ch 09 allergies and immunologic diseases

Question 1

Elevated painful fungivform papillae often red, white or yellow in color with unknown etiology resolving on their own

Answer 1

Transient Lingual papillitis

Question 2

This is a common oral mucosal pathoses that is caused by different things in different people, characterized by a large ulcer on nonkeratinized mucosa

Answer 2

Aphthous ulcer/Aphthous stomatitis/recurrent aphthous ulcer (RAU)

Question 3

Layman’s term for Recurrent Aphthous ulcer(RAU)

Answer 3

Canker sore

Question 4

7 factors that can contribute to Recurrent Aphthous Ulcer (RAU)

Answer 4

Allergies Genetics
Nutritional deficiency Hematologic abnormalities Hormones
Trauma
Stress

Question 5

9 systemic disorders associated with Recurrent Aphthous Ulcer (RAU)

Answer 5

Bechet’s Syndrome (ocular/orogenital lesions)
Celiac disease (Gluten sensitivity in Small intestine) Cyclic neutropenia (cyclic low neutrophils ~21 days) Nutritional deficiencies
IgA deficiency
Immunocompromised
Inflammatory Bowel Disease
Reiter’s Syndrome (inflammatory arthritis,
conjunctivitis, urethritis/cervicitis)
Sweet’s syndrome (febrile neutrophilic dermatosis)

Question 6

3 Clinical variations of aphthous ulcer

Answer 6

Minor 80% Major 10%

Herpetiform 10%

Question 7

Aphthous ulcer variation with fewest recurrences, shortest duration, 1-5 lesions buccal and labial mucosa, but very painful

Answer 7

Minor aphthous

Question 8

Longest duration aphthous ulcer taking 2-6 weeks to heat, 1-10 lesions, labial mucosa, soft palate, tonsillar fauces, may cause scaring

Answer 8

Major Aphthous

Question 9

Aphthous ulcer with the most frequent recurrence, greatest number of lesion, up to 100

Answer 9

Herpetiform Aphthous ulcers

Question 10

If see HerpetiformAphthous ulcer, what should be done with medical history

Answer 10

)review med history to rule out underlying systemic disorder

Question 11

2 drugs to treat Herpetiform Aphthous ulcer

Answer 11

topical corticosteroids

Injections of triamcinolone acetonide

Question 12

Treatment for all 3 Aphthous type ulcers

Answer 12

steroids

Question 13

multisystem disorder with oral, genital, ocular lesions, always having oral lesions at some point, looking like aphthous ulcers

Answer 13

Behcet’s syndrome

Question 14

What is required to diagnose Bechet’s Syndrome

Answer 14

Recurrent oral ulcers w/ twof of the following: Recurrent genital ulcers
Eye lesions
Skin lesions Positive pathergy

Question 15

What is positive pathergy associated with Bechet’s Syndrome

Answer 15

skin reaction to the injection of sterile saline

Question 16

Where do aphthous ulcers associated with Behcet’s Syndrome appear orally

Answer 16

soft palate and oropharynz

Question 17

Treatment for Bechet’s Syndrome aphthous ulcers

Answer 17

topical or intralesional corticosteroids or oral colchicines or dapsone

Question 18

Multisystem granulomatous disorder of unknown etiology

Answer 18

Sarcoidosis

Question 19

What race is more affected by Sarcoidosis

Answer 19

Blacks, 10-17 times more than whites

Question 20

2 age range peaks for Sarcoidosis

Answer 20

25-35, 45-65

Question 21

What system is always involved in Sarcoidosis

Answer 21

Lymph

Question 22

Sarcoidosis lesions that appear frequently on the nose, ear, lips, and face that are chronic, violaceous (violet color)), indurated

Answer 22

Lupus pernio

Question 23

Sarcoidosis lesions that are scattered, nonspecific tender erythematous nodules, frequently occurring on the lower legs

Answer 23

Erythema nodosum

Question 24

What causes Sarcoid lesions

Answer 24

noncaseating granulomas

Question 25

2 syndromes associated with Sarcoidosis

Answer 25

Lofgren’s syndrome Heerfordt’s syndrome

Question 26

Character of Lofgren’s Syndrome

Answer 26

``` Erythema nodosum (sarcoid) Bilateral hilar lymphadenopathy (sarcoid) Arthralgia (joint pain) ```

Question 27

Character of Heerfordt’s Syndrome (good board question)

Answer 27

uveo-parotid fever Parotid enlargement Anterior uveitis (eye inflammation) Facial paralysis Fever

Question 28

This is a trashcan disorder that is diagnosed by the exclusion of other disorders. It’s character is nonspecific granulomatous inflammation

Answer 28

Orofacial granulomatosis

Question 29

What 4 other granuloma diseases must be ruled out before diagnosing Orofacial Granulomatosis

Answer 29

Sarcoidosis Chrohn’s disease (form of irritable disease) Fungus infection Foreign body reaction

Question 30

Orofacial granulomatosis + Facial paralysis + fissured tongue (board question)

Answer 30

Melkersson-Rosenthal Syndrome

Question 31

Allergic reaction of the oral mucosa to the systemic administration of a medication

Answer 31

stomatitis medicamentosa

Question 32

2 best things to do when person comes in with highly ulcerated mouth

Answer 32

list of meds, when they started taking each one, and how long the ulcers have been there

Question 33

Allergic contact stomatitis caused by what and is prevalent in which gender

Answer 33

diverse topical agents Female predilection

Question 34

Acute Allergic Contact stomatitis symptoms

Answer 34

burning Redness Edema Itching, stinging, tingling

Question 35

Chronic Allergic Contact stomatitis symptoms

Answer 35

erythematous White/hyperkeratotic Erosions in affected zone

Question 36

4 ways to treat Allergic Contact stomatitis

Answer 36

remove suspected allergen Antihistamine therapy Topical anesthetic (dyclonine HCl) Topical corticosteroids (fluocinonide gel or dexamethasone elixir)

Question 37

Unique inflammatory skin disease that involves the circumoral area

Answer 37

Perioral dermatitis

Question 38

What exacerbates perioral dermatitis

Answer 38

Topical corticosteroid application

Question 39

Treatment of perioral dermatitis

Answer 39

Metronidazole

Question 40

What is a risk of cinnamon flavoring

Answer 40

Contact stomatitis on gingiva

Question 41

What does cinnamon flavor induced contact stomatitis resemble

Answer 41

plasma cell gingivitis (irradescent red gingivitis)

Question 42

When there is a hypersensitivity to a dental metal, what metal is it

Answer 42

Mercury

Question 43

Lichenoid lesion only in the area of a dental material

Answer 43

Lichenoid contact stomatitis

Question 44

Hypersensitivity reactions to dental metals disappear after how many days once metal is removed

Answer 44

10-14 days

Question 45

Most commonly affected sites for Lichenoid contact stomatitis

Answer 45

posterior buccal mucosa, ventral surface of lateral border of the tongue

Question 46

46.)Diffuse edematous swelling of the soft tissues that most commonly involves the subcutaneous and submucosal connective tissues but may affect the GI or respiratory tract , occasionally fatal

Answer 46

Angioedema/Quincke’s disease

Question 47

Most common cause of Angioedema

Answer 47

Mast cell degranulation causing histamine release

Question 48

2 ways to treat angioedema

Answer 48

PO antihistamine IM Epinephrine