Unit 1 - Introduction to Oral Pathology (Lecture)

Question 1

Pathology

Answer 1

The study of the nature of a disease and its causes, development, and consequences

Question 2

What are the 4 components of disease addressed by pathology?

Answer 2

1. Cause/etiology
2. Mechanisms of development
3. Morphologic changes/structural alteration of cells
4. Consequences of changes (lesions/manifestations)

Question 3

Pathogenesis

Answer 3

Study of the development of disease

Question 4

Pathophysiology

Answer 4

Study of the changes of normal mechanical, physiological, and biochemical functions, either caused by a disease or resulting from an abnormal syndrome

Question 5

Oral Pathology

Answer 5

Study of specifically diseases affecting the oral cavity

Question 6

Lesion

Answer 6

Term used to describe a specific local change in the tissue

Question 7

Manifestation

Answer 7

Clinical evidence or effects (signs & symptoms of disease)

Question 8

What are our 3 obligations as DH’s to study oral pathology?

Answer 8

Legal, professional, and ethical

Question 9

What is the role of the DH in oral pathology?

Answer 9

Identifying, Interpreting, and Reporting

Question 10

Accurate descriptions of oral lesions must include what 3 things?

Answer 10

Location, distribution, and physical characteristics

Question 11

Describe a tissue reflectance test

Answer 11

This test includes using a light providing a blue-white illumination and an acetic mouth rinse prior to illumination. Conducted in a dim room.

Question 12

Describe normal vs. abnormal tissue readings during a tissue reflectance test

Answer 12

Normal tissue appears dark (absorbs light), whereas abnormal tissue appears bright white (reflects light)

Question 12

Describe normal vs. abnormal tissue readings during a tissue reflectance test

Answer 12

Normal tissue appears dark (absorbs light), whereas abnormal tissue appears bright white (reflects light)

Question 13

Describe an autofluorescence test

Answer 13

Hand held unit emits a cone of blue light creating different levels of fluorescence

Question 14

Describe normal vs. abnormal tissue readings during an autofluorescence test

Answer 14

Healthy tissues appear pale green, whereas abnormal tissues appear dark green/black

Question 15

Describe an autofluorescence spectroscopy

Answer 15

Combines tissue reflectance and autofluorescence using white light; it uses a small probe, making it only useful on small lesions and only those noted on observation. The value of this test is questionable.

Question 16

What is a toluidine blue stain test?

Answer 16

A valuable preliminary screening tool for oral cancer. The dye is applied topically to suspected site; the dye will define margins for biopsy.

Question 17

What is the disadvantage/draw back to the use of toluidine blue stain?

Answer 17

Inflammatory cells will also pick up stain.

Question 18

Describe a positive result for a toluidine blue stain test?

Answer 18

Only dark royal blue staining is positive. Benign lesions have no nuclear staining and appear pale blue.

Question 19

What does the acronym MIND stand for?

Answer 19

Metabolic, Inflammatory, Neoplasm, Developmental

Question 20

What are the 3 subcategories and sub-subcategories of a metabolic disease/lesion?

Answer 20

Compromised Organ System
Hormonal
Nutritional
(no sub-sub categories)

Question 21

What are the 4 subcategories and sub-subcategories of an inflammatory disease/lesion?

Answer 21

Trauma (Physical, Chemical, Thermal)
Reactive (no sub-sub)
Infection (Bacterial, Fungal, Viral)
Immunologic (Endogenous allergen, Exogenous allergen)

Question 22

What are the 3 subcategories and sub-subcategories of a neoplasm disease/lesion?

Answer 22

Benign (N/A)
Premalignant (N/A)
Malignant (Carcinoma, Sarcoma)

Question 23

What are the 2 subcategories and sub-subcategories of a developmental disease/lesion/condition?

Answer 23

Genetic

Acquired

Question 24

What are the 8 categories of diagnosis?

Answer 24

Clinical, Radiographic, Historical, Laboratory, Surgical, Therapeutic, Microscopic, Differential

Question 25

What type of diagnosis: diagnosis derived from clinical appearance and palpation of the lesion; based on colour, shape, location, and history of the lesion

Answer 25

Clinical

Question 26

What type of diagnosis: microscopic evaluation of a biopsy specimen taken from the lesion is often the main component of the definitive diagnosis

Answer 26

Microscopic

Question 27

What type of diagnosis: personal history, family history, past and present medical and dental histories, history of drug ingestion and history of presenting disease or lesion provides information necessary for the definitive diagnosis

Answer 27

Historical

Question 28

What type of diagnosis: radiograph provides sufficient information to establish the diagnosis

Answer 28

Radiographic

Question 29

What type of diagnosis: surgical intervention provides conclusive evidence of diagnosis when the lesion is opened

Answer 29

Surgical

Question 30

What type of diagnosis: prescribing therapeutic drugs and observing the results based on clinical and historical information

Answer 30

Therapeutic

Question 31

What type of diagnosis: laboratory tests, including blood chemistries and urinalysis, can provide information for a definitive diagnosis

Answer 31

Laboratory

Question 32

What are the 4 main reasons for biopsy?

Answer 32

- Highly reliable and accurate method - Provides a microscopic examination (to have greater knowledge of the area) - Rules out or confirms the malignancy of the area - Allows for a definitive diagnosis

Question 33

What is an excision biopsy?

Answer 33

Surgical removal of the entire lesion plus a rum of surrounding normal tissue with a scalpel (safety margin)

Question 34

What is an incisional biopsy?

Answer 34

Removal of only a small position of the whole lesion plus a small section/rim of surrounding tissue (wedge shape)

Question 35

What is a needle biopsy?

Answer 35

Needle aspiration; thin needle inserted into the area and material of the lesion is removed

Question 36

What is a punch biopsy>

Answer 36

Tubular instrument is inserted through to the deeper tissue to cut off tissue at the base; a type of incisional biopsy

Question 37

A test involving scraping the lesion with a cotton swab, evaluating only superficial cells, making it not ideal.

Answer 37

Exfoliative Smear/Cytology Sample

Question 38

When a sample has an abnormal result during an exfoliative smear, what is the next step?

Answer 38

A biopsy is mandatory

Question 39

Brush painlessly collects cells from full thickness (penetrates to basement membrane); positive results should be biopsied

Answer 39

Transepithelial Cytology

Question 40

Once lesion/portion is removed during oral exfoliate and transepithelial cytology, what happens?

Answer 40

1. Specimen is placed in a fixative solution (formalin) 2. Specimen is sent to a lab where microscopic slides are prepared for examination 3. Examination by cytopathologist leads to definitive diagnosis