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Gastrointestinal > Oral pathology > Flashcards

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
Q

How does alcohol cause salivary gland cancers?

A

Alcohol is metabolised to acetaldehyde, which is a known mutagen and carcinogen, which is metabolised in the salivary glands, mucosa and via oral bacteria

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26
Q

What is the usual treatment of oral cancer?

A

Surgery +/- Chemotherapy

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27
Q

What should be done in case of a suspected oral cancer?

A

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
Q

What are torus mandibularis?

A

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
Q

What are torus palotonus?

A

bony protuberances on the roof of the mouth, which are developmental abnormalities which do not usually require treatment unless they obstruct dentures

30
Q

What is angular cheilitis?

A

This is cracking of the corners of the mouth

31
Q

What are some possible causes of angular cheilitis?

A

Candidiasis
Staphylococcus infection
Anaemia
Crohn’s disease

32
Q

What are the 3 sub-types of recurrent aphthous-like stomatitis?

A

Minor
Major
Herpetiform

33
Q

What is the underlying cause of recurrent aphthous-like stomatitis?

A

Anaemia

34
Q

What is meant by recurrent aphthous-like stomatitis?

A

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
Q

What tests are carried out in cases of recurrent aphthous-like stomatitis?

A

FBC
Serum B12
Folate
Ferritin

36
Q

Describe the ulcers in minor recurrent aphthous-like stomatitis

A

Ulcers <1cm in diameter
Clear within 7-14 days
Up to 10 ulcers at a time

37
Q

Describe the ulcers in major recurrent aphthous-like stomatitis

A

Ulcers ≥1cm in diameter
Clear within 4 weeks
Cause scarring
Usually up to 3 at a time

38
Q

Describe the ulcers in herpetiform recurrent aphthous-like stomatitis

A

Small, pinhead sized ulcers
Coalesce to form larger ulcers
Clear within 7-14 days
Can be hundreds present at a time
Very painful

39
Q

What are some common oral manifestations of Crohn’s disease? (6)

A

Swollen lips
Angular cheilitis
Oral ulceration
Mucosal tags
Cobblestone mucosa
Stag horning of sub-lingual folds

40
Q

What are the 2 types of oral ulcers in Crohn’s disease?

A

Aphthous-like
Slit-like

41
Q

What are mucosal tags?

A

Folds of tissue within the labial sulci

42
Q

What is Crohn’s disease that only affects the mouth known as?

A

Oral Crohn’s disease

43
Q

What is orofacial granulomatosis?

A

This is a disease that presents exactly as oral Crohn’s disease, however does not lead to inflammation or anaemia

44
Q

What disease can orofacial granulomatosis develop into?

A

Crohn’s disease

45
Q

How can orofacial granulomatosis and Crohn’s disease be distinguished?

A

Test for CRP and faecal calprotectin
Test for anaemia
Ask about GI symptoms

46
Q

What is pyostomatitis vegetans?

A

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
Q

What is a possible, rare oral manifestation of ulcerative colitis?

A

Pyostomatitis vegetans

48
Q

How can Coeliac’s disease present in the mouth?

A

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
Q

What are some conditions that can predispose to acute pseudomembranous candidiasis (Thrush)?

A

Immunodeficiency
Asthma due to inhaler use
Undiagnosed or poorly controlled diabetes

50
Q

What is lichen planus?

A

Lichen planus is a condition causing systemic inflammation and erosion, presenting with itchy purple papules with white striae on the shins and forearms

51
Q

How can lichen planus present in the mouth?

A

It can cause erythema or the gingivae and buccal mucosa as well as bilateral ulceration

52
Q

What does lichen planus increase a persons risk of?

A

Oral squamous cell cancer (1% risk over 10 years)

53
Q

What is mucus membrane pemphigoid?

A

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
Q

How can mucus membrane pemphigoid affect the eyes?

A

Conjunctival healing can cause scar formation, known as symblepharon, leading to loss of sight, known as cicatrical pemphigoid

55
Q

What is a symblepharon?

A

A scar across the conjunctive of the eye, caused by mucus membrane pemphigoid

56
Q

What is cicatrical pemphigoid?

A

Loss of sight due to conjunctival scarring in mucus membrane pemphigoid

57
Q

What is Sjogren’s syndrome?

A

This is a connective tissue disease which effects the exocrine glands

58
Q

What is meant by primary Sjogren’s syndrome?

A

This is when Sjogrens syndrome is the only connective tissue disease affecting the patient

59
Q

What is meant by secondary Sjogren’s syndrome?

A

This is when Sjogrens syndrome is accompanied by another connective tissue disease such as rheumatoid arthritis

60
Q

What are some symptoms of Sjogrens syndrome?

A

Dry eyes
Dry mouth

61
Q

What are some possible oral manifestations of HIV/AIDS?

A

Candidiasis
Hairy leukoplakia
Kaposi’s sarcoma

62
Q

What is meant by hairy leukoplakia?

A

This is a white corrugated lesion on the surface of the tongue, usually associated with Epstein-Barr Virus

63
Q

What is Kaposi’s sarcoma?

A

A tumour caused by human herpes virus 8

64
Q

What is Bechet’s disease?

A

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
Q

How can SLE present in the mouth?

A

Ulceration, white patches or red and white patches

Gastrointestinal (22 decks)

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