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Principles of Oral Diagnosis > Lecture 1: Diagnostic techniques for evaluating oral diseases > Flashcards

Lecture 1: Diagnostic techniques for evaluating oral diseases Flashcards

1
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
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2
Q

List the CONTRAINDICATIONS of oral exfoliative cytology:

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

T/F: Exfoliative cytology is indicated as a follow up for treated malignancy. Exfoliative cytology is contraindicated if there is suspicion of malignany

A

Both statements true

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4
Q

List the INDICATIONS of culture and sensitivity testing:

A
  1. Life-threatening infection
  2. Unsuccessful previous antibiotic therapy
  3. Immunosuppressed patient
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5
Q

Why is culture and sensitivity testing limited in dentistry?

A

Because it is difficult for anaerobic conditions

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6
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

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7
Q

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

A

Tissue Autofluorescence imaging

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8
Q

Tissue autofluorescence imaging has ______ sensitivity but ____ specificity in distinguishing pre-malignant and chronic inflammatory lesions

A

HIGH sensitivity; LOW specificity

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9
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

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10
Q

What drives autofluorescence of oral mucosa?

A

Refractory index of tissue

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11
Q

With autofluorescence of oral mucosa, we see:

A

500-600nm

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12
Q

With autofluorescence of oral mucosa, blue light of the scope =

A

400-460nm

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13
Q

With autofluorescence of oral mucosa, UV=

A

<400 nm

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14
Q

What are some of the ENDOGENOUS fluorescing products?

A
  1. Tryptophan
  2. Porphyrins
  3. Collagen
  4. Elastin
  5. Flavins
  6. NADH
  7. Fluorophores
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15
Q

What does flavin adenine dinucleotide (FAD) excited at?

A

515 nm

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16
Q

What does nicotinamide adenine dinucleotide (NADH) excite at?

A

450 nm

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17
Q

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

A

Objective information

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18
Q

-Temperature, size
-color, duration
-consistency
-surface contour

These are all examples of:

A

Signs

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19
Q

Signs are _____ information

A

objective

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20
Q

Patients own interpretation of a clinical circumstance. They rely on neurologic and psychologic experiences:

A

Subjective information

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21
Q

-Patient awareness of presence of a lesion
-pain intensity
-pain quality (stabbing, burning, shocking, etc.)

These are all examples of:

A

Symptoms

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22
Q

Symptoms are _____ information

A

Subjective

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23
Q

What is involved in a differential diagnosis?

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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24
Q

-Orderly sequential approach
-Gathering and analyzing data
-Knowledge and experience enable recognition of abnormal findings
-Include/exclude disease processes based on an educated assessment of process

These are all steps in:

A

Differential diangosis

25
Q

When obtaining a differential diagnosis, one must gather and analyze data- what does this entail?

A

-History
-Specific signs
-Specific symptoms
-Lab data

26
Q

What should you be aware of when obtaining a differential diagnosis?

A

Be aware of radiographic appearances, clinical manifestations, age, gender, location

27
Q

What are examples of clinical descriptions?

A

-Single vs. multiple
-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, intense, striated, lacy)
-Base and surface

28
Q

-Single vs. multiple
-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, intense, striated, lacy)
-Base and surface

These are all examples of:

A

Clinical descriptions

29
Q

What are descriptive terms for SURFACE?

A

-Smooth
-Corrugated
-Eroded
-Raised
-Depressed

30
Q

What are descriptive terms for BASE?

A

-Pedunculated
-Sessile
-Nodular
-Dome shape

31
Q

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

A

Diascopy

32
Q

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

A

Palpation

33
Q

It is palpation with an instrument (perio probe, caries explorer, needle tip, etc.)

A

Probing

34
Q

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

-give an example of when this would be useful

A

Percussion; ankylosis

35
Q

The withdrawal of fluids from a body cavity:

A

Aspiration

36
Q

Listening for sounds within the body:

A

Auscultation

37
Q

What are the 3 diagnostic lab tests for oral lesions:

A
  1. Biopsy (incisional, excisional, needle)
  2. Immunofluorescence
  3. Exfoliative cytology
38
Q

What are some biopsy indications?

A

-Lesion with >14 day duration
-Unusual location
-Unusual appearance
-Any excised tissue
-Confirmed diagnosis of systemic disease
-Suspicion of neoplasia

39
Q

A possible indication to biopsy is if there is suspicion of neoplasia:

A

-Persistant ulceration
-Persistent erythroplasia
-Induration
-Fixation
-Chronicity
-Lymphadenopathy

40
Q

What is being performed in this image?

A

excisional biopsy

41
Q

Describe the following surface textures:

A
  1. smooth
  2. granular
  3. verrucous
  4. papillomatous
42
Q

Describe the following surface textures:

A
  1. papillomatosous (pebbly)
  2. papillomatosous (cobblestone)
  3. bosselated
  4. lobulated
43
Q

Describe the lesion:

A

Nodular smooth

44
Q

Describe the lesion:

A

Nodular smooth

45
Q

Describe the lesion:

A

Verrucoid plaque

46
Q

What is being performed in this image?

A

Diascopy

47
Q

What is being performed in this image?

A

Probing

48
Q

What is being performed in this image?

A

Palpation

49
Q

What is being performed in this image?

A

Percussion

50
Q

What is being performed in this image?

A

Aspiration

51
Q

What is being performed in this image?

A

Auscultation

52
Q

What is being performed in this image?

A

Incisional biopsy

53
Q

What is being performed in this image?

A

Suture pull

54
Q

What is being performed in this image?

A

Needle biopsy

55
Q

A needle biopsy may also be referred to as:

A

-fine needle
-fine needle aspiration & cytology

56
Q

List the INDICATIONS for a needle biopsy:

A
  1. to determine the cause of tissue enlargement
  2. to distinguish between benign and malignant processes
  3. to stage metastatic cancer
57
Q

List the LIMITATIONS to a needle biopsy:

A
  1. more technique sensitive with additional preservative and lab processes
  2. does not localize cells to affected tissues
  3. appositional information to adjacent tissues is lost
58
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

59
Q
A

Principles of Oral Diagnosis (2 decks)

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