Oral Medicine and Pathology Flashcards

A patient presents with a white patch on the lateral border of the tongue that cannot be wiped off. Which diagnosis should be considered first and investigated?

Answer: Leukoplakia — a potentially malignant disorder requiring biopsy to exclude dysplasia

A white patch that cannot be wiped off is a leukoplakia by definition. As a potentially malignant disorder with variable rates of malignant transformation, it requires biopsy and histological examination to assess for dysplasia.

Which of the following is the MOST common type of oral cancer?

Answer: Squamous cell carcinoma (SCC)

Squamous cell carcinoma accounts for over 90% of oral malignancies. It arises from the stratified squamous epithelium lining the oral cavity and is strongly associated with tobacco and alcohol use.

A patient presents with multiple painful oral ulcers, each measuring 3-5mm, affecting the labial and buccal mucosa but not the attached gingiva. The ulcers heal without scarring within 7-10 days but recur regularly. What is the most likely diagnosis?

Answer: Minor recurrent aphthous stomatitis (minor RAS)

Minor RAS (aphthous ulcers, canker sores) classically presents as recurring small round/oval ulcers on non-keratinised movable mucosa, healing without scarring in 7-10 days. They are the most common oral mucosal ulcerative condition.

Which salivary gland is MOST commonly affected by pleomorphic adenoma?

Answer: Parotid gland

Pleomorphic adenoma (benign mixed tumour) most commonly arises in the parotid gland, which accounts for approximately 80% of salivary gland tumours, with the majority being benign and pleomorphic adenoma being the most common benign type.

Erythroplakia in the oral cavity is significant because it:

Answer: Has the highest risk of all oral mucosal lesions for malignant transformation or existing carcinoma

Erythroplakia (a red patch that cannot be attributed to another cause) carries the highest risk of all oral mucosal lesions — approximately 90% show severe dysplasia, carcinoma in situ, or invasive squamous cell carcinoma on biopsy.

Oral candidiasis most commonly presents as pseudomembranous candidiasis ('thrush'). Which patient group is at HIGHEST risk for developing this condition?

Answer: Immunocompromised patients, denture wearers, patients on broad-spectrum antibiotics, or inhaled corticosteroid users

Oral candidiasis predominantly affects those with compromised host defences — HIV/immunosuppression, denture wearers (especially with poor hygiene), patients on antibiotics (disrupting normal flora), and steroid inhaler users.