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Pathology II > Intro and Principles of Soft Tissue Diagnosis- Exam I > Flashcards

Intro and Principles of Soft Tissue Diagnosis- Exam I Flashcards

1
Q

The medical science and specialty practice, concerned with all aspects of disease, but with special reference to the essential nature, causes, and the development of abnormal conditions, as well as the structural and functional changes that result from the disease processes:

A

Pathology

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2
Q

Probabilities from possibilities includes:

  1. All possible lesions for a patient of:
  2. All possible lesions from:
  3. All possible lesions that:
A
  1. this age, sex, & race
  2. this anatomical location
  3. look this way
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3
Q

Recognition requires a thorough knowledge of ____ and ____. This is also known as:

A

normal; “the range of normal”; WNL

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4
Q

Components of developing a differential diagnosis include:

A
  1. Recognition
  2. Description of the lesion
  3. Patient contribution
  4. Possibilities
  5. Probabilities
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5
Q

DDx:

A

Differential diagnosis

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6
Q

When making a differential diagnosis, patient contributions include:

A
  1. age, gender, race
  2. current medical conditions and meds
  3. supplements
  4. social habits
  5. oral habits
  6. past medical history
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7
Q

When you have a lesion that can only look a certain way- this is considered:

A

pathognomic

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8
Q

For diagnosis of a soft tissue lesion, what should be considered?

A
  1. texture/consistency
  2. association with surrounding tissue (fixed vs. movable, displacing vs. devouring)
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9
Q

For diagnosis of a soft tissue lesion, anatomic location:

A

changes DDx

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10
Q

A white diagnostic possibilities characterized by “surface debris”: (5)

A
  1. psuedomembraneous candidiasis
  2. chemical burns
  3. thermal burns
  4. chemical sloughs (SLS)
  5. Fibrinous membranes- ulcers
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11
Q

A white diagnostic possibilities characterized by “Sub-epithelial lesions”: (4)

A
  1. congenital keratotic cysts
  2. scars
  3. fordyce granules
  4. oral lymph-epithelial cysts
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12
Q

A white diagnostic possibilities characterized by “epithelial thickening”: (14)

A
  1. Alveolar ridge keratosis
  2. Contact mucositis (especially cinnamon)
  3. Familial epithelial hyperplasia (white sponge nevus)
  4. Frictional keratosis
  5. Hairy tongue
  6. Hereditary benign intraepithelial dyskeratosis (HBID)
  7. Leukoedema
  8. Leukoplakia
  9. Lichen planus
  10. Linea alba
  11. Morsicatio
  12. Oral hairy leukoplakia
  13. Skin grafts
  14. Snuff Dipper’s Keratosis
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13
Q

What is characteristic of the following conditions:

-Congenital keratotic cysts
-Scars
-Fordyce granules
-Oral lymphoepithelial cysts

A

White sub-epithelial lesions

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13
Q

What is characteristic of following conditions:

-Psuedomembranous candidiasis
-Chemical/thermal burns
-Fibrinous membranes
-Chemical sloughs (SLS)

A

White surface debris

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14
Q

What is characteristic of the following conditions:

-Linea alba
-Leukoplakia
-Leukoedema
-Lichen planus

A

White epithelial thickening

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15
Q

Which should you be more concerned about- Red or White lesions?

A

Red

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16
Q

What is characteristic of the following conditions:

-Alveolar ridge keratosis
-Frictional keratosis
-Snuff Dipper’s keratosis
-Hereditary benign intraepithelial dyskeratosis (HBID)

A

White epithelial thickening

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17
Q

What is characteristic of the following conditions:

-Familial epithelial hyperplasia (white sponge nevus)
-Hairy tongue
-Oral hairy leukoplakia
-Contact mucositis (especially cinnamon)
-Skin grafts
-Morsicatio

A

White epithelial thickening

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18
Q

When encountering a white lesion, what steps should be followed? (5)

A
  1. wipe first
  2. sources of friction
  3. chemicals
  4. heat
  5. alter environment and re-evaluate
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19
Q

What is the first step that should be taken when encountering a white lesion?

A

Wipe first!

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20
Q

White lesions are mostly _____ lesions, but ____ matters

A

Low-risk; location

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21
Q

What are some possible red diagnostic possibilities caused by trauma?

A
  1. physical/sexual
  2. chemical
  3. thermal
  4. radiation
  5. hematoma
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22
Q

Can you feel a macule?

A

No- you can only see it

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23
Q
  • hemangioma
  • nevus flameus
  • capos sarcoma

These are all considered:

A

Vascular lesions (Red)

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24
Q
  • lichen planus
  • mucous membrane pemphigoid
  • pemphigus vulgaris

These are all considered:

A

Desquamative gingivitis

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25
Q

What steps should be taken/considered when encountering a red lesion?

A
  1. diascopy
  2. location
  3. habits
  4. trauma
  5. medical history (coagulation)
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26
Q

What type of diagnostic possibilities are listed below?

  • Lichen planus
  • Erythema migrans
  • Nicotinic stomatitis
  • SCCa
  • Lichenoid mucositis
A

Red-white

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27
Q

What type of diagnostic possibilities are listed below?

  • contact allergy
  • drug reactions
  • graft-versus-host disease (GVHD)
  • candidiasis variants
A

Red-white

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28
Q

What is the hardest plaque to recognize clinically?

A

Erythroplakia

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29
Q

What type of diagnostic possibilities are listed below?

  • discoid lupus erythematosus
  • chronic ulcerative stomatitis
  • speckled leukoplakia
    -sick lip syndrome
A

Red-white

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30
Q

When encountering a red/white lesion, what should be considered?

A
  1. social history
  2. tooth paste/floss
  3. mouthwash
  4. candies, gums, mints, tic-tacs, lozenges
  5. herbal supplements
  6. changes in medications
  7. oral habits
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31
Q

What is the magic number for differential diagnosis?

A

3

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32
Q

When encountering a pigmented lesion, what should be considered?

A
  1. number
  2. size
  3. onset
  4. distribution
  5. borders
  6. location
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33
Q

Give an example of a differential diagnosis for tobacco pouch keratitis?

A
  1. dysplasias (can present as a leukoplakia)
  2. hyperplastic candidiasis
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34
Q

When encountering an ulcer, what should be considered?

A
  1. number
  2. size
  3. onset
  4. frequency/duration
  5. location
35
Q

Being able to describe the lesion allows you to:

A

include some lesions, while excluding others

36
Q

In describing the lesion _____ will emerge

A

patterns

36
Q

The basic components of describing a lesion:

A
  1. size
  2. shape
  3. color
  4. borders
  5. texture
  6. consistency
  7. location
36
Q

A small, circumscribed elevated lesion usually less than 1cm in diameter, usually contains serous fluid:

A

Vesicle

37
Q

Diagnose the following image:

A

Vesicle

38
Q

Vesicles usually contain:

A

Serous fluid

39
Q

Describe the size of a vesicle:

A

less than 1 cm

40
Q

Describe what is seen in the following picture:

A

-multiple circumscrie elevated lesions
-less than 1cm lesions
-fluid filled

(Vesicle)

41
Q

Diagnose the following image:

A

Bulla

42
Q

Bullas usually contain:

A

serous fluid

43
Q

Circumscribed elevated lesion that is around 1cm in diameter, usually contains serous fluid:

A

Bulla

44
Q

Describe the size of a bulla:

A

usually around 1 cm

45
Q

Describe the following image:

A

-circumscribed elevated lesion
-about 1 cm in diameter
-fluid filled

(Bulla)

46
Q

Various sized circumscribed elevations containing pus:

A

Pustule

47
Q

Diagnose the following image:

A

Pustule

48
Q

Describe what is seen in the following image:

A

-various small circumscribed elevation
-pus filled

49
Q

An area that is usually distinguished by a color different from that of the surrounding tissue- it is flat and does not protrude above the surface of the normal tissue:

A

Macule

50
Q

Diagnose the following image:

A

Macule

51
Q

Describe the following image:

A

-flat area different in color from surrounding tissue

52
Q

A small circumscribed lesion usually less than 1cm in diameter that is elevated or protrudes above the surface of normal surrounding tissue:

A

papule

53
Q

Diagnose the following image:

A

papule

54
Q

Describe the following image:

A

-small circumscribed lesion
-less than 1cm in diameter
-elevated above surface/protrudes

55
Q

A circumscribed lesion usually greater than 1cm in diameter that is elevated or protrudes above or below the surface of normal surrounding tissue:

A

nodule

56
Q

Diagnose the following image:

A

Nodule

57
Q

Describe the following image:

A

-circumscribed lesion greater than 1cm in diameter
-elevated/protrudes above surface

58
Q

Attached by a stem-like stalk or base:

A

pedunculated

*remember this is an incomplete description alone

59
Q

Describe the attachment seen in this image:

A

Pedunculated

60
Q

Describing the base of a lesion that is flat stem-like:

A

Sessile

*remember this is an incomplete description alone

61
Q

Describe the attachment seen in this image:

A

Sessile

62
Q

A loss of continuity of the epithelium that penetrates to the underlying connective tissue:

A

Ulcer

63
Q

Diagnose the lesion in this image:

A

Ulcer

64
Q

Describe the lesion in this image:

A

-loss of continuity of the epithelium
-penetrates to the underlying connective tissue

65
Q

A patch or differentiated area on a body surface:

A

Plaque

66
Q

Diagnose this image:

A

Plaque

(Left image= erythematous plaque, right image= leukoplakia)

67
Q

Describe the surface texture seen in this image:

A

Corrugated (wrinkled)

68
Q

“wrinkled”

A

Corrugated

69
Q

A cleft or grove, normal otherwise, showing prominent depth:

A

Fissure

70
Q

Describe the surface texture seen in this image:

A

Fissured

71
Q

Resembling small nipple-shaped projections or elevations found in clusters:

A

Papillary

72
Q

Describe the surface texture seen in this image:

A

Papillary

73
Q

Surface texture may be described as: (6)

A

-smooth
-rough
-folded
-corrugated
-fissured
-papillary

74
Q

Describe the surface texture seen in the following image:

A

Smooth

75
Q

Describe the surface texture seen in the following image:

A

Rough

76
Q

Describe the surface texture seen in the following image:

A

Folded

77
Q

Clinical presentation of radiographic lesions may be categorized as: (3)

A
  1. radiolucent
  2. mixed
  3. radiopaque
78
Q

Clinical presentation of mucosal & soft tissue lesions may categorized as: (8)

A
  1. colored
  2. white
  3. red
  4. red/white
  5. systemic hyperkeratosis- genodermatosis (+syndromes with it)
  6. soft tissue masses
  7. ulcers/vesiculo-erosive
  8. papillary
79
Q

Once you have a list of differential diagnosis what might you do? (5):

A
  1. alter environment
  2. observe (not active neglect)
  3. treat
  4. biopsy
  5. refer
80
Q

All a differential diagnosis is:

A

an educated guess

81
Q

What is the take home message of differential diagnosis?

A

Recognition and Action are the most important

82
Q
A

Pathology II (17 decks)

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