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Head And Neck > Final - Oropharynx > Flashcards

Final - Oropharynx Flashcards

1
Q

With Herpes Labialis

  • common symptoms prior to lesions appearing
  • cause
  • triggers
A

cold sore

  • burning, tingling, itching
  • HSV-1 causes episodes of vesicles eruption (usually recurrent)
  • infection, emotional stress, fatigue
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2
Q

What are we looking for with an oral exam of the lips?

A

Color (cyanosis or pallor)
Lesions
Congenital deformities (cleft lip and/or palate are common)

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3
Q

What 5 areas do we check with an oropharynx exam of the mouth and throat?

A

Lips, mucosa, teeth, tongue, pharynx

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4
Q

What is IMPORTANT TO KNOW about the treatment for Herpes Labialis (cold sores)

A

Not required

Vesicles typically rupture and crust over in ~1 week without treatment
(If not resolved within 1 week monitor for signs of secondary infection)

duration of symptoms is only shortened if topical or oral treatment is started within 24-48 hours of the onset of initial symptoms (pain, itching, burning)

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5
Q

What are TREATMENT OPTIONS for Herpes Labialis (cold sores)

A

OTC topical creams
–> Example: docosanol 10% (Abreva) applied 5x/day

Ancedotal use of citrus or tea tree oils

Referral to PCP for oral antiviral prescription medication (Rx) is also an option
–> Example: Acyclovir orally 5x/day for 7–10 days

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6
Q

With Angular Cheilitis what are

  • symptoms
  • causes
A
  • Edentulous patient with figuring at the angles of the mouth

Symptoms

  • excessive moisture from ill-fitting dentures/no teeth
  • possibly nutrition deficiencies (iron, B2 [riboflavin])
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7
Q

What is the treatment for angular cheilitis?

A
  • Identify and treat underlying cause (can become secondarily infected > consider culture for candida or bacteria)
  • refer to dentist for denture fitting
  • recommend protective barrier: zinc oxide or Vaseline
  • refer to PCP if bacterial/fungal treatment needed
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8
Q

Ulcerated or crusted lesion

A

Squamous Cell Carcinoma (SCC)

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9
Q

What is the management for SCC?

A
  • refer to dermatologist for biopsy/resection if suspected

* early detection is KEY! Can usually be cured by local resection if treated when <2 cm

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10
Q

What are you looking for when inspecting the oral mucosa?

A

Lesions or masses

*can see by all mucosa, opening of the parotid duct

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11
Q

What is buccal mucosa

A

Inside of cheek

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12
Q

What are three salivary glands

A

Parotid - drains to upper buccal mucosa

Submandibular and sublingual gland -

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13
Q

Stone formation in a salivary gland or duct is known as ______ and is most common in the _____

What are the risk factors

A

Sialolithiasis
Submandibular

-dehydration, smoking

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14
Q

Unilateral, painful, facial swelling from a stone in

duct. (Sometimes only swelling, sometimes only pain) worse when eating & swelling comes and goes.

A

Sialandenitis

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15
Q

Conservative treatment for Sialolithiasis/Sialadenitis

4 things

A
  1. Apply heat to the area
  2. Massage gland/duct
  3. Plentiful hydration
  4. Tart hard candies (lemon drops) to promote salivary secretion > may flush out small stones

*consider referral to PCP or urgent care for antibiotic co-treatment

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16
Q

Well-defined, soft nodule on the inner lip

filled with clear mucus. Caused by trauma of minor salivary gland

A

Mucocele

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17
Q

What is the treatment for mucocele

A
  • may resolve spontaneously

- may require surgical removal

18
Q

Painful 1-5mm round white superficial ulcer

surrounded by red border/halo

A

Aphthous ulcer (canker sore)

19
Q

What is the prevalence of aphthous ulcer (canker sore).

Prognosis?

A

Affects 20-25% of people at some point in time

Good - typically resolve on their own within 2 weeks
Bad - common to have recurrences

20
Q

Treatment for aphthous ulcer (canker core)

A

OTC symptomatic relief may be obtained with
• benzocaine (Orabase, Anbesol, Orajel) – avoid food and drink for 30 minutes after application

Naturopathic remedies
• Citrus oil/magnesium salt patches
• DGL (deglycyrrhizinated liquorice) mouthwash/chews

Refer to PCP for Rx options if severe:
– Steroids - topical paste or oral (pill form)
– Mouthwashes

21
Q

What is a Candida yeast infection that will scrape off

A

Thrush

  • Can result from taking antibiotics or prescription
    steroids but may also indicate immunocompromised state
22
Q

What is the treatment for thrush?

A

Refer to PCP for antifungal

23
Q

What is a Thick white plaque that is potentially cancerous and Does NOT scrap off?

A

Leukoplakia

24
Q

What is the management for leukoplakia?

A

Must refer for biopsy if present for >2-3 weeks

Refer to oral surgeon or ENT

25
Q

red swollen gum margins caused by plaque

A

Gingivitis

26
Q

What is a puffy red spot in the mouth than can be cause by a cavity that traveled to the root? Can lead to swollen, painful face

A

Tooth abscess

  • Refer to PCP, urgent care, or dentist for antibiotics
27
Q

What is halitosis

Where does it come from

A

Chronic, bad breath

Most often comes from oral cavity or nasal passages
– occasionally lung abscess or GI disorder

28
Q

What could a sweet or fruity breath odor be due to

A

Ketoacidosis of diabetes

29
Q

What could ammonia breath be due to

A

Kidney failure

30
Q

What could fishy or rotting breath odor be due to

A

Hepatic disease

31
Q

A lesion on the tongue lasting ___ is concerning

A

> 2 weeks

32
Q

Chronic raised white lesion, firm, painless*

A

Carcinoma

33
Q

What are the risk factors for oral carcinoma

A

Tobacco, alcohol, human papilloma virus (HPV)

34
Q

Sides of tongue, white will NOT scrape off,

seen in HIV/AIDs (viral infection)

A

Hairy Leukoplakia of Tongue

35
Q

Benign bony growth(s) in the sublingual area

A

Torus Mandibularis (singular) aka Mandibular Tori (plural)

*no management required)

36
Q

Benign bony growth on the hard palate

A

Torus palatinus

37
Q

If bilaterally enlarged tonsils are present with no ____, ___ or ____, it is probably not infected

A

Fever, sore throat, lymphadenopathy

38
Q

Tonsillitis with exudate is cause by ____

A

Viral URI or bacterial infection

39
Q

What are the 4 symptoms of strep throat?

A

CAFE

  • no cough
  • anterior cervical adenopathy
  • fever
  • tonsillar exudates

*use total score to determine diagnostic testing and management plan
(2-4 of sx needed to refer for rapid strep testing ad antibiotics)

40
Q

A strep score of O to 1 treatment

A

Provide symptomatic conservative care recommendations for assumed non-strep pharyngitis

41
Q

Strep score 2-4 treatment

A

Perform rapid antigen test
- Antigen test positive: refer to PCP or urgent care
for antibiotics
- Antigen test negative: Send throat culture

42
Q

Non-strep pharyngitis conservative care

A
  • Salt water gargles
  • Teas
  • Lozenges
  • OTC throat sprays
  • OTC analgesics (acetaminophen, ibuprofen, aspirin)
    —> Side

Head And Neck (18 decks)

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