30 Most Common Oral Lesions 1-8 Flashcards Preview

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Flashcards in 30 Most Common Oral Lesions 1-8 Deck (74):
1

the 30 most comon oral lesions make up ___% of all reported lesions

93%

2

  • white plaque that does not rub off
  • cannot be identified as any other well known entity

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leukoplakia

the fact that the lesion starts and stops is more worrisome than if it were one discontinuous lesion; you would want to take multiple incisional biopsies in this case

3

5 white lesions that can be scraped off

  • materia alba
  • white coated tongue
  • burn (thermal, chemical, cotton roll, etc.)
  • pseudomembranous candidiasis
  • toothpaste or mouthwash overdose

4

can be scraped off

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materia alba

5

is white coated tongue symptomatic or asymptomatic? what is the treatment?

  • asymptomatic
  • treatment is tongue scraping or brushing

6

  • asymptomatic
  • wipes off

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white coated tongue

7

can be wiped off

history of placing aspirin in this area

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chemical burn

8

history of recent dental work, where cotton rolls were used, wipes off

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cotton roll burn

9

generalized throughout the mouth, history of toothpaste irritation, wipes off

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toothpaste allergy

10

wipes off

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candidiasis

11

bilateral on buccal mucosa at occlusal plane, does not wipe off

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  • linea alba
  • no treatment necessary
  • can be from friction or sucking

12

goes away when stretched

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leukoedema

13

leukoedema is bilaterally present in what percent of african american patients?

70-90%

14

what is the treatment for leukoedema?

no treatment necessary

15

history of smoking

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nicotine stomatitis

16

what do the red spots represent?

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salivary gland duct openings

17

this is bilateral; what is the etiology?

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oral hairy leukoplakia, etiology is EBV (patients are usually immunocompromised, and this is often seen in HIV patients)

18

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tobacco pouch keratosis

treatment is to move tobacco pouch to a different location or stop using smokeless tobacco

19

does not wipe off

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lichen planus

take incisional biopsy

20

what are the four possibilities of a leukoplakia biopsy?

  • hyperkeratosis
  • dysplasia (mild, moderate, severe)
  • carcinoma-in-situ
  • squamous cell carcinoma

21

what are the 3 high risk sites for leukoplakia?

floor of mouth > tongue > lip

22

what is the best guide to potential progression of oral lesions?

degree of dysplasia

23

severe dysplasia has ___% transformation rate

moderate dysplasia has ___% transformation rate

mild dysplasia has ___% transformation rate

16%, 3-15%, <5%

a dx of mild dysplasia does not necessarily warrant excisional biopsy; you can watch it and determine treatment from there

in any case, excision significantly reduces the transformation rate

24

what is the average transformation time for leukoplakia?

4.3 years

25

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torus mandibularis

26

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torus palatinus

27

what are some cases where you would recommend removing tori?

  • dentures
  • causing problems
  • cosmetics/personal preference

28

what percent of the population has torus palatinus? are they more common in males or females? caucasians or african americans?

  • 20-35%
  • 2:1 F:M 
  • C=B

29

what percent of the population has torus mandibularis? more common in males or females? caucasians or african americans? what percent is bilateral?

  • 7-10%
  • M>F
  • C=B
  • 90% bilateral

30

what is kenalog-10 (or kenalog-40) used for?

treats traumatic ulcers

31

when using kenalog-10, how many mg do you need for a 1cm lesion?

in kenalog-10, there is 10mg per 1ml of fluid, so for a 1cm lesion, you'd need 10mg, or 1ml

so if the lesion is 3cm, you need 30mg or 3ml kenalog-10

32

when using kenalog-40, how many mg do you need for a 1cm lesion?

in kenalog-40, there is 40mg per 1ml of fluid, so for a 1cm lesion, you'd need 10mg (0.25ml)

for a 3cm lesion, you'd need 30mg or 0.75ml of kenalog-40

33

hx of trauma

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traumatic ulcer

34

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pericornitis

operculum - fragment of oral soft tissue that overlies some of the occlusal table

35

how can you test whether this is a periodontal abscess or endo?

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use gutta percha to track it

36

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fibroma

most common location is the buccal mucosa along the occlusal table

37

what is the most common benign neoplasm of the oral cavity? most common locations?

fibroma

buccal mucosa > labial mucosa > tongue > gingiva

38

what is the treatment for a fibroma?

surgical excision

39

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fibroma

40

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fibroma

41

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fibroma

42

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fordyce granules

ectopic sebaceous glands

43

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fordyce granules

44

___% of the population has fordyce granules

80%

45

what are the most common locations for fordyce granules? what is the treatment?

buccal mucosa > lips

no treatment

46

clinically blanches under pressure

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hemangioma

47

what is a hemangioma caused by?

benign proliferation of blood vessels

48

hemangiomas affect ___% of children

10-12%

49

what is the treatment for hemangioma?

  • clinical observation
  • removal - surgery, laser, embolization
  • sclerotherapy

50

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hemangioma

51

painful, history of recurrence

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recurrent apthous ulcer, major

52

recurrent aphthous ulcers affect what percent of the population?

20-25%

53

recurrent aphthous ulcers occur on __keratinized/non-keratinized__ tissues, and on __bound/non-bound___ mucosa

non-keratinized, non-bound mucosa

54

recurrent apthout ulcers are usually how large in diameter? how many lesions are usually present?

0.5-1 cm in diameter

1-2 lesions

55

what is the treatment for recurrent aphthous ulcers?

topical steroids

56

what 3 pieces of information do you need to make a successful diagnosis of recurrent aphthous ulcers?

location + size + number of lesions

57

what is the etiology of recurrent aphthous ulcers?

  • "different things in different people"
  • 3 theories - autoimmune, hypersensitivity, and stress

58

what are 7 examples of prescriptions used to treat recurrent aphthous ulcers?

  • aphthasol
  • betamethasone
  • temovate
  • decadron
  • lidex
  • kenalog
  • medrol

59

what lesion can have a cauliflower appearance?

squamous papilloma

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60

___ is a benign proliferation of squamous epithelium

papilloma

61

what locations are squamous papillomas most common on?

tongue > soft palate

62

are squamous papilloma lesions usually solitary or are there multiple? are they sessile or pedunculated?

they are solitary pedunculated wart-like lesions

63

what is the treatment for squamous papilloma lesions?

surgical excision

64

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squamous papilloma

65

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squamous papilloma

66

what is the differential for a papillary lesion?

  • squamous papilloma
  • verruca vulgaris (wart)
  • condyloma acuminatum (venereal wart)
  • focal epithelial hyperplasia (heck's disease)
  • verucciform xanthoma
  • *sinonasal papilloma is also a variation of a papilloma but would not be included on a differential based on location

67

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verruca vulgaris

68

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condyloma accuminatum

69

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condyloma accuminatum

70

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focal epithelial hyperplasia

71

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sinonasal papilloma

72

what is the viral etiology for squamous papilloma?

HPV 6 and 11

73

what is the viral etiology for condyloma accuminatum?

HPV 16, 18

74

what is the viral etiology for focal epithelial hyperplasia (heck's disease)?

HPV 13, 32