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HD 4 - dental relevance > Oncology > Flashcards

Oncology Flashcards

1
Q

characteristic of a cycstim lump?

A

well defined

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2
Q

if a lump is bruit what does this mean?

A

pulsatile

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3
Q

if a lump is warm what does this indicate?

A

inflammation

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4
Q

if a lump is tranilluminability what does this indicate?

A

full of cystic fluid

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5
Q

define Ludwig’s angina

A

bilateral swelling of submandibular + sublingual areas

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6
Q

2 anatomical group of cervical lymph nodes

A

circular - submental, submandibular, pre+post auricular, parotid, retro-pharyngeal + occipital

vertical chain - anterior + posterior

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7
Q

6 classification of cervical lymph nodes

A
  1. submandibular + submental
  2. upper deep cervical
  3. mid cervical
  4. lower deep cervical
  5. posterior triangle
  6. anterior compartment
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8
Q

what 2 conditions my acute lymphadenitis be secondary to?

A

sore throat + periocoronitis

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9
Q

what is sarcoidosis?

A

lump caused by abnormal amount of inflammatory cells causing granulomatous

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10
Q

what is lymphadenopathy?

A

inflammation of lymph nodes

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11
Q

what type of bacteria causes TB

A

TB bacilli entering lymphatics causing lymphadenopathy

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12
Q

is a TB abscess cold or hot and why?

A

cold - chronic abscess formed by necrosis + not pus

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13
Q

what is collar stud abscess a symptom of?

A

TB

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14
Q

what is a thyroglossal cyst?

A

any cyst along tract of where thyroid gland starts embryologically - will move

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15
Q

what are dermoid cysts?

A

cysts that occur at points of fusions of epithelium - likely in midline

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16
Q

what is a rannula?

A

mucous extravagation cyst

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17
Q

what is a branchial cyst?

A

cyst in neck present from birth

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18
Q

what could a lump in neck be?

A
  1. thyroid problem
  2. lymph node enlargement
  3. congenital cyst
  4. salivary gland disorder
  5. lumps in skin
  6. tumours
  7. actinomycosis
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19
Q

what is senescence?

A

state between apoptosis + differentiaiton

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20
Q

4 types of cell growth and what they mean?

A
  1. multiplicative - increase in no
  2. autexic - increase in size
  3. accretionary - increase in ECM
  4. combined - all of above
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21
Q

what are labile, stable + permanent cells

A 
labile = continuously dividing e.g. haematopeoic + ep
stable = Go reversible phase e.g. hepatocytes + renal
permanent = Go irreversible phase e.g. cardiocytes + neurones
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22
Q

which type of cells are most susceptible to cancer and why?

A

labile cells - constantly dividing, can undergo hyperplasia

e.g lung, prostate, breast

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23
Q

difference between hyperplasia + hypotrophy?

A 
hyperplasia = increase in cell numbers and/or decrease in apoptosis
hypertrophy = increase in cell size
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24
Q

what is tuner tooth?

A

trauma occurs to primary tooth resulting in permanent tooth being traumatised = hypoplasia

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25
Q

difference between hypotrophy + atrophy?

A 
hypotrophy = development failure
atrophy = with age
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26
Q

what is metaplasia?

A

reversible transformation of one mature differential cell type into another - adaptive response to environment stimuli

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27
Q

what is the condition called where there is glandular metaplasia at gastro-oesophageal junction due to acid reflux?

A

barretts oesophagus

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28
Q

what is dysplasia?

A

uncontrolled division of cells - increased cell growth, altered differentiation, change in architecture of tissue

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29
Q

where is masticatory mucosa found?

A

gingiva + hard palate

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30
Q

3 basic layers of oral mucosa?

A

epitherlium
lamina propria
submucosa

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31
Q

4 layers of oral masticatory epithelium

A

keratin layer
granular cell layer
prickle layer (stratum spinosum)
basal layer

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32
Q

what lies between epithelium + lamina propria?

A

basement membrane

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33
Q

where is lining mucosa (non-keratinised) found in mouth?

A 
labial mucosa
buccal mucosa
venture of tongue
FOM
soft palate
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34
Q

where is specialised keratinised mucosa found?

A

dorsum of tongue - has papillae

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35
Q

what are the 2 types of hyperkeratosis seen pathologically + what is the difference between the 2?

A

hyperparakeratosis - can see nuclei

hyperorthokeratosis - no nuclei, granular layer present

36
Q

what are fordyces spots?

A

enlarged intramural sebacous glands - white/yellow spots on lips - don’t confuse with white patches

37
Q

3 examples of hereditary white lesions?

A

white sponge naevus
genodermatoses
pachyonychia congenita - skin lesions also

38
Q

causes of mechanical traumatic white lesions?

A

frictional keratosis
acute trauma - ulcer
chronic trauma - hyperkeratosis

39
Q

common dental example of chemical trauma white lesion?

A

hyperkeratosis with lichenoid inflammation due to amalgam

40
Q

common example of chemical/thermal keratosis?

A

smokers keratosis

white plaques + melanosis

nicotinic stomatitis also common

41
Q

4 examples of infective white patches?

A
  1. syphilis
  2. candidosis
  3. hairy leukoplakia
  4. squamous cell papilloma
42
Q

difference between chronic hyper plastic candidiasis + acute pseudomembranous candidiasis?

A 
CHC = not rubbed off
APC = rubs off
43
Q

where is hair leukoplakia most commonly found?

A

bilateral on lateral border of tongue

44
Q

what white patch is commonly found in HIV patients?

A

hairy leukoplakia

45
Q

what virus is hairyleukplakia associated with?

A

EBV +/- candida

46
Q

what oral white patches can HPV cause?

A

squamous cell papilloma

47
Q

2 examples of dermatological oral white patches?

A

lichen planus

lupus erythematous

48
Q

what is lichen Planus?

A

type IV hypersensitive reaction

atrophic or erosive

49
Q

what is lupus erythematosus?

A

auto-immune disease, type III hypersensitivity

50
Q

example of an idiopathic oral white patch?

A

leukoplakia

51
Q

example of a neoplastic oral white patch? it is the most common oral cancer.

A

squamous cell carcinoma

52
Q

difference between incisional + excisional biopsy?

A 
incisional = take part
excisional = take all - never do this if suspected malignancy
53
Q

how are amalgam tattoos produced?

A

taken up by macrophages + mucosa - present as blue/black mark

54
Q

what classification is used to stage cancers?

A

TNM

T= size
N= spread
M = metastases
55
Q

how would metastases of breast/lung/kidney cancer in jaw be detected?

A

radiolucency on radiographs

56
Q

how would metastases of prostate cancer in jaw be detected?

A

radio opacities on radiographia

57
Q

oral complications of radiotherapy

A 
mucositis
ulceration
candidosis
xerostomia - leading to radiation caries 
dental hypersensitive 
PD
loss of taste
trismus
osteoradionecrosis of jaw
58
Q

what causes osteoradionecrosis of jaw?

A

endarteritis obliterates - inferior alveolar artery shrinks - loss of blood supply = necrosis

diminishing ability to heal OVER TIME

59
Q

what should happen before radiotherapy/chemotherapy?

A

pt should see dentist to make sure restoratively stable

OHI

60
Q

what can be used to relive mucositis?

A

difflam mouthwash (benztdamine hydrochloride)- ant- inflammatory + analgesic

lidocaine lollipops

61
Q

oral complications of chemotherapy

A 
infections due to pancytopenia 
ulcers
mucositis
lip cracking
bleeding due to pancytopenia 
xerostomia
62
Q

what can be used during chemotherapy to reduce oral inflammation/stomatits?

A

suck on ice cubes

63
Q

what can be used during chemotherapy to reduce oral ulceration?

A

systemic/topical folic acid

64
Q

methotrexate used for chemotherapy interacts with which popular medications?

A

NSAIDs + aspirin

65
Q

WHO mucositis scale - 4 stages

A
  1. soreness/erythema
  2. erythema/ulcers but still eat solids
  3. ulcers, liquid diet
  4. oral intake not possible - hospitalisation
66
Q

what is angiogenesis?

A

new blood vessels formed - cancers grow blood vessels

67
Q

how does radiotherapy work?

A

X-rays/gamma rays target DNA (displace electrons) of rapidly dividing cells + leads to cell death + tumour necrosis

68
Q

how is sievert different to gray measure of radiotherapy?

A

sievert considers biological quality of the tissue

69
Q

radiotherapy regime for oral cancer?

A

5/7 for 6 weeks

70
Q

what internal radiation therapy is used for carcinoma of thyroid?

A

131 iodine taken orally

71
Q

what does pancytopenia mean? when is it seen?

A

low platelets + red/white blood cells

after chemo due to bone marrow toxicity

abnormal blood count until proven otherwise

prolonged bleeding + infection risk

72
Q

main oral side effect of methotrexate?

A

oral ulceration

73
Q

how would you treat chemo patient with candidiasis?

A

fluconazole 50mg 1 or 2/52

74
Q

how would you treat chemo patient with herpetic infection?

75
Q

platelet level cut off for dental surgery?

A

<50x10^9 /litres

76
Q

granulocyte level cut off for dental surgery without antibiotics?

A

<2x10^9 /litres

77
Q

is bilateral reticular lichen Planus low or high risk of cancer?

78
Q

is erosive/ulcerated lichen Planus low or high risk of cancer?

79
Q

how is SCC of larynx treated?

A

laryngectomy - now breathe through whole in neck

80
Q

when should hoarseness become concerning?

A

over 3 weeks - laryngitis should get better pithing 3 weeks

associated factors - pain/earache/dysphagia/stridor

81
Q

when should sore throat/dysphagia become concerning?

A

persistent, unilateral

associated symptoms - earache/stridor/foetor/bleeding/weight

82
Q

when to become suspicious of a neck lump?

A

progressive

impaired eating then drinking

pain

neck mass

hoarseness

83
Q

what might deafness caused by middle ear effusion be a sign of?

A

nasopharyngeal tumour

84
Q

what syndrome is post-cricoid carcinoma associated with?

A

Patterson brown-kelly syndrome (Plummer Vinson)

85
Q

what is a pedicle flap?

A

flap used to close OAC

86
Q

what is secondary intention healing?

A

wound left open to heal

HD 4 - dental relevance (12 decks)

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