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Oral pathology Flashcards

1
Q

What should be done in patients presenting with deep fissures on the tongue?

A

Give reassurance as this is a variation of normal
Advise patients to clean their tongue thoroughly to prevent plaque build up

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2
Q

What causes a black, hairy tongue?

A

This is caused usually by a combination of poor dental hygiene, soft diet and smoking

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3
Q

What should be done in patients present with a black, hairy tongue?

A

Teaching the patient proper oral hygiene
Advising a harder diet
Give opportunity for smoking cessation

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4
Q

What is the name given to white patches in the mouth?

A

Leukoplakia

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5
Q

What is the name given to red patches in the mouth?

A

Erythroplakia

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6
Q

What are fordyce spots?

A

Small, uniform, white patches on the cheeks or lips, which are harmless overgrowths of ectopic sebaceous glands

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7
Q

How can hyperkeratosis present in the mouth?

A

leukoplakia and some erythema caused by a reaction to friction within the mouth, allowing excess water movement into the epithelial lining

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8
Q

What are some possible causes of leukoplakia in the mouth?

A

Fordyce spots
Hyperkeratosis
Oral candidiasis
Oral cancer

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9
Q

What should be performed in cases of erythroplakia or leukoplakia?

A

Biopsy

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10
Q

What can be caused if a patient does not remember to remove their dentures for long periods of time?

A

Fungus such as candida can grow, causing red folds of the mucosa

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11
Q

What is a polyp in the mouth?

A

This is a lump caused by a benign overgrowth of oral epithelium

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12
Q

What is the most common cause of oral polyps?

A

Cheek biting

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13
Q

What is the most suspected diagnosis in a patient with a necrotic lump of the tongue which protrudes in and causes immobilisation of the tongue?

A

Cancer of the tongue

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14
Q

What are the 2 types of polyp in the mouth?

A

Cessile
Perdonculated

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15
Q

What are the most common causes of ulcers in the mouth?

A

Hormonal changes
Dietary changes

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16
Q

Are ulcers usually painful?

A

YES! So painless ulcers should raise suspicion as they can be suggestive of cancer

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17
Q

What is the most common cancer of the mouth?

A

Squamous cell carcinomas

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18
Q

What are some cancers that affect the mouth?

A

Squamous cell carcinoma
Salivary gland tumours
Lymphomas

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19
Q

What are some cancers that can metastasise to the mouth?

A

Breast
Lung
Kidney
Colon
Prostate

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20
Q

How do salivary gland tumours usually present?

A

They are usually benign growths within the parotid gland, presenting with a large lump between the ear and jaw

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21
Q

How do lymphomas of the mouth tend to appear?

A

Ulcers in the gingivae

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22
Q

What are some risk factors of oral squamous cell carcinoma?

A

Tobacco
Alcohol
HPV
Poor nutrition
UV light
Immunocompromised
Genetics
Lichen planus

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23
Q

What are some genetic conditions that can increase the risk of oral squamous cell carcinoma?

A

Facing’s anaemia
Bloom’s syndorme
Dyskeratosis congenita

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24
Q

How long of not smoking is required to return the risk of cancer back to that of a never smoker?

A

20 years

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25
How does alcohol cause salivary gland cancers?
Alcohol is metabolised to acetaldehyde, which is a known mutagen and carcinogen, which is metabolised in the salivary glands, mucosa and via oral bacteria
26
What is the usual treatment of oral cancer?
Surgery +/- Chemotherapy
27
What should be done in case of a suspected oral cancer?
Take photos Document findings Refer to a dentist and review after 2 weeks If no improvement, refer using NICE or SIGn guidelines for biopsy and imaging
28
What are torus mandibularis?
These are bony protuberances on the floor of the mouth, which are developmental abnormalities and do not usually require treatment unless they obstruct dentures
29
What are torus palotonus?
bony protuberances on the roof of the mouth, which are developmental abnormalities which do not usually require treatment unless they obstruct dentures
30
What is angular cheilitis?
This is cracking of the corners of the mouth
31
What are some possible causes of angular cheilitis?
Candidiasis Staphylococcus infection Anaemia Crohn's disease
32
What are the 3 sub-types of recurrent aphthous-like stomatitis?
Minor Major Herpetiform
33
What is the underlying cause of recurrent aphthous-like stomatitis?
Anaemia
34
What is meant by recurrent aphthous-like stomatitis?
This is a condition caused by anaemia, causing the formation of small white ulcers with a yellow base and red erythematous halo around them
35
What tests are carried out in cases of recurrent aphthous-like stomatitis?
FBC Serum B12 Folate Ferritin
36
Describe the ulcers in minor recurrent aphthous-like stomatitis
Ulcers <1cm in diameter Clear within 7-14 days Up to 10 ulcers at a time
37
Describe the ulcers in major recurrent aphthous-like stomatitis
Ulcers ≥1cm in diameter Clear within 4 weeks Cause scarring Usually up to 3 at a time
38
Describe the ulcers in herpetiform recurrent aphthous-like stomatitis
Small, pinhead sized ulcers Coalesce to form larger ulcers Clear within 7-14 days Can be hundreds present at a time Very painful
39
What are some common oral manifestations of Crohn's disease? (6)
Swollen lips Angular cheilitis Oral ulceration Mucosal tags Cobblestone mucosa Stag horning of sub-lingual folds
40
What are the 2 types of oral ulcers in Crohn's disease?
Aphthous-like Slit-like
41
What are mucosal tags?
Folds of tissue within the labial sulci
42
What is Crohn's disease that only affects the mouth known as?
Oral Crohn's disease
43
What is orofacial granulomatosis?
This is a disease that presents exactly as oral Crohn's disease, however does not lead to inflammation or anaemia
44
What disease can orofacial granulomatosis develop into?
Crohn's disease
45
How can orofacial granulomatosis and Crohn's disease be distinguished?
Test for CRP and faecal calprotectin Test for anaemia Ask about GI symptoms
46
What is pyostomatitis vegetans?
This is a condition causing small, pinhead-sized pustular lesions on the gingiva or oral labia, which is seen in IBD, especially ulcerative colitis
47
What is a possible, rare oral manifestation of ulcerative colitis?
Pyostomatitis vegetans
48
How can Coeliac's disease present in the mouth?
Coeliac's disease can cause malabsorption, and thus cause iron and folate deficiency, presenting with haematinic deficiency, and therefore can cause recurrent aphthous-like stomatitis
49
What are some conditions that can predispose to acute pseudomembranous candidiasis (Thrush)?
Immunodeficiency Asthma due to inhaler use Undiagnosed or poorly controlled diabetes
50
What is lichen planus?
Lichen planus is a condition causing systemic inflammation and erosion, presenting with itchy purple papules with white striae on the shins and forearms
51
How can lichen planus present in the mouth?
It can cause erythema or the gingivae and buccal mucosa as well as bilateral ulceration
52
What does lichen planus increase a persons risk of?
Oral squamous cell cancer (1% risk over 10 years)
53
What is mucus membrane pemphigoid?
This is an autoimmune condition, affecting the oral, nasal and genital mucosa and conjunctiva, characterised by the presence of auto-antibodies against the basement membrane, causing sub-membranous blisters which can rupture and form ulcers
54
How can mucus membrane pemphigoid affect the eyes?
Conjunctival healing can cause scar formation, known as symblepharon, leading to loss of sight, known as cicatrical pemphigoid
55
What is a symblepharon?
A scar across the conjunctive of the eye, caused by mucus membrane pemphigoid
56
What is cicatrical pemphigoid?
Loss of sight due to conjunctival scarring in mucus membrane pemphigoid
57
What is Sjogren's syndrome?
This is a connective tissue disease which effects the exocrine glands
58
What is meant by primary Sjogren's syndrome?
This is when Sjogrens syndrome is the only connective tissue disease affecting the patient
59
What is meant by secondary Sjogren's syndrome?
This is when Sjogrens syndrome is accompanied by another connective tissue disease such as rheumatoid arthritis
60
What are some symptoms of Sjogrens syndrome?
Dry eyes Dry mouth
61
What are some possible oral manifestations of HIV/AIDS?
Candidiasis Hairy leukoplakia Kaposi's sarcoma
62
What is meant by hairy leukoplakia?
This is a white corrugated lesion on the surface of the tongue, usually associated with Epstein-Barr Virus
63
What is Kaposi's sarcoma?
A tumour caused by human herpes virus 8
64
What is Bechet's disease?
This is a hereditary systemic vasculitis causing the formation of aphthous-like ulcers as well as genital ulceration, uveitis, erythema nodosum and other systemic features
65
How can SLE present in the mouth?
Ulceration, white patches or red and white patches

Gastrointestinal (22 decks)

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