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NDEB/RCDC Exam themes > Oral Pathology Differential > Flashcards

Oral Pathology Differential Flashcards

1
Q

Vesiculobullous lesions

A

PV
MMP
Plasma cell gingivitis
Chronic ulcerative stomatitis

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2
Q

Necrotizing periodontal disease

A

MMP
PV
Primary herpetic gingivostomatitis

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3
Q

Perio abscess

A

Dentoalveolar abscess
Lateral dental cyst
Pyogenic granuloma
SSC

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4
Q

Lichen planus

A

Lichenoid reaction
Leukoplakia
Discoid lupus erythematosus
hyperkeratosis

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5
Q

ulcer in the buccal mucosa

A

PV
MMP
LP
erythema multiforme
Discoid lupus erythematosus
Traumatic ulceration
SSC

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6
Q

White lesion in buccal mucosa

A

Candidiasis
Leukoedema
Lichen planus
Lichenoid reaction
Lupus erythematosus
Cheek biting
White sponge nevus
Hereditary benigh interepithelial dysplasia
Leukoplakia

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7
Q

Desquamative gingivitis

A

MMP
Oral Lichen Planus
PV
Lupus
Linear IgA disease

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8
Q

White lesions on the lateral border of the tongue

A

Tongue biting
Hairy Leukoplakia
Leukoplakia
SSC

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9
Q

Acute lesions

A

Primary herpetic gingivostomatitis
Necrotizing periodontal disease
Erythema multiforme??

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10
Q

Differential Diagnosis for Gingival Nodules

A
  • Pyogenic granuloma (red-pink)
  • Peripheral Ossifying Fibroma (pink-red)
  • Peripheral Giant Cell Carcinoma (Purple-red)
  • Squamous Cell Carcinoma (Ulcerated angry red)
  • Fibroma
  • Metastatic Cancer
  • Peripheral ameloblastoma (rare)
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11
Q

Differential Diagnosis for Nodules in Other areas

A
  • Pyogenic granuloma (red-pink)
  • Squamous Cell Carcinoma (Ulcerated angry red, HPV 16)
  • Fibroma
  • Mucocele (Lower lip)
  • Pleomorphic Adenoma (Parotid/Palate)
  • Mucoepidermoid Carcinoma (Parotid/Minor salivary - Hard Palate)
  • Metastatic Cancer
  • Lipoma
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12
Q

Differential Diagnosis for the Inflammed Palate

A
  • Inflammatory Papillary Hyperplasia
  • Nicotine Stomatitis
  • Candidiasis
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13
Q

Differential Diagnosis for Papillary Lesions

A
  • Squamous Papilloma (HPV 6, 11)
  • Condyloma acuminatum (Genital warts, sexually active young adults, HPV 6, 11)
  • Verruca vulgaris (Common wart, children, spreads from fingers to mouth, HPV 2,4)
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14
Q

Differential Diagnosis for Pigmented Lesions

A
  • Amalgam tattoo
  • Melanotic Macule (well-defined, does not increase in size, uniform)
  • Oral Nevus (Common mole, intraoral presentation is rare)
  • Oral Melanoacanthoma
  • Drug-induced pigmentation (Minocycline, anti-malarials- Chloroquine)
  • Physiologic pigmentation
  • Smoker’s melanosis
  • Melanoma (deadly, acute sun exposure, very concerning if pigmented lesion is on palate or max gingiva)
  • Systemic – Pzeutz Jehgers, McCune Albright, Addison
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15
Q

Differential Diagnosis for White Plaques (Leukoplakia)

A
  • Frictional Keratosis
  • Lichen planus
  • Allergic Chronic stomatitis (Cinnamon, Aluminium Chloride, Toothpastes)
  • Lichenoid Mucositis (Medications – Aspirin, Chloroquine, Allopurinol, Dapsone: Pemphigoid)
  • Tobacco pouch keratosis
  • Candidiasis (can be rubbed off so)
  • SCC
  • Carcinoma-in-situ
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16
Q

Differential Diagnosis for Multilocular Radiolucency

A
  • Myxoma
  • Ameloblastoma (15% recurrence)
  • Central Giant Cell Granuloma
  • Hemagioma
  • Odontogenic Keratocyst (30% recurrence)
17
Q

Differential Diagnosis for Unilocular Radiolucency

A
  • Dentigerous cyst
  • Odontogenic Keratocyst
  • Unilocular Ameloblastoma
  • Residual Cyst
  • Stafne’s cyst
  • Simple bone cyst/Traumatic bone cyst (not a true cyst – no epithelium lining. Scraping of the walls promotes healing. Aspirate before surgery)
  • Lateral Periodontal Cyst
18
Q

Differential Diagnosis for Radiopacities

A
  • Idiopathic Osteosclerosis
  • Compound Odontoma (tooth)
  • Complex Odontoma (irregular mass)
  • Periapical cemento-osseous dysplasia (African/Black women, anterior)
  • Focal cemento-osseous dysplasia
  • Florid cemento-osseous dysplasia (mature avascular lesions – can easily necrose/osteomyelitis – do not disturb, do not attempt implants)
  • Condensing osteitis (non-vital)
  • Fibrous dysplasia
  • Osteomas
19
Q

Differential Diagnosis for Ulcerations

A
  • Squamous cell carcinoma
  • Traumatic Ulcer
  • Recurrent Aphthous Ulcer
  • Histoplasmosis
20
Q

Differential Diagnosis for Mucocutaneous lesions (Red)

A
  • Pemphigus Vulgaris
  • Mucocutaneous Pemphigoid
  • Erosive Lichen Planus
  • Candidiasis - Erythematous
  • Crohn’s
  • Erythroplakia – Chronic Ulcerative Mucositis
  • Lichenoid Mucositis
  • If Gingiva - Plasma cell gingivitis
21
Q

Differential Diagnosis for Gingival enlargement

A
  • Drug-influenced gingival enlargements
  • Periodontitis
  • Leukemia
  • Plasma cell gingivitis
  • Hereditary gingival fibromatosis
22
Q

Treatment for Oral Fungal infections

A
  • Fluconazole 100 mg (2 tabs day 1 and then 1 tab daily for 10 days)
  • Clotrimazole 10 mg (Troches 5 times a day)
  • Clotrimazole 1% Ointment (Angular Cheilitis – 3/4 times a day)
  • Nystatin Oral Suspension (Denture Stomatitis - dentures with metal soak overnight)
23
Q

Treatment for Aphthous ulcers/Erosive Lichen Planus/Chronic Ulcerative Stomatitis:

A
  • Fluocinonide gel 0.5%
  • Clobetasol 0.05% gel
  • Betamethasone gel 0.05%
  • Triamcinolone 0.1%
24
Q

Treatment for Acute Herpetic Gingivostomatitis/Recurrent Herpes

A
  • Acyclovir 200mg 5 times a day for 5 days
  • Valacyclovir 500 mg
25
Q

Necrotizing periodontal disease differential diagnosis

A
  • Acute herpetic gingivostomatitis
  • Desquamative gingivitis (MMP, PV, Erosive Lichen Planus, Chronic Ulcerative Stomatitis)
  • Leukemia
  • Allergic reactions – Plasma cell gingivitis
  • Crohn’s (Malnutrition)
  • Chronic periodontitis
26
Q

Treatment of necrotizing periodontal disease

A
  • Perform debridement under local anesthesia, including gentle scaling.
  • Gently remove pseudo-membrane, using cotton pellet dipped in 0.12% chlorhexidine.
  • Provide the patient with oral hygiene instructions and prescribe antibacterial mouthwash (0.12% chlorhexidine, b.i.d.)
  • Tell the patient to control pain with analgesics (ibuprofen 400–600 mg, t.i.d. or acetaminophen 750 mg, t.i.d.).
  • Provide patient counseling: ensure proper nutrition, take vitamin supplements, avoid spicy foods, adopt appropriate fluid intake, increase sleep, decrease stress, and quit smoking, if possible.
  • Prescribe antibiotics if signs of systemic involvement or immucompromised (e.g., fever, malaise, lymphadenopathy): Amoxicillin: 500 mg for 7 days; or combination of amoxicillin 250 mg and metronidazole 250 mg one tab of each t.i.d. for 7 days
    If the patient is immunocompromised (e.g. AIDS, HIV-positive, leukemia, cyclic neutropenia), it is important to follow-up with their physician when you prescribe antibiotics. The risk of super infection with oral Candida must be considered when using systemic antibiotics in immunocompromised patients. In those cases, antifungal medication might be needed.
  • Assess treatment outcomes in 24-48 hours, then every other day until signs and symptoms are resolved and gingival health and function are restored.
27
Q
A

NDEB/RCDC Exam themes (2 decks)

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