Oral Path Exam 1 - Diagnostic Process Algorithm

Question 1

What does DADD algorithm stand for?

Answer 1

Describe
Ask
Differential (II MIND)
Do

Question 2

What are the 6 major disease categories? (II MIND)

Answer 2

Injury
Infectious
Metabolic
Immune-mediated
Neoplastic
Developmental

Question 3

Inflammatory rxn starting with physical (mechanical, thermal) or chemical exposure that should heal when stimulus is removed

Answer 3

Injury

Question 4

Viral, bacterial or fungal (candidiasis)

Answer 4

Infectious

Question 5

Variety of presentations (acute/chronic)
Typically painful
Systemic symptoms (fever, LAD, malaise)

Answer 5

Infectious

Question 6

Disease resolves when organism is destroyed through meds or immune system self-limits

Answer 6

Infectious

Question 7

Nutritional (vitamin deficiencies), endocrine problems. Not common- very specific situations

Answer 7

Metabolic

Question 8

Immune/inflammatory response to something (self antigen, piece of an organism, medication etc.)

Answer 8

Immune-mediated

Question 9

Come and go with flare-ups or show gradual worsening; acute or chronic

Answer 9

Immune-mediated

Question 10

Can affect skin and/or mucosal sites as blisters, erosions, ulcers

Answer 10

Immune-mediated

Question 11

Can’t cure; treat by suppressing immune response (steroids)

Answer 11

Immune-mediated

Question 12

Show continued increase in size. Usually
painless

Answer 12

Neoplasms

Question 13

What type of neoplasm?

Well-defined, grow slowly, can destroy locally but don’t spread (invade/metastasize)

Answer 13

Benign

Question 14

What type of neoplasm?

Poorly defined, grow faster, spread (invade and can metastasize). Can cause pain and/or paresthesia

Answer 14

Malignant

Question 15

Present at birth (congenital) or show up often during the first 2 decades

Answer 15

Developmental

Question 16

Typically limited growth potential, but may grow like a tumor (ex: cysts)

Answer 16

Developmental

Question 17

Often solitary; if inherited or syndromic, then there are multiple lesions

Answer 17

Developmental

Question 18

What questions should you ask? (I Don’t Paint Cats, I Tickle)

Answer 18

Isolated finding?
Duration?
Pain or paresthesia?
Change?
Injury?
Treatment?

Question 19

Which category of disease?

Typically solitary

Answer 19

Developmental (cysts)
Neoplasm

Question 20

Which category of disease?

Duration = however long the injury has been present, usually acute onset

Answer 20

Injury

Question 21

Which category of disease?

Duration = days to weeks

Answer 21

Infectious

Question 22

Which category of disease?

Duration = slow and chronic

Answer 22

Metabolic

Question 23

Which category of disease?

Duration = acute or chronic

Answer 23

Immune-mediated

Question 24

Which category of disease?

Duration = weeks to years

Answer 24

Neoplastic

Question 25

Which category of disease?

Duration = discovered during youth, cysts are slow growing, others can be discovered abruptly

Answer 25

Developmental

Question 26

Which category of disease?

Pain = not painful until large

Answer 26

Developmental
Most neoplasms

Question 27

Which category of disease?

Change = none

Answer 27

Developmental
Injury (depends)

Question 28

Which category of disease?

Change = gets bigger/worse

Answer 28

Metabolic
Infectious
Neoplastic

Question 29

Which category of disease?

Change = comes and goes

Answer 29

Immune-mediated

Question 30

What do you do?

Random, non-repetitious injury, healing in 2-3 weeks

Answer 30

No immediate tx, but follow-up

Question 31

What do you do?

Developmental lesion

Answer 31

No immediate tx, but follow-up

Question 32

What do you do?

Metabolic, neoplastic, developmental cysts, immune-mediated, and maybe infectious

Answer 32

Get more info (radiology, labwork, biopsy)

Question 33

What do you do?

Injury- eliminate source of chronic injury (crown margin, calculus, biting, etc)

Answer 33

Definitively treat and follow-up

Question 34

What do you do?

Bacterial infection- pulp-related; perio
Viral infection
Fungal infection

Answer 34

Definitively treat and follow-up

Question 35

When do you refer to PCP?

Answer 35

Systemic disease