Unit 1 - Introduction to Oral Pathology (Textbook)

Question 1

Define: Pathology

Answer 1

The science of the causes & effects of diseases.

Question 2

Define: Pathogenesis

Answer 2

The development of a disease.

Question 3

Define: Pathophysiology

Answer 3

The abnormal physiological process/functional changes associated with disease or injury.

Question 4

Define: Oral Pathology

Answer 4

The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral regions.

Question 5

What does the acronym ‘MIND’ stand for?

Answer 5

Metabolic, Inflammatory, Neoplasia, and Developmental

Question 6

What are the subcategories of metabolic oral pathologies?

Answer 6

Hormonal & Nutritional

Question 7

What are the 5 subcategories of inflammatory oral pathologies?

Answer 7

Trauma, Reactive, Radiation, Infection, Immunologic

Question 8

What are the subcategories of neoplasia oral pathologies?

Answer 8

Benign & Malignant

Question 9

What are the subcategories of developmental oral pathologies?

Answer 9

Genetic & Acquired

Question 10

What are the 2 divisions of benign neoplasia oral pathologies?

Answer 10

Odontogenic & Nonodontogenic

Question 11

What are the 2 divisions of malignant neoplasia oral pathologies?

Answer 11

Carcinoma & Sarcoma

Question 12

What are the 8 categories of diagnosis?

Answer 12

Clinical, radiographic, historical, laboratory, microscopic, surgical, therapeutic, differential

Question 13

What type of diagnosis suggests that the strength of the diagnosis comes from the clinical appearance of the lesion?

Answer 13

Clinical

Question 14

When a diagnosis can be made on unique clinical features, biopsy and/or surgical intervention is not necessary. True or false?

Answer 14

True

Question 15

Name some examples of lesions that can be easily diagnoses clinically

Answer 15

Fordyce Granules, Torus Plantinus, Mandibular Tori, Melanin Pigmentation, Retrocuspid Papillae, Lingual Varicosities

Question 16

The use of personal history, family history, past and present medical/dental history, drug history, and the history of disease can provide information necessary for final diagnosis. What type of diagnosis is this?

Answer 16

Historical

Question 16

What is considered radiographic diagnosis?

Answer 16

The radiograph provides sufficient information to establish the diagnoisis; although additional clinical and historical information may contribute, the diagnosis is obtained from the radiograph.

Question 17

Pathologic conditions in which the family history contributes a role in diagnosis include:

Answer 17

Amelogensis Imperfecta, Dentinogenesis Imperfecta

Question 18

Clinical laboratory tests, including blood chemistries and urinalysis, can provide information that contributes to a diagnosis. Which type of diagnosis?

Answer 18

Laboratory

Question 19

The microscopic examination of the biopsy specimen taken from the lesion in question contributes significant information. Which type of diagnosis?

Answer 19

Microscopic

Question 20

The strength of a surgical diagnosis comes from surgical intervention. Which type of diagnosis?

Answer 20

Surgical

Question 21

Which type of deficiencies are common conditions to be diagnosed by therapeutic means?

Answer 21

Nutritional

Question 22

What is a differential diagnosis?

Answer 22

The differential diagnosis is that point in the diagnostic process when the practitioner decides which test or procedure is required to rule out the conditions originally suspected and to establish the definitive or final diagnosis. All previously discussed components are applied to the differential diagnosis. The final diagnosis emerges from a thorough evaluation of the suspected lesions.

Question 23

What is a biopsy?

Answer 23

A biopsy is the surgical removal of a section of tissue or other material for the purpose of diagnosing, estimating the prognosis, and monitoring the course of disease when the tissue undergoes microscopic assessment.

Question 24

Which type of biopsy uses a tubular surgical instrument that is inserted through to the deeper tissue to cut the tissue off at the base?

Answer 24

Punch Biopsy

Question 25

What is an excision biopsy?

Answer 25

The entire lesion with borders is removed for assessment.

Question 26

What is an incisional biopsy?

Answer 26

Only representative tissue samples are obtained by excising a wedge of tissue.

Question 27

What is an exfoliate smear/cytology?

Answer 27

Sample cells to be examined are collected by scraping the surface of a lesion with a cotton swab.

Question 28

What is the main disadvantage to using an exfoliate smear?

Answer 28

It is likely to evaluate only superficial cells, which may have little diagnostic value.

Question 29

Exfoliate cytology plays a major role in the detection of precancerous and cancerous lesions. True or false?

Answer 29

False. They play a minor role, as the method is likely to evaluate only superficial cells, which may have little diagnostic value..

Question 30

What is the function of toluidine blue dye?

Answer 30

It differentially stains cells depending on their configuration. The dye has a selective dye uptake by abnormal cells, which confirms abnormal cellular changes.

Question 31

Toluidine blue dye is often used during biopsy to define margins of the lesion to discover secondary lesions. True or false?

Answer 31

True.

Question 32

What is the primary disadvantage to using toluidine blue dye on surface lesions?

Answer 32

Inflammatory cells are often present with a benign lesion and also take up the stain, which makes interpretation of the test difficult.

Question 33

A recent study regarding toluidine blue dye suggests that only dark royal blue staining should be regarded as positive. What colour do benign lesions stain and why is that?

Answer 33

Benign lesions appear as more pale blue, as they have no nuclear staining.

Question 34

This test includes a light that provides a blue-white illumination and a flavoured acetic acid mouth rinse before the ruse to the light source. What is it?

Answer 34

Tissue Reflectance

Question 35

What is the purpose of the tissue reflectance test?

Answer 35

It permits the detection of abnormalities in the oral cavity that may not be visible.

Question 36

Describe the appearance of typical vs. abnormal epithelium during a tissue reflectance test.

Answer 36

Typical epithelium absorbs the light and appears dark, whereas abnormal epithelium reflects and appears bright white.

Question 37

A kit combining the tissue reflectance test with blue dye is available. Is this test effective in the early detection of oral cancer?

Answer 37

No, instead, they detect dysplasia, a condition that may or may not be cancerous.

Question 38

A handheld device provides the direct visualization of autofluorescence and the changes in fluorescence that can occur when abnormalities are present. The unit omits a cone of blue light into the oral cavity, creating different fluorescence responses, depending on the tissue health. Which test is this?

Answer 38

Autofluorescence (Narrow-Emission)

Question 39

Describe healthy vs. abnormal tissue appearance using autofluorescence testing.

Answer 39

Tissues considered abnormal look dark green to black; health tissues appear pale green.

Question 40

What test is a combination of tissue reflectance and autofluorescence, using a white light source?

Answer 40

Autofluorescence Spectroscopy

Question 41

What is the purpose of an autofluorescence spectroscopy test?

Answer 41

It can help to identify oral mucosal abnormalities.

Question 42

The small probe size that is used during an autofluorescence spectroscopy is only useful on smaller localized lesions and only on those initially noted by observation. True or false?

Answer 42

True

Question 43

The use of salivary biomarkers should increase the amount of unnecessary negative biopsies. True or false?

Answer 43

False. It should decrease them.

Question 44

Many of the early detection methods discussed in this unit are often subjective, requiring a biopsy for suspicious lesions. True or false?

Answer 44

True.

Question 45

Thinning of tissue layers with a shiny and translucent appearance

Answer 45

Atrophy

Question 46

A circumscribed, elevated lesion that is more than 5mm in diameter, usually containing serous fluid, and looks like a blister.

Answer 46

Bulla

Question 47

A segment or lobe that is a part of the whole; these lobes sometimes appear fused together

Answer 47

Lobule

Question 48

An area that is usually distinguished by a colour different from that of the surrounding tissue; it is flat and does not protrude above the surface of the normal tissue. Ex. Freckle.

Answer 48

Macule

Question 49

A small, circumscribed lesion usually less than 1 cm in diameter that is elevated or protrudes above the surface of normal surrounding tissue. (not puss containing)

Answer 49

Papule

Question 50

Attached by a stemlike or stalklike base, similar to that of a mushroom.

Answer 50

Pedunculated

Question 51

Discrete, slightly elevated area of altered texture or colouration.

Answer 51

Plaque

Question 52

Variously sized circumscribed elevations containing pus.

Answer 52

Pustules

Question 53

Lesions with a broad base.

Answer 53

Sessile

Question 54

Deep loss of epithelial layer that may extend to connective tissue layers.

Answer 54

Ulcer

Question 55

A small, elevates lesion less than 1cm in diameter that contains a serous fluid.

Answer 55

Vesicle

Question 56

A palpable solid lesion found in soft tissue; it can occur above, level with, or beneath the skin surface.

Answer 56

Nodule

Question 57

The evaluation of a lesion by feeling it with the fingers to determine the texture of the area.

Answer 57

Palpation

Question 58

An abnormal redness of the mucosa or gingiva

Answer 58

Erythema

Question 59

A clinical term used to describe an oral mucosal lesion that appears as a smooth red patch or granular red and velvety patch.

Answer 59

Erythroplakia

Question 60

A clinical term for a white plaque like lesion on the oral mucosa that cannot be rubbed off or diagnosed as a specific disease.

Answer 60

Leukoplakia

Question 61

Paleness of the skin or mucosal tissues

Answer 61

Pallor

Question 62

Corrugated

Answer 62

Wrinkled

Question 63

Central depression

Answer 63

Crater

Question 64

A hard covering that is composed of dried serum, pus, blood, or a combination

Answer 64

Crust

Question 65

A cleft or groove, normal or otherwise, showing prominent depth

Answer 65

Fissure

Question 66

Iduration

Answer 66

Hardness of tissue from an increased number of surrounding epithelial cells

Question 67

Resembling small, nipple-shaped projections or elevations found in clusters

Answer 67

Papillary

Question 68

Loose membranous surface layer of exudate that contains microorganisms formed during an inflammatory reaction.

Answer 68

Pseudomembrane

Question 69

Deep lesion that pushes up and stretches the surface tissue

Answer 69

Smooth

Question 70

Rough warlike surface with multiple irregular folds

Answer 70

Verrucous

Question 71

The process by which parts of a whole join together, or fuse, to make one.

Answer 71

Coalescence

Question 72

Diffuse

Answer 72

Describes a lesion with borders that are not well defined, making it impossible to detect the exact parameters of the lesion; this may make treatment more difficult and, depending on the biopsy results, more radical.

Question 73

Multilocular

Answer 73

Describes a lesion that extends beyond the confines of one distinct area and is defined as many lobes or parts that are somewhat fused together, making up the entire lesion.

Question 74

Observed radiographically when the apex of the tooth appears shortened or blunted and irregularly shaped; occurs as a response to stimuli, which can include a cyst, tumor, or trauma

Answer 74

Root Resorption

Question 75

Unilocular

Answer 75

Having one compartment or unit that is well defined or outlined, as in a simple radicular cyst

Question 76

A radiolucent lesion that extends between the roots, as seen in a traumatic bone cyst; this lesion appears to extend up the periodontal ligament

Answer 76

Scalloping Around Root

Question 77

Term used to describe a lesion with borders that are specifically defined and in which one can clearly see the exact margins and extent

Answer 77

Well Circumscribed

Question 78

After arriving at a differential diagnosis, information from which one of the following categories will best establish a final or definitive diagnosis? a. Clinical b. Historical c. Microscopic d. Radiographic

Answer 78

Microscopic