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Pathology II > Intro and Principles of Soft Tissue Diagnosis- Exam I > Flashcards

Intro and Principles of Soft Tissue Diagnosis- Exam I Flashcards

1
Q

The medical science and specialty practice, concerned with all aspects of disease, but with special reference to the essential nature, causes, and development of abnormal conditions, as well as the structural and functional changes that result from the disease process:

A

Pathology

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2
Q

Probabilities from possibilities includes:
1. All possible lesions for a patient of:
2. All possible lesions from:
3. All possible lesions that:

A
  1. this age, sex, & race
  2. this anatomical location
  3. look this way
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3
Q

Recognition requires thorough knowledge of ___ and ___. This is also known as:

A

Normal and the “range of normal”; WNL

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4
Q

Components of developing a differential diagnosis include:

A
  1. recognition
  2. description of lesion
  3. patient contribution
  4. possibilities
  5. probabilities
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5
Q

DDx:

A

Differential Diagnosis

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6
Q

When making a differential diagnosis, patient contributions include: (6)

A
  1. Age, gender, race
  2. Current medical conditions and meds
  3. Supplements
  4. Social hx
  5. Oral habits
  6. Past medical history
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7
Q

When you see a lesion that can only look a certain way- this is considered:

A

pathognomic

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8
Q

For diagnosing a soft tissue lesion, what should be considered?

A
  1. texture/consistency
  2. association with surrounding tissue (is it fixed vs. moveable) (is it displacing vs. devouring)
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9
Q

For diagnosing a soft tissue lesion, anatomic location:

A

changes DDx

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10
Q

A white diagnostic possibility characterized by “surface debris”: (5)

A
  1. pseudomembranous candidiasis
  2. chemical burns
  3. thermal burns
  4. chemical sloughs (SLS)
  5. fibrous membranes- ulcers
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11
Q

A white diagnostic possibility characterized by “sub-epithelial lesions”: (4)

A
  1. congenital keratitis cysts
  2. scars
  3. fordyce granules
  4. oral lymphoepithelial cysts
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12
Q

A white diagnostic possibility characterized by “epithelial thickening”: (14)

A
  1. alveolar ridge keratosis
  2. contact mucositis- especially cinnamon
  3. familial epithelial hyperplasia (white sponge nevus)
  4. frictional keratosis
  5. hairy tongue
  6. hereditary benign intraepithelial dyskeratosis (HBID)
  7. leukoedema
  8. leukoplakia
  9. lichen planus
  10. linea alba
  11. morsicatio
  12. oral hairy leukoplakia
  13. skin grafts
  14. snuff dipper’s keratosis
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13
Q

What could be noted with the following conditions?

  • Pseudomembraneous Candidiasis
  • Chemical Burns
  • Thermal Burns
  • Fibrous membranes
  • Chemical sloughs (SLS)
A

White surface debris

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14
Q

What could be noted with the following conditions?

  • Congenital kertotic cysts
  • Scars
  • Fordyce granules
  • Oral lymphoepithelial cysts
A

White sub-epithelial lesions

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15
Q

What could be noted with the following conditions?

  • Linea alba
  • Leukoplakia
  • Leukoedema
  • Lichen planus
A

White epithelial thickening

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16
Q

What should you be more concerned about white or red lesions?

A

Red lesions

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17
Q

What could be noted with the following conditions?

  • Alveolar ridge keratosis
  • Frictional keratosis
  • Snuff Dipper’s keratosis
  • Hereditary benign intraepithelial dyskeratosis (HBID)
A

White epithelial thickening

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18
Q

What could be noted with the following conditions?

  • Familial Epithelial hyperplasia (white sponge nevus)
  • Hairy tongue
  • Oral hairy leukoplakia
  • Contact mucositis- esp. cinnamon
  • Skin grafts
  • Morsicatio
A

White epithelial thickening

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19
Q

When encountering a white lesion, what steps should be followed? (5)

A
  1. wipe first
  2. sources of friction
  3. chemicals
  4. heat
  5. alter environment and re-evaluate
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20
Q

What is the first step that should be taken when encountering a white lesion?

A

Wipe first!

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21
Q

White lesions are mostly _____ lesions, but _____ matters

A

“low risk”; location

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22
Q

What are some possible red diagnostic possibilities caused by trauma?

A
  1. physical/sexual
  2. chemical
  3. thermal
  4. radiation
  5. hematoma
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23
Q

Can you feel a macule?

A

No

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24
Q
  • Hemangioma
  • Nevus Flameus
  • Kaposi Sarcoma

These are all considered:

A

vascular lesions (red)

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25
Q
  • Lichen planus
  • Mucous membrane pemphigoid
  • pemphigus vulgaris

These are all considered:

A

Desquamative gingivitis

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26
Q

What steps should be taken/considered when encountering a red lesion?

A
  1. diascopy
  2. location
  3. habits
  4. trauma
  5. medical history (coagulation)
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27
Q

What type of diagnostic possibilities are listed below?

  • Lichen planus
  • Erythema migrans
  • Nicotinic stomatitis
  • SCCa
  • Lichen mucositis
A

Red-white

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28
Q

What type of diagnostic possibilities are listed below?

  • contact allergy
  • drug reactions
  • GVHD
  • candidiasis variants
A

Red-white

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29
Q

What type of diagnostic possibilities are listed below?

  • discoid lupus erythmatosus
  • chronic ulcerative stomatitis
  • speckled leukoplakia
  • sick lip syndrome
A

Red-white

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30
Q

What is the hardest plaque to recognize clinically?

A

erythroplakia

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31
Q

When encountering a red/white lesion, what should be considered?

A
  1. social history
  2. tooth paste/ floss
  3. mouthwash
  4. candies, gums, mints, tic-tacs, lozenges
  5. herbal supplements
  6. changes in medications
  7. oral habits
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32
Q

What is the “magic number” for a differential diagnosis?

A

3

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33
Q

When encountering a pigmented lesion, what should be considered?

A
  1. number
  2. size
  3. onset
  4. distribution
  5. borders
  6. location
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34
Q

What can present as a leukoplakia?

A
  1. dysplasia’s
  2. hyperplastic candidiasis

and more

35
Q

When encountering an ulcer what should be considered?

A
  1. number
  2. size
  3. onset
  4. frequency/duration
  5. location
36
Q

Being able to describe the lesion allows you to:

A

include some lesions while excluding others

37
Q

In describing the lesion, ___ will emerge

A

patterns

38
Q

The basic components of describing a lesion:

A
  1. size
  2. shape
  3. color
  4. borders
  5. texture
  6. consistency
  7. location
39
Q

A small circumscribed elevated lesion usually less than 1cm in diameter, usually contains serous fluid:

A

vesicle

40
Q

Diagnose the following image:

A

vesicle

41
Q

Vesicles usually contain:

A

serous fluid

42
Q

Describe the size of a vesicle:

A

less than 1 cm

43
Q

Describe what is seen in the following image:

A
  • multiple circumscribed elevated lesions
  • less than 1cm lesions
  • fluid filled

= vesicle

44
Q

Diagnose the following image:

A

Bulla

45
Q

Bullas usually contain:

A

serous fluid

46
Q

Circumscribed elevated lesion that is around 1cm in diameter, usually contains serous fluid

A

Bulla

47
Q

What is the size of a bulla?

A

usually around 1cm

48
Q

Describe the following image:

A
  • circumscribed elevated lesion
  • about 1cm in diameter
  • fluid filled

= bulla

49
Q

Various sized circumscribed elevations containing pus:

A

Pustule

50
Q

Diagnose the following image:

A

pustule

51
Q

Describe the following image:

A
  • various small circumscribed elevations
  • pus filled
52
Q

An area that is usually distinguished by a color different form that of the surrounding tissue- it is flat and does not protrude above the surface of the normal tissue:

A

macule

53
Q

Diagnose the following image:

A

macule

54
Q

Describe the following image:

A
  • flat area different in color from surrounding tissue
55
Q

A small circumscribed lesion usually less than 1cm in diameter that is elevated or protrudes above the surface of normal surrounding tissue:

A

papule

56
Q

Diagnose the following image:

A

papule

57
Q

Describe the following image:

A
  • small circumscribed lesion
  • less than 1cm in diameter
  • elevated above surface/ protrudes
58
Q

A circumscribed lesion usually greater than 1cm in diameter that is elevated or protrudes above or below the surface of normal surrounding tissue:

A

nodule

59
Q

Diagnose the following image:

A

nodule

60
Q

Describe what can be seen in the following image:

A
  • circumscribed lesion greater than 1cm in diameter
  • elevated/protrudes avocet the surface
61
Q

Attached vy a stem-like stalk or base:

A

pedunculated

(remember this is an incomplete description alone)

62
Q

Describe the attachment seen in this image:

A

pedunculated

63
Q

Describing the base of lesion that is flat stem-like

A

sessile

(remember this is an incomplete description alone)

64
Q

Describe the attachment seen in this image:

A

sessile

65
Q

A loss of continuity of the epithelium that penetrates to the underlying connective tissue:

A

ulcer

66
Q

Diagnose the lesion in this image:

A

ulcer

67
Q

Describe the lesion in this image:

A
  • Loss of continuity of the epithelium
  • Penetrates to the underlying connective tissue
68
Q

A patch or differentiated area on a body surface:

A

plaque

69
Q

Diagnose this image:

A

plaque

(left image = erythematous plaque)
(right image= leukoplakia)

70
Q

Describe the surface texture seen in this image:

A

Corrugated (wrinkled)

71
Q

“wrinkled”

A

corrugated

72
Q

A cleft of grove, normal otherwise, showing prominent depth:

A

fissure

73
Q

Describe the surface texture seen in this image:

A

fissured

74
Q

Resembling small nipple-shaped projections or elevations found in clusters:

A

papillary

75
Q

Describe the surface texture seen in this image:

A

papillary

76
Q

Surface texture may be described as: (6)

A
  • smooth
  • rough
  • folded
  • corrugated
  • fissured
  • papillary
77
Q

Describe the surface textures seen in this image:

A

smooth

78
Q

Describe the surface textures seen in this image:

A

rough

79
Q

Describe the surface textures seen in this image:

A

folded

80
Q

Clinical presentation of radiographic lesions may be categorized as: (3)

A
  1. radiolucent
  2. mixed
  3. radiopaque
81
Q

Clinical presentation of mucosal and soft tissue lesions may be categorized as: (8)

A
  1. colored
  2. white
  3. red
  4. red/white
  5. systemic hyperkeratosis- genodermatosis + syndromes
  6. soft tissue masses
  7. ulcers/vesiculo-erosive
  8. papillary
82
Q

Once you have a list of differential diagnosis, what might you do? (5)

A
  1. alter environment
  2. observe (not active neglect)
  3. treat
  4. biopsy
  5. refer
83
Q

All a differential diagnosis is:

A

an educated guess

84
Q

What is the take home message of differential diagnosis?

A

recognition and action are the most important

Pathology II (17 decks)

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