HEENT QUIZ 3- MOUTH & THROAT Flashcards
types of leukoplakia
- homogenous: uniform white patch on buccal mucosa, most common type, likely cancer
- verrucous: white patch on red base
etiology of leukoplakia
chronic irritation – chronic smokers
peak age of incidence of leukoplakia
40-60 y/o
possible complications of leukoplakia
2-6% are early squamous cell carcinoma
sx of leukoplakia
leukoplakia is usually asymptomatic
which is more likely to become squamous cell carcinoma , leukoplakia or erythroplakia?
erythroplakia– 90% are SCC
who is at a high risk of developing oral candidiasis “thrush”
-infants
-denture wearers
- immunocompromised
-broad spectrum antibiotics
candidiasis sx:
white patches , raw at base and painful
can be scraped off
glossitis sx:
glossitis is painless loss of papillae
possible causes of glossitis
severe fe deficiency and megolablastic anemia
glossodynia definition and causes
-pain/burning of the tongue
-asociated with irritants(psoriasis), menopause, nutritional deficiencies (b12)
symptoms of geographic tongue
-surpiginous border
-erythma
-not painful, asymptomatic
-changes shape and location , bening
- loss of papillae
-hyperkeratotic
etiology of necrotizing ulcerative gingivitis
-eating rodents in the wawar in the trenches
-smoking
-poor oral hygiene
what is another name for vincent’s infection
necrotizing ulcerative gingivitis aka trench mouth
pt presents abrupts onset of painful, bleeding gingiva, what is a likely finding in physical exam
dx:necrotizing ulcerative gingivitis
finding: punched out lesions with grayish membrane on gingiva
Would a patient with necrotizing ulcerative gingivitis have a fever?
usually no fever , not contagious
what bacteria is associated with necrotizing ulcerative gingivitis ?
fusiform bacillus which is part of the normal flora and becomes pathogenic
pt presents with small ulcers in soft palate, under the tongue and buccal mucosa. she says the have been there for 2 weeks and are painful. she has a hx of chohn’s disease. possible dx ?
aphthous stomatitis aka canker sores
what can cause a canker sore to flare up
foods and high fever
where are canker sores found
unkeratinized mucosa: soft palate, under tongue, cheeks, inside of the lips
aphthous stomatitis sx:
1-5 painful and discrete ulcers (1-10mm)
unkeratinized mucosa
what is a possible association of canker sores
possible autoimmune etiology: association with inflammatory bowel disease
cause of herpetic stomatitis aka fever blisters
HSV-1
onset of herpetic stomatitis
usually before 10 years old in 90% of pts
-usually recurrent (sickness, fever, sunburn )
-initial illness with systemic sxs
where is herpatic stomatitis found?
unkeratinized and keratizined mucosa
6 year old presents with sudden onset of fever and dysphagia, on exam you find white/gray vesicles with red halos 1mm in diameter, possible dx ?
herpangina
etiology of herpangina
coxsackie virus A and B
where is herpangia usually found?
tonsilar fossa
incidence of herpangina
children less than 6 y/o in the summer
Etiology of hand-foot-mouth disease
coxsackie virus A-16
incidence of hand-foot-mouth disease
young children in the spring and summer
where is hand-foot-mouth disease seen
lips and buccal mucosa
sx of hand-foot-mouth diseases
-vesicles, small ulcers
-transient, macular rash on trunk and extremities
-mild systemic fever- low grade fever
most common site of oral cancer? most common type ?
tongue is the most common type of oral cancer
-over 90% are squamous cell cancers
what is the 5 year survival rate of oral cancers?
5 year survival rate is 50%
etiology of pharyngitis/ tonsillitis
usually viral
sx of pharyngitis/ tonsillitis
-may or may not have exudate
-may or may not have LAO
possible complications of strep throat and mononucleosis
carditis via strep
-splenomegaly via mononucleosis
definition of scarlet fever
scarlet fever is strep throat with sandpapery rash (red papules)
sings and symptoms of strep pharyngitis
- strawberry tongue and circumoral pallor
- pastias lines in antecubital fossa
- sandpapery rash ( strep is g+ and releases exotoxins)
- hot potato voice ( due to avoiding rubbing together of throat structures)
Centor’s criteria (what is it for?)
to determine if strep testing needs to be done
- hx of fever
- no cough
- tender anterior cervical LAO
- exudate or tonsillar swelling
etiology and incidence of rheumatic fever
-sequelae of strep pharyngitis
- peak ages of 5-15 y/o
jones criteria
must have have
2 major manifestations or
2 minor, 1 major and a positive strep test
major manifestations in jones criteria
- carditis: high fever and chest pain, valvular defects
- migratory polyarthritis: lasts for 3-4 wks, 5 or more joints, usually larger joints
- erythema marginatum: lasts <1 day , sort lived surpiginous macular rash
- subcutaneous nodules on extensor surfaces of larger joints
- sydenham’s chorea (St. vitus dance): lasts 3-6 months, inapproapriate bizarre movements
minor manifestions in jones criteria
-arthralgias
-fever
-evelated CRP,ESR
-prolonged PR interval in EKG
infection between the tonsils and the superior pharyngeal muscle is called ?
peritonsillar abscess aka quincy
where would the uvula and tonsils be moved to if a peritonsillar abscess is present
uvula will be displaced to the unaffected side
tonsils will be moved medially
symptoms of a peritonsillar abscess
severe pain and fever
etiology of peritonsillar abscess
Strep group A - not treated
does a referral need to be made if a patient has a peritonsillar abscess?
yes, refer to ENT for Irrigation and drainage (I&D)
incidence of epiglottis
2-5 years old , pre-school age
onset of epiglottis
6-8 hours onset
-go down for a nap and wake up unable to breathe, drooling and looking at you
sx of epiglottis
- high fever
-tachypnia
-drooling - inspiratory stridor
-severe respiratoy distress- life threathening
etiology of epiglottis
haemophilus influenzae type B
treatment for epiglottis
- antibiotics and mechanical ventilation
- do not visualize pharynx until in a controlled environment
what is the most common congenital cystic neck mass ?
thyroglossal duct cyst
when is a thyroglossal duct cyst usually discovered?
infancy or childhood
cause of a thryoglossal duct cyst?
failure of tract to involute after embryonic descent of the thyroid
symptoms of a thyroglossal duct cyst . location?
painless, cystic lesion in anterior midline of he neck
when is a branchial cleft cyst usually diagnosed?
in adulthood. often with ear or dental infection
location of a branchial cleft cyst
area of the lower pole of the parotid
