?

A 
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%
32
Q

What is the criteria for stage 4 cancer?

A

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

33
Q

Define Occult metastasis

A

Non-detectable metastasis

34
Q

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

A

50%. it cuts it in half

35
Q

Define tumor grading

A

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

36
Q

What are the TNM classifications

A 
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
37
Q

What are the T’s

TX, T0, Tis, T1, 2, 3, 4

A 
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
38
Q

What are the N’s

N0, N1, N2a, N2b, N2c, N3

A 
N0 = No palpable nodes
N1 = Single ipsilateral node 6cm
39
Q

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

A

90%

40
Q

Identify the clinical signs that would indicate a biopsy is needed

A 
Intense whiteness
Redness/ulceration bleeding 
Granular or verruciform surface
Exophytic growth
Mass formation, induration
41
Q

What is the dye commonly used to ID dysplastic tissue

A

Toludine blue

42
Q

What are the M’s

MX, M0, M1

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

Oral Oncology (1 decks)

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