Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS4 BAMS Oral Medicine > Reactive Oral Mucosal Lesions > Flashcards

Reactive Oral Mucosal Lesions Flashcards

1
Q

What epithelium is found in the oral cavity ?

A

Stratified squamous epithelium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What subtypes of stratified squamous epithelium are found in the oral cavity ?

A

Lining, masticatory, gustatory.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sites of non-keratinised mucosa ?

A

Soft palate, ventral surface of the tongue, buccal mucosa.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Site of keratinised mucosa ?

A

Hard palate, gingivae.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why does non-keratinised tissues have little uptake of stain histologically ? i.e. features of non-keratinised tissues ?

A

Glycogen store in intermediate layer.
Spacing between cells - mobile tissue.
Will have underlying muscle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where does cell division occur ?

A

Basal and suprabasal cell layers i.e. where progenitor cells are found.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where does cell maturation occur ?

A

Stratum spinosum (prickle cell layer).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the four epithelial cell layers ?

A

Stratum corneum.
Stratum granulosum.
Stratum spinosum.
Basal cell layer.
Lamina propria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Define parakeratosis.

A

Reactive epithelial change characterised by excessive keratin formation. Will appear white (example - linea alba).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are examples of reactive changes of the oral mucosa ? Clinical and histological.

A

HISTOLOGICAL
Keratosis.
Acanthosis.
Elongated rete ridges.

CLINICAL
Atrophy.
Erosion.
Ulceration.
Oedema.
Blister formation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define acanthosis.

A

Hyperplasia of stratum spinosum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do elongated rete ridges signify ?

A

Hyperplasia of basal cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define atrophy.

A

Reduction in viable cell layers.
Causing thinner mucosa, red in colour, can see blood vessels through.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define erosion.

A

Partial thickness loss of epithelium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define ulceration.

A

Full thickness loss with fibrin on surface (appears as yellow) to prevent exposure of underlying cell layers to oral cavity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define cellular atypia.

A

DESCRIPTIVE TERM ONLY, NOT A DIAGNOSIS.
Changes which occur in cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are examples of cellular atypia ?

A

Larger or smaller in size - pleomorphism.
Increased DNA content in nuclei - will stain darker.
Change in order of epithelial cells - disordered looking cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

BENIGN LESIONS OF THE GINGIVA

What is the cause of an epulis ? And how should they be managed ?

A

Reaction to chronic inflammation/trauma i.e. subgingival calculus or defective restoration margin causing inflammation of the soft tissue.

Remove cause and monitor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

BENIGN LESIONS OF THE GINGIVA

What are the characteristics of fibrous epulis ?

A

Found on gingivae.
Firm nodule covered with tissue of normal colour.
Can have overlying ulceration.
Histology - granulation tissue covered by hyper plastic epithelial tissue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

BENIGN LESIONS OF THE GINGIVA

What is the difference between pyogenic granuloma and fibrous epulis ?

A

Same histologically and same process.
Just found in different locations in the mouth -
- Fibrous epulis - gingivae only.
- Pyogenic granuloma - anywhere in mouth (inc. tongue).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

BENIGN LESIONS OF THE GINGIVA

Common sites for fibroepithelial polyps.

A

Cheek, lip, tongue.
Reactive lesions to trauma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

BENIGN LESIONS OF THE GINGIVA

How should a fibroepithelial polyp be managed ?

A

Can be left and monitored.
Concerns with appearance or annoying patient - can be removed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

BENIGN LESIONS OF THE GINGIVA

What are three denture induced fibrous overgrowths ?

A

Denture induced hyperplasia - should regress after 4 weeks.
Leaf fibroma - compressed fibroepithelial polyp.
Papillary hyperplasia of palate - can look dysplastic, normal on bx.

24
Q

BENIGN LESIONS OF THE GINGIVA

What medications can cause gingival overgrowth ?

A

Calcium channel blockers.
Anti-convulsants - i.e. phenytoin.
Ciclosporin - immunosuppressants.

25
Q

BENIGN LESIONS OF THE TONGUE

Define geographic tongue and what does it look like.

A

Idiopathic altered maturation and replacement of cells distinct locations of the tongue, resulting in loss of filiform papillae.

Areas of atrophy and keratinisation in semi-circular patterns.

26
Q

BENIGN LESIONS OF THE TONGUE

You have diagnosed a patient with geographic tongue, what advice would you now give them ?

A

Reassure benign.
Avoid spicy, citrus and SLS toothpaste.
Will be an intermittent conditions but will subside itself.
Maintain fluid uptake and OH.

27
Q

BENIGN LESIONS OF THE TONGUE

Define glossitis and its presentation.

A

Atrophy of cells of the tongue.
Smooth, glossy appearance to tongue.

28
Q

BENIGN LESIONS OF THE TONGUE

What investigations would you consider carrying out for a patient presenting with glossitis ?

A

Haematinic blood tests.
Fungal cultures.

29
Q

BENIGN LESIONS OF THE TONGUE

You have diagnosed a patient with fissured tongue, what advice would you give them ?

A

Reassure benign.
Encourage good OH.
Soft bristle toothbursh on tongue surface to prevent food trapping and bacteria which can cause localised inflammation.
Maintain fluid uptake.

30
Q

BENIGN LESIONS OF THE TONGUE

Define black/brown hairy tongue, its characteristic appearance and its causes.

A

Black/brown pigmentation due to staining of elongated filiform papillae (due to hyperplasia).

Pigmentation can be caused by commensal bacteria, antibiotic use, chlorhexidine use, smoking and diet.

31
Q

BENIGN LESIONS OF THE TONGUE

You have diagnosed your patient with black/brown hairy tongue, what advice would you give them ?

A

Reassure benign.
Use tongue scraper.
Peach stone.
Eat pineapple (contains enzymes which breakdown pigment build up).
Smoking cessation.

32
Q

BENIGN LESIONS OF THE GINGIVA

What is desquamative gingivitis ?

A

Full thickness erythema extending beyond marginal gingivae, includes gingivae and alveolar mucosa.

It is not caused by plaque but can be worsened by it.

33
Q

BENIGN LESIONS OF THE GINGIVA

What are the symptoms of desquamative gingivitis ?

A

Mucosal gingival bleeding.
Oral discomfort.
Exacerbated by spicy or acidic foods.

34
Q

BENIGN LESIONS OF THE GINGIVA

What are the four most commonly associated conditions with desquamative gingivits ?

A

Lichen planus.
Linear IgA bullous disease.
Mucous membrane pemphigoid.
Pemphigus vulgaris.

35
Q

BENIGN LESIONS OF THE GINGIVA

What treatment would you provide for a patient with desquamative gingivitis ?

A

Supra and subgingival scaling.
Encourage to continue OH using soft bristle toothbrush.
Can prescribe 0.2% chlorhexidine mouthrinse to help where suboptimal OH.
Topical corticosteroid therapy - 0.1% tacrolimus gel.
Review within 1-2 weeks.

36
Q

BENIGN LESIONS OF THE GINGIVA

What % of population have tori ?

A

30-40%

37
Q

BENIGN LESIONS OF THE GINGIVA

Define tori (torus mandibularis and palatinus).

A

Benign overgrowth of calcified bone.

38
Q

BENIGN LESIONS OF THE GINGIVA

What problems are associated with tori ?

A

Denture construction.
Prone to ulceration.
Risk for MRONJ/ORN patients with traumatised.

39
Q

BENIGN LESIONS OF THE GINGIVA

What syndrome is associated with bony exotosis/tori ?

A

Gardner’s syndrome.
Ask about GI symptoms, growing lesions, asymmetrical lesions and unsual sites.

40
Q

BENIGN LESIONS OF THE GINGIVA

What investigations can you use to monitor tori ?

A

Clinical photos.
Study models.
X-rays.

41
Q

COLOUR CHANGES OF ORAL MUCOSA

What are some localised causes of oral pigmentation ?

A

Melanotic macule.
Melanocytic naevus.
Amalgam tattoo.
SDF.
Malignant melanoma.
Kaposi’s sarcoma.

42
Q

COLOUR CHANGES OF ORAL MUCOSA

What are some generalised causes for oral pigmentation ?

A

Racial genetic tendencies.
Smoking.
Drugs - tetracyclines, oral contraceptives.
Addison’s disease.
Cushing’s disease.

43
Q

COLOUR CHANGES OF ORAL MUCOSA

What two drugs can cause oral pigmentation ?

A

Tetracyclines.
Oral contraceptives.

44
Q

COLOUR CHANGES OF ORAL MUCOSA

Define melanotic macule.

A

Normal number of melanocytes, producing increased amount of melanin.

45
Q

COLOUR CHANGES OF ORAL MUCOSA

Define melanocytic naevus.

A

Increased number of melanocytes producing normal melanin.

46
Q

COLOUR CHANGES OF ORAL MUCOSA

What are features of malignant melanoma ?

A

Variable pigmentation.
Irregular outline.
Raised surface.
Symptomatic - itch/bleeding.

47
Q

COLOUR CHANGES OF ORAL MUCOSA

What are some causes of white patches in oral mucosa ?

A

Oral white sponge naevus (hereditary).
Smoker’s keratosis.
Lichen planus, SLE, GVHD.
Carcinoma.
Fordyce spots.
Linea alba.
Aspirin/alendronic acid burn.
Herpes simplex.
Candidosis.

48
Q

COLOUR CHANGES OF ORAL MUCOSA

What causes the mucosa to turn white ?

A

Thickening of mucosa/keratin. Less blood in tissues (vasoconstriction). Increased fluid.

49
Q

COLOUR CHANGES OF ORAL MUCOSA

Define leukoplakia.

A

White patch which cannot be scrapped off or attributed to any other cause.
i.e. no histopathological connotation or malignancy.

50
Q

COLOUR CHANGES OF ORAL MUCOSA

What are some causes for red patches to arise in the mouth ?

A

Haemangioma.
Desquamative gingivitis.
Denture-related irritation.
Lymphangioma.
Giant cell (temporal) arteritis.
Kawaski disease.

51
Q

COLOUR CHANGES OF ORAL MUCOSA

What are the three types of haemangioma ?

A

Capillary, cavernous, papillary.

52
Q

COLOUR CHANGES OF ORAL MUCOSA

How should haemangiomas be managed ?

A

Do nothing and monitor.
Cryotherapy if frequent bleeding.

53
Q

COLOUR CHANGES OF ORAL MUCOSA

Why does the mucosa turn red ?

A

Increased blood flow due to inflammation or dysplasia.
Reduced thickness of epithelium.

54
Q

COLOUR CHANGES OF ORAL MUCOSA

Define erythroplakia.

A

Atrophic or non-keratotic patch which cannot be attributed to any cause.

55
Q

COLOUR CHANGES OF ORAL MUCOSA

What is Kaposi sarcoma ?

A

Malignant cancer cells found on the skin and in the mucous membranes which line the GI tract.
Presents as purple lesions on the skin or white on oral mucosa.

BDS4 BAMS Oral Medicine (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions