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Princples of Oral Med > Lecture 1: Diagnostic Techniques for Evaluating Oral Diseases > Flashcards

Lecture 1: Diagnostic Techniques for Evaluating Oral Diseases Flashcards

1
Q

Information that can be measured or perceived by the investigating clinician:

A

OBJECTIVE

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2
Q

Patients own interpretation of a clinical circumstance, relying on neurological and psychological experiences:

A

SUBJECTIVE

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3
Q

temp, size, color, duration, consistency, surface contour:

A

SIGNS (objective)

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4
Q

patient awareness of presence of a lesion, pain intensity, pain quality (stabbing, burning, shocking)

A

SYMPTOMS (subjective)

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5
Q

What is involved in a differential diagnosis? (4)

A
  1. orderly sequential approach
  2. gathering and analyzing data
  3. knowledge and experience enable recognition of abnormal findings
  4. include/exclude disease processes based on an educated assessment of process
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6
Q

T/F: The following are all included in gathering and analyzing data:
-history
- specific signs
- specific symptoms
- lab data

A

true

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7
Q

When making a differential diagnosis, be aware of: (5)

A
  1. radiographic appearances
  2. clinical manifestations
  3. age
  4. gender
  5. location
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8
Q
  • single vs. multiple
  • location
  • relative proximity to adjacent structions
  • size in dimension (mm)
  • outline (well demarcated vs. diffuse)
  • color (red, white, mixed, pigmented)
  • consistency (firm, flaccid, compressible)
  • intensity (mild, moderate, intense, striated, lacy)
  • base and surface

These are all:

A

clinical descriptions

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9
Q

The following describe:
- smooth
- corrugated
- eroded
- raised
- depressed

A

surface

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10
Q

The following describe:
- pedunculated
- sessile
- nodular
- dome shaped

A

base

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11
Q

Compressing tissue with a glass slide to determine the vascular nature of a lesion:

A

diascopy

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12
Q

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

A

palpation

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13
Q

Palpation with an instrument:

A

probing

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14
Q

Striking tissues with fingers or an instrument and listening to resulting pressure changes in tissues:

A

percussion

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15
Q

The withdrawal of fluids from a body cavity:

A

aspiration

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16
Q

Listening for sounds within the body:

A

auscultation

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17
Q

What the the 3 DIAGNOSTIC LAB TESTS for oral lesions?

A
  1. biopsy (incisional, excisional, aspirational, needle)
  2. immunofluorescence
  3. exfoliative cytology
18
Q

A biopsy is one of the three diagnostic lab tests for oral lesions. The types of biopsies include:

A
  1. excisional
  2. incisional
  3. aspirational
  4. needle
19
Q

What are some indications for biopsies? (6)

A
  1. lesion with greater than 14 day duration
  2. unusual location
  3. unusual appearance
  4. any excised tissue
  5. confirmed diagnosis of systemic disease
  6. suspicion of neoplasia
20
Q

What might make you suspicious of neoplasia?

A
  1. persistent ulceration
  2. persistent erythroplasia
  3. induration
  4. fixation
  5. chronicity
  6. lymphadenopathy
21
Q

A needle biopsy may also be called:

A

fine needle aspiration or fine needle aspiration and cytology

22
Q
  • to determine the cause of tissue enlargement
  • to distinguish between benign and malignant processes
  • to stage metastatic cancer

The following are indications for:

A

needle biopsy

23
Q

What are limitations to a needle biopsy?

A
  1. more technique sensitive with additional preservative and lab processing
  2. does not localize cells to affected tissues
  3. appositional information to adjacent tissues is lost
24
Q

A technique for determining the location of an antigen or antibody in tissues by reaction with an antibody or antigen labeled with fluorescent dye:

A

Immunofluorescence

25
Q

List the INDICATIONS of oral exfoliative cytology:

A
  1. Innocuous lesion
  2. suspicious lesion with negative biopsy
  3. patient refuses biopsy
  4. follow up of treated malignancy
  5. lesion where patient is poor candidate for surgery
26
Q

List the CONTRAINDICATIONS of oral exfoliative cytology:

A
  1. Keratotic or crusty mucosa
  2. Red, vesicular, or velvety mucosa
  3. Submucosal swelling with normal mucosa
  4. Suspicion of malignancy
27
Q

T/F:

Exfoliative cytology is indicated as a follow up for treated malignancy. Exfoliative cytology is contraindicated if there is suspicion of malignancy

A

Both statements true

28
Q

List the INDICATIONS of culture and sensitivity testing:

A
  1. life threatening infection
  2. unsuccessful previous antibiotic therapy
  3. immunosuppressed patient
29
Q

Why is cultural and sensitivity testing limited in dentistry?

A

Difficult for anaerobic conditions

30
Q

Assist in the detection of early potentially malignant mucosal changes that are difficult to discern by visual inspection alone:

A

Oral cancer screening aids

31
Q

Increases the ability to distinguish the lesion mucosa and healthy mucosa:

A

Tissue autofluorescence imaging

32
Q

Tissue autofluorescence imaging has _____ sensitivity and _____ specificity in distinguishing pre-malignant and chronic inflammatory lesions:

A

HIGH sensitivity; LOW specificity

33
Q

Tissue autofluorescence imaging has _____ sensitivity and ____ specificity in identifying areas of dysplasia and invasive cancer that extend beyond the evident lesion

A

HIGH sensitivity; HIGH specificity

34
Q

What drives autofluorescence of oral mucosa?

A

Refractory index of tissue

35
Q

With autofluorescence of oral mucosa we see:

A

500-600 nm

36
Q

With autofluorescence of oral mucosa, blue light of the scope is:

A

400-460 nm

37
Q

With autofluorescence of oral mucosa, UV =

A

<400nm

38
Q

What are some of the ENDOGENOUS fluorescing products? (7)

A
  1. tryptophan
  2. pophyrins
  3. collagen
  4. elastin
  5. flavins
  6. NADH
  7. Fluorophores
39
Q

What does Flavin Adenine Dinucleotide (FAD) excite at?

A

515 nm

40
Q

What does nicotinamide adenine dinucleotide (NADH) excite at?

A

450 nm

41
Q
A

Princples of Oral Med (2 decks)

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