Oral Path Exam 1 - Diagnostic Process Algorithm Flashcards
What does DADD algorithm stand for?
Describe
Ask
Differential (II MIND)
Do
What are the 6 major disease categories? (II MIND)
Injury
Infectious
Metabolic
Immune-mediated
Neoplastic
Developmental
Inflammatory rxn starting with physical (mechanical, thermal) or chemical exposure that should heal when stimulus is removed
Injury
Viral, bacterial or fungal (candidiasis)
Infectious
Variety of presentations (acute/chronic)
Typically painful
Systemic symptoms (fever, LAD, malaise)
Infectious
Disease resolves when organism is destroyed through meds or immune system self-limits
Infectious
Nutritional (vitamin deficiencies), endocrine problems. Not common- very specific situations
Metabolic
Immune/inflammatory response to something (self antigen, piece of an organism, medication etc.)
Immune-mediated
Come and go with flare-ups or show gradual worsening; acute or chronic
Immune-mediated
Can affect skin and/or mucosal sites as blisters, erosions, ulcers
Immune-mediated
Can’t cure; treat by suppressing immune response (steroids)
Immune-mediated
Show continued increase in size. Usually
painless
Neoplasms
What type of neoplasm?
Well-defined, grow slowly, can destroy locally but don’t spread (invade/metastasize)
Benign
What type of neoplasm?
Poorly defined, grow faster, spread (invade and can metastasize). Can cause pain and/or paresthesia
Malignant
Present at birth (congenital) or show up often during the first 2 decades
Developmental
Typically limited growth potential, but may grow like a tumor (ex: cysts)
Developmental
Often solitary; if inherited or syndromic, then there are multiple lesions
Developmental
What questions should you ask? (I Don’t Paint Cats, I Tickle)
Isolated finding?
Duration?
Pain or paresthesia?
Change?
Injury?
Treatment?
Which category of disease?
Typically solitary
Developmental (cysts)
Neoplasm
Which category of disease?
Duration = however long the injury has been present, usually acute onset
Injury
Which category of disease?
Duration = days to weeks
Infectious
Which category of disease?
Duration = slow and chronic
Metabolic
Which category of disease?
Duration = acute or chronic
Immune-mediated
Which category of disease?
Duration = weeks to years
Neoplastic
Which category of disease?
Duration = discovered during youth, cysts are slow growing, others can be discovered abruptly
Developmental
Which category of disease?
Pain = not painful until large
Developmental
Most neoplasms
Which category of disease?
Change = none
Developmental
Injury (depends)
Which category of disease?
Change = gets bigger/worse
Metabolic
Infectious
Neoplastic
Which category of disease?
Change = comes and goes
Immune-mediated
What do you do?
Random, non-repetitious injury, healing in 2-3 weeks
No immediate tx, but follow-up
What do you do?
Developmental lesion
No immediate tx, but follow-up
What do you do?
Metabolic, neoplastic, developmental cysts, immune-mediated, and maybe infectious
Get more info (radiology, labwork, biopsy)
What do you do?
Injury- eliminate source of chronic injury (crown margin, calculus, biting, etc)
Definitively treat and follow-up
What do you do?
Bacterial infection- pulp-related; perio
Viral infection
Fungal infection
Definitively treat and follow-up
When do you refer to PCP?
Systemic disease
