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Oral Diseases > random theme 5/6 > Flashcards

random theme 5/6 Flashcards

1
Q

what is hairy tongue?

A

clinical manifestation of elongation of filiform papillae - no etiologic cause

asymptomatic

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2
Q

4 things hairy tongue is often a response to?

A

infection
fever
xerostomia
substances - antibiotics, tobacco

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3
Q

keratinolytic drug used for hairy tongue

A

podophydllin 25% in tincture of benzoin

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4
Q

what is geographic tongue

A

depapillation of the filiform papillae on the dorsal of the tongue causing erythmatosus configurations

often white border

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5
Q

microscopical signs of geographic tongue

A

loss of filiform papillae
elongated rete ridges
neutrophil accumulation in the superficial epithelium

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6
Q

what is median rhomboid glossitis?

A

rhomboidal or elliptical reddish smooth or nodular surface located in midline of tongue

often associated with candida

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7
Q

what are fordyce granules? how can they be removed?

A

manifestation of heterotic sebaceous glands

co2 laser therapy

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8
Q

what causes white sponge naevus?

A

mutation in keratin 13 or 4 - hyperkeratosis

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9
Q

features of white spongy naves?

A

asymptomatic, diffuse, bilateral, white lesions, shaggy/spongy/wrinkled surface

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10
Q

how to diagnose leukodema?

A

stretch buccal mucosa - opaque change will dissipate

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11
Q

difference between erosion + ulcerations

A

erosion - epithelium only

ulceration - whole epithelium breached

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12
Q

3 types of white oral lichen planus

A
  1. papular
  2. reticular
  3. plaque - like
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13
Q

when is lichen Planus most common + uncommon?

A

most common - posterior buccal mucosa

spread to tongue, gingiae, labial mucosa, vermillion of lower lip

uncommon - palate, FOM, upper lip

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14
Q

3 types of red oral lichen planus

A
  1. atrophic - erythematous
  2. erosive - ulcerative
  3. bullous - blisters
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15
Q

what is planopilaris?

A

Lichen Planus involving scalp + hair follicles

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16
Q

most common place to find lichen Planus skin lesions

A

volar wrists + forearms

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17
Q

what is lichen planus

A

chronic inflammatory disorder of stratified squamous epithelium

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18
Q

4 histopathological characteristic of lichen Planus

A
  1. hyperkeratosis
  2. civatte bodies - basal cell liquefaction with apoptic cells
  3. bank-like inflammatory infiltrate mainly composed of T cells
  4. absence of epithelia dysplasia
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19
Q

how to determine difference between LP + OLCL (oral lichenoid contact lesion)

A

cannot distinguish histologically

patch testing

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20
Q

what reaction can amalgam cause orally?

A

oral lichenoid contact lesion

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21
Q

which virus may cause oral lichen Planus?

A

HCV

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22
Q

2 features of OLP that cause increased risk of malignant transformation

A

reticular plaque

atrophic-erosive

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23
Q

5 special investigation in oral med

A
  1. blood test
  2. skin patch testing
  3. exfoliate cytology
  4. biopsy
  5. direct/indirect immunofluorescence
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24
Q

difference between direct + indirect immunofluroence

A

direct = detect in situ deposition of Ig and/or complements

indirect = detect circulating autoantibodies

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25
Q

colour coding scheme for oral lesions

A 
green = GDP monitor
amber = GDP in conjunction with specialist unit
red = specialist referral centre
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26
Q

description of smokers keratosis

A

lesion on palate with small red spots

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27
Q

what virus causes oral hairy leukoplakia

A

EBV

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28
Q

what is hydroxychloroquine sulphate used to treat?

A

oral lichen Planus

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29
Q

skin condition associated with geographic tongue?

A

psoriasis

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30
Q

characteristics of aphthous ulcers/stomatitis

A 
superficial oral mucosa ulceratin
recurrent
no obvious cause
usually self limiting
individual healthy
occur on non-keratinised oral ep usually
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31
Q

difference between major and minor recurrent aphthous stomatitis

A

minor = 1-5 ulcers, lasts 7-14 days, no scarring

major = 1-2 ulcers, lasts >14 days, scar (deeper)§

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32
Q

what is herpetiform RAS

A

small ulcers merge to form irregular shaped larger ulcers

> 10 per crop
lasts 7-21days
+/- scarring

33
Q

9 causes of RAS

A
  1. genetics
  2. haematinic deficiency
  3. food allergy
  4. gluten sensitivity
  5. sex hormones
  6. drugs - NSAIDs, B blockers, nicorandil
  7. immunodeficiency
  8. infections
  9. trauma

ulcers in systemic conditions too but not technically ras- behcets, reiters, cyclic neutropenia

34
Q

deficiencies causing RAS

A

iron, folic, zinc, B1, B2, B6, B12

35
Q

what is behcets disease?

A

recurrent oral ulceration with 2 of the following: recurrent genital ulcers, eye lesions, skin lesions, positive pathergy test

36
Q

1st line of treatment for oral ulcers

A

topical corticosteroids

37
Q

pemphigus lesions are threatening to what?

A

life

38
Q

pemphigoid lesions are threatening to what?

A

sight

39
Q

what causes pemphigus ?

A

anti-epithelial auto-antibodies against surface of the keratinocytes

40
Q

characteristics of pemphigus

A
  1. blisters + ulcerations
  2. acantholysis
  3. intra-epithelial
  4. autoantibodies
  5. intracellular deposits of IgG + c3 in immunofluorescence
41
Q

2 types of oral pemphigus

A

pemphigus vulgaris

pemphigus paraneoplastic

42
Q

most common oral pemphigoid

A

mucous membrane pemphigoid (MMP)

43
Q

process of diagnosising bullis disease

A
  1. history
  2. clinical evaluation
  3. direct immunofluorescence
  4. indirect IF, immunoprecepitation, ELISA
  5. diagnosis
44
Q

what cell type is predominant in chronic inflammation/ granulomatosis

A

activated macrophages

45
Q

4 clinical manifestations of orofacial granulomatosis

A
  1. erythema
  2. ulceration
  3. oedema
  4. tissue enlargement
46
Q

3 types of infection granulomatous disorders

A
  1. TB
  2. tertiary syphilis - gumma
  3. mycotic granulomatous infection
47
Q

bowel condition causing orofaical granulomatosis

A

crohns disease

48
Q

triad for diagnosis of melkersson-rosenthal syndrome?

A

persistent orofacial swelling
fissured tongue
facial paralysis

49
Q

7 causes of non-infectious orofacial granulomatosis

A
  1. idiopathic OFG
  2. crohns
  3. melkerson-rosenthal syndrome
  4. cheilitis granulomatosis of miescher
  5. sarcoidosis
  6. wegeners granulomatosis
  7. foreign body reaction
50
Q

what is chelitis granulomatosa

A

painless enlargement of 1/both lips - recurrent

51
Q

triad to diagnose wegeners granulomatosis

A
  1. necrotising granulomatous lesions upper/lower respiratory tract
  2. systemic vasculitis
  3. necrotising glomulonephritis
52
Q

what is sarcoidosis

A

multisystem granulomatous disorder of unknown cause

53
Q

what is orofacial granulomatosis

A

persistent enlargement of face/oral cavity

caused by inflammation

54
Q

orofacal manifestations of granulomatosis

A

soft tissue swellings
major salivary gland enlargement - mainly parotid
ulcerations

55
Q

bacteria causing TB

A

mycobacterium tuberculosis/tb bacilli

56
Q

staining test for TB

A

ziehl Neelson

57
Q

colour of amalgam tattoo

A

grey-blue

58
Q

histology of malanotic macule

A

increased melanin pigmentation in basal cell layer

no increase in melanin number

59
Q

how to tell difference between freckle + melanotic macules

A 
freckle = worse with sun
melanotic = no change with sun
60
Q

what is naevi

A

mole - proliferation of melanocytes

61
Q

how would you treat oral naevi

A

excision - may be melanoma

62
Q

what is melanoma

A

aggressive tumour of melanocytes

63
Q

where are melanomas mostly found

A

hard palate, gingiva, tongue

64
Q

clinical appearance of melanomas

A

pigmented plaques with asymmetrical irregular borders
dark brown/black (5-15% amelanotic/pink)
rapidly enlarging nodes causing - ulcers, bleeding, pain, tooth mobility

normally metastic not primary

65
Q

2 types of oral melanomas

A

radial growth phase - in situ

vertical growth phase - invasive

66
Q

clinical appearance of smokers melanosis

A

patchy brown macular pigmentations - buccal mucosa

67
Q

histology of smokers melanosis

A

basilar melanosis without melanocyte proliferation

68
Q

oral manifestation of peutz-jehgers syndrome

A

lips + buccal mucosa pigmentation

GI involvement too

69
Q

most common drug induced pigmentation

A

minocycline induced pigmentation

70
Q

6 options for peripheral diagnosis of soft tissue lump

A 
cyst
abscess
granuloma
hyperplasia
neoplasia benign
neoplasia malignant
71
Q

6 examples of hyper plastic soft tissue lumps

A 
fibroepithelial polylp
pyogenic granuloma
epulides
denture granuloma
squamous cell papilloma
mucoceles
72
Q

what is an epulis

A

any swelling on gingiva

development or reactive (calculus, partial)

73
Q

When to treat OLP

A

if erosive or symptomatic

74
Q

treatment options for OLP

A
  1. high potency topical steroids
  2. systemic steroids or ciclosporin if SS contradicated

SS +/- azathiopine

75
Q

treatment order of minor RAS

A
  1. chlorhexidine mouthwash
  2. topical steroids
  3. systemic steroids
76
Q

treatment of major RAS

A
  1. topical steroids

2. systemic steroids

77
Q

treatment of herpetiform

A

systemic steroids

then topical

78
Q

treatment for MMP or PV

A

topical or systemic steroids with adjunct agents

or other immunosuppressants if contraindicated

Oral Diseases (14 decks)

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