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Patient Care 2 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

The extraoral exam must be performed in a ______ and _____ fashion

A

through and systematic

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2
Q

what is defined as “WNL”

A

normal, found in most individuals

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3
Q

what is defined as “not present in all individuals but still within normal limits”

A

atypical- a variation of normal

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4
Q

what is defined as “associated with infection, trauma, neoplastic growth, and errors in development”

A

pathologic

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5
Q

what is hemiplegia

A

paralysis of one side

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6
Q

what is the usual cause of hemiplegia

A

from stroke

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7
Q

what is paraplegia

A

paralysis on both sides

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8
Q

what is hemiparesis

A

weakness on one side

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9
Q

what is paraparesis

A

weakness on both sides

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10
Q

what is ataxic gait

A

presence of abnormal uncoordinated movements

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11
Q

what is parkinsonian gait

A

motor disturbances- resting tremors

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12
Q

what are 4 things associated with parkinsonian gait

A

-tremor
-rigidity
-postural instability
-hypokinesia

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13
Q

what type of gait causes you to have an unsteady staggering gait that is uncoordinated

A

ataxia gait

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14
Q

what gait causes you to move slowly, take jerky, small, shuffling steps, and loose the ability to pick up your feet

A

parkinsons gait

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15
Q

what should you keep in mind when interacting with a person riding in a wheelchair

A

-avoid presumptions about abilities
-greet the user
-speak directly to the user
-learn locations of accessible areas
-offer help when appropriate

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16
Q

what should be the steps of the wheelchair transfer

A

-position wheels as close as possible
-lock all wheels in place
-fold footrests out of the way
-ask pt what works best
-lift with your legs

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17
Q

what are examples of stature

A

short and tall

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18
Q

what are examples of habitus

A

thin and obese

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19
Q

what are signs and symptoms of Marfans syndrome

A

-tall
-thin
-arachnodactily
-wingspan> height
-chest concavity
-heart murmur

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20
Q

what is described as “abnormal side curvature of spine”

A

scoliosis

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21
Q

what is defined as “abnormal roundback”

A

kyphosis

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22
Q

where is the outer canthus

A

lateral corner of eye

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23
Q

where is the inner canthus

A

medial corner of eye

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24
Q

what is the ala

A

the wing of nose

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25
Q

what is the philtrum

A

vertical fold above upper lip

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26
Q

where is the tragus

A

little triangle in front of ear

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27
Q

where is the naision

A

between eyebrows

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28
Q

what does HEENT stand for

A

-head
-eyes
-ears
-nose
-throat

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29
Q

what is a prognathic profile

A

jaw jutting foreward
underbite

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30
Q

what is a retrognathic profile

A

recessed jaw
excessive overjet

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31
Q

what are common things to ask about during the head and neck exam

A

-lumps in neck
-hoarseness
-scratchy throat
-pain
-nosebleeds
-congestion
-trouble swallowing

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32
Q

what does chemotherapy do to the health of a patient

A

makes them immunocompromised

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33
Q

what can head and neck radiation therapy cause in the oral cavity

A

-xerostomia
-mucosal irritation
-cervical caries

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34
Q

what are things to consider when looking at/ for skin lesions

A

-ask if there are any chronic, non-healing lesions
-changes in pre-existing lesions
-check areas of high sun exposure

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35
Q

what is the most common type of skin cancer

A

basal cell

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36
Q

where are basal cell carcinomas usually found

A

middle 2/3 of face

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37
Q

do basal cell carcinoma heal

A

no

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38
Q

are basal cell carcinomas usually harmful

A

no

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39
Q

what type of skin cancer has
-irregular borders
-crusty surface
-persistent thick rough scaly patches that may bleed

A

squamous cell carcinomas

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40
Q

what makes up 90% of all oral cancers

A

squamous cell carcinomas

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41
Q

what type of skin cancer is described as having
-multiple colors
-irregular borders
-flat or slightly raised borders
-asymmetrical in form

A

melanoma

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42
Q

nodular melanomas are aggresive lesions that have only _____ growth

A

vertical

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43
Q

what type of skin cancer is highly infiltrative

A

melanoma

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44
Q

what is the sclera

A

white of eye

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45
Q

what is ptosis

A

lid lag

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46
Q

what is ptosis sometimes a sign of

A

past stroke

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47
Q

what is ocular hypertelorism

A

excessive spacing between eyes

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48
Q

what is exophthalmos

A

abnormal protrusion of the eye

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49
Q

what can exopthalmos be a sign of

A

hyperthyroidism

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50
Q

what does a yellow sclera indicate

A

hepatotoxicity

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51
Q

what system are lymph nodes a part of

A

lymphatic system

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52
Q

what are the 4 main groups of lymph nodes

A

-cervical
-axillary
-inguinal
-internal

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53
Q

what group of lymph nodes are you unable to palpate

A

internal

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54
Q

what are the 9 areas of the cervical lymph nodes

A

-submental
-submandibular
-tonsillar/jugulodigastic
-preauricular
-postauricular
-occipital
-anterior cervical chain
-supraclavicular
-posterior cervical chain

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55
Q

what lymph nodes are just below the chin

A

submental

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56
Q

what group of lymph nodes are 3-6 nodes beneath the body of the mandible

A

submandibular

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57
Q

what group of lymph nodes tends to be some of the largest lymph nodes in the cervical chain due to their significant lymphatic drainage

A

tonsillar/ jugulodigastric

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58
Q

what group of lymph nodes are nodes that lie both on top and beneath the sternocleidomastoid muscles on either side of the neck, from the angle of the mandible to the top of the clavicle

A

anterior clavicle chain

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59
Q

what group of lymph nodes is found in the hollow above the clavicle, just lateral to where it joins the sternum

A

supraclavicular

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60
Q

what group of lymph nodes extends in a line posterior to the SCM but in front of the trapezius

A

posterior clavicular chain

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61
Q

what state of lymph node tends to be firm, tender, enlarged, and warm

A

infected lymph nodes

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62
Q

what is lymphoma an example of

A

primary malignancy of lymph node

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63
Q

a lymph node with a malignancy tends to be

A

-firm
-non-tender
-matted (stuck to each other)
-fixed (not freely mobile)
-increases in size over time

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64
Q

what is the lymph node palpation sequence

A

-ahead and behind ear
-slide down under angle of mandible
-slide down to SCM
-shift down to above collarbone

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65
Q

what are characteristics of healthy lymph nodes

A

-soft like a grape
-movable

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66
Q

a lymphadenopathy is any abnormality in

A

-size
-consistency
-number

of lymph nodes

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67
Q

what characteristics of a lymph node abnormality that you should describe

A

-location
-size
-tenderness
-consistency
-mobility

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68
Q

where are the most common lymphadenopathy

A

cervical

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69
Q

what are clues to routine swelling from recent infection of lymph nodes

A

-tender
-mobile
-current or recent viral infection
-bilateral, but not always
-predictable locations
-long durations without change

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70
Q

what is mumps an infection of

A

parotid gland

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71
Q

what symptom does mumps cause

A

swelling in the cheek and sore lymph nodes

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72
Q

where is the thyroid located

A

inferior to the larynx and just superior

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73
Q

how do you perform a thyroid exam

A

-gently place fingers on either side of adams apple
-slide to just below it
-ask pt to swallow
-feel gland rise up and drop back down
-feel for lumps and symmetry

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74
Q

what are commisures

A

corners of lips

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75
Q

where does angular cheilitis occur

A

corners of mouth

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76
Q

what is angular cheilitis caused by typically

A

candida

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77
Q

does TMD affect more men or women

A

women

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78
Q

what are symptoms of TMD

A

-joint pain
-headaches
-tinnitus
-insomnia
-neck ache
-sensitive teeth

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79
Q

what is one of the first signs of bruxism

A

teeth becoming sensitive to hot and cold

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80
Q

what are causes of TMD

A

-bruxism
-clenching
-stress
-malocclusion
-arthritis
-trauma
-stimulants

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81
Q

what are the 3 broad classes of TMD

A

-muscles
-soft tissue of joint
-hard tissue of joint

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82
Q

referred pain of the temporalis indicates

A

generally anterior teeth

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83
Q

referred pain of the masseter indicates

A

generally posterior teeth

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84
Q

what do you do for the TMJ diagnostic exam

A

-measure range of motion
-palpate for crepitus and clicking while opening and closing
-palpate for tenderness in masseter and temporalis muscles

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85
Q

what could indicate TMD when doing your exam

A

-excessive tooth mobility
-widened PDL seen radiographically
-migration without perio disease
-buccal mucosal ridging
-lateral tongue scalloping
-asymmetry of face, jaws, and dental arches

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86
Q

what can be used to treat TMD

A

-nightguards/splints
-meds
-PT
-Surgery

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87
Q

how do nightguards or splints treat TMD

A

-redistribute occlusal forces
-relax muscles of mastication and stabilze joint
-protect dentition and dental work

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88
Q

what meds may be used to treat TMD

A

-NSAIDS
-Antianxiety
-muscle relaxers
-botox

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89
Q

what are you looking for with the intraoral exam

A

-cancer
-signs of systemic disease
-tissue trauma
-pain
-esthetic concerns
-infections
-occlusal dysfunction

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90
Q

what is the purpose of the periodontal probe

A

to evaluate the health of the periodontium

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91
Q

what makes up the periodontium

A

-gingiva
-PDL
-cementum
-alveolar bone

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92
Q

what is a probing depth

A

a measurement of the depth of a sulcus

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93
Q

what are you measuring when perio probing

A

measuring the distance from a gingival margin to the base of the pocket using a calibrated perio probe

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94
Q

what is a sulcus

A

healthy gingival pocket with no attachment loss
natural space between the surface of the tooth and the surrounding gingiva

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95
Q

what is a periodontal pocket

A

diseased pocket with attachment loss of supporting structures

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96
Q

does a healthy sulcus permit a perio probe

A

barely

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97
Q

what are healthy probing depths

A

1-3 mm

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98
Q

when do periodontal pockets occur

A

when probing depths of >3 mm

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99
Q

what are clinical manifestations of perio pockets

A

inflammation and bleeding

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100
Q

what do perio pockets occur as a result of

A

bacterial plaque and apical migration of the junctional epithelium
(clinical attachment loss)

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101
Q

What is the type of probe used at UMKC

A

marquis

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102
Q

what is the marquis probe measured at

A

3,6,9, and 12 blocks

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103
Q

how many sites does probing measure

A

6

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104
Q

what are the 6 probing sites measured

A
  1. DF
    2.F
    3.MF
    4.DL
    5.L
  2. ML
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105
Q

what is defined as “act of walking the tip of a probe along the junctional epithelium within the sulcus or pocket for the purpose of assessing the health status of the periodontal tissues

A

probing

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106
Q

what type of stroke is used to probe

A

walking stroke

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107
Q

it is essential to evaluate the entire _____ of the pocket base becasue the JE is not necessarily at a uniform level around the tooth

A

length

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108
Q

what grasp do you use to hold a perio probe

A

modified pen grasp

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109
Q

what do you fulcrum on when probing

A

fulcrum close to the tooth you are probing

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110
Q

probe should be _______ to the long axis of the tooth along all proximal surfaces

A

long axis

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111
Q

should the probe be parallel to the long axis of the tooth at all times

A

no- not when probing the interproximal spaces

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112
Q

how do you know when you are at the base of the sulcus

A

gingival tissues will blanch

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113
Q

research implicates _____ as the underlying cause of as many as 72% of oropharyngeal squamous cell carcinomas

A

HPV

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114
Q

HPV related SSC increase has had a predominant increase in what group of people

A

younger white men

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115
Q

in general, cancer in younger people tends to be much more _______ and tends to have a ________ prognosis

A

aggressive, poorer

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116
Q

what is the gold standard for determining a definitive diagnosis for oral cancer

A

biopsy of the suspicious area followed by evaluation by a pathologist to determine its histological makeup

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117
Q

what is the rate at which dental practitioners misdiagnose oral lesions when the are based on clinical observations alone

A

43%`

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118
Q

what percent of oral caner is squamous cell

A

90%

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119
Q

what percent of all cancer does oral cancer make up

A

3%

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120
Q

what is the 5 year survival rate of oral cancer

A

57%

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121
Q

oral cancer affects men _____ than women

A

2x more

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122
Q

what percent of oral cancer is found in stage I or II

A

40%

123
Q

what is the survival rate for oral cancer diagnosed in Stage I or II

A

80-90%

124
Q

what percent of oral cancer is diagnosed in stage III or IV

A

60%

125
Q

what is the survival rate for oral cancer diagnosed in stage III or IV

A

33%

126
Q

for oral cancer diagnosed in stage III or IV what is the rate or recurrence in 2 years

A

67%

127
Q

what is the #1 risk factor for oral cancer

A

tabacco

128
Q

what is the #2 risk factor for oral cancer

A

alcohol

129
Q

what viruses can be risk factors for oral cancer

A

HPV and HIV

130
Q

what are general risk factors for oral cancer

A

-sun exposure
-inadequate nutrition
-genetic predisposition
-chronic inflammation
-radiation exposure
-carcinogen exposure

131
Q

what percent of oral cancer could be prevented by eliminating tobacco and alcohol

A

75%

132
Q

what is the reduction in oral cancer risk after 5 years without tocbacco

A

35%

133
Q

what are ways to prevent oral cancer

A

-lip balm with sunscreen
-HPV vaccine
-diet rich in fruits and veg

134
Q

what are high risk areas for oral cancer

A

-floor of mouth
-lateral border of tongue
-ventral surface of tongue
-oropharynx

135
Q

what can contain tonsil stones

A

tonsillar crypts

136
Q

patients with tonsil stones often complain of

A

halitosis (bad breath)

137
Q

can the tonsils regrow

A

yes

138
Q

a bifid uvula may be an indication of what

A

submucous cleft palate

139
Q

what is pitting indicative of

A

edema

139
Q

what technique is used to palpate the floor of the mouthq

A

bimanual

139
Q

a bifid uvula may cause difficulties with what

A

speech and swallowing

139
Q

what are signs and symptoms of oral cancer

A

-nonhealing ulcer
-bleeding
-lymphadenopath
-hardness
-paresthesis
-drooling

139
Q

what does induration mean

A

firm but not as hard as bone

139
Q

what does compressible mean

A

pressure alters its shape

139
Q

what does doughy mean

A

returns slowly to original shape

140
Q

what does spongy mean

A

returns quickly to original shape

140
Q

what does pitting mean

A

soft and leaves indentation

140
Q

what does collapsing mean

A

contents expressed- usually fluid from an abscess

140
Q

what does blanching mean

A

color change

141
Q

what does discrete mean

A

separate, not running together or blending

142
Q

what does confluent mean

A

running together, merging, blended. originally separate but now formed into one

143
Q

what does papillary mean

A

having small bumplike elevations or projections

144
Q

what is a verrucose or verrucous lesion

A

covered with or full or wartlike growths

145
Q

what does sessile mean

A

attached to the surface on a broad base
immoble, fixed, firmly attached, and lacks a stalk

146
Q

what is a pedunculated lesion

A

elevated lesion having a narrow stem which acts as a base
elongated stalk

147
Q

where do pedunculated squamous papillomas usually occur

A

-soft palate
-tonsil
-epiglotis

148
Q

are pedunculated squamous papillomas lethal

A

sometimes

149
Q

what is an erythema

A

red area of variable size and shape

150
Q

do erythemas occur in one area or in patches

A

in patches

151
Q

what is petechiae

A

round red pinpoint areas of hemorrhage

152
Q

what usually causes petechia

A

trauma, viral infections, or bleeding problems

153
Q

what is a macule

A

freckle

154
Q

what is eschar

A

a sloughing of epithelium caused by disease, trauma, or chemical burn

155
Q

what is a torus

A

bony elevation or prominence

156
Q

what is a good example of a patch

A

-port wine stain
-not elevated or depressed

157
Q

what causes port wine stain

A

abnormal formation of tiny blood vessels in skin

158
Q

what is an ulcer

A

a denuded area extending below the basal layer

-gradual tissue disintegration

159
Q

what is a crust

A

an outer layer covering, or scab, from a coagulation of blood, serum, pus, or any combination

160
Q

what is a plaque

A

a solid, flat area > than 1 cm that is ofter keratinized

161
Q

what is an example of a plaque

A

Snuff dipper’s lesion

162
Q

what is a papule

A

a superficial, elevated, solid lesion <1 sm
any color
solid base or pperdunculated

163
Q

what is an example of a papule

A

parulis
^^ a gum boil

164
Q

what the difference between a papule and a vesicle

A

vesicle is filled with fluid and papule is solid

165
Q

what is a vesicle

A

a small <1 cm fluid filled elevated lesion with a thin surface covering

166
Q

what does a vesicle contain

A

lymph or serum

167
Q

what is an example of a vesicle

A

herpes simplex before it bursts

168
Q

what is a pustule

A

a small <1cm vesicular lesion that contains purulent material rather than clear fluid

169
Q

what is an example of a pustule

A

dental abscess

170
Q

what is a nodule

A

an elevated, deep, solid lesion 0.5-2.0 cm where overlying mucosa is not fixed

171
Q

what is an example of a nodule

A

fibroma

172
Q

an irritation fibroma is classified as what

A

a tumor

173
Q

an irritation fibroma is classified as a tumor because it

A

is persistent and progressively increases in size

174
Q

what is a bulla

A

a large vesicle >1 cm that contains serum

175
Q

where are bulla usually found

A

mucosal-submucosal junction

175
Q

what are examples of bulla

A

-pemphigus
-2nd degree burn

176
Q

what is defined as “white line, parallel to occlusal plane, asymptomatic, atypical, and caused by trauma”

A

linea alba

177
Q

what is defined as “milky white surface or blue gray, symmetrical, and atypical”

A

leukodema

178
Q

does leukoedema rub off

A

no, but it does disappear when stretched

179
Q

what group of people is leukoedema most common in

A

african american

180
Q

what has interlacing striae of Wickham with erythema surrounding mucosa

A

lichen planus

181
Q

does lichen planus appear bilaterally

A

yes

182
Q

is leukoedema symmetrical

A

yes

183
Q

can lichen planus be painful

A

yes- can cause painful erythmatous erosions and ulcers

184
Q

how does lichen planus appear on the skin

A

purplish, itchy, flat bumps

185
Q

does lichen planus affect more men or women

A

equally, but orally it is more common in women

186
Q

what is described as “ sulfur colored 1-3 mm papules in oral cavity”

A

fordyce granules

187
Q

are fordyce granules asymptomatic

A

yes and atypical

188
Q

where are the two places fordyce granules may be found

A

oral cavity and lip vermillion

189
Q

what is an abnormailty found in the buccal vestibule that may be flat or slightly elevatede

A

Kaposi’s sarcoma

190
Q

what do you look for when examining the hard palate

A

-rugae
-torus palatinus
-ulcerations
-lesions

191
Q

what are torus palatinus

A

bony lumps on hard palate
asymptomatic and atypical

192
Q

what percent of people have torus palatinus

A

20-30%

193
Q

are men or women more likely to have torus palatinus

A

women 2:1`

194
Q

does torus palatinus require tx

A

no- unless need denture, partial, ot interfers with daily life

195
Q

what is torus mandibularis

A

bony lumps on mandible
atypical and asymptomatic

196
Q

what is a habit that makes torus mandibularis more common

A

bruxism

197
Q

what percent of people have mandibular tori

A

8-16%

198
Q

are men or women more likely to have mand tori

A

equal

199
Q

do mand tori require tx

A

no- unless getting denture or partial, or it interfers with daily life

200
Q

what is nicotine stomatitis

A

lesion of the hard palate that appears white, rough, asymptomatic, and leathery

-contains numerous red dots or macules

201
Q

what causes nicotine stomatitis

A

extreme heat in mouth

202
Q

where is the most common place for oral cancer to occur on the tongue

A

lateral border and the base of the tongue

203
Q

what are examples of atypical findings on the dorsal surface of the tongue

A

common
-fissuring
-scalloping
-enlarged papilla
-benign migratory glossitis

204
Q

what is described as “ lesions that heal in one area and then move to another part of the tongue”

A

benign migratory glossitis

205
Q

what is another name benign migratory glossitis

A

geographic tongue

206
Q

geographic tongue has areas of what

A

erythematous, well demarcated areas of papillary atrophy

207
Q

does geographic tongue cause symptoms

A

usually asymptomatic, but can cause discomfort, pain, or burning sensations in some cases, often related to eating spicy or acidic foods

208
Q

what causes fissured tongue

A

dry mouth

209
Q

can leukoplakia be wiped off

A

no

210
Q

what is described as “white or grayish white keratotic patch like lesion on the mucosa that cannot be rubbed off”

A

leukoplakia

211
Q

what is hairy leukoplakia caused by

A

epstein barr virus and associated with HIV infection or other immunosuppressive conditions

212
Q

where does hairy leukoplakia usually occur

A

lateral borders of tongue

213
Q

is hairy leukoplakia uni or bilateral

A

can be either

214
Q

what is described as white rough patches on lateral border of tongue

A

hairy leukoplakia

215
Q

what is hairy tongue caused by

A

-trapped debris
-bacteria
-fungus
-coffee
-tobacco
-antibiotics and other drugs

216
Q

what is another name for the submandibular duct

A

Whartons duct

217
Q

what does Whartons duct do

A

drains saliva from the submand and sublingual glands

218
Q

what duct accounts for 60% of saliva

A

submandibular or whartons duct

219
Q

what is a common thing to note on the ventral side of the tongue that is normal with age

A

lingual varicosities

220
Q

what condition is a side effect of numerous medications, can be a sign of a systemic disease, can be a response to physical climate or emotional distress

A

xerostomia

221
Q

what group of people is at a greater risk of developing xerostomia

A

elderly

222
Q

what condition significantly increases the risk for caries, erosion, dental hypersensitivity, and candidiasis

A

Xerostomia

223
Q

most cases of xerostomia are

A

chronic

224
Q

what are things that you may note in the medical history of a patient that may cause xerostomia

A

-diabetes
-hormone changes (menopause or pregnancy)
-depression or anxiety medications
-radiation for hear and neck cancer
-autoimmune diseases (sjogrens)

225
Q

what are things you may see in the clinical assessment that may lead to a diagnosis of xerostomia

A

-reddened, pebbled surface of tongue
-dry and cracked corners of mouth
-red, glossy, parched mucosal tissues

226
Q

what is the mirror test

A

test for xerostomia
-place mirror against buccal mucosa and tongue and see if they stick

227
Q

what are symptoms of xerostomia

A

-candidiasis
-angular chelitis
-burning tongue
-root and cervical caries
-stomatatitis
-dysphagia

228
Q

what is stomatitis

A

inflammation of the mucous membranes of the mouth

229
Q

what is described as “white plaque, creamy lesion, looks like hyperkeratosis, but rubs off”

A

candidiasis

230
Q

where can you find candidiasis

A

buccal mucosa and lateral borders of tongue

231
Q

where can thrush spread to

A

-tongue
-hard and soft palate
-tonsilar region

232
Q

what are candidiasis risk factors

A

-immunocompromised
-pregnancy
-poor oral hygiene
-smoking
-stress
-depression
-birth control
-long term antibiotics
-diabetes
-dentures that dont fit properly
-xerostomia
-iron, B12 deficiency

233
Q

what is the most common candidiasis infection

A

psuedomembranous candidiasis

234
Q

when you wipe off candidiasis white patch what is left behind

A

erythematous base

235
Q

what are symptoms of thrush

A

-pain with spicy or acidic foods
-dysphagia

236
Q

where is angular chelitus found

A

corners of mouth

237
Q

what causes atrophic candidiasis

A

illfitting or dentures that are never taken out
-red on palate or tongue
-burn with spicy food or alcohol

238
Q

what are treatments for candidiasis

A

-oral hygiene
-yogurt, acidophilus
-avoid alcohol and simple sugars
-antifungal medications (nystatin rinse or tablet)(ketaconzole- can cause severe liver damage)

239
Q

primary herpes gingivostomatitis is seen mainly in

A

children

240
Q

what is primary herpes gingivostomatitis caused by in most cases

A

HSV1

241
Q

what are symptoms of severe primary herpes infections

A

-oral lesions
-high fever
-malaise
-cervical lymphadenopathy
-dehydration

242
Q

less common infections of herpes occurs in which age group

A

young adult
may be HSV1 or 2

243
Q

in the case of herpes gingivostomatatitis, where do vesicles develope

A

pharynx, palate, buccal mucosa, lips, and or tongue

244
Q

how long does it take for a herpes lesion to heal without tx

A

2 weeks

245
Q

does HSV survive well in the external enviroment

A

no, almost all infections are from contact with an infected person who is releasing the virus

246
Q

what percent of the population has HSV

A

50-80%

247
Q

HSV1 affects what

A

mouth, lips, and face

248
Q

HSV2 affects what

A

genitalia

249
Q

what stage is HSV contagious

A

vesicle stagew

250
Q

what are the prodromal signs of HSV

A

tingling, itching, and burning

251
Q

when do prodromal signs of a cold sore begin

A

6-24 hours before lesions develop

252
Q

what is the first sign of a cold sore

A

multiple fluid filled blisters that then merge and collapse

then yellowish crust

253
Q

what is herpes simplex

A

a virus

254
Q

where does HSV remain

A

dormant in nerve cells

255
Q

what can cause an HSV recurrence

A

-stress
-fever
-illness
-injury
-sunburn

256
Q

what is herpatic whitlow

A

HSV infection of the thumbs or fingers
grouped fluid or pus filled
usuually itchy and or painful

257
Q

what is the tx for primary herpatic gingivostomatitis

A

alcyclovir suspension initiated suring the first three symptomatic days in a rinse and swallow technique 5x a day for 5 days

258
Q

what stage is recurrent herpes labialis treated in

A

prodromal phase

259
Q

what can be used to treat recurrent herpes labialis

A

-acyclovir ointment for reduction in number of vesicles
-systemic acyclovir, valcyclovir, and famccyclovir`

260
Q

in patients with recurrent labial herpes, you may advise them to take what before a dental procedure

A

2g of valacyclovir 2x a day before the procedure and 1g 2x the following day

261
Q

what percent of the population is affected by aphthous ulcers

A

60%

262
Q

when does a herpes infection typically begin

A

<10

263
Q

when does the occurance of aphthous ulcers usually begin

A

10-20 years old

264
Q

what are the prodromal signs of an aphthous ulcer

A

tingling and burning 1-2 days before th eulcer appears

265
Q

how long does an aphthous ulcer usually hurt3

A

3 days

266
Q

how long does it usually take for an aphthous ulcer to heal

A

7 days

267
Q

in a mild case of an aphthous ulcer, what is the tx

A

topical corticosteroids

268
Q

what appears to e the cause of aphthous lesions

A

mucosal destruction representing a T cell mediated immunological reaction

269
Q

if both parents have a history of aphthous ulcers, their child will have what chance of devloping lesions

A

90%

270
Q

what are the 3 clinical variations of aphthous ulcers

A

-minor
-major
-herpetiform

271
Q

in the case of ______ aphthous lesions, patients experience the fewest recurrences and shortest duration

A

minor

272
Q

in minor cold sores ulcers arise exclusivly on what tissue

A

nonkeratinized mucosa and may be preceded by an erythematous macule in association with prodromal burning and itching

273
Q

what are the size of ulcers in a minor aphthous lesion

A

3-10 mm in diameter

274
Q

in the case of minor cold sores how long does it take to heal

A

7-14 days

275
Q

how many lesions in minor aphthous ulcer

A

1-5 lesions
pain disproportional

276
Q

what mucosa are affected most frequently by minor aphthous lesions

A

buccal and labial mucosa followed by ventral surface of tongue

277
Q

what is the age of onset of minor aphthous lesions

A

10 years old

278
Q

what is the size range for major aphthous lesions

A

1-3 cm

279
Q

what class of aphthous lesion has the longest duration per episode

A

major

280
Q

how long does it take for a major aphthous lesion to heal

A

2-6 weeks

281
Q

a major aphthous lesion may cause

A

scarring

282
Q

how many ulcers are associated with major aphthous lesions

A

1-10

283
Q

what is the age of onset of major aphthous lesions

A

after puberty

284
Q

what class of aphthous lesion has the greatest number of lesions and most frequen recurrence

A

herpetiform

285
Q

what are the size and quantity of lesions in herpetiform aphthous lesions

A

small 1-3 mm with as many as 100 lesions in a single episode

286
Q

it is common for herpetiform aphthous lesions to

A

coalesce into larger irregular lesions

287
Q

how long does it take for herpetiform aphthous lesions to heal

A

7-10 days, but recurrence tend to be closely spaced

288
Q

how long are patients with herpetiform aphthous lesions constantly affects typically

A

as long as 3 years

289
Q

what mucosa is involved in herpetiform aphthous lesions

A

any oral mucosa

290
Q

are herpetiform aphthous lesions more common in men or women

A

women

291
Q

what is the onset of herpetiform aphthous lesions

A

adulthood

292
Q

what are tx for aphthous ulcers

A

for symptoms:
-viscous (benzocaine)
-orajel, anbesol

local antiinflammatory:
-kenalog in orabase paste 2-4x a day

sealing agent:
-ameseal

293
Q

what is the only FDA approved tx for canker sores

A

aphthasol

paste
apply 2x a day
must start in prodromal stage

Patient Care 2 (1 decks)

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