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year 4 > oral med > Flashcards

oral med Flashcards

1
Q

Which papillae are elongated in black hairy tongues?

a) fungiform
b) filiform
c) vallate
d) foliate

A

b) filiform

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2
Q

A patient has a blueish black oral pigment in the mandibular gingiva localised to an extraction space. The patient informs you the patch has been there for a while and has not increased in size. The patient noticed it after the tooth had been extracted

the patch is flat and has slightly blurred edges.

what could it possibly be?

A

amalgam tattoo

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3
Q

How do you manage black hairy tongue?

A
  • reassurance
  • oral hygiene improvement
  • avoid excessive tongue brushing
  • oxidising mouthwash
  • smoking cessation
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4
Q

true or false:

For a lesion suspect as a graphite tattoo, a biopsy is not necessary

A

False

biopsy is needed to rule out malignancy

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5
Q

what is the second most common cause of exogenous localised oral pigmentation?

A

graphite tattoos

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6
Q

What location are graphite tattoos commonly found?

A

young children anterior palates

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7
Q

what oral pigment pigmentation can be confused for sub gingival calculus?

A

burton’s lines or Lead lines

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8
Q

How do lead lines or Burton’s lines form?

A

salts present in the crevicular fluid are precipitated by H2s from plaque microorganisms

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9
Q

what are the differences between an oral melanotic macule and an oral melanoma?

A

oral melanotic macule:

  • distinct borders
  • benign
  • no changes in size
  • uniformly flat
  • black/brown macule

Oral melanoma

  • irregular borders
  • malignant / poor prognosis
  • darkish brown/ can be amelanotic
  • irregular colour distribution
  • thickening
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10
Q

what can spontaneous ecchymosis represent?

A

underlying platelet or coagulation disorders

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11
Q

what are varices and name the common oral sites?

A

abnormal venous dilation

commonly seen in lips and sublingual areas

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12
Q

list three developmental causes for oral pigmentation

A
  • peutz jeghers syndrome
  • pigmented neavi (mole)
  • racial pigmentation
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13
Q

what syndromes would a patient with peutz jeghers syndrome present with?

A

oral pigmented lesions

abdominal pain

rectal bleeding

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14
Q

How can haematinic deficiency affect the oral cavity?

A
  • depapillation of tongue
  • decrease in taste
  • general oral epithelial atrophy
  • soreness
  • ulceration
  • candidiasis
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15
Q

What oropharyngeal conditions are associated with haematinic deficiencies?

A
  • plummer-vinson syndrome/patterson kelly syndrome
  • burning mouth
  • recurrent oral ulcerations
  • angular cheilitis + candidosis
  • glossitis
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16
Q

What is patterson kelly/ plummer-vinson syndrome?

A

marked by

  • anaemia
  • web like growth in the oesophagus (difficulty swallowing)
  • increased risk of oesophageal cancer
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17
Q

what does ascorbic acid deficiency lead to?

A
  • impaired phagocytosis

- altered antibody response to viral agents

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18
Q

what does retinol/zinc deficiency lead to?

A
  • diminished cell mediated immunity

- early breakdown in oral mucosal integrity

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19
Q

What oral features exist of alcoholism?

A
  • sialosis
  • dental erosion due to acid reflux
  • oral squamous cell carcinoma
  • signs of liver cirrhosis
  • malnutrition
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20
Q

what are the clinical features of bulemia?

A
  • weight in normal range
  • hypokalaemia (low potassium)
  • sialosis
  • dental erosion
  • russell’s sign (callous on dorsum hand)
  • ulcers on soft palate
  • angular cheilitis
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21
Q

what are the risk factors of acute necrotizing ulcerative gingivitis?

A
  • smoking
  • poor plaque control
  • stress
  • malnutrition
  • immunosuppression
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22
Q

What is the difference between mucosal erosion and ulcer?

A

erosion - area of partial loss of skin or mucous membrane

ulcer - area of total loss of epithelium

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23
Q

Define sialadenosis

A

sialadenosis is non specific salivary gland enlargement

usually of parotid gland and bilateral

24
Q

Define sialadenitis

A

the enalrgement of one or more salivary glands due to an infection, inflammation or obstruction

usually of parotid and submandibular glands

25
Q

define sialothiasis

A

the presence of stones in salivary glands causing pain and swelling

usually submandibular

26
Q

Which salivary gland tumour is the most common?

a) pleomorphic adenoma
b) warthin tumour
c) haemangioma
d) mucoepidermal carcinoma
e) adenoid cystic carcinoma
f) carcinoma ex-pleomorphimic adenoma
g) nectrozing sialometaplasia

A

a) pleomorphic adenoma

27
Q

Why is the recurrence rate of pleomorphic adenoma high?

A

due to their incomplete capsule shape making complete incisions difficult

28
Q

which salivary gland tumour is the most common in children?

a) pleomorphic adenoma
b) warthin tumour
c) haemangioma
d) mucoepidermal carcinoma
e) adenoid cystic carcinoma
f) carcinoma ex-pleomorphimic adenoma
g) nectrozing sialometaplasia

A

c) haemangioma

29
Q

Which salivary gland tumour presents as a smooth soft parotid mass, is multi-cystic, well capsulated and benign?

a) pleomorphic adenoma
b) warthin tumour
c) haemangioma
d) mucoepidermal carcinoma
e) adenoid cystic carcinoma
f) carcinoma ex-pleomorphimic adenoma
g) nectrozing sialometaplasia

A

b) warthin tumour

30
Q

Which salivary gland tumour intially grow rapidly and present as dark red, lobulated swellings and are usually asymptomatic and unilateral?

a) pleomorphic adenoma
b) warthin tumour
c) haemangioma
d) mucoepidermal carcinoma
e) adenoid cystic carcinoma
f) carcinoma ex-pleomorphimic adenoma
g) nectrozing sialometaplasia

A

c) haemangioma

31
Q

Which salivary gland tumour is most common in parotid gland and consists of two types of cells, mucous and epidermal?

A

mucoepidermal carcinoma

32
Q

Which salivary gland tumour has a high rate of metastasis to regional lymph nodes ?

A

mucoepidermal carcinoma

33
Q

Which salivary gland tumour is locally invasive, with low metastasis rates to regional lymph nodes, but high rates of distant metastasis eg lungs?

a) pleomorphic adenoma
b) warthin tumour
c) haemangioma
d) mucoepidermal carcinoma
e) adenoid cystic carcinoma
f) carcinoma ex-pleomorphimic adenoma
g) nectrozing sialometaplasia

A

e) adenoid cystic carcinoma

34
Q

How would you diagnose dry mouth?

A
  • mouth feels dry for more than three months
  • waking up at night to drink fluid
  • recurrent/persistent swollen salivary glands
35
Q

list the aetiology of dry mouth

A
  • dehydration
  • habits eg mouth breathing
  • medication
  • salivary gland disease
  • systemic disease
  • nerve damage
  • age
36
Q

List some systemic diseases associated with dry mouth

A
  • sjogrens syndrome
  • diabetes
  • liver disease
  • amyloidosis
  • sarcoidosis
  • thyroid disease
37
Q

What are the types of sjorgrens syndrome?

A

primary (sicca) - dry mouth and eyes

secondary - connective tissue disease, dry mouth and eyes

38
Q

what mediction can be used to treat severe xerostomia?

A

pilocarpine

39
Q

An elderly patient complains of a sore tongue that feels as if burning. clinically the tongue appears bright red. blood levels are normal.

what could a possible diagnosis be?

A

acute atrophic candidiasis

40
Q

A smoker presents with a persistent white patch on the lateral borders of the tongue. List the possible differential diagnosis

A
  • hyperplastic candidiasis
  • lichen planus
  • squamous cell carcinoma
41
Q

How do you manage denture stomatitis?

A
  • reinforce denture hygiene
  • tissue conditioners
  • miconazole on denture fit surface
42
Q

List two topical measures to manage angular cheilitis

A

miconazole gel

trimovate cream

43
Q

which three problems classically present in autoimmune polyendocrine syndrome? and which one of the three is the first major sign to appear?

A
  • chronic mucocutanous candidosis - first major sign to appear
  • hypoparathyroidism
  • primary adrenocortical insufficiency
44
Q

A patient arrives with fluid filled blisters of 6mm and irregular blisters which bleed on the lips. they also have circular red lesions on their palms and soles of feet.

name a possible diagnosis

A

erythema multiforme

45
Q

What management techniques are there for Crohns?

A
  • topical tacrolimus
  • adalimumab
  • thialodmide
  • diet : eliminate benzoates and cinnamon
  • corticosteroids
46
Q

list some specific oral features of crohns

A
  • mucosal tags
  • cobblestone appearance
  • mucogingivitis
  • lip swelling with vertical fissures
  • deep linear ulcerations
47
Q

What is pyostomatitis vegetans?

A

rare oral manifestation

multiple pustules on erythematous base on gingiva and oral mucosa

non specific lesion of crohns

48
Q

what are the features of melkerson rosenthal syndrome?

A

lower motor neurone palsy

  • fissured tongue
  • plicated mucosal swelling
49
Q

List the histopathological features of lichen planus

A
  • severe thinning and flattening of epithelium
  • basal cell destruction
  • lymphocyte dominant sub-epithelial band
  • hyperkeratosis
50
Q

name a second line management technique for lichen planus

A

topical calcinuerin inhibitor

eg

topical tacrolimus/ciclosporin

51
Q

list the types of oral lichen planus

A
  • reticular
  • erosive
  • atrophic
  • plaque
  • bullous
  • desquamative gingivitis
  • papular
52
Q

What are the skin lesions for lichen planus like?

A

purplish papules 2-3mm

itchy

white minute striae

53
Q

what are the differentiating features of lupus and lichen planus oral lesions?

A

lupus:

less well defined erythematous borders, irregular atrophic areas, often patchy and unilateral

found on palate

54
Q

what are civatte bodies?

A

histology feature found in oral lesion of discoid lupus erythematous

55
Q

What is the difference between an erosion and an ulcer?

A

erosion: area of partial loss of skin or mucous membrane surface epithelium but not breaching the basement membrane
ulcer: area of total loss of epithelium - both surface and basement membrane

year 4 (3 decks)

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