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Patient Care 2 > Intraoral exam > Flashcards

Intraoral exam Flashcards

1
Q

what is the gold standard for diagnosing oral cancer

A

biopsy

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2
Q

what percent of cancers does oral cancer make up

A

3%

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3
Q

what percentage of people diagnosed with oral cancer have a 5 year survival rate

A

57%

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4
Q

what gender is more affected by oral cancer

A

men twice as much

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5
Q

what percent of oral cancer is found in stage 1 or 2

A

40%

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6
Q

what is the survival rate of stage 1 or 2 oral cancer

A

80-90%

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7
Q

what is the survival rate of state 3 or 4 oral cancer

A

33%

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8
Q

what is the recurrence percentage in stage 3 or 4 oral cancer in 2 years

A

67%

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9
Q

how do you describe cancerous lesions

A

-number
-size
-shape
-color
-profile
-base
-border
texture

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10
Q

what are the risk factors for oral cancer

A

-tobacco #1
-alcohol #2
-viruses HPV and HIV
-sun exposure
-inadequate nutrition
-genetic predisposition
-chronic inflammation
-radiation exposure
-carcinogen exposure

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11
Q

what percentage of oral cancer could be prevented by eliminating tobacco and alcohol use

A

75%

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12
Q

what percent reducation after 5 years without tobacco

A

35%

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13
Q

how do you avoid oral cancer

A

-eliminate tobacco and alcohol
-lip balm with sunscreen
-HPV vaccine
-diet rich in fruit and veggies

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14
Q

what are the high risk areas for oral cancer

A

-floor of mouth
-lateral border of tongue
-ventral surface of tongue
-oropharynx

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15
Q

what are signs and symptoms of oral cancer

A

-nonhealing ulcer
-bleeding
-lymphadenopathy
-hardness
-parasthesia
-drooling

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16
Q

what is induration

A

firm but not as hard as bone

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17
Q

describe a routine oral cancer exam

A

-question pt about risk factors
-examine face
-palpate lymph nodes
-palpate lips
-palpate labial and buccal mucosa
-examine bimanually palpate floor of mouth
-examine/palpate tongue
-examine hard and soft palate
-examine tonsils and oropharynx

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18
Q

what is compressible

A

pressure alters its shape

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19
Q

what is doughy

A

returns slowly to original shape

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20
Q

what is spongy

A

returns quickly to original shape

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21
Q

what is collapsing

A

contents expressed usually fluid like -abscess

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22
Q

what is pitting

A

soft and leaves indentation- edema

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23
Q

what is blanching

A

color change

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24
Q

what is discrete

A

separate, not running together or blending

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25
Q

what is confluent

A

running together, merging, blended

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26
Q

what is verrucose

A

covered with wart like growths, cauliflower like surface

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27
Q

what is sessile

A

attached to the surface on a broad base
-immobile, fixed, firmly attached
-lacks a stalk

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28
Q

what is a pedunculated lesion

A

elevated lesions having a narrow stem which acts as a base, elongated stalk

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29
Q

where do pedunculated squamous papilloma occur

A

on the soft palate, tonsil, or epiglottis

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30
Q

what is erythema

A

red area of variable size and shape usually in patches

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31
Q

what are petechiae and what are they caused by

A

round red pinpoint areas of hemorrhage caused by trauma, viral infection or bleeding problem

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32
Q

what are macules

A

-small circumscribed area of color change
-brown, black, blue,red
-not elevated or depressed
-ex: a freckle

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33
Q

what is an eschar

A

a sloughing of epithelium caused by disease trauma or chemical burn

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34
Q

what is a torus

A

bony elevation or prominence

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35
Q

what is a patch

A

-large area of color or texture change
-not elevated or depressed

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36
Q

what is an ulcer

A

an area extending below the basal layer
-gradual tissue disintegration
-usually painful

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37
Q

what is crust

A

an outer layer covering or scab from a coagulation of blood, serum, pus or any combination

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38
Q

what is plaque

A

a solid, flat, area often keratinized

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39
Q

what is a papule

A

a superficial elevated solid lesion, any color, solid base or pedunculated

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40
Q

what is a vesicle

A

smal fluid filled, elevated lesion with a thin surface covering

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41
Q

what is a pustule

A

small vesicular type lesion containing purulent material rather than clear fluid
-creamy white or yellow

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42
Q

what is a nodule

A

an elevated deep solid lesion
-overlying mucosa not fixed

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43
Q

what is an irritation fibroma classified as and why

A

a tumor because this lesion is persistent and increases in size

44
Q

what is a bulla

A

a large vesicle, contains serum, usually at the mucosal, submucosal junction

45
Q

what is linea alba

A

-white line on inner cheek
-parallel to oclussal plane, asymptomatic, atypical, caused by chewing

46
Q

what is leukodema

A

milk white surface blue or grey, symmetrical, atypical, doesnt rub off, disappears when stretched

47
Q

what population are leukodemas more popular in

A

african americans

48
Q

what is lichen planus

A

common inflammatory disease involving the skin and mucous membranes
-interlacing white striae with erythema of the surrounding mucosa
-usually bilateral
-painful erythematous erosions and ulcers may also occur
- on skin appears as purplish, itchy, flat bumps

49
Q

what gender is lichen planus more common in

A

women

50
Q

what are fordyce granules

A

-sulfur colored
-asymptomatic
-atypical
- 1-3 mm papules in oral cavity or lip vermillion

51
Q

describe torus palatinus

A

-bony lumps
-asymptomatic
-atypical

52
Q

what percentage of people have torus palatinus

A

20-30%

53
Q

what is ratio of females to males with torus palatinus

A

2:1

54
Q

what percentage of people have torus mandibularis

A

8-16%

55
Q

what gender is more likely to have torus mandibularis

A

they are equal

56
Q

what is nicotine stomatitis

A

-lesion of hard palate
-white , rough, asymptomatic, leathery appearing
contains red dots or macules

57
Q

what is nicotine stomatitis caused by

A

extreme heat in the mouth

58
Q

what is benign migratory glossitis

A

lesions heal in one area then move to a different part of the tongue

59
Q

where is the most common place for cancer to occur on the tongue

A

lateral border and the base

60
Q

what is leukoplakia

A

white or grayish thick keratotic patch like lesion on the mucosa which cannot be rubbed off

61
Q

what is hairy leukoplakia caused by

A

epstein barr virus

62
Q

where does hairy leukoplakia occur

A

on the lateral border of the tongue, white rough patches

63
Q

what causes hairy tongue

A

-trapped debris from bacteria
-fungus
-coffee
-tobacco
-antibiotics and other drugs

64
Q

what is the submandibular duct also called

A

whartons duct

65
Q

what percentage of saliva does whartons duct account for

A

60%

66
Q

what are xerostomia symptoms

A

-candidiasis
-angular chelitis
-burning tongue
-root and cervical caries
-stomatitis
-dysphagia

67
Q

what is candidiasis

A

white plaque
-creamy white lesions
-rubs off but looks like hyperkaratosis
-found on buccal mucosa and lateral borders of tongue

68
Q

where can thrush spread to

A

tongue
-hard and soft palate
-tonsillar region

69
Q

what are the risk factors for candidiasis

A

-immunocompromised
-pregnancy
-poor oral hygiene
-smoking
-stress
-depression
-birth control
-long term antibiotics
-diabetes
-dentures that dont fit
-xerostomia
-iron B12 deficiency

70
Q

what is acute pseudomembranous candidiasis

A

creamy white patches on tongue, buccal mucosa, floor
-easily wipe off leaving an erythematous base
-dysphagia
-white plaque

71
Q

what is atrophic candidiasis

A

under dentures, red on palate or tongue

72
Q

what is the treatment for candidiasis

A

-oral hygiene
-yogurt
-avoid alcohol and simple sugars
-antifungal medications like nystatin and ketaconozole

73
Q

what population is herpes gingivomatitis most seen in and what is it caused by

A

children caused by HS1 mostly

74
Q

what are severe primary herpes simplex infections with oral lesions accompanies by

A

high fever, malaise, cervical hymphadenopathy, and dehydration

75
Q

where do vesicles in herpes gingivostomatitis occur

A

in the pharynx, palate, buccal mucosa, lips and or tongue. may extend into lips or buccal mucosa

76
Q

how long does it take for herpes gingivostomatitis lesions to resolve without treatment

A

2 weeks

77
Q

what percentage of the population gets herpes simplex, cold sores

A

50%

78
Q

where are type 1 herpes simple located? type 2?

A

1: mouth, lips, face
2: genital

79
Q

what are the prodromal signs of herpes simplex

A

tingling, itching, pain, burning. arise 6-24 hours before lesions develop

80
Q

what is herpetic whitlow

A

infections of the thumbs or fingers
-grouped, fluid or pus filled
-usually itch and/or painful

81
Q

what is the treatment for primary herpetic gingivostomatitis

A

antiviral medications
-acyclovir suspension during first 3 symptomatic days in a rinse and swallow techniques 5x/day for 5 days

82
Q

when is recurrent herpes labialis best treated

A

in the prodrome phase

83
Q

what does acyclovir ointment do

A

decreases number of herpes vesicles but not pain or healing time

84
Q

what do you prescribe to patients with herpes recurrences associated with dental procedures

A

prescribe a regiment of 2g of valacyclovir taken 2x a day on day of procedure and 1g taken 2x the following day

85
Q

what percentage of the population get apththous ulcer

A

60%

86
Q

what are aphthous ulcers

A

canker sores

87
Q

when do apthous ulcers start

A

10-20 years old

88
Q

what are prodromal symptoms of aphthous ulcers

A

tingling or burning sensation usually 1-2 days before it appears

89
Q

how long do aphthous ulcers persist

A

3 days pain, 7 days healed

90
Q

what is the cause of aphthous ulcers

A

mucosal destruction causes T cell mediated immunologic reaction

91
Q

when both parents have aphthous ulcers what chance is it that kids get it

A

90%

92
Q

what are the clinical variations of aphthous ulcers

A

minor, major, herpetiform

93
Q

where do minor apthous ulcers arise

A

almost exclusively on nonkeratinized mucosa. buccal and labial then ventral surface of tongue

94
Q

describe minor aphthous ulcerations

A

-3-10 mm
- heal without scarring in 7-14 days

95
Q

how large are major aphthous ulcers and how many lesions are there usually

A

1-3 mm. usually 1-10 lesions

96
Q

which type of ulcer has longest duration

A

major

97
Q

which type of ulcer has greatest number of lesions and most frequent occurence

A

herpetiform

98
Q

what gender mostly suffers from herpetiform aphthous ulcers

A

women

99
Q

what are treatment options for aphthous ulcers

A
  • benzocaine, orajel, anbesol, (for symptoms)
    -kenalog (local anti inflammatory)
    -ameseal (sealing agent)
    -aphthasol (apply 2-4x a day and start in prodromal stage)
100
Q

how long do major aphthous ulcerations take to heal

A

2-6 weeks and may scar

101
Q

when is the onet of major aphthous ulcerations

A

after puberty

102
Q

how big are herptiform aphthous ulcerations and how many lesions are present at once

A

1-3 mm and as many as 100 ulcers at once

103
Q

how long to herpetiform aphthous ulcers take to heal

A

7-10 days but recurrences are so closely spaced it can last for 3 years

104
Q

what oral mucosa and gender is predominantly involved with herpetiform aphthous ulcers

A

any oral mucosa and females predominantly

105
Q

when is the onset of herpetiform aphthous ulcers

A

adulthood

Patient Care 2 (8 decks)

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