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Gastrointestinal Conditions (JBR) > Oral Cavity > Flashcards

Oral Cavity Flashcards

1
Q

What causes oral candidiasis?

A

Candida albicans causes an opportunistic infection

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2
Q

Which conditions are required for candida albicans to cause an infection?

A

Oral cavity flora change

Immunocompromised

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3
Q

How does candida albicans present?

A

White plaques on oral mucosa that can be rubbed off with a painless, red base underneath

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4
Q

How do you treat candidiasis?

A

Miconazole or Nystatin (anti-fungals)

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5
Q

How do you identify leukoplakia and erythoplakia and how do you distinguish between them?

A

Raised, sharply defined edges
Cannot be rubbed off
Leuko = white patches
Erythro = red patches

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6
Q

What is the significance of leuko- and erythroplakia?

A

They are pre-malignant

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7
Q

Which, between leukoplakia and erythroplakia, is at higher risk of malignancy?

A

Erythroplakia

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8
Q

How do you investigate leuko- and erythroplakia?

A

Biopsy

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9
Q

What is the management plan for leukoplakia and erythroplakia?

A

Frequent clinical exam with photographic records

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10
Q

> 90% of oral tumours have which histological cell type?

A

Squamous cell carcinomas

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11
Q

What are oral SCCs?

A

Invasive oral cancers that end to have granular or smooth texture

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12
Q

What is the macroscopic appearance of oral SCCs?

A

20% have elevation of approx. 1 mm

Majority have no ulceration/bleeding and aren’t indurated (hardened)

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13
Q

What are causes/risk factors of oral SCCs?

A 
Tobacco
Alcohol
Diet and nutrition
HPV (risk increase with number of sexual partners and age)
UV-Light
Candida
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14
Q

Where are high risk sites for oral tumours?

A 
(soft non-keratinising site)
Ventral of tongue
Floor of mouth
Lateral tongue
Soft palate
Retro-molar pad
Tonsillar pillars
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15
Q

Where are rare sites of oral tumours?

A

Hard palate

Dorsum of tongue

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16
Q

What are potentially malignant lesions of the mouth?

A 
Erythroplakia 
Erythroleukoplakia
Leukoplakia
Erosive lichens planus
Submucous fibrosis
Dyskeratosis congenita
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17
Q

Histopathologically, oral SCCs show considerable variation but are cytologically _________________ and all show ______?

A

Malignant squamous epithelium

invasion and destruction of local tissue

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18
Q

How do oral tumours present?

A

Red, white (or both) lesions
Ulcer
Numb feeling
Unexplained pain in mouth or neck (late-stage cancer or benign ulcer)
Change in voice
Dysphagia
Drooping eyelid or facial palsy, fracture of mandible, double vision, blocked or bleeding nose/fascial swelling

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19
Q

What are investigations for oral tumours?

A

Refer for biopsy

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20
Q

How do you treat oral tumours?

A

Radiotherapy
Chemotherapy
Surgical resection

21
Q

The majority of salivary gland tumours are?

A

Pleomorphic adenomas

22
Q

What are pleomorphic adenomas?

A

Benign tumours of glandular tissue

23
Q

Is a tumour more likely to be malignant if its in a small or large salivary gland?

A

Small

24
Q

What are the risk factors for salivary gland tumours?

A

Smoking
Radiation exposure
Hx of previous cancer

25
Q

How do salivary gland tumours present?

A 
Facial nerve weakness
Facial lump
Ulceration of overlying skin
Paraesthesia or anaesthesia of the skin
Pain
26
Q

How do you investigate salivary gland tumours?

A

Refer for USS +/- FNA

27
Q

FNA gives you the _____ of the tumour

A

cytology

28
Q

Biopsy gives you the _______ of the tumour

A

Architecture

29
Q

How do you treat salivary gland tumours?

A

Local ablation
Radiotherapy
Surgical resection

30
Q

How do you treat salivary gland tumours?

A

Local ablation
Radiotherapy
Surgical resection

31
Q

Where do salivary gland stones form?

A

Typically in the major salivary glands and block associated ducts

32
Q

How do salivary gland stones present?

A

Colicky post-prandial pain

Swelling

33
Q

How do you investigate Salivary gland stones?

A

USS

34
Q

How do you treat salivary gland stones?

A 
Oral analgesics
Abx if infection
Good hydration
Massage
Endoscopic or surgical removal
35
Q

Where are lichen planus found?

A 
Oral mucosa
Skin
Scalp
Nails
Genitals 
Oesophagus
36
Q

What causes lichens planus?

A

Unknown - potential link to ACEI treatment

37
Q

What is the danger of lichen planus?

A

Potentially malignant

38
Q

What are macroscopic features of lichen plans?

A

+/- erosive

+/- ulceration

39
Q

What is angular chelitis?

A

Cracking at the corner of the mouth

Bleeding when mouth open

40
Q

What are causes of angular chelitis?

A

Anaemia or haematinimic deficiencies

Often related to bacteria like Staph aureus

41
Q

What is aphthous stomatitis?

A

Mouth ulcers
Oval
Yellow base + red periphery

42
Q

Aphthous stomatitis can persist up to?

A

4 weeks

43
Q

What are herpetiform?

A

Yellow base + red periphery

44
Q

How many herpetiform ulcers are usually found?

A

Hundreds

45
Q

Herpetiform ulcers can be caused by?

A

Anaemia
Vitamin B12
Coeliac’s Disease
Folic Acid

46
Q

What is hairy leukoplakia?

A

Shaggy white patch on the side of the tongue seen in HIV

Caused by EBV

47
Q

What are causes of aphthous ulcers?

A

Crohns and coeliac’s disease

Infections

48
Q

What are therapy options for minor aphthous ulcers?

A

Avoid oral trauma and acidic foods or drinks

Tetracylcine or antimicrobial mouthwashes

49
Q

How do you treat severe aphthous ulcers?

A

Prednisolone or thalidomide

Gastrointestinal Conditions (JBR) (33 decks)

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