SUPERDOC Flashcards
3 ways tumours can spread
Haematogenous- through blood/ circulatory system
Lympathic
Transcoelomic- through body wall into chest cavity/ abdomen
How can cancer be classified?
BY TISSUE TYPE
- carcinoma, sarcoma, myeloma, leukemia, lymphoma, mixed
BY GRADE
- abnormality of cells compared to surrounding normal tissue
- Low grade- well differentiated cells that closely resemble normal specialised cells. High grade- undifferentiated cells that are highly abnormal.
Grade 1-4
BY STAGE
TNM staging - tumour size, degree of regional spread/node involvement, distant metastasis.
What are some signs of cellular atypia?
hyperchromatism,
pleomorphism,
changes in size/number,
mitotic bodies in epithelium not just basal cell layer
Risk factors for oral cancer
smoking large v alcohol poor oh poor diet chewing betel quid/ tobacco EBV, HSV, HPV
What is stomatitis?
Infection of mouth and lips
What is primary gingivoostomatitis?
combination of gingivitis and stomatitis, mouth and gum swelling. lesions in mouth resembling canker sores. Normally initial presentation of herpes simplex virus.
Lies dormant in the trigeminal ganglion, reactivated onto lip/vermillion border with stress, ill-health such as a
cold
Symptoms Primary gingivostomatitis
pain bleeding gingiva ulceration unable to eat malaise pyrexia lymphadenopathy
How to test for primary gingivostomatitis?
viral culture
PCR
antigen tests
Tx gingivostomatitis?
Hydration
Bed rest
If early- aciclovir
Triggers of herpes?
UV light, feeling unwell, stress, trauma and immunosuppression
2 Oral mucosal diseases caused by coxsackie virus
Herpangina + Hand foot and mouth
2 Disorders of esptein-barr virus:
Hairy Leukoplakia, Glandular Fever/Mononucleosis, OSCC
What are these all & Place these in order of incidence (Asinic cell carinoma, adeniod systic cell carcinoma, mucal epidermoid
carcinoma, pleumorphic adenoma, warthin tumour)
SALIVARY GLAND TUMOURS
Pleomorphic Salivary Adenoma, Warthin Tumour, Adenocystic Carcinoma, mucal epidermoid carcinoma, asinic
cell carcinoma.
3 Histological findings of pleomorphic adenoma
Mixed Tumour: Duct epithelium, myoepithelial cells, myxoid
and chondroid areas.
Histological features of Warthin‛s Tumour:
cystic with spaces, brightly stained epithelium and potentially
including lymph tissue.
Tx options and surgical procedure for removing salivary duct calculus
Tx options: Surgery, Ultrasound, radiologically guided stone removal: basket/balloon, sialoendoscopy,
lithotripsy and laser ablation.
Identify stone, LA, holding suture, incise at duct orifice and along duct, squeeze out or ultrasonic/bur to
separate stone/calculi, suction
6 types of candidosis
Acute pseudomembranous (thrush), Acute erythmatous (Antibiotic sore mouth), Chronic erythmatous (denture induced), Chronic hyperplastic (Commisures of mouth, increased malignant potential), Median Rhomboid Glossitis (chronic), Angular Cheilitis
Aetiology candidosis
Smoking, local immunosuppresion, systemic immunosuppresion, diabetes, denture issue, underlying disease/deficiency, xerostomia, HIV .
Investigations candidosis
FBC, Haematinics, Blood glucose, dry mouth, HIV, Swab/Rinse.
Disadvantage of rinse testing
Only indicates presence of microbe not role in infection
Advantage of smear testing
Includes local cells and tissues .:. can show implication of microbe in infection.
:( can be uncomfortable for pt
tx candidosis
Fix deficiency, treat underlying disease, fix diabetes, stop smoking, inhaler use instruction, OHI and denture hygiene instruction, fix denture problem, diet advice to reduce refined carbs.
4 antifungals commonly used
CHX, nystatin, fluconazole, miconazole
For CHX:
Type, method of action, prescription and any warnings
T: bis-biguanide
MoA: dicatatonic- one binds to pellicle, other to cell membrane to increase permeability .:. at high conc leads to cell death
P: 0.2% in 10ml, 2 x daily
W: anaphylaxis, 0.18% is bacteriocidal