oncology

Question 1

characteristic of thyroid lump

Answer 1

moves up with swallowing

hard may mean malignant

Question 2

3 possibilities for lymph node enlargement

Answer 2

lymphomas/leukaemia
metastic tumour
inflammation

Question 3

what is a goitre

Answer 3

general swelling of thyroid gland

Question 4

7 differential diagnosis for neck lump

Answer 4

thyroid disorder
lymph node enlargement 
congenital cysts
salivary gland disorders
lumps in skin
rare tumours
actinomycosis

Question 5

3 neck cysts

Answer 5

thyroglossal- moves if tongue stuck out
branchial
cystic hygroma - present from birth
sublingual dermoid - points of fusion

Question 6

describing a lump

Answer 6

site, shape, size
surface
edge
fixation
consistency
hard soft rubbery fluctulance
pulsatility
temperature
transilluminability
local lymphadenopathy

Question 7

difference between hyperplasia + hypertrophy

Answer 7

hyperplasia = increase in cell number
hypertrophy = increase in cell size

Question 8

difference between atrophy + hypoplasia

Answer 8

hypoplasia = developmental 
atrophy = occurs with ageing

Question 9

2 examples of oral metaplasia

Answer 9

squamous metaplasia of trachea - smoking

barrets oesophagus - due to acid reflux - increased chance of oropharyngeal carcinoma

Question 10

2 types of hyperkeratosis

Answer 10

hyperparakeratosis - can see nuclei

hyperorthokeratosis - no nuclei, thick keratin, granular cell layer present

Question 11

where is lining mucosa not found

Answer 11

dorsum (top) of tongue

keratinised mucosa

Question 12

4 layers of keratinised mucosa epithelium

Answer 12

keratin
granular cell
prickel cell (stratum spinosum)
basal cell

Question 13

layers of non-keratinised mucosa

Answer 13

stratified squamous epithelium
lamina propria
submucosa (minor salivary glands + basement membrane)

Question 14

cause of white spongy naevus

Answer 14

hereditary

Question 15

3 infective cause of white patch

Answer 15

syphilis
candidosis
hairy leukoplakia (EBV)

Question 16

characteristics of hairy leukoplakia

Answer 16

usually seen in immunosuppressed/HIV

bilateral on lateral border of tongue , vertical white folds (corrugated), +/- candida

associated with EBV

Question 17

which metastases cause radiolucenice and which cause radiopacity

Answer 17

breast/lung/kidney = radiolucent
prostate = radiopaque

Question 18

oral complications of radiotherapy

Answer 18

mucositis
ulceration 
infection - candida
xerostomia - caries/PD
loss of taste
trismus
osteoradionecrosis

Question 19

management of radiotherapy pt

Answer 19

during - discourage smoking/alcohol, climate infection, relieve mucositis, saliva substitute

after - OH, antibiotics, OMFS for extraction, fluoride, saliva substitutes

Question 20

oral complications of chemo

Answer 20

infection + bleeding - pancytopenia
ulcers, mucositis
xerostomia
delayed development of child

Question 21

how to reduce chance of ulcer in cancer therapy

Answer 21

systemic/topical folic acid

Question 22

measures to treat mucositis

Answer 22

reduce smoking, spirits, spices
good OH
difflam mouthwash
ice
analgesics

Question 23

WHO mucositis scale

Answer 23

1. soreness/erythema
2. erythema/ulcers - eat solids
3. ulcers - liquid diet
4. oral intake not possible

Question 24

when to get concerned about difficulty swallowing/hoarseness

Answer 24

after 3 weeks

laryngitis usually improves in 3 weeks

Question 25

what syndrome is post cricoid carcinoma associated with

Answer 25

Plummer-vinson/patterson kelly
related to iron deficiency
cricoid web = dysphagia

Question 26

what cancer is HPV associated with

Answer 26

oropharyngeal cancer