white lesions

Question 1

features of epithelial thickening

Answer 1

asymptomatic, rough, DO NOT rub off

Question 2

features of surface debris

Answer 2

symptomatic, rub off, underlying erythema

Question 3

features of subepithelial lesions

Answer 3

asymptomatic, smooth to palpation, translucent

Question 4

keratinized tissue in oral mucosa

Answer 4

tongue, hard palate, attached ging, outer lip

Question 5

non-keratinized tissue in oral mucosa

Answer 5

everywhere else

buccal and labial mucosa, soft palate, floor of mouth

Question 6

what makes lesions white

Answer 6

hyper-keratinized tissue

Question 7

white sponge nevus

Answer 7

autosomal dominant with abnormal keratin production, appearing in early childhood

Question 8

white sponge nevus presents as

Answer 8

multiple white rough surface lesions throughout oral cavity (bilateral)

Question 9

vacuolation of the spinous layer appears in

Answer 9

white sponge nevus

Question 10

tx for white sponge nevus

Answer 10

no tx needed, not pre malignant

Question 11

frictional keratosis

Answer 11

huge callous
related to chronic rubbing or friction anywhere in the oral cavity (even on places that don’t normally have keratinized tissue)

Question 12

tx of frictional keratosis

Answer 12

reduces/resolves after removal of causative agent

Question 13

hairy tongue

Answer 13

elongation of filiform papillae due to the accumulation of keratin

Question 14

tx of hairy tongue

Answer 14

brush/scrape with tongue

Question 15

hairy leukoplakia

Answer 15

thickening of the BILATERAL surfaces of the tongue usually in immunocompromised pts

Question 16

tx for hairy leukoplakia

Answer 16

none (other than to determine the immune status of the pt)

Question 17

leukoedema

Answer 17

variation of normal that looks white, opalescent, filmy, folded surfaces, does not rub off

Question 18

tx of leukoedema

Answer 18

none, stretch it goes away (water is “expelled” bt cells)

Question 19

erythema migrans

Answer 19

geographic tongue/benign migratory glossitis

red with white borders due to atrophy of filiform papillae with elevated white border

Question 20

opposite of hairy tongue

Answer 20

erythema migrans (destruction of filiform papillae due to inflammation)

Question 21

type of sensation associated with erythema migrans

Answer 21

burning sensation

Question 22

tx for erythema migrans

Answer 22

topical steroids for symptomatic lesions

Question 23

lichen planus

Answer 23

common oversensitivity to T lymphocytes

AI disease with unknown trigger

Question 24

how is lichenoid mucositis different than lichen planus

Answer 24

due to reaction to meds
graft vs host disease
may be focal or multifocal
but same microscopic and clinical appearance

Question 25

skin features of lichen planus

Answer 25

p's: | planar, purple, pruritic, polygonal, plaque, papule

Question 26

describe the lesions of lichen plaus

Answer 26

multifocal, bilateral on buccal mucosa

Question 27

2 types of presentations of lichen planus

Answer 27

1. reticular (wickhams stria - white lacey) | 2. erosive (painful ulceration, wickhams striae can be present too)

Question 28

tx of reticular lichen planus

Answer 28

because they are asymptomatic, no tx occurs, but if there is burning, tx with topical corticosteroids

Question 29

tx of erosive lichen planus

Answer 29

topical corticosteroids

Question 30

clinical way to determine lichen planus or lichenoid mucositis

Answer 30

find out in the history if they have had a bone marrow transplant (graft vs host disease) OR if it is unilateral reacting to amalgam

Question 31

nicotinic stomatitis

Answer 31

hot nicotine causing inflammation of the palate/minor salivary gland ducts no premalignant potential

Question 32

t/f reverse smoker's palate has a significant risk of dysplasia/carcinoma

Answer 32

true

Question 33

linea alba

Answer 33

variation of normal, where the teeth come together on the buccal mucosa no tx

Question 34

morsicatio buccarum

Answer 34

``` chronic cheek chewing laborium = labial mucosa linguarum = tongue no tx (lateral acrylic shield ```

Question 35

leukoplakia

Answer 35

a white patch/plaque that cannot be characterized clinically as any other disease only way to determine true diagnosis is with a biopsy and microscope

Question 36

t/f. leukoplakia is strictly a clinical term and implies a specific diagnosis

Answer 36

true, then false. it does NOT imply a specific diagnosis

Question 37

hyperkeratosis

Answer 37

callous, not premalignant, does not need removal

Question 38

epithelial dysplasia

Answer 38

premalignant | mild - not removed; moderate - can be removed; severe - remove

Question 39

t/f carcinoma in situ and superficial squamous cell carcinoma must be removed

Answer 39

true

Question 40

t/f. carcinoma in situ is confined to epithelium

Answer 40

true

Question 41

candida

Answer 41

most common oral fungal infection | component of normal oral microflora

Question 42

predisposing factors to candida

Answer 42

immunodeficiency, acquired immunosupression, endocrine disturbances, DM, corticosteroids, systemic sb therapy, xerostomia, bad hygiene

Question 43

pseudomembrane candidosis

Answer 43

thrush white plaques that RUB OFF leaving a red base pain or burning sensation

Question 44

tx of candidiasis

Answer 44

topical - nystatin rinse or ointment, clotrimazole rinse or troches, ketoconazole cream systemic - ketoconazole or fluconazole tablets

Question 45

what can determine diagnosis of candida

Answer 45

cytology smear

Question 46

toothpaste slough is due to

Answer 46

sodium lauryl sulfate and pyrophosphates which can cause burning and look like gray/white plaques, but is more apparent in the morning

Question 47

burns are an area of...

Answer 47

yellow-white epithelial necrosis

Question 48

congenital cysts

Answer 48

developmental "inclusion" cysts | Epstein pearls or Bohns nodules (salivary) or gingival cysts of a new born

Question 49

tx of cysts

Answer 49

no tx

Question 50

fordyce granules

Answer 50

ectopic sebaceous (sweat) glands that appear as yellow, granular plaques and nodules

Question 51

tx of fordyce granules

Answer 51

none

Question 52

if something is classified as leukoplakia, it can be 1 of these 4 things

Answer 52

hyperkeratosis (most frequent) epithelial dysplasia carcinoma in situ squamous cell carcinoma