Diseases of Oral Cavity - Kleppinger Flashcards
Identify this condition and describe the management:
pt (4 yo) presents with a lesions on the attached gingiva and moveable mucosa
exam: irritable, anorexia, anterior cervical lymphadenopathy, fever (103-105)
Primary Herpetic Gingivostomatitis (children)
typically occurs 6 months to 5 years
MAY BE ASYMPTOMATIC
Primary Herpetic Infections Adult
presents as pharyngotonsillitis
watch for vessicles on tonsillar pillar
clinically similar to bacterial tonsillitis
Identify this condition and describe the managment:
pt presents with multiple vesicles containing clear fluid on her lower lip, she noted that the area felt tingly the day before
Recurrent Oral Herpes (Cold Sores)
prodromal stage: 12 hours-2 days prior to outbreak
vesicels crust over in approximately 1 week, total healing 2 weeks
subsequent eruptions triggered by: stress (UV light, malnutrition, trauma, immunological issues)
TX: Pencyclovir (Cream), Valacyclovir (capusles) - taken at the onset of the prodromal stage
Identify this condition and describe the management:
pt presents with 2 lesions approximately 5 mm in size on the non-keratizined tissues of his mouth, the lesions are ulcerated, erythematous macules with a red halo and very painful
Minor Apthous Stomatitis (Canker Sore)
immunologic cause - minor trauma + trigger
80% of all apthous stomatitis
heals over without scars in 7-10 days
tx: topical corticosteroids (triamcinolone acetonide)
Identify this condition and describe the management:
pt presents with a painful 3 cm lesion on the labial mucosa
Major Apthous Stomatitis
10% of Apthous Stomatitis
cause: immunolgic
other sites: posterior oral cavity, soft palate, tonsillar fauces
heals with scarring in 2-6 weeks
tx: topical corticosteroid (triamcinolone acetonide)
Identify this condition and describe the management:
pt presents with numerous lesions (2 mm in size) across the entire mucosal surface
Herpetiform Apthous Stomatitis
greatest number of lesions (up to 100), most frequent recurrences
predominantely nonkeratinized tissue but can occur on any oral mucosal surface
form of erythema multiforme
tx: topical corticosteroid (triamcinolone acetonide)
Identify this condition and describe the management:
pt presents with white, cottage cheese like plaque on his tongue and a “bad taste” in his mouth
exam: the plaque could be wiped away with a tongue blade
Candidiasis (aka trush)
most common oral fungal infection
caused by Candida Albicans
predisposing factors: diabetes mellitus, steroids, broad-spectrum antibiotics, dentures, iron-deficiency, immunocompromised
Identify this condition:
pt reports that his mouth feels “like it was scalded”, he was on penicillin a week ago for strep throat
Acute Atrophic Candidiasis
antibiotic sore mouth
tx: clotrimazole (troche), Nystatin (ointment)
Identify this condition:
pt presents with an erythematous, sharply circumscribed, asymptomatic, plaque-like lesion on the dorsal midline of the tongue
Median Rhomboid Glossitis
tx: clotrimazole (troche), Nystatin (ointment)
Identify this condition:
pt presents with erythema, fissuring and scaling of the corners of the mouth
Angular Cheilitis
causes: C. Albicans, Mixed, Staph aureus
combined with old, worn dentures and collapsed bite
tx: clotrimazole (troche), Nystatin (ointment)
Identify this condition:
pt is an 80 year old female, presents with asymptomatic, red, irritated tissue below where her dentures are placed
Denture Stomatitis
aka Chronic Atrophic Candidiasis
tx: clotrimazole (troche), Nystatin (ointment)
define Leukoplakia
not a disease but a clinical term
white patch or plaque that cannot be attributed to any other disease
pre-malignant lesion (4% lifetime risk of malignant transformation
risk of lesion increases with age
etiology of Leukoplakia
tobacco: (80% of smokers)
alcohol: synergistic effect with tobacco
UV: low lip vermillion
microbes: C. albicans and HPV
define Erythroleukoplakia
speckled leukoplakia
red and white mixed colored lesion
28% transformation to malignancy
define Erythroplakia
pre-malignant lesion
50% are already invasive carcinoma by time of biopsy
typically found of floor of mouth, tongue and soft palate (all high risk locations)
What are the 4 clinical variants of oral Squamous Cell Carcinoma?
leukoplakia (erythroleukoplakia)
erythroplakia
exophytic (mass-forming)
endophytic (ulcerating)
Oral Squamous Cell Carcinoma
90% of oral malignancies
far more deadly than SCC of skin
