38. Diseases of the Oral Cavity and Oropharynx

Question 1

lack of b12 can show lobulations on the surfacy or in advanced cases be shiny smooth and red, iron deficinecy anemia can show oral mucosa as ash gray with the tongue smooth, shiny, and devoid of papillae, thalassemia has diffuse pallor or the oral mucosa and cyanosis, osler-weber-rendu disease shows spiderlike blood vessels or angiotamous ** menopausal gingivostomatitis shows dry oral mucosa with burning sensatin, diffuse erythema, shiny mucosa, and occassionally fissuring, violaceous macules on the oral mucosa is kaposi’s sarcoma, erythema multiforme shows iris like or target lesions, intraepidermoid **`

Question 2

common seen on lingual or buccal aspect of anterior mandible

Answer 2

benign bony exostosis

Question 3

neoplasm of enamel origin, presents often in the third and fourth decade ***

Answer 3

ameoblastoma

Question 4

soft palate and uvula, palatine tonsils and tonsillar pillars, palatoglossus and ***, lymphatic nodules with germinal centers, tonsillar crypts, superior pharyngeal constrictor

Answer 4

oropharynx subunits

Answer 5

grading of palatine tonsils

Question 6

acute tonsilitis, tonsillolith, peritonsillar abscess, mononucleosis, parapharyngeal space mass, lymphoma, squamous cell carcinoma

Answer 6

palatine tonsil differential

Question 7

usually viral and self limiting, supportive care with hydration and analgesia

Answer 7

acute tonsillitis

Question 8

7 episodes of tonsillitis in one year, 5 episoders per year for two consecutive years, 3+ per year for three consecutive years, significant missed school/work;hospital/ED;PTA other circumstances, hypertrophy causing upper airway obstruction like sleep disordered breahing or obstructive sleep apnea, chronic tonsillitis, tonsil stones refractory to conservative treatment, suspicion of malignancy with asymmetry tonsils or unknown primary, hypertrophy causing deglutition problems, there is morbidity of post operative hemorrhage at 2-4, dehydration, pain, post obstructive pulmonary edemna, and VPI, mortality is 1:20,000 of hemorrhage, airway obstruction, anesthesia

Answer 8

tonsillectomy surgical indications

Question 9

amalgam of bacteria and debirs, sporadic/intermitten or chronic, recurrent infections, chronic infections. ***

Answer 9

tonsil stones/tonsillolithotomy

Question 10

purulence deep to the tonsilarcapsul between the tonsil and superior constrictor muscle, presents with severe odynophagia, medialized tonsil, uvula deviation ***, diagnosis principally by history and exam, adjunctive diagnostic testing with CT with contrast and inflammatory markers, treatment with incision and drainage, potentially aspiration only, maybe IV antibiotics initially, quinsy tonsillectomy

Answer 10

peritonsillar abscess

Question 11

infections can spread fast due to spaces at the peripharyngeal and retropharyngeal areas

Answer 11

spaces

Question 12

anterior pharyngeal constrictor /buccopharyngeal fascia, posterior alar fascia, laterally parapharyngeal space and carotid sheath, extends length of neck:skull base to the mediastinum, 80% of retropharyngeal abscesses obccur before the age of 5, due to nodes of Rouvier and recedes ***

Answer 12

retropharyngeal space

Question 13

skull base to hyoid, medially bounded by visceral deep cervical fascia including the soft palate, superior constrictor, laterally by superfiical layer of the deep cervical fasica

Answer 13

parapharyngeal space