oral lesions

Question 1

what tests should be done if a patient presents with glossitis

Answer 1

haematinic tests and fungal cultures

Question 2

fibroepithelial polyp

Answer 2

same colour as surrounding mucosa, no cause of concern but may disrupt function depending on location

Question 3

name 2 reasons why mucosa may appear white

Answer 3

less blood flow in tissues e.g LA with vasoconstrictor
thickening of mucosa or keratin deposition - visibility of blood vessels decreased

Question 4

leukoplakia

Answer 4

white patch that cant be rubbed off and cant be attributed to any other cause

Question 5

fordyce spots

Answer 5

ectopic sebaceous glands
seen mostly on buccal mucosa, sometimes lips
benign, normal structures

Question 6

frictional keratosis

Answer 6

keratosis as a response to trauma
thickening sees loss of visibility of blood vessels and therefore white appearance

Question 7

smokers keratosis

Answer 7

seen on palate
keratosis as a result of trauma from thermal gases

histologically thick layer of keratin and often an increase in melanocytes so pigment changes may also be seen

Question 8

white sponge naevus

Answer 8

hereditary keratosis
fluid accumulates between cells making visibility of blood vessels less
if one family member has it another often does too

Question 9

name 2 reasons for mucosa to appear red

Answer 9

increase in blood flow - inflammation or dysplasia
reduced thickness of epithelium

Question 10

erythroplakia

Answer 10

red patch which cannot be attributed to any other cause
more of a malignancy concern than leukoplakia

Question 11

capillary haemangioma

Answer 11

red in colour
lots of blood vessels within one area of connective tissue
defined border - think mark on chest

Question 12

cavernous haemangioma

Answer 12

blue in colour
slow moving blood with rapid deoxygenation

Question 13

melanocytic naevus

Answer 13

‘mole’
increased number of melanocytes in a specific area - increased pigment production

Question 14

melanotic macule

Answer 14

increased deposition of melanin
rare in oral area - provoked by sun exposure

Question 15

name 4 characteristics of a melanoma lesion

Answer 15

variable pigmentation - high and low
irregular outline
raised surface
symptomatic - itch, bleed

Question 16

most common sites of oral cancer

Answer 16

floor of mouth
lateral border of the tongue
retromolar regions
soft and hard palate
gingivae
buccal mucosa

Question 17

what is thought to be responsible for the rapid rise in oro-pharyngeal cancer cases

Answer 17

HPV epidemic

Question 18

name 3 potentially malignant lesions

Answer 18

leukoplakia
erythroplakia
lichen planus

Question 19

what are the 3 categories of dysplasia

Answer 19

mild
moderate
severe

Question 20

field cancerisation concept

Answer 20

site experiencing malignancy is not the only site that has experienced changes and stimuli leading to cancer
patient displaying dysplasia/cancer in one site of mucosa is at risk of this in other mucosa sites.
Risk is high within 5cm radius - basically all of oral cavity and pharynx