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Oral pathology > acute and chronic ulcerative lesions 1 > Flashcards

acute and chronic ulcerative lesions 1 Flashcards

1
Q

anesthetic necrosis category

A

injury

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2
Q

anesthetic necrosis etiology

A
  • necrosis secondary to administration of local anesthetic
  • may result from ischemia or faulty technique
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3
Q

anesthetic necrosis demographics

A

patients who recently received oral local anesthetic

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4
Q

anesthetic necrosis clinical presentation

A
  • well circumscribed ulcer at site of previous injection
  • hard palate most common site
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5
Q

anesthetic necrosis diagnosis

A

clinical diagnosis based on history of recent local anesthetic injection

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6
Q

anesthetic necrosis tx

A

heals over time

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7
Q

necrotizing sialometaplasia category

A

injury

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8
Q

necrotizing sialometaplasia etiology

A

ischemia of salivary tissue leads to local infarction

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9
Q

necrotizing sialometaplasia demographics

A

predisposing factors:
- trauma
- dental injections
- ill-fitting dentures
- eating disorders with binge-puringing
- upper respiratory tract infection

remember injury category

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10
Q

necrotizing sialometaplasia clinical presentation

A
  • most cases on hard palate
  • nonulcerated, painful swelling initially
  • within 2-3 weeks, a crater-like ulcer forms and pain is reduced
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11
Q

necrotizing sialometaplasia diagnosis

A

biopsy (a malignant process must be excluded)

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12
Q

necrotizing sialometaplasia tx

A

heals in 5-6 weeks

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13
Q

primary herpetic gingivostomatitis category

A

infectious

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14
Q

primary herpetic gingivostomatitis etiology

A

initial infection of herpes simplex virus type 1 (HSV-1)

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15
Q

primary herpetic gingivostomatitis demographics

A
  • usually in children 6 months to 6 years
  • can occur in adults
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16
Q

primary herpetic gingivostomatitis clinical presentation

A
  • acute onset
  • may have fever and lymphadenopathy
  • multiple small vesicles progress to ulceration of oral mucosa, lips and perioral skin
  • painful, erythematous gingiva
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17
Q

primary herpetic gingivostomatitis diagnosis

A
  • clinical diagnosis
  • viral culture (slow) or PCR
  • cytologic smear (least invasive, most cost effective)
  • biopsy
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18
Q

primary herpetic gingivostomatitis tx

A
  • lesions heal spontaneously in 2 weeks
  • symptomatic relief (NSAIDs, lidocaine rinse)
  • antiviral (should be administered during day 2 or 3 for best effect)
  • HSV-1 remains latent in the trigeminal ganglion
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19
Q

cytologic smear steps

A
  • lightly moisten tongue depressor with water
  • gently remove cells (scrape) area
  • spread accumulated cells on microscope slide
  • spray slide lightly with fixative
  • submit to pathologist
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20
Q

primary herpetic gingivostomatitis antiviral prescriptions

A
  1. Valacyclovir (Valtrex) 1 g
    disp: 14 tabs
    sig: 1 tab every 12h until finished
  2. Acyclovir (Zovirax) 400 mg
    disp: 21 tabs
    sig: 1 tab three times a day until finished
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21
Q

recurrent herpes labialis category

A

infectious

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22
Q

recurrent herpes labialis etiology

A
  • reactivation of HSV-1
  • can recur multiple times
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23
Q

recurrent herpes labialis risk factors

A
  • advanced age
  • UV light
  • physical/emotional stress
  • dental treatment
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24
Q

recurrent herpes labialis demographics

A

worldwide prevalence of HSV-1 is 67% in individuals under 50

25
recurrent herpes labialis clinical presentation
- may experience prodrome 6-24 hrs before lesions appear ---> pain, burning, itching, tingling, localized warmth, erythema - multiple, small, erythematous papules form clusters of fluid-filled vesicles - affects vermillion border and skin adjacent to lips
26
recurrent herpes labialis diagnosis
- clinical diagnosis - viral culture (slow) or PCR - cytologic smear - biopsy
27
recurrent herpes labialis tx
- antivirals - heals in 7-10 days
28
recurrent herpes labialis when should the antivirals be taken
must be taken at earliest prodromal symptom
29
recurrent herpes labialis antiviral prescriptions
1. Valacyclovir (Valtrex) 500 mgs Disp: 7 tabs Sig: Take 4 initially, 2 at 12 hrs, then 1 at 24 hrs 2. Acyclovir (Zovirax) 800 mg Disp: 6 tabs Sig: take 3 initially, then 2 at 12 hrs, then 1 at 24 hrs
30
recurrent intraoral herpes simplex category
infectious
31
recurrent intraoral herpes simplex etiology
- reactivation of HSV-1
32
recurrent intraoral herpes simplex risk factors
- advanced age - UV light - physical/emotional stress - dental treatment
33
recurrent intraoral herpes simplex clinical presentation
- affects keratinized mucosa bound to bone (attached gingiva, hard palate) - small vesicles that collapse to form cluster of erythematous macules
34
recurrent intraoral herpes simplex diagnosis
- clinical diagnosis - viral culture (slow) or PCR - cytologic smear - biopsy
35
recurrent intraoral herpes simplex treatment
- antiviral (same as recurrent herpes labialis) - heals in 7-10 days
36
herpes zoster is aka
shingles
37
herpes zoster category
infectious
38
herpes zoster etiology
- reactivation of Varicella Zoster Virus (HHV-3) - recurs once
39
herpes zoster demographics
- incidence increases with age - immunosuppression increases susceptibility
40
herpes zoster clinical presentation
- prodrome: severe neuralgia (with or without fever, malaise, and headache) - acute: clusters of vesicles with erythematous base, terminate at midline - chronic: postherpetic neuralgia (15% of patients) - pain and lesions tend to occur alone one dermatome
41
herpes zoster diagnosis
- clinical diagnosis - viral culture (slow) or PCR - cytologic smear - biopsy
42
herpes zoster treatment
- antiviral (within 3 days of onset) - symptomatic relief (NAIDs, diphenhydramine, gabapentin, steroids)
43
herpes zoster prevention
shingrix vaccine recommended for adults 50 years and older
44
herpes zoster antiviral prescriptions
1. Valacyclovir (Valtrex) 500 mg Disp: 42 tabs Sig: 2 tabs three times a day until finished 2. Acyclovir (Zovirax) 400 mg Disp: 70 tabs Sig: 2 tabs five times daily until finished
45
hand-foot-and-mouth disease category
infectious
46
hand-foot-and-mouth disease etiology
enterovirus infectious
47
hand-foot-and-mouth disease demographics
most common in children
48
hand-foot-and-mouth disease clinical presentation
1. oral lesions arise first - multiple apthous-like ulcerations - buccal mucosa, labial mucosa, and tongue most common 2. cutaneous lesions - erythematous macules become vesivles - primarily affects hands and feet
49
hand-foot-and-mouth disease diagnosis
- clinical diagnosis - PCR confirmation if necessary
50
hand-foot-and-mouth disease tx
self-limiting (no tx necessary)
51
necrotizing ulcerative gingivitis category
infectious
52
necrotizing ulcerative gingivitis etiology
Fusobacterium nucleatum (and other bacteria)
53
necrotizing ulcerative gingivitis demographics
most frequent among young and middle-aged adults
54
necrotizing ulcerative gingivitis risk factors
- psychologic stress - immunosuppression - smoking - local trauma - poor nutritional status - poor oral hygiene - inadequate sleep - recent illness
55
necrotizing ulcerative gingivitis clinical presentation
- interdental papillae blunted, inflamed, edematous, and hemorrhagic - "punched out" craterlike necrosis covered with gray pseudomembrane - fetid odor - severe pain - may be accompanied by lymphadenopathy, fever, and malaise
56
necrotizing ulcerative gingivitis diagnosis
clinical diagnosis
57
necrotizing ulcerative gingivitis tx
- scaling, curettage, or ultrasonic instrumentation - chlorhexidine rinse - antibiotics if lymphadenopathy or fever present - evaluation for underlying cause of immunosuppression (HIV)
58

Oral pathology (7 decks)

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