Oncology Flashcards
(86 cards)
1
Q
characteristic of a cycstim lump?
A
well defined
2
Q
if a lump is bruit what does this mean?
A
pulsatile
3
Q
if a lump is warm what does this indicate?
A
inflammation
4
Q
if a lump is tranilluminability what does this indicate?
A
full of cystic fluid
5
Q
define Ludwig’s angina
A
bilateral swelling of submandibular + sublingual areas
6
Q
2 anatomical group of cervical lymph nodes
A
circular - submental, submandibular, pre+post auricular, parotid, retro-pharyngeal + occipital
vertical chain - anterior + posterior
7
Q
6 classification of cervical lymph nodes
A
- submandibular + submental
- upper deep cervical
- mid cervical
- lower deep cervical
- posterior triangle
- anterior compartment
8
Q
what 2 conditions my acute lymphadenitis be secondary to?
A
sore throat + periocoronitis
9
Q
what is sarcoidosis?
A
lump caused by abnormal amount of inflammatory cells causing granulomatous
10
Q
what is lymphadenopathy?
A
inflammation of lymph nodes
11
Q
what type of bacteria causes TB
A
TB bacilli entering lymphatics causing lymphadenopathy
12
Q
is a TB abscess cold or hot and why?
A
cold - chronic abscess formed by necrosis + not pus
13
Q
what is collar stud abscess a symptom of?
A
TB
14
Q
what is a thyroglossal cyst?
A
any cyst along tract of where thyroid gland starts embryologically - will move
15
Q
what are dermoid cysts?
A
cysts that occur at points of fusions of epithelium - likely in midline
16
Q
what is a rannula?
A
mucous extravagation cyst
17
Q
what is a branchial cyst?
A
cyst in neck present from birth
18
Q
what could a lump in neck be?
A
- thyroid problem
- lymph node enlargement
- congenital cyst
- salivary gland disorder
- lumps in skin
- tumours
- actinomycosis
19
Q
what is senescence?
A
state between apoptosis + differentiaiton
20
Q
4 types of cell growth and what they mean?
A
- multiplicative - increase in no
- autexic - increase in size
- accretionary - increase in ECM
- combined - all of above
21
Q
what are labile, stable + permanent cells
A
labile = continuously dividing e.g. haematopeoic + ep stable = Go reversible phase e.g. hepatocytes + renal permanent = Go irreversible phase e.g. cardiocytes + neurones
22
Q
which type of cells are most susceptible to cancer and why?
A
labile cells - constantly dividing, can undergo hyperplasia
e.g lung, prostate, breast
23
Q
difference between hyperplasia + hypotrophy?
A
hyperplasia = increase in cell numbers and/or decrease in apoptosis hypertrophy = increase in cell size
24
Q
what is tuner tooth?
A
trauma occurs to primary tooth resulting in permanent tooth being traumatised = hypoplasia
25
difference between hypotrophy + atrophy?
```
hypotrophy = development failure
atrophy = with age
```
26
what is metaplasia?
reversible transformation of one mature differential cell type into another - adaptive response to environment stimuli
27
what is the condition called where there is glandular metaplasia at gastro-oesophageal junction due to acid reflux?
barretts oesophagus
28
what is dysplasia?
uncontrolled division of cells - increased cell growth, altered differentiation, change in architecture of tissue
29
where is masticatory mucosa found?
gingiva + hard palate
30
3 basic layers of oral mucosa?
epitherlium
lamina propria
submucosa
31
4 layers of oral masticatory epithelium
keratin layer
granular cell layer
prickle layer (stratum spinosum)
basal layer
32
what lies between epithelium + lamina propria?
basement membrane
33
where is lining mucosa (non-keratinised) found in mouth?
```
labial mucosa
buccal mucosa
venture of tongue
FOM
soft palate
```
34
where is specialised keratinised mucosa found?
dorsum of tongue - has papillae
35
what are the 2 types of hyperkeratosis seen pathologically + what is the difference between the 2?
hyperparakeratosis - can see nuclei
| hyperorthokeratosis - no nuclei, granular layer present
36
what are fordyces spots?
enlarged intramural sebacous glands - white/yellow spots on lips - don't confuse with white patches
37
3 examples of hereditary white lesions?
white sponge naevus
genodermatoses
pachyonychia congenita - skin lesions also
38
causes of mechanical traumatic white lesions?
frictional keratosis
acute trauma - ulcer
chronic trauma - hyperkeratosis
39
common dental example of chemical trauma white lesion?
hyperkeratosis with lichenoid inflammation due to amalgam
40
common example of chemical/thermal keratosis?
smokers keratosis
white plaques + melanosis
nicotinic stomatitis also common
41
4 examples of infective white patches?
1. syphilis
2. candidosis
3. hairy leukoplakia
4. squamous cell papilloma
42
difference between chronic hyper plastic candidiasis + acute pseudomembranous candidiasis?
```
CHC = not rubbed off
APC = rubs off
```
43
where is hair leukoplakia most commonly found?
bilateral on lateral border of tongue
44
what white patch is commonly found in HIV patients?
hairy leukoplakia
45
what virus is hairyleukplakia associated with?
EBV +/- candida
46
what oral white patches can HPV cause?
squamous cell papilloma
47
2 examples of dermatological oral white patches?
lichen planus
| lupus erythematous
48
what is lichen Planus?
type IV hypersensitive reaction
| atrophic or erosive
49
what is lupus erythematosus?
auto-immune disease, type III hypersensitivity
50
example of an idiopathic oral white patch?
leukoplakia
51
example of a neoplastic oral white patch? it is the most common oral cancer.
squamous cell carcinoma
52
difference between incisional + excisional biopsy?
```
incisional = take part
excisional = take all - never do this if suspected malignancy
```
53
how are amalgam tattoos produced?
taken up by macrophages + mucosa - present as blue/black mark
54
what classification is used to stage cancers?
TNM
```
T= size
N= spread
M = metastases
```
55
how would metastases of breast/lung/kidney cancer in jaw be detected?
radiolucency on radiographs
56
how would metastases of prostate cancer in jaw be detected?
radio opacities on radiographia
57
oral complications of radiotherapy
```
mucositis
ulceration
candidosis
xerostomia - leading to radiation caries
dental hypersensitive
PD
loss of taste
trismus
osteoradionecrosis of jaw
```
58
what causes osteoradionecrosis of jaw?
endarteritis obliterates - inferior alveolar artery shrinks - loss of blood supply = necrosis
diminishing ability to heal OVER TIME
59
what should happen before radiotherapy/chemotherapy?
pt should see dentist to make sure restoratively stable
OHI
60
what can be used to relive mucositis?
difflam mouthwash (benztdamine hydrochloride)- ant- inflammatory + analgesic
lidocaine lollipops
61
oral complications of chemotherapy
```
infections due to pancytopenia
ulcers
mucositis
lip cracking
bleeding due to pancytopenia
xerostomia
```
62
what can be used during chemotherapy to reduce oral inflammation/stomatits?
suck on ice cubes
63
what can be used during chemotherapy to reduce oral ulceration?
systemic/topical folic acid
64
methotrexate used for chemotherapy interacts with which popular medications?
NSAIDs + aspirin
65
WHO mucositis scale - 4 stages
1. soreness/erythema
2. erythema/ulcers but still eat solids
3. ulcers, liquid diet
4. oral intake not possible - hospitalisation
66
what is angiogenesis?
new blood vessels formed - cancers grow blood vessels
67
how does radiotherapy work?
X-rays/gamma rays target DNA (displace electrons) of rapidly dividing cells + leads to cell death + tumour necrosis
68
how is sievert different to gray measure of radiotherapy?
sievert considers biological quality of the tissue
69
radiotherapy regime for oral cancer?
5/7 for 6 weeks
70
what internal radiation therapy is used for carcinoma of thyroid?
131 iodine taken orally
71
what does pancytopenia mean? when is it seen?
low platelets + red/white blood cells
after chemo due to bone marrow toxicity
abnormal blood count until proven otherwise
prolonged bleeding + infection risk
72
main oral side effect of methotrexate?
oral ulceration
73
how would you treat chemo patient with candidiasis?
fluconazole 50mg 1 or 2/52
74
how would you treat chemo patient with herpetic infection?
aciclovir
75
platelet level cut off for dental surgery?
<50x10^9 /litres
76
granulocyte level cut off for dental surgery without antibiotics?
<2x10^9 /litres
77
is bilateral reticular lichen Planus low or high risk of cancer?
low
78
is erosive/ulcerated lichen Planus low or high risk of cancer?
high
79
how is SCC of larynx treated?
laryngectomy - now breathe through whole in neck
80
when should hoarseness become concerning?
over 3 weeks - laryngitis should get better pithing 3 weeks
associated factors - pain/earache/dysphagia/stridor
81
when should sore throat/dysphagia become concerning?
persistent, unilateral
| associated symptoms - earache/stridor/foetor/bleeding/weight
82
when to become suspicious of a neck lump?
progressive
impaired eating then drinking
pain
neck mass
hoarseness
83
what might deafness caused by middle ear effusion be a sign of?
nasopharyngeal tumour
84
what syndrome is post-cricoid carcinoma associated with?
Patterson brown-kelly syndrome (Plummer Vinson)
85
what is a pedicle flap?
flap used to close OAC
86
what is secondary intention healing?
wound left open to heal
