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63 Cards in this Set
- Front
- Back
how is diagnosis made
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gathering information
eight distinct diagnostic categories each piece plays a significant role in the final diagnosis. |
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the diagnostic process
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clinical diagnosis
radiographic diagnosis historical diagnosis laboratory diagnosis s microscopic diagnosis surgical diagnosis therapeutic diagnosis differential diagnosis |
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clinical diagnosis
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diagnosis is derived from the clinical appearance and palpation of the lesion. It is based on color, shape, location and history of the lesion
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radiographic diagnosis
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radiographs provide sufficient info. to establish the diagnosis
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historical diagnosis
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personal history, family history, past and present medical and dental histories, history of drug ingestion, and history of the presenting disease of lesion provides info. needed for the definitive diagnosis
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laboratory diagnosis
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lab tests, including blood chemistries and urinalysis, can provide conclusive info. for a definitive diagnosis.
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microscopic(histologic)diagnosis
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microscopic evaluation of a biopsy specimen taken from the lesion is often the main component of the definitive diagnosis
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surgical diagnosis
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surgical intervention provides conclusive evience of the diagnosis when the lesion is opened.
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therapeutic diagnosis
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prescribing therapeutic drugs and observing the results based on clinical and historical information.
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differential diagnosis
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a list of possible diseases or lesions that fit the information derived from evaluation of the patient.
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How do you begin
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before you can id a lesion or abnormal condition, it is necessarry to have a solid understanding of the basic and dental sciences, such as human anatomy and physiology, histology, and dental anatomy.
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clinical symptoms
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described by the patient
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clinical signs
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described by the examiner
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ex. of clinical symptoms
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pain
throbbing pain and ache pressure pain heat chill sweating |
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soft tissue lesions
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macule, papule, nodule, tumor, exophytic, sessile, erosive, erythematous, pedunculated, papillary , vesicle, bullous, pustular, ulcerated, plaque
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macule
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an area that is usually distinguished by a color different than that of the surrounding tissue. it is FLAT and does not protrude above the surface of the normal tissues. (freckles)
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papule
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a small curcumscribed lesion usually less than 1 cm in diameter that is elevated or protrudes above the surface of normal surrounding tissue.
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nodule
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a palpable SOLID lesion up to 1 cm. in diameter found in soft tissue. it can occur above, level with or beneath the skin or mucosal surfaces
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tumor
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a solid, raised mass that is LARGER than 1 CM in dieameter and has the dimension of depth. this term also describes a mass consisting of neoplastic cells.
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exophytic
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an outwardly growing lesion
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pedunculated
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attached by a STEM LIKE OR STALK base similar to that of a mushroom.
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sessile
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describing the base of a lesion that is flat or broad instead of stem like
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papillary
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describing a small nipple shaped projection or elevation usually found in clusters
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vesicle
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a well defined lesion of the skin and mucous membranes that resembles a sac, contains fluid and is less than 1 cm. in diameter
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bulla
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a curcumscribed elevated lesion that is MORE THAN 1 cm in diameter and contains serous fluid, and looks like a blister
This is commonly associated with autoimmune diseases |
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pustule
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variously sized circumscribed elevations containing PUS
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ulcer
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loss of surface tissue (epithelial covering) due to a sloughing of necrotic inflammatory tissue.
it can be caused by infection, trauma, abnormal immune reaction, malignancies (cancer) |
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erosion
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a non healing ulcer
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fissure
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a narrow slit of cleft
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plaque
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an area with a flat surface and raised edges
if white = leukoplakia |
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petechia
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little red spots on the slkin or mucous membrant, ranging in size from pinpoint to several millimeters in diameter caused by escape of a small amount of blood.
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eccymosis
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large redish blue areas caused by the escape of blood into the tissues, commonly referred to as a brusie. Echymosis do not blanch on diascopy
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telangiectasia
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the formation of capillaries near the surface of a tissue. may be a sign of hereditary disorder, alcohol abuse, or malignancy in the region.
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consistency upon palpation
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soft, hard, cheesy, fluctuant, rubbery, firm, bony, undurated
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soft
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lesion composed of soft tissue
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hard
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lesion not easlily penetrated, cut, or seperated into parts; not yielding to pressure; firm; solid; compact
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cheesy
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lesions textures is similar to curds of cheese
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fluctuant
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a wave like motion that is felt when a fluid containing structure is palpated
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rubbery
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lesion resembling rubber; having elasticity
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firm
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fixed; closely compressed; compact lesion
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bony
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lesion consisting of bone, or of bones; full of bone; pertaining to bone
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indurated
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an excessive hardening or firmness
hard borders are common here. |
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color upon inspection
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erythamatous, blanchin, pigmented, white, yellow
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erythematous
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reddish color
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size
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mm; cm
size of lesion is best estimated by comparing the lesion with familiar landmarks of known size immediately adjacent to it. |
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variation of normal
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fordyce granules, tori(palatinus and mandibularis), physiologic pigmentation, leukodemia, lingual varicocities
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fordyce granules
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collections of ectopic (out of place) sebaceous glands that occur in various locations within the oral cavity.
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torus palatinus (tori)
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an exophytic nodular growth of dense cortical bone located in the midline of the palate
- no need to remove unless patient needs an upper denture. |
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torus mandibularis
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an exophytic nodular growth of dense cortical bone located in the canine/premolar area of the lingual mandible.
- asymptomatic |
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physiologic melanin pigmentation
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a normal finding of melanin-containing cells in the gingival tissues of non Caucasians.
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lingual varicosities
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prominent, dilated, lingual veins on ventral and lateral surface of teh tongue; asymptomatic, with bilateral symmetry; requires no treatment. Most commonly seen in the elderly
- may be seen in the upper and lower lip |
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leukoedema
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accumulation of fluid within epithelial cells of the buccal mucosa presented as a grayish or white mucosal lesion
- asymptomatic - common in non - caucasian - when you stretch the cheek the color goes away. |
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benign conditions of unknown origin (idiopathic or unknown etiology)
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fissured tongue, geographic tongue, hairy tongue
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hairy tongue
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a relatively rare condition in whith the filiform papillae become elongated resulting in a white, yellow, brown, or black hairy tongue
- the patient may complain of pain - due to poor tongue hygeine - brush to make pain go away |
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geographic tongue (migratory glossitis)
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multiple, occasionaly sensitive, irregularly shaped erythematous patches on the tongue with white rims that enlarge and change shape.
- loss of papillae - has a distinct white rim - sores move with time - to fix it: rinse with salt water or topical steroid, if severe. |
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fissured tongue
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a rare disorder characterized by grooves or depressions (fissures) on the tongue
- symptoms may occur if they don't clean good enough. |
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radiographic terminology
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radiolucent, radiopaque and mixed.
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radiographic shape
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unilocular ; multilocular
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If margin of radiograph is well defined then
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it is likely a slow growing lesion
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if the margin of a radiograph is poorly defined (moth eaten?)
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may ID malignancy or rapid growing infection.
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unilocular
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a term used to describe a radiograph appearance of a single, rounded compartment or locule.
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multiolocular (honeycomb)
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a term used to describe a radiographic appearance of multiple, rounded campartments of locules. These can appear as soap bubbles or honeycomb like.
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other radiographic terminology
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root resorption - breakdown or destruction of root structure.
scalloping - fluted border ground glass - fine radiopaque spots in radiolucent background expansile (cortical expansion) - capable of being extended or expanded punched out radiolucency - small areas of radiolucency. |