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Medicine I: HEENT > Reactive and Neoplastic Oral Diseases > Flashcards

Reactive and Neoplastic Oral Diseases Flashcards

1
Q

Traumatic Ulcers

A

Removable, yellow membrane with a rolled white border and surrounding erythema

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2
Q

Cause of Traumatic Ulcers

A

Mechanical damage

Accidental biting, sharp teeth, sharp foods, etc

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3
Q

Tx of Traumatic Ulcers:

A

Remove irritating source
Palliative
Salt-water rinses
Local anesthetic rinse (Dyclonine HCl )

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4
Q

Morsicatio Buccarum

A

AKA chronic cheek chewing
Thickened, shredded, white areas found on anterior buccal mucosa at midline
Possible zones of erythema or ulceration

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5
Q

Cause of Morsicatio Buccarum:

A

Chronic biting

Common in people under high stress

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6
Q

Tx of Morsicatio Buccarum:

A

Cessation of habit
Reduce stress
No long-term difficulties

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7
Q

Mucocele:

A

small dome-shaped swelling
Often tranlucent or bluish
Can wax & wane

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8
Q

Cause of Mucocele:

A

Rupture of a salivary duct (usually by trauma) & spillage of mucin into tissue
Most often on lower lip

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9
Q

Tx of Mucocele:

A

Removal of lesion and offending minor salivary gland

May recur

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10
Q

Epulis Fissuratum:

A

Poorly fitting denture

Usually 2 folds of tissue where denture fits

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11
Q

Tx of Epulis Fissuratum:

A

Surgical removal of tissue

Adjust or remake denture

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12
Q

Pyogenic Granuloma

A

Reactive, tumor-like growth

Erythematous mass, usually ulcerated
Painless & bleeds easily
May grow rapidly

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13
Q

Cause of Pyogenic Granuloma:

A

Local irritation or trauma

Female predilection, especially during pregnancy– “Pregnancy granuloma”

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14
Q

Tx of Pyogenic Granuloma:

A

Excision

Defer tx during pregnancy, higher recurrence if removed during pregnancy

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15
Q

Nicotine Stomatitis:

A

Hard palate is gray or white
Numerous elevated papules with red centers
Papules are inflamed minor salivary glands

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16
Q

Cause of Nicotine Stomatitis:

A

Reaction to heat in cigarettes or cigars

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17
Q

Tx of Nicotine Stomatitis:

A

Cessation of habit, completely reversible after 2 weeks of smoking cessation

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18
Q

Fibroma:

A

Most common ‘tumor’ of oral cavity
Reactive hyperplasia of fibrous connective tissue

small painless, sessile, smooth pink nodule
Most are found on cheek along bite line

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19
Q

Cause of Fibromas:

A

Local irritation or trauma

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20
Q

Tx of Fibromas:

A

Surgical excision

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21
Q

Papillomas:

A

Up to 5 mm (pencil eraser is 6 mm)
Painless, raised growth with numerous finger-like surface projections
White, slightly red, or normal in color
Grow rapidly to full size

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22
Q

Cause of Papillomas:

A

(HPV), usually strains 6 and 11

Extremely low virulence & infectivity rate

23
Q

Tx of Papillomas:

A

Surgical excision, recurrence unlikely

24
Q

Common Benign Oral Neoplasms

A

Pleomorphic adenoma
Lipoma
Hemangioma

25
Q

Pleomorphic Adenoma:

A

Benign salivary tumor
Most common salivary neoplasm
Most common locations: palate & parotid gland
Painless, slowly growing firm mass
Often smooth surfaced, may be ulcerated from trauma

26
Q

Tx of Pleomorphic Adenoma:

A

Excision

27
Q

Lipoma:

A

Benign tumor of fat
Appear to be more common in obese patients

Soft, painless, yellow or pink nodular masses

28
Q

Tx of Lipomas:

A

Excision

Recurrence rare

29
Q

Hemangiomas:

A

Benign vascular tumor
Most common tumor of infancy
Head and neck is most common location

Rapid growth during first few weeks of life
Superficial skin lesions are raised with a bright-red color
Feels firm & rubbery, blood does not move when pressure is applied
Deeper tumors are slightly raised and blue

30
Q

Tx of Hemangiomas:

A

“Watchful neglect”

90% spontaneously resolve before age 10

31
Q

Complications of Hemangiomas:

A

Ulceration, possible infection

Vision problems, airway obstruction

32
Q

Pre-malignant lesions

A

Leukoplakia

Erythroplakia

33
Q

Leukoplakia:

A 
“White patch” 
Strictly a clinical diagnosis
Most are due to thickened surface keratin
Considered precancerous lesion
Most common oral pre-cancer
34
Q

Risk Factors for Leukoplakia:

A

Tobacco
80% of pts are smokers
Alcohol
Ultraviolet radiation

35
Q

High risk sites for malignant transformation of Leukoplakia:

A

Tongue (ventral/lateral)
Lip vermillion
Floor of mouth
90% with dysplasia or carcinoma found in these locations

36
Q

Presentation of Leukoplakia:

A

Early lesions are grayish plaques
Lesions then extend, become thicker, & white
The mucosa feels leathery & may have fissures
Next, increased surface irregularities & scattered red patches develop
Erythroleukoplakia

37
Q

Tx of Leukoplakia:

A

Biopsy!

38
Q

Complications of Leukplakia:

A

Recurrence likely, especially for thick lesions

39
Q

Erythroplakia:

A

“Red patch”
Strictly a clinical diagnosis
Almost all are dysplasia or carcinoma

40
Q

Most common sites of Erythroplakia:

A

Floor of mouth
Tongue (ventral/lateral)
Soft palate

41
Q

Presentation of Erythroplakia:

A

Well-demarcated, asymptomatic, erythematous plaque with soft texture

42
Q

Tx of Erythroplakia:

A

Biopsy is mandatory and guides tx

43
Q

Complications of Erythroplakia:

A

Recurrence is common

Long-term follow-up is necessary

44
Q

Most Common Malignant Neoplasms:

A

Squamous cell carcinoma
Non-Hodgkin’s lymphoma
Mucoepidermoid carcinoma

45
Q

SCCA:

A 
95% of all oral malignancies
Cause is multifactorial 
Tobacco smoke
Alcohol
Syphilis
Sunlight (lip)
Human papilloma virus (HPV 16, 18, 31, 33)
Iron-deficiency anemia
Immune suppression
Radiation
46
Q

Causes of SCCA:

A

Heredity is NOT a cause
Most are preceded by a precancerous lesion,
There is minimal pain during early stages!!
Delayed detection, delayed treatment

47
Q

Most common sites of SCCA:

A

Most common sites
#1. Tongue (ventral/lateral)
2. Floor of mouth
3. Soft palate

48
Q

Tx of SCCA:

A

Wedge resection if on lower lip
Wide excision
Radiation
Chemotherapy

49
Q

Non-Hodgkin’s Lymphoma:

A

2nd most common malignancy of head & neck after SCCA
More common in older patients

Painless, diffuse “boggy” swelling, may be red or purple

50
Q

Tx of Non-Hodgkin’s Lymphoma:

A 
Depends on grade and type of lymphoma
“Watch and wait”
Rituximab
Radiation
Chemotherapy
........
Prognosis; If high-grade, 60% 5-year survival rate
51
Q

Complications of Non-Hodgkin’s Lymphoma:

A

Complications:

Infection, effects of treatment

52
Q

Mucoepidermoid Carcinoma:

A

Most common salivary gland malignancy
Found parotid or palate in all ages

Asymptomatic swelling
In palate, may be fluctuant & have a bluish color

53
Q

Tx of Mucoepidermoid Carcinoma:

A

Surgical resection, sometimes radiation

Medicine I: HEENT (13 decks)

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