Goljan 18: Oral Cavity and Salivary Glands Flashcards
What are the oral manifestations of HIV?
- Candidiasis 2. Aphthous ulcers 3. Hairy leukoplakia - glossitis due to EBV 4. Kaposi sarcoma - HHV8
Dental caries are most often caused by:
Strep mutans Prevention is fluoride
What is the diagnosis? Notched teeth
Congenital syphilis Treponma Palladium Incisors are notched and tapered like pegs, molars look like mulberries
What is the diagnosis? Glossitis associated with bilateral white excrescences on lateral border of tongue
Hairy leukoplakia Pre-AIDS defining lesion
What is the diagnosis? Recurrent vesicular lesions on the lips, reactivated by stress, sunlight, menses
Herpes labialis HSV-1 (usually)
What is the diagnosis? Bilateral parotitis with increased serum amylase; Complications include meningoencephalitis, unilateral orchitis or oophoritis and pancreatitis
Mumps (paroxymyxovirus)
What is the diagnosis? Painful vesicles or small white papules occur on an erythematous base typically at the junction of the soft and hard palate
Herpangina due to coxackievirus When vesicles located in mouth and distal extremities, it’s hand, foot and mouth disease
What is the diagnosis? “Sulfur granules” in pus contain gram + branching filamentous anaerobic bacteria ; often follows extraction of an abscessed tooth
Cervicofacial actinomycosis Actinomyces israelii
What is the diagnosis? Shaggy gray pseudomembrane in posterior pharynx and upper airways
Diphtheria Corynebacterium diphtheriae
Peritonsillar abscess can be a complication of:
Tonsillitis (strep pyogenes) uvula deviates from contralateral side; “hot potato” voice foul-smelling breath
What is the diagnosis? Cellulitis involving the submaxillary and sublingual space
Ludwig Angina follows facial planes due to aerobic or anaerobic strep eikenella or corrodens causes are trauma or dental work
T/F: Nephritogenic strains of Strep pyogenes pose no risk for acute rheumatic fever
True
What is the diagnosis? Necrosis of interdental papilla with punched out lesions covered by grayish pseudomembrane
Acute necrotizing gingivitis Anaerobic bacterial infection of the gingiva
What is the diagnosis? Hypersensitivity reaction against mycoplasma or sulfa drugs
Erythema multiforme called Stevens-Johnson syndrome when it involves the mouth
What is the diagnosis? Melanin pigmentation of the lips and oral mucosa
Peutz-Jeghers syndrome could also be Addison disease (on buccal mucosa) could also be lead poisoning
When tooth discoloration occurs in children as a result of medication, what is the implicated medication?
Tetracycline When tooth discoloration is not due to tetracycline, it is usually excess fluoride (chalky white) OR could be congenital erythropoetic porphyria (reddish brown)
Myxedema Down syndrome Acromegaly Systemic amyloidosis Mucosal neuromas in multiple endocrine neoplasia syndrome IIb These are all causes of what oral finding?
Macroglossia (enlarged tongue)
What is the diagnosis? Sore, beefy, red tongue with or without papillary atrophy
Glossitis (inflammation of the tongue) Causes include: long-standing iron deficiency B12 or folate deficiency Scurvy Pellagra (niacin deficiency) Scarlet fever EBV-associated hairy leukoplakia
What is the diagnosis? Vermilion border on the lower lip
Leuko/erythroplakia
What is the diagnosis? Wickham striae on the buccal mucosa (fine white lacey lesions)
Lichen planus May be associated with SCC or dysplasia
What is an ameloblastoma?
Benign tumor of the epithelium Arises from enamel organ epithelium or a dentigerous cyst; Located in the mandible –> “soap bubble” appearance; Locally invasive but does not metastasize
What is the diagnosis? Most common benign tumor in the oral cavity; Exophytic tumor with a fibrovascular core May occur on the tongue, gingiva, palate, or lips
Squamous papilloma
What kind of cancer is associated with chew tobacco?
Verrucous carcinoma of the oral cavity
Malignancy of the oral cavity typically metastasizes to what lymph node?
Tonsillar node (superior jugular node)
What is the diagnosis? Most common cancer of the upper lip Associated with UVB exposure
Basal cell carcinoma
What is the diagnosis? Autoimmune destruction of the salivary glands and lacrimal glands
Sjogren syndrome
What is the diagnosis? Women; painless movable mass at the angle of the jaw; may become malignant epithelial cells intermixed with myxomatous and cartilaginous stroma
Pleomorphic adenoma
What is the diagnosis? Men; Benign parotid gland tumor; Smokers at increased risk; Heterotropic salivary gland tissue is trapped in a lymph node
Warthin tumor (papillary cystadenoma lymphomatosum)
What is the diagnosis? Most common malignant salivary gland tumor; Most commonly in the parotid gland; Mixture of neoplastic squamous and mucus-secreting cells
Mucoepidermoid carcinoma
