Clinical Examination

Question 1

Before asking the patient questions and the starting exam, list 5 things you are observing

Answer 1

1. Gait
2. Mobility
3. Facial asymmetries
4. Lesions
5. Scars

Question 2

Legally, how often must medical history be signed and dated? what is the recommendation for checking Medical History?

Answer 2

Legally - has to be done at least every year
Recommended - to be checked every appointment

Question 3

The standardized oral examination method is recommended by which organization?

Which two other organizations is this consistent with?

Answer 3

The standardized oral examination method is recommended by the World Health Organisation (WHO)

The Centres for Disease Control and Prevention
and
The National Institutes of Health are consistent with WHO

Question 4

When investigating the history of a lesion, list 5 things you would want to note.

Answer 4

1. Duration of lesion
2. Size, shape, colour and location (use ruler)
3. Raised or flat with well/ill-defined margins
4. Fixed or mobile
5. Effect of lesion

Question 5

Give the definitions of these terms to describe a lesion:
1. Sessile
2. Pedunculated
3. Macule
4. Patch
5. Papule

Answer 5

1. Sessile - broad based
2. Pedunculated - has a “stalk”
3. Macule - flat <1cm
4. Patch - flat >1cm
5. Papule - circumscribed, solid elevation of skin <1cm

Question 6

What is the Stensen’s duct and its location?

Answer 6

It is attached to the parotid gland (largest saliva gland) and opens into the mouth next to the upper molars

Question 7

What are Fordyce granules and where are they commonly seen?

Answer 7

Fordyce granules: ectopic sebaceous glands - yellow beige spots commonly seen on the upper lip

Question 8

What is Linea Alba (frictional keratosis) and list 2 other terms in can be called when it becomes pronounced.

Answer 8

Linea Alba - a white, slightly raised keratotic line along the occlusal plane of the buccal mucosa

Can be called - chronic cheek bite keratosis or morsicatio buccarum

Question 9

What appearance do benign vascular lesions have and which patients typically have them?

Answer 9

Red or purple areas on oral mucosa (lips and tongue) mainly seen on older patients

Question 10

What 8 sections should be included in a referral letter?

Answer 10

1. Patient details
2. Consultant/surgeon
3. Biopsy site
4. Clinical description
5. Related lesions
6. Previous biopsy results/ special investigations
7. MH, Smoking? Alcohol?
8. Differential clinical diagnosis