30 most common Flashcards

1
Q

1 leukoplakia

A

intraoral white plaque, doesn’t rub off, not any well know entity.
may show benign hyperkeratosis, epithelial dysplasia, squamous cell carcinoma, carcinoma-in-situ.
remove potential causes and biopsy after 2 weeks.
diagnose by exclusion of other diseases.
premalignant: 5-25% dysplastic at biopsy
4% malignant transformation if allowed to grow.
etiology: tobacco, alcohol, sanguinaria, UV radiation, microorganisms & frictional keratosis.

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2
Q

white lesions that rub off

A
materia alba
white coated tongue
burn (thermal, chemical, cotton roll, etc.)
pseudomembranous candidiasis
toothpaste/mouthwash overdose
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3
Q

white coated tongue

A

asymptomatic
tongue scraping/brushing
looks like a white/yellow dirty tongue

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4
Q

thermal/electrical burn

A

most common burn is from microwaved foods.

children sometimes bite electrical cords.

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5
Q

aspirin burn

A

chemical coagulation necrosis
stop aspirin use
similar burns from peroxide, silver nitrate, phenol, endo material

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6
Q

toothpaste/mouthwash overdose

A

chronic overuse causes topical burn.
mucosa sloughs
listerine 21-27% ethanol

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7
Q

cotton roll burn

A

drying effect of cotton on mucosa.

chemicals may be absorbed by cotton against mucosa.

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8
Q

candidiasis

A

most common oral infection
fungal: candida albicans
2 forms: spore & hyphae
30-50% population (spores)
predisposing: immune deficient, medications, dentures
increases white cell count (neutrophils & myelocytes)
treat with antifungals (nystatin)

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9
Q

other candidiasis forms

A
white pseudomembranous
red erythematous
central papillary atrophy of tongue (median rhomboid glossitis)
angular cheilitis
denture stomatitis
mucocutaneous
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10
Q

readily identifiable white plaques

A
linea alba
leukoedema
nicotine stomatitis
oral hairy leukoplakia
tobacco pouch keratosis
lichen planus
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11
Q

linea alba

A

bilateral at occlusal plane of buccal mucosa.

no treatment

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12
Q

leukoedema

A

70-90% blacks
disappears when stretched
gray-white, milky appearance
no treatment

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13
Q

nicotine stomatitis

A

smoker’s palate, white hyperkeratotic hard palate from cigar/pipe smoking
males 45+yrs
fissured white mucosa, red punctate orifices of glands
stop smoking

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14
Q

oral hairy leukoplakia

A

epstein-barr virus related in AIDS patients.
white hyperkeratotic folds bilaterally on lateral tongue.
candidiasis on surface.
treat AIDS

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15
Q

tobacco pouch keratosis

A

young males (10-30yrs old)
white plaque, horizontal furrows in snuff pouch.
gingival recession & root caries.
dose response leads to verrucous carcinoma.
stop dipping

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16
Q

lichen planus

A

chronic mucocutaneous disease
middle aged, women 3:2 men
purple, pruritic, polygonal, papules on skin
oral: reticular & erosive
- reticular more common, posterior buccal mucosa bilaterally, striae of wickham, wax & wanes.
- erosive: less common, more symptomatic, needs steroid therapy, ulcers with radiating striae.
lichenoid drug reactions can produce similar appearance.

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17
Q

2 tori

A

palatal: 20-35% 2F:1M
mandible: 7-10% M>F
only treat for repeated trauma/ulceration or preprosthetic surgery

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18
Q

3 inflammation or irritation

A

traumatic ulcer
pericornitis
perio abscess
ANUG

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19
Q

4 fibroma

A

MOST COMMON BENIGN NEOPLASM OF ORAL CAVITY
buccal mucosa > labial mucosa > tongue > gingiva
surgical removal
smooth surface, pink, white, or gray
0.1-2.0cm elevation
asymptomatic
2F:1M, adults

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20
Q

fibroma look-a-likes

A
3 P's and FIFH:
pyogenic granuloma
peripheral giant cell granuloma
peripheral ossifying fibroma
focal inflammatory fibrous hyperplasia
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21
Q

pyogenic granuloma

A

excessive tissue reaction to irritation/trauma, red.
75% on gingiva, 25% on lips, tongue & buccal mucosa.
young adults, more female (‘pregnancy turmor’)
excision & scaling/root planing

22
Q

peripheral giant cell granuloma

A

local irritation/trauma on alveolus, blue-purple.
31-41yrs old average, 60% female.
excision to bone & scaling/root planing

23
Q

peripheral ossifying fibroma

A
mature pyogenic granuloma or peripheral giant cell granuloma??
sessile gingival mass, ulcerated often.
10-19 yrs old average, 67% female.
bone with fibrous tissue.
excision & scaling/root planing
24
Q

focal inflammatory fibrous hyperplasia

A

local irritation cause increased fibrocytes and collagen production.
remove cause and hyperplastic tissue.

25
Q

5 fordyce’s granules

A

ectopic sebaceous glands, 80% population.
yellow/white papules.
buccal mucosa > lips
no treatment

26
Q

6 hemangioma

A

benign proliferative blood vessels, 60% in head & neck, 80% as single lesions.
10-12% children, most common birth mark, 3F:1M.
blanches under pressure, red = arteriolar, blue = venous.
associated with sturgeweber angiomatosis
surgery/lasers to remove

27
Q

7 inflammatory ulcer

A

recurrent aphthous ulcer, canker sore (not cold sore/fever blister).
20-25% population
non-keratinized, non-bound down mucosa (never palate or attached gingiva).
1-2 lesions, 0.5-1.0cm
treat with steroids & antibiotics, but recurrent.
diagnose with location + size + number

28
Q

8 papilloma

A

benign proliferation of squamous epithelium.
tongue > soft palate
wart-like pedunculation, soft, painless, finger-like projections.
0.1-1.0cm single lesion, M=F.
surgical removal

29
Q

9 epulis fissuratum

A

inflammatory fibrous hyperplasia, ill-fitting denture.
folds of tissue in vestibule.
F>M, middle aged or elderly.
surgical removal, remake denture.

30
Q

10 varicosities

A

dilated & tortuous veins
age (not disease) related
sublingual
no treatment

31
Q

11 fissured tongue

A

scrotal tongue, deep grooves on dorsal tongue, 2-6mm.
2-5% population, increase with age
mild burning/soreness
brush tongue

32
Q

12 geographic tongue

A
1-3% population, 2F:1M
dorsal tongue, rarely ventral
erythema due to atrophy of filiform papillae, moves around.
asymptomatic
no treatment
33
Q

13 papillary hyperplasia

A

denture papillomatosis, 20% patients who wear dentures 24/7, candidiasis.
pebbly surface on hard palate.
asymptomatic
surgical excision, new denture

34
Q

14 herpes viral infection

A

initial exposure 6months-5yrs old.
60-100% population exposed to HSV-1.
<1% require treatment.
chills, nausea, fever, ulcers, erythematous gingiva.
antiviral meds (acyclovir, best by day 3), resolution 10-14days.
cold sore or fever blister, 15-45% population.
UV light, trauma, hormones trigger.
pain, burning, itching, tingling before vesicular stage.
vesicles 2-4 days, vesicles rupture, scab, crust, dry up by 10-12 days.
palatal/gingival herpes: cluster of lesions (10-15) grows to ulcer.
diagnose with location + size + number

35
Q

15 mucocele

A

rupture & spillage of saliva into soft tissue.
young adults, trauma related.
lower lip (60%), buccal mucosa, ventral tongue, floor of mouth, retromolar pad, soft palate.
ranula - mucocele of floor of mouth.
surgical excision

36
Q

16 scar tissue

A

post trauma/surgery

no treatment

37
Q

17 angular cheilitis

A

reduced vertical dimension, salivary pooling, candidiasis.
often bilateral
antifungals, increase vertical dimension.

38
Q

18 lingual tonsil

A

lymphoid hyperplasia, posterior lateral tongue borders, bilateral.
discrete 1cm, enlarges with infection, red
no treatment
part of waldeyer’s ring

39
Q

19 hematoma

A

accumulation of blood in tissues after trauma, blood blister.
no treatment.

40
Q

20 tobacco pouch

A

gray-white lesion of mucosa at site of snuff pocket.
dose response changes, recession & root caries.
stop dipping before progression to verrucous carcinoma.

41
Q

21 chronic cheek biting

A

2F:1M
irregular, ragged white mucosa
bite guard or no treatment

42
Q

22 lichen planus

A
chronic mucocutaneous disease
3F:2M, middle aged
purple, pruritic, polygonal, papules.
striae of wickham
steroid treatment
43
Q

23 buccal exostoses

A

bony growth on buccal of max. or mand.
remove only with repeat trauma or preprostetic surgery.
rare: palatal, subpontic, subgraft

44
Q

24 amalgam tattoo

A

amalgam in soft or hard tissue.
black, blue, grey soft tissue tattoo.
possible radiopacity, no treatment.
rule out melanoma with biopsy or radiograph.

45
Q

25 oral melanotic macule

A

oral freckle, well-demarcated brown macule, 1-7mm.
2F:1M
lower lip > buccal mucosa > gingiva
biopsy to rule out melanoma, no other treatment

46
Q

26 median rhomboid glossitis

A

central papillary atrophy of tongue.
asymptomatic red zone in posterior midline dorsal tongue.
antifungals, brushing tongue

47
Q

27 black hairy tongue

A

elongated filiform papillae
0.5% population
usually asymptomatic, or bad taste, gagging.
tongue scraping or brushing.
smoking, antibiotics, poor hygiene, radiotherapy, breath mints

48
Q

28 smooth red tongue

A

pernicious anemia (systemic problem), medications, avitaminosis.
burning and pain
treat underlying cause

49
Q

29 epidermoid cyst

A

skin cyst, inflammed hair follicle.
oral cysts in midline floor of mouth.
slow growing, painless
surgical removal

50
Q

30 lipoma

A

benign fat tumor
buccal mucosa > tongue > floor of mouth > lips.
yellowish soft nodular mass.
surgical excision