617 the mouth

Question 1

Apthous Stomatitis

Answer 1

Cancore sores-painful, shallow recurrent, painful ulcers of the oral mucosa
caused by direct trauma, vitamin deficiency, anemia

Question 2

Apthous Stomatitis

Answer 2

PE: circular shallow ulcers covered by a grey membrane and raised border that is inflammed. Minor occurances 1-5, major recurrent 5 or more and herpeliform-recurrent is 5-100
TX: self-limiting, benedryl/mylanta swish and swallow or lidacaine/ ? swish and spit. Can use nystatin for relief. Solve underlying problem
Ck hx of smoking, family prevelence, alcohol, chew, ??

Question 3

Glossitis

Answer 3

Swollen tongue that may change color, smooth
HX: may be allergic reaction, dry mouth, recent infection, low fe+, ck social hx, yeast, trouble speaking, swallowing, etc?

Question 4

Glossitis

Answer 4

PE: finger-like bumps on the surface of the tongue.
Swollen, tender tongue, smooth surface, pale or fire red?
TX: good hygiene, magic mouthwash, or treat with nystatin swish and swallow. 5 ml 4 times per day. If fungal, can use diflucan for 10 days 100-200 mg.

Question 5

Parotitis

Answer 5

Mumps-fever, chills, pus-like discharge. Need two dose MMR. Get CBC and C&S. Parenteral antibiotics with resistant penicillins amoxicillin-clavulante

Question 6

Pharyngitis

Answer 6

strep throat caused by Group A streptococus

Question 7

Strep-

Answer 7

sore throat, fever, HA, n/v, swollen lymph nodes, absence of cough and URI symptoms. HPI is very important is treating empirically

Question 8

#1-History of fever
#2 exudate on tonsils
#3 anterior lymphandenopathy
#4 absence of cough

Answer 8

If they have all 4 you can treat
If they have 3 and a + rapid strep test you can treat
if they have 2 and + rapid strep test you can treat
No two and neg rapid, do not treat

Question 9

strep

Answer 9

PE: mouth, throat, nose, neck, CV, resp, rapid strep test, culture of throat
Based on these, treat with penicillin 250mg BID for 10 days or amoxicillin if PCN allergies. Dispose of toothbrush after three days. Contagious. non contagious after 24 hours of antibiotics and no fever.
Take all meds, etc.

Question 10

Strep

Answer 10

can cause glomerulonephritis and acute rhuematic fever

Question 11

strep

Answer 11

when treated should start to feel better in 24-48 hours

Question 12

Thrush

Answer 12

yeast infection of the mucous membrane lining the mouth and tongue. white velvety sores that may bleed.
HX: cancer, chemo, diabetes, recent antibiotic use, dentures

Question 13

thrush

Answer 13

PE: tongue, mouth, throat, neck, CV, resp
Culture mouth lesions
TX: nystatin-4-6 ml (100,000u/ml) swish and swallow
Diflucan 100-200 mg daily

Question 14

Infectious mononucleosis

Answer 14

viral infection, caused by Epstein Barr virus. or cytomeglalovirus. Fever, sore throat, swollen lymph nodes, fatigue.
OLDCARTS:-fever, fatigue, muscle aches, sore throat, just fees ill

Question 15

Infectious mononucleosis

Answer 15

PE: nose, throat, neck, CV, respiratory, GI-spleen, liver, MS, skin, do a rapid monospot test and an antibody titer

Question 16

Mono

Answer 16

Treatment: fluids, rest, NSAIDS, salt water gargles, corticosteroids, No contact sports for 4 weeks. client muct come back. Extremely infectious. Can feel crappy up to a year.