Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FINALS - Oral Medicine > OMIT - Malignancies > Flashcards

OMIT - Malignancies Flashcards

1
Q

What is an oral potentially malignant disorder?

A

A group of lesions and conditions in the oral mucosa that can display an increased risk of malignant transformation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common types of OPMDs?

A

Leukoplakia
Erythroplakia
Oral submucous fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Oral leukoplakia clinical features?

A

A keratotic lesion that cannot be removed
Asymptomatic
Homogenous or non-homogenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Oral leukoplakia risk factors

A

Smoking
Alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Oral leukoplakia cancer risk?

A

anywhere from 0.13%-34%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Oral sub mucous fibrosis, define, and give clinical features.

A

An oral precancerous condition characterized by a inflammation and progressive fibrosis of the submucosal tissues.

Burning sensation
Blanching
Trismus
Loss of pigmentation
Mucosal surfaces and third of esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

key diagnostic for leukoplakia

A

Can’t be removed
Absence of any other cause
Diagnosis through exclusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Leukoplakia likelyhood for malignancy

A

Very variable: 0.1-30%
Dependant on modifiable risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Erythroplakia diagnosis

A

Exclusive diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Erythroplakia malignancy rate

A

14-15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define proliferative verrucous leukoplakia?

A

It is an aggressive slow growing form of leukoplakia with high malignant transformation.

Non-homogenous affecting multiple sites with nodular appearance. More common in females and elderly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Histopath factors associated with risk of malignancy

A

Chromosome number abnormality
Loss of heterozygosity
DNA and mRNA hypermethylation
Gene expression profiling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What clinical factors raise your suspicion of malignancy?

A

Non-healing
Unexplained
Changes in the lesion
High risk site (ventro-lateral tongue FOM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is key when biopsying mixed colored lesions?

A

Obtain representative sample, with a sample of healthy tissue for comparison.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What screening tools are available for potentially malignant disorders?

A

Clinical exam under white light
Vital staining
Light based detection
Oral brush biopsy
Salivary diagnostics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What vital staining may indicate potentially malignant tissue?

A

Toluidine blue
Acetic acid
Lugol’s iodine solution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the benefits and drawbacks of vital staining?

A

Positives
- Further testing to confirm
- Quick results

Negatives
- Tastes bad
- False negatives

18
Q

What types of light-based detection are available

A

Reflective visualization
Optical fluorescence imaging

19
Q

What is oral brush biopsy?

A

Minimally invasive approach for harvesting cells in oral mucosa.

Brush obtains superficial cells, however this is less effective than full biopsy.

Utilizes exfoliative replacement cytology.

20
Q

What is the purpose of salivary diagnostic as an OPMD screening tool?

A

Contains hormones, DNA, RNA, antibodies etc.
Saliva can mirror physiological changes of the body.

21
Q

What is the difference in surgical excision margins between OPMDs and OSSC?

A

OSSC generally larger.

22
Q

What are the main principles in treating OPMDs?

A

Risk factor modification
Topical medicaments
Systemic medications
Monitoring and surveillance
Surgical intervention

23
Q

What types of surgical interventions can be undertaken to manage these lesions?

A

Excision with cold steel
Ablation
Cold blade
CO2 Laser
Photodynamic therapy

24
Q

What is the purpose of prescribing steroids for OPMDs?

A

Symptom management only, will not lower malignancy risk.

25
Q

What are some of the issues when deciding to perform surgery on an OPMD or not?

A

Risk of malignancy
Removal of OSCC much more destructive
Patient response to non-surgical therapy
Patient wishes and opinions

26
Q

What is a P16 cancer?

A

p16 is a tumor supressor gene, that when activated can act as a biomarker for HPV infection - a risk factor for oral cancer.

27
Q

How do HPV related tumors respond to treatment?

A

Respond better to radiotherapy, better outcome

28
Q

How to monitor potentially malignant disorder?

A

Degree of dysplasia
Changes in clinical features

29
Q

How is cancer staged?

A

TNM Staging (Tumor, nodes, metastasis)

30
Q

How is cancer graded?

A

Low grade - slow growing
Intermediate - middle grade
High Grade - Fast growing

31
Q

What risk factors can be modified in a patient with OPMDs?

A

Tobacco use
Alcohol intake
Areca nut chewing
Poor diet/nutrient deficiencies

31
Q

Outline the steps taken during active monitoring?

A

Predicative risk assessment
Assessment with screening tools
Further biopsy appointments
Dedicated appointments for lesion

31
Q

What is radiotherapy?

A

Utilizes ionizing radiation to target and kill cancer cells.
Damages DNA inside the targeted cells preventing them from multiplying.

32
Q

What is the typical dose of radiation given during radiotherapy?

A

Total dose is around 60-70Gy

33
Q

What are the general side effects of chemotherapy?

A

Fatigue
Skin changes – irritated and sensitive
Nausea and vomiting – if tx near abdomen
Hair loss – specific to tx area
Difficulty swallowing
Changes in taste or appetite
Diarrhoea or bowel changes
Urinary changes

34
Q

What are the oral side effects of chemotherapy?

A
  • Oral mucositis
  • Pain in teeth and gingivae
  • Taste loss
  • Trismus
  • Odynophagia
  • Dysphagia
  • Candidiasis
  • Radiation dermatitis
  • Osteoradionecrosis
35
Q

What are the long term complications of chemotherapy?

A

Tissue fibrosis
Chronic fatigue
Skin changes
Secondary cancers
Bone and joint problems
Hormonal changes
Organ dysfunction
Cognitive changes

36
Q

Outline the WHO scale of oral mucositis?

A

0 - None: -

I - Mild: Oral soreness and erythema

II - Moderate: Oral erythema, ulcers, solid
diet tolerated

III – Severe: Oral ulcers, liquid diet only

IV – Life Threatening: Oral alimentation impossible

37
Q

What is chemotherapy?

A

The use of medications to reduce rate of cancer cell division when compared to most cells in the body.

The medications are cytotoxic and interact with cancer DNA or RNA to disrupt cell life cycle.

38
Q

What are the oral implications of chemotherapy?

A

Altered taste
Increased bleeding
Xerostomia
Candidal infection
Nausea and vomiting
Anaemia
Caries
Chemotherapy induced mucositis

39
Q

What are the main considerations for a dentist managing a patient undergoing treatment for H+N cancer?

A

Promote prevention and OH
Avoid dentures encourage SDA
Diet and lifestyle advice
High F toothpaste
Follow up protocols when concerned
Management of oral manifestations

FINALS - Oral Medicine (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions