Chapter 10 lecture 3

Question 1

What is a chronic progressive scarring high-risk precancerous condition of the oral mucosa known as?

Answer 1

-Oral submucous fibrosis

Question 2

What is oral submucous fibrosis linked to?

Answer 2

-Chronic placement of betel quid or paan

Question 3

What ethnicity of people will you mostly find oral submucous fibrosis?

Answer 3

-India

Question 4

What are the ingredients of quid?

Answer 4

• Areca nut
• Slaked lime
• Betel leaf
• Tobacco
• Sweeteners

Question 5

What is the first chief complaint of a person with oral submucous fibrosis?

Answer 5

• Trismus

- Mucosal pain from eating spicy foods

Question 6

What are the most commonly affected sights with oral submucous fibrosis?

Answer 6

• Buccal mucosa
• Retromolar areas
• Soft palate

Question 7

If you stop using the betel quid or paan will the lesion regress?

Answer 7

-No

Question 8

What is the risk of getting oral cancer when someone has oral submucous fibrosis?

Answer 8

-10%

Question 9

What is nicotine stomatitis?

Answer 9

-White keratotic change on the palate

Question 10

Is nicotine stomatitis premalignant?

Answer 10

-No

Question 11

If you do reverse smoking what does that increase your chance for oral cancer?

Answer 11

-Yes significantly

Question 12

T/F Nicotine stomatitis is completely reversible

Answer 12

True

-Returns to normal within 2 weeks of cessation

Question 13

If they reverse smoke is it called nicotine stomatitis?

Answer 13

-No it is called reverse smokers palate (demands a biopsy)

Question 14

What is a common cutaneous premalignant lesions caused by cumulative UV radiation known as?

Answer 14

-Actinic Keratosis

Question 15

What does actinic keratosis appear as?

Answer 15

-Scaly, irregular plaques

Question 16

What percent of actinic keratosis turn in to SCCA in 2 years?

Answer 16

-10%

Question 17

What are the most common places to see actinic keratosis?

Answer 17

-Scalp

Question 18

What is a common premalignant alteration of the lower lip vermilion resulting from long-term exposure to UV light?

Answer 18

-Actinic Cheilosis

Question 19

If you have loss of definition of the vermillion border with crusting or white changes what should you be thinking?

Answer 19

-Actinic Cheilosis

Question 20

What is the cause of oral Squamous cell carcinoma?

Answer 20

-Multifactorial

Question 21

Do pipe and cigar smoking or cigarette smoking carry a greater oral cancer risk?

Answer 21

-Pipe and cigar smoking

Question 22

If a person has SCC caused by iron deficiency what are the syndromes known as?

Answer 22

-Plummer-Vison

Question 23

What can iron deficiency SCC produce?

Answer 23

-Esophageal webs

Question 24

What is the most common site of the intraoral SCCA?

Answer 24

-Tongue

Question 25

Where are the most common sites of intral oral SCCA?

Answer 25

1- Tongue 2- FOM 3-Soft palate 4-Gingiva

Question 26

SCCA metastatic spread is largely done how?

Answer 26

-Lymphatics

Question 27

How do nodes that have SCCA present?

Answer 27

- Firm - Painless - Enlarged - Fixed

Question 28

Distant metastasis below the clavicles is found where?

Answer 28

- Lungs - Liver - Bones

Question 29

How is the staging of cancer determined?

Answer 29

- TNM system - T = size of primary local tumor in centimeters - N = Involvement of local lymph nodes - M = Distant metastasis

Question 30

T/F Clinical staging is a better prognostic indicator than histologic grading

Answer 30

True

Question 31

How is lip carcinoma typically treated?

Answer 31

-Wedge resection with excellent results

Question 32

What guides the treatment for intraoral carcinoma?

Answer 32

-Clinical stage guides

Question 33

Between the lip and the oral cavity of SCCA what has a better survival rate?

Answer 33

-Lip

Question 34

T/F Patients with one carcinoma of the mouth or throat are at an increased risk for an additional SCCA

Answer 34

True

Question 35

If a person has a SCCA and then another carcinoma happens concurrently what is that known as?

Answer 35

-Synchronous

Question 36

If a person had a SCCA and then develops another carcinoma at a different time what is that known as?

Answer 36

-Metachronous

Question 37

What is field cancerization?

Answer 37

-Tendency toward development of multiple mucosal cancers

Question 38

What is Snuff dippers cancer known as?

Answer 38

-Verrucous carcinoma

Question 39

What are the most common sites of involvement of Verrucous carcinoma?

Answer 39

- Mandibular vestibule | - Gingiva

Question 40

What is a low grade variant of oral SCC?

Answer 40

-Verrucous carcinoma (looks like cauliflower)

Question 41

Who gets verrucous carcinoma?

Answer 41

-Smokeless tobacco users

Question 42

What percent of verrucous carcinoma can have a SCCA developing within its borders?

Answer 42

20%

Question 43

What refers to a group of malignancies that arise from the lining epithelium of the nospharynx?

Answer 43

-Nasopharyngeal carcinoma

Question 44

What ethnicity is most likely to get nospharyngeal carcinoma?

Answer 44

-Chinese

Question 45

What are possible contributory factors with nasopharyngeal carcinoma?

Answer 45

- EBV virus - Vitamin C deficiency - Consumption of salt fish with N-nitrosamines

Question 46

What is the first sign in pats with nasopharyngeal carcinoma?

Answer 46

-Cervical lymph node metastasis

Question 47

What is the most common of all cancers?

Answer 47

-Basal cell carcinoma

Question 48

What are other clinicopathologic basal cell carcinomas?

Answer 48

- Pigmented - Sclerosing - Superficial

Question 49

What is a malignant neoplasm of melanocytic origin known as?

Answer 49

-Melanoma

Question 50

What type of skin cancer accounts for the most deaths?

Answer 50

-Melaonma

Question 51

What are the two growth patterns of melonma?

Answer 51

- Radical (spreads laterally - flat) | - Vertical

Question 52

What does basal cell carcinoma result from?

Answer 52

-UV radiation

Question 53

What is the most common form of basal cell carcinoma?

Answer 53

-Noduloulcerative

Question 54

What type of blood vessels are seen in noduloulcerative basal cell carcinoma?

Answer 54

-Telangieactatic

Question 55

What is Mohs micrographic surgery?

Answer 55

-Frozen sections to evaluate margins during surgery

Question 56

T/F Damage from UV radiation is a major causative factor of Melanoma

Answer 56

True

Question 57

What raises addition risk factors for melanoma?

Answer 57

- Fair complexion - Light hair - Tendency to sunburn easily - History of blistering sunburns in childhood - Personal history of melanoma - Personal history of dysplastic or congenital nevus

Question 58

What type of skin cancer accounts for the most deaths?

Answer 58

-Melaonma

Question 59

What is the ABCDE system to distinguish melanoma from a nevus?

Answer 59

- Asymmetry - Border irregularity - Color variation - Diameter greater than 6 mm - Evolving lesions

Question 60

An invasion of how far in oral melanoma has a poor prognosis?

Answer 60

-0.5 mm

Question 61

What areas have the worst prognosis with melanoma?

Answer 61

- Interscapular area of the back - Posterior upper arm - Posterior and lateral neck - Scalp

Question 62

List the malignant transformation from most potential to least?

Answer 62

- Proliferative veruccous leukoplakia - Nicotine stomatitis in reverse smokers - Erythroplakia - Oral submucous fibrosis - Erythroleukoplakia - Granular leukoplakia - Actinic cheilosis