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oral medicine and diagnosis > diagnosis techniques > Flashcards

diagnosis techniques Flashcards

1
Q

Clinical Decisions

A
  • requires succinct evaluation
  • it’s frustrating at best
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2
Q

Objective info

A

Information that can be measured or
perceived by the investigating clinician;
i.e. signs
e.g. temperature, size , color, duration,
consistency, surface contour, etc..

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3
Q

subjective info

A

Subjective
Patient’s own interpretation of a clinical
circumstance; i.e., symptoms
Relies on neurologic and psychologic
experiences
e.g. patient awareness of presence of a
lesion, pain intensity, pain quality
(stabbing, burning, shocking, etc…),
temperature, etc…

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4
Q

Differential Diagnosis components
* Orderly?
* Gathering?
* Knowledge and experience enable?
* Include and/or exclude disease processes
based on?

A
  • Orderly sequential approach
  • Gathering and analyzing data
  • Knowledge and experience enable
    recognition of abnormal findings
  • Include and/or exclude disease processes
    based on an educated assessment of the
    process
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5
Q

Gather and analyze data

A

– History
– Clinical findings
* Specific/unique signs
* Specific/unique symptoms

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6
Q

Differential Diagnosis
* Be aware of characteristic what?

A
  • Be aware of characteristic radiographic
    appearances
  • Be aware of characteristic clinical
    manifestations
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7
Q
  • Be aware of characteristic manifestations based on:
A

– Age
– Gender
– location

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8
Q

inspection

A

visual observations

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9
Q

Clinical Description components

A

single vs multiple, (aka systemic)
* location
* relative proximity to adjacent structures
* size in dimension (mm)
* outline - well-demarcated vs diffuse
* color – red, white, mixed, pigmented
* consistency – firm, flaccid, compressible
* intensity – mild, moderate, intense, striated, lacy
* base and surface

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10
Q

surface descriptors

A

smooth, corrugated, eroded, raised,
depressed

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11
Q

base descriptors

A

base – pedunculated, sessile, nodular, dome-shape

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12
Q

mucosal lesion morphologies

A
  • bulla
  • ulcer
  • pustule
  • fissure
  • macule
  • nodule
  • papule
  • plaque
  • vesicle
  • wheal
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13
Q

bulla

A

raised, fluid filled, larger than vesicle

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14
Q

fissure

A

crack/break in skin

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15
Q

macule

A

flat, colored

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16
Q

nodule

A

solid/raised, larger than papule

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17
Q

papule

A

small, circular, raised

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18
Q

plaque

A

raised, flat

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19
Q

pustule

A

raised, contains pus

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20
Q

ulcer

A

destrcution of epithelium lining

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21
Q

vesicle

A

small, fluid filled, raised

22
Q
A
23
Q

wheal

A

smooth, rounded, slightly raised, associated with itching

24
Q

diascopy

A

compressing tissue with a glass slide to
determine vascular nature of a lesion

25
Q

Palpation

A
  • feel and press a lesion
    to yield information
    about texture,
    consistency,
    temperature and
    function
26
Q
A
27
Q

Probing

A
  • palpation with an
    instrument
  • instruments include
    perio probe, caries
    explorer, needle tip, etc..
28
Q

Percussion

A
  • striking tissues with
    fingers or an
    instrument and
    listening to resulting
    pressure changes in
    the tissues
  • eg. tooth ankylosis
29
Q

Aspiration

A
  • withdrawl of fluids
    from a body cavity
  • E.g., needle aspiration
    of cysts, vascular
    tumors, purulent
    swellings, etc…
30
Q

Auscultation

A
  • listening for sounds
    within the body (TMJ)
31
Q

types of biopsies

A

Incisional
Excisional
Aspirational
Needle

32
Q

Diagnostic Lab Tests
for Oral Lesions

A
  1. Biopsy
  2. Immunofluorescence
  3. Exfoliative Cytology
33
Q

incisional biopsy

A

only part of lesion taken (larger lesions)

34
Q

excisional biopsy

A

entire lesion taken (smaller lesions)

35
Q

aspirational lesion

A

fluid filled lesions, some fluid removed for analysis

36
Q

needle biopsies

A

aka Fine Needle Aspiration (FNA) or Fine Needle Aspiration and Cytology (FNAC)

similar to aspiration but may have cellular elements

37
Q

BIOPSY INDICATIONS

A
  • Lesion with > 14 day duration
  • Unusual location
  • Unusual appearance
  • Suspicion of neoplasia
  • Any excised tissue
  • Confirm diagnosis of systemic disease
38
Q

Suspicion of neoplasia

A

– Persistent ulceration
– Induration
– Fixation
– Chronicity
– Lymphadenophathy
– Unexplained leukoplakia
– Persistent erythroplasia

39
Q

needle biopsy indications

A
  • To determine the cause of tissue enlargement.
  • To distinguish between benign and malignant processes.
  • To stage metastatic cancer
40
Q

limitations of needle biopsy

A
  • More technique sensitive with additional preservatives and lab processing
  • does not localize cells to affected tissues
  • appositional information to adjacent tissues is lost
41
Q

IF

A

use of binding pro to Ag of interest with a flourescent tag

42
Q

ORAL EXFOLIATIVE CYTOLOGY
* Indications

A

– Innocuous lesion
– Suspicious lesion with negative biopsy
– Patient refuses biopsy
– Follow-up of treated malignancy
– Lesion where patient is a poor risk for surgery

43
Q

ORAL EXFOLIATIVE CYTOLOGY
* Contraindications

A

– Keratotic or crusty mucosa
– Red, vesicular or velvety mucosa
– Submucosal swelling with normal mucosa
– Suspicion of malignancy

44
Q

ORAL EXFOLIATIVE CYTOLOGY method

A
45
Q

CULTURE AND SENSITIVITY TESTING
* Indications

A

– Life threatening infection
– Unsuccessful previous antibiotic therapy
– Immunosuppressed patien

46
Q

CULTURE AND SENSITIVITY TESTING
* use in dentistry

A
  • Limited use in dentistry
    – Difficult for anaerobic conditions
    – Turnover time too long; best to attempt
    trial therapies of certain antibiotics as
    results may occur quicker than the time
    interval of the tes
47
Q

oral cancer screening aids/ adjuncts

A
  • Assist in the detection of early potentially
    malignant mucosal changes that are difficult to
    discern by visual inspection alone
  • Non-invasively assesses the malignant
    potential of a mucosal abnormality
48
Q

Tissue Autofluorescence Imaging
* Increase the ability to distinguish?

  • sensitivity/ specificity in distinguishing premalignant and chronic inflammatory lesions
  • sensitivity/ specificity in identifying areas of dysplasia and invasive cancer that extends beyond the clinically evident lesion.
A
  • Increase the ability to distinguish the lesional
    mucosa and healthy mucosa
  • High sensitivity but low specificity in distinguishing premalignant and chronic inflammatory lesions
  • High sensitivity and specificity in identifying areas of dysplasia and invasive cancer that extends beyond the clinically evident lesion.
49
Q

dysplasia flouresence

A

Decreased Levels of Normal Autofluorescence

50
Q
A

oral medicine and diagnosis (6 decks)

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