Red and white patches

Question 1

Mucosa colour depends on…

Answer 1

epithelial thickness
keratinisation
vasculature
inflammation
melanin

Question 2

white patches causes

Answer 2

increased keratin
abnormal
candida

Question 3

Systemic RF for candida

Answer 3

Immunocompromised : Medication, Medical conditions
Deficiency states: Anaemia
Extremes of age

Question 4

Local RF for candida

Answer 4

Hyposalivation
Smoking
broad-spectrum antimicrobials
Corticosteroids
Thrush/Yeast/Fungal infection

Question 5

Antifungal Management of Candida

Answer 5

Fluconazole
Miconazole
Nystatin

Question 6

Local Measures of Candida

Answer 6

Rinse after inhalers
Use a Spacer
Denture hygiene
Smoking cessation

Question 7

Traumatic Keratosis

Answer 7

increased keratin at site
encourage smoking cessation
refer if high risk site/patient

Question 8

OLP types

Answer 8

reticular
atrophic
papular
erosive
plaque like
bullous

Question 9

OLP

Answer 9

CD8+ T Cell-mediated destruction of basal keratinocytes
asymptomatic
burning/stinging
generalised/idiopathic
malignant potential 1% over 10 years

Question 10

OLR causing drugs

Answer 10

Antihypertensives
Antimalarials
NSAIDS
Allopurinol
Lithium

Question 11

OLR causing materials

Answer 11

metals (gold, nickel)

Question 12

OLP/OLR Management (symptomatic relief)

Answer 12

HSMW
L.A (lidocaine)
Avoid triggers ( spicy food, fizzy drink)
Steroid MW (betamethasone)
Beclomethasone MDI
Change restorations
Referral to OM

Question 13

Hairy Leukoplakia

Answer 13

lateral border of tongue
para-keratin projections
acanthotic
Triggered by EBV
(20-25% HIV patients)

Question 14

Leukoplakia

Answer 14

clinical diagnosis
malignant potential
can be dysplastic
need biopsy for histological diagnosis

Question 15

Red patches

Answer 15

atrophic tissue (becomes thinner)
inflammation
patch with no known cause (high malignant potential)

Question 16

Granulomatosis with polyangiitis

Answer 16

systemic vasculitis
fever and weight loss
92% have ENT manifestations
potentially fatal
management with immunosuppressants

Question 17

Erythroplakia

Answer 17

velvety, firery, red patch
high malignant potential
URGENT REFERRAL

Question 18

OFG and Oral Crohn’s

Answer 18

non necrotising granuloma formation
Consider GI Investigations

Question 19

OFG and Oral Crohn’s Management

Answer 19

Topical steroids
Avoidance diets
Intralesional steroid
Biologics for Crohn’s disease
(Infliximab, adalimumab(Anti TNF), ustekinumab (Anti IL21/23, vedolizumab(Anti-a4b7))

Question 20

Erythroleukoplakia

Answer 20

Speckled red and white patches
High malignant change potential

Question 21

Erythroleukoplakia management

Answer 21

URGENT REFFERAL

Question 22

Lesion assessment

Answer 22

location
colour
hard or soft (induration)
raised or flat
texture
symmetry
wipeable?
homo/heterogenity