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BDS4 > OM- Dysplasia+Oral Cancer > Flashcards

OM- Dysplasia+Oral Cancer Flashcards

1
Q

2 distinct disease patterns of oral cancer

A

Oral cavity cancer
Oral pharyngeal cancer

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2
Q

Risk factors for oral cancer

A

Smokers who don’t drink- 2x
Drinkers(3-4 daily)- 2x
Smoke and drink- 5x
Paan- 3x
SES- 2x- low educational attainment/low income
FH
Oral health
Sexual activity- HPV

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3
Q

Is there a higher cancer risk with erythroplakia or leukoplakia

A

Erythroplakia

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4
Q

What is dysplasia

A

Disordered cell maturation in a tissue

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5
Q

Categorisation of dysplasia

A

Low grade
High grade
Carcinoma-in-situ

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6
Q

What causes the cytological features for histological grading of dysplasia

A

Abnormal DNA content in nucleus, failure to mature or keratinise correctly, increased proliferation

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7
Q

Cytological grading for histological grading

A

Abnormal variation in nucleus or cell shape/size
Increased number and size of nucleoli
Atypical mitosis figures

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8
Q

What causes the architectural features for histological grading of oral mucosa dysplasia

A

Abnormal structure of maturation or abnormal layering of epithelium

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9
Q

Architectural features for histological grading of dysplasia

A

Abnormal and increased mitoses
Abnormal keratinisation
Irregular epithelial stratification
Drop-shaped rete ridges

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10
Q

Histological prognostic factors of dysplasia- help to inform MDT on management of cancer

A

Pattern of invasion
Depth of invasion
Perineural invasion
Vessels invasion

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11
Q

Low grade dysplasia

A

Considerable Keratin production
Stratification
Well formed basal cell layer
Tumour islands well defined and continuous with surface epithelium

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12
Q

High grade dysplasia

A

Little resemblance to normal squamous epithelium
Considerable atypia
Mitotic figures prominent

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13
Q

What is carncinoma-in-situ grading

A

Abnormal architectural changes
Pronounced cellular atypia+frequent generalised mitoses
Cytologically malignant but not invading

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14
Q

What is field cancerisation concept

A

Increased risk of cancer in 5cm radius around mucosa affected by dysplasia

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15
Q

High risk sites for mouth cancer

A

FoM
Lateral border of tongue
Retromolar regions
Gingivae
Buccal mucosa

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16
Q

Which virus is strongly linked to rapid increase in oro-pharyngeal cancer rates

A

HPV

17
Q

Oral cancer staging

A

T=primary tumour size
N=regional lymph node
M=distant metastasis

18
Q

Lip cancer presentation

A

Non healing ulcer 2W+
Exophytic
Crusted
Rarely metastises to nodes

19
Q

Lip cancer risk factors

A

UV exposure
Smoking

20
Q

Oral cancer screening methods

A

HPV16 screening
Toluidene blue- false positives
VELscope- nonspecific to just cancer
Clinical judgment of experienced clinician

21
Q

Oral cancer in primary care

A

Primary prevention- smoking cessation, alcohol reduction/diet advice
Monitor lesions with photos
Remove local factors which may be causing ulcer then review
2W rule for referral to hospital

22
Q

Potentially malignant conditions-oral types

A

Lichen planus
Oral submucous fibrosis
Iron deficiency
Tertiary syphilis

23
Q

Potentially malignant lesions- oral types

A

Leukoplakia
Erythroplakia
Chronic hyperplastic candidosis
Oral submucous fibrosis

24
Q

Which stain is needed to demonstrate candida albicans hyphae clearly in chronic hyperplastic candidosis

A

Periodic Schiff Stain

25
Q

Tx of chronic hyperplastic candidosis

A

Systemic antigungal- fluconazole
Biopsy
Stop smoking
Observe

26
Q

Risk factors for malignant change in leukoplakia

A

Age and gender- females>males
Idiopathic
Site- FoM,tongue
Type of leukoplakia- homogenous/non-homogeneous

27
Q

Methods of predicting malignant change- leukoplakia

A

Histopathology- signs of dysplasia/atrophy/candida infection
Biological markers- DNA content in leukoplakia

28
Q

Histological signs of cellular atypia?

A

Pleomorphism
Hyperchromatism

29
Q

Carcinogenesis steps

A

Initiation
Promotion-mutation in gene involved in DNA repair
Transformation
Progression

30
Q

Carcinogens types of gene changes

A

Mutations
Deletions
Translocations
Amplifications
Epigenetic changes

31
Q

Most important gene involved in carcinogenesis

A

Tp53 mutation or inactivation

32
Q

Hallmarks of cancer

A

Evading apoptosis
Sustained angiogenesis
Self-sufficiency in growth signals
Insensitivity to anti-growth signals
Tissue invasion and metastasis
Limitless replicative potential

33
Q

Sign of potential malignancy despite no intra-oral manifestation of suspected lesion

A

Unexplained mobility of tooth

34
Q

What is TNM system used for

A

Clinical staging

BDS4 (50 decks)

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