2: Oral manifestations of systemic disease Flashcards
What papillae are found in a V shape towards the posterior end of the tongue?
Circumvallate papillae
Foliate papillae are associated with which lymphatic tissue?
Tonsils
What is an exostosis?
Cartilaginous growth off a bone as part of normal development
What normal bony growths are found underneath the tongue?
Torus mandibularis
If you have any doubt over whether or not an oral finding is normal, what should be done with the patient?
Referred
What is angular cheilitis also known as?
Angular stomatitis
What is the underlying cause of angular cheilitis?
Anaemia
Haematinic deficiency (iron, Vitamin B12 and folate)
What does angular cheilitis look like?
Inflammation of corners of lips
What do mouth ulcers look like?
Superficial
Round
Yellow
Apthous ulcers are (a one off / recurrent).
recurrent
What causes apthous stomatitis (mouth ulcers)?
Anaemia
Haematinic deficiency (Iron, Vitamin B12 or folic acid)
What is haematinic deficiency?
A deficiency of:
Iron
Vitamin B12
Folate
People with recurrent mouth ulcers should be screened for which GI diseases?
(Which testing method is used?)
Coeliac disease; IBD
IgA-tTG test; Colonoscopy
Which disease, other than coeliac disease, can cause mouth ulcers due to damage to the oral mucosa and malabsorption?
Crohn’s disease
Recurrent oral ulceration is, in general, an indication of ___ disease.
GI
In Crohn’s disease, ulcers are similar to those seen in deficiency - where are they found?
Crevices in the mouth
What aspect of the oral cavity can be inflamed in Crohn’s disease?
Gingiva
What may be found in the inferior midline of the oral cavity in Crohn’s disease?
Mucosal tags
What may be found in the palate of Type II diabetes patients?
Thrush
Oral candidiasis
Upon scraping thrush from a patient’s palate, what would you see?
Erythema
Who else may develop oral candidiasis?
Asthmatics who use ICS
Oral thrush is a marker of ___ control of diabetes.
poor
What endocrine disease is oral thrush an indicator of?
Type II diabetes
Oral symptoms may occur as an adverse reaction to ___.
medication
What is nicorandil used to treat?
What class of drug is it?
Angina
K+ channel activator
What oral reaction do patients have to nicorandil?
Mouth ulcers
insert pic
If a patient develops ulcers anywhere after starting on nicorandil, what should you do?
Stop using it
Where else may nicorandil-related ulcers appear?
GI tract (bad - bleeding, peritonitis)
Conjunctiva
Anus
What disease causes lesions in the mouth, skin etc. and is potentially malignant?
Lichen planus
What kind of oral lesions are caused by lichen planus?
White thready lesions
Wickham’s striae
Lichen planus can also cause inflammation of the ___.
gingiva
Can lichen planus lesions be removed by scraping?
No
Oral manifestations of lichen planus tend to appear (unilaterally / bilaterally).
bilaterally
What anti-hypertensive drug can cause lichen planus?
ACE inhibitors
What dental procedure can cause lichen planus?
Fillings
The causes of the vast majority of lichen planus are ___.
unknown
How is lichen planus diagnosed?
Biopsy
How is lichen planus treated?
Usually isn’t - symptom management only
Topical steroids
What is a rare condition which has both oral and conjunctival manifestions?
Mucous membrane pemphigoid
What is seen in the mouth of someone with mucous membrane pemphigoid?
Blisters
Oral mucous membrane pemphigoid ___ without issue.
Conjunctival mucous membrane pemphigoid can cause ___ and __ __ __.
heals
scarring , loss of sight
Who should someone with mucous membrane pemphigoid be referred to?
Opthalmologist
What rheumatic disease has oral manifestations?
Sjogren’s syndrome
What is the oral manifestation of Sjogren’s syndrome?
Dry mouth
Who should a patient with dry mouth associated with Sjogren’s syndrome be referred to?
Rheumatologist
If your tongue spatula, or dental mirror, or gloved finger is sticking to the inside of the patient’s mouth, what do they have?
Dry mouth
Patients with a dry mouth tend to have ___ saliva.
foamy
There are a lot of oral signs indicating ___ infection.
HIV
Which oral infection, also seen in those with Type II diabetes, is seen in the oral cavities of HIV / AIDS sufferers?
Thrush / oral candidiasis
What is hairy leukoplakia?
What acute infection does it indicate?
What chronic infection does it indicate?
Lesions on the lateral aspect of the tongue with a hairy appearance
Epstein-Barr virus
caused by HIV
If hairy leukoplakia or Kaposi’s sarcoma are found in a patient’s mouth, what should they be tested for?
HIV / AIDS
What type of oral cancer is seen on the tongue?
Squamous cell carcinoma
Where in the mouth is squamous cell carcinoma found?
Tongue
