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Patient Care Exam 1 > Intraoral Exams > Flashcards

Intraoral Exams Flashcards

1
Q

Where is the type 2 Herpe simplex fever blisters located?

A

genital

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2
Q

• VESICLES DEVELOP IN THE ORAL CAVITY, INCLUDING
THE PHARYNX, PALATE, BUCCAL MUCOSA, LIPS, AND/OR
TONGUE.
• THE VESICLES RAPIDLY BREAK DOWN INTO SMALL
ULCERS AND ARE COVERED WITH AN EXUDATE
• LESIONS MAY EXTEND TO INVOLVE THE LIPS AND
BUCCAL MUCOSA.
• THE LESIONS GENERALLLY RESOLVE WITHOUT
THERAPY IN TWO WEEKS

A

HERPES GINGIVOSTOMATITIS

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3
Q
  • Common for individual lesions to coalesce into larger irregular ulcerations.
  • Heal within 7-10 days, but the recurrences tend to be closely spaced.
  • Many patients are affected almost constantly for periods as long as 3 years.
  • Any oral mucosal may be involved
  • Female predominance
  • Onset is adulthood.
A

HERPETIFORM APHTHOUS ULCERATIONS

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4
Q

What is the difference between Minor and Major Canker sores

A

Minor: <1 cm and shallow

Major > 1 cm and deeper

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5
Q

Which is the only FDA approved treatment for canker sores? What is significant about it.

A

Aphthasol

must be started early in the prodromal stage.

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6
Q

Running together, blended. Originally separate but now formed into one.

A

CONFLUENT

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7
Q

Bony lump(s)•Asymptomatic•20-30% of people•Females: males = 2:1•No tx necessary•Unless need dentures

A

Torus Palatinus•

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8
Q

Bony hard

A

( torus)

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9
Q

On the _____, Look for: •Rugae (normal) = Horizontal ridges•Torus palatinus (normal) = Bony lump•Ulcerations•Lesions

A

Hard palate

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10
Q

The increase in HSV-2 is due partly to lack of prior
exposure to ______ increased sexual activity, and
lack of barrier contraception.

A

HSV-1,

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11
Q

returns quickly to original shape

A

Spongy =

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12
Q

•having small bump-like elevations or projections

A

Papillary

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13
Q

An elevated, deep solid lesion .5 – 2.0 cm. •Overlying mucosa not fixed•Ex: fibroma

A

Nodule•

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14
Q

(pressure alters its shape)

A

Compressible

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15
Q

INFECTIONS OF THE THUMBS OR

FINGERS. • GROUPED, FLUID OR PUS FILLED. • USUALLY, ITCH AND /OR PAINFUL

A

HERPETIC WHITLOW

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16
Q

attached to the surface on a broad base.•Immobile, fixed

A

Sessile•

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17
Q

color change - freckle

A

Blanching =

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18
Q

Recurrent herpes labialis is best treated in the_______

phase.

A

prodrome

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19
Q

Under dentures
• Red on palate or tongue
• Burn w/ spicy foods & alcohol

A

Atrophic Candidiasis

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20
Q 
Diabetes
Hormone Changes 
Menopause 
Pregnancy 
Depression/ anxiety 
Radiation for head and neck cancer 
Auto immune disease
A

Medical History that can indicate Xerostomia

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21
Q

white line •parallel to occlusal plane •Asymptomatic•Caused by trauma •Chewing cheek

A

Linea Alba•

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22
Q

• Prodromal signs-tingling, itching,
pain, burning. Arise 6-24 hours
before lesions develop. • multiple fluid-filled blisters • merge and collapse • yellowish crust • 2 weeks healing

A

Herpes Simplex

I could not think of better way to ask this.

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23
Q

More common in African-Americans•“milky” white surface or blue-grey•Symmetrical•Doesn’t rub off•Disappears / decreases when stretched•normal

A

Leukoedema•

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24
Q

bony elevation or prominence

A

Torus•

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25
Q

A denuded area extending below the basal layer•Gradual tissue disintegration•Usually, painful•Ex: aphthous or herpes simplex

A

Ulcer•

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26
Q

(returns slowly to original shape)

A

Doughy

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27
Q

Small (<1 cm.) vesicular-type lesion containing purulent material rather than clear fluid•Creamy white or yellow•Ex: dental abscess

A

Pustule•

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28
Q

firm but not as hard as bone (solid rubber ball) •

A

Induration =

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29
Q

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

A

Crust•

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30
Q

_______ suspension-initiated during the first 3 symptomatic
days in a rinse-and-swallow techniques 5x/day for 5 days.
Significant acceleration in clinical resolution is seen.

A

Acyclovir

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31
Q

White plaque
• Looks like hyperkeratosis
• But rubs off
• Inside the corners, buccal mucosa, lateral tongue

A

Visual evidence of Candidiasis

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32
Q

Canker Sores (aphthous ulcers) vs. cold sores (herpes simplex)

A 
• no blister
• generally larger
• rarely merge
• movable intraoral
tissue 
• tongue, buccal
mucosa, soft palate,
inner lip
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33
Q

Sulfur-colored•Very common•Asymptomatic•1-3mm papules in the oral cavity•Or lip vermillion

A

Fordyce granules•

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34
Q

Risks of Candidiasis

A 
Immunocompromised
• Pregnancy 
• Poor oral hygiene 
• Smoking 
• Stress 
• Depression
 Birth control pills 
• Long term AB 
• Diabetes 
• Dentures that
don’t fit 
• Xerostomia 
• Iron, B12
deficiency
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35
Q

contents expressed - abscess

A

Collapsing =

36
Q

Which is an example of a sealing agent used for aphthous ulcers

A

ameseal

37
Q

Trapped debris:

Bacteria • Fungus • Coffee • Tobacco • Antibiotics
and other drugs
can cause.

A

Hairy Tongue

38
Q 
•Larger than minor aphthae-usually 1-3cm. 
•Have the longest duration per episode. 
•Ulcerations are deeper and can take 2-6
weeks to heal. 
•May cause scarring. 
•Lesions vary from 1-10 
•Onset is after puberty
A

MAJOR APHTHOUS ULCERATIONS

39
Q

Which apthous ulcer treatment is probably best

A

Local anti-inflammatory:
• Kenalog in Orabase 2-
4x / day

40
Q

A solid, flat, raised area >1cm.•Often keratinized (white)•Ex: Snuff dipper’s lesion

A

Plaque•

41
Q

Vesicular form of a canker sore

A

Herpetiform

42
Q

A superficial, elevated, solid lesion <1 cm.•Any color•Solid base or pedunculated•Ex: parulis •(“gum boil”)

A

Papule•

43
Q

What are the 4 areas at high risk for oral cancer?

A

Floor of mouth, lateral border of tongue, ventral surface of tongue, and oropharynx

44
Q

On the _____, Depress tongue•Say “Ah”•Look for: •Ulcers•Patches

A

Soft palate

45
Q

Ulcers arise almost exclusively on nonkeratinized mucosa and may be preceded by an erythematous macule in
association with prodromal symptoms of burning, itching, or stinging.

A

MINOR APHTHOUS ULCERATIONS

46
Q

stone in salivary gland

A

Sialolithiasis

47
Q 
• White plaque 
• Looks like
hyperkeratosis
•But rubs off
• Inside the
corners, buccal
mucosa, lateral
tongue
A

Chronic Hyperplastic Candidiasis

48
Q

Small (<1 cm) fluid filled, elevated lesion with a thin surface covering •= Small blister•Lymph or serum•Ex: Herpes simplex (before it bursts)

A

Vesicle•

49
Q

What are the symptoms of xerostomia

A 
candidiasis 
angular chelitis 
Burning tongue 
Root and Cervical caries 
stomatitis 
Dysphagia
50
Q

Mandibular duct

A

Wharton’s

51
Q

• Greatest number of lesions and most frequent recurrence. • Lesions are small 1-3mm with as many as 100 ulcers present in a single recurrence.
• Because of their small size and large number, the lesions bear a superficial
resemblance to a primary HSV infection.

A

HERPETIFORM APHTHOUS ULCERATIONS

52
Q

_______ exposure correlates directly with sexual

activity.

A

HSV-2

53
Q

How do you treat a symptomatic apthous ulcer

A
  • Viscous benzocaine

* Oragel, Anbesol

54
Q

nonhealing ulcer, bleeding, lymphadenopathy, hardness, pain, paresthesia, and drooling are signs and symptoms of ____

A

Oral cancer

55
Q

Where is the type 1 Herpe simplex fever blisters located?

A

mouth, lips, face

56
Q 
60% of U.S. pop. 
• starts around 10-20 yrs. old 
• frequency varies 
• prodromal tingling 
• 3 days pain, 7 days healed 
• If mild disease-treatment is topical corticosteroids.
A

Aphthous Ulcers (“Canker Sores”)

57
Q

Where is Candidiasis “thrush” seen in an intraoral exam?

A

Tongue
Buccal mucosa
Soft palate

58
Q 
White or
grayish thick
keratotic
patch-like
lesion on the
mucosa
which cannot
be rubbed off
A

Leukoplakia

59
Q 
Tends to occur along family
lines.  When both parents
have a history of aphthous
ulcers, there is a 90% chance
that their children will develop
the lesions.
A

Aphthous Lesions

60
Q

elevated lesions having a narrow stem which acts as a base. Elongated stalk

A

Pedunculated lesion•

61
Q

Sjogren’s syndrome

A

autoimmune disease that results in dry mouth

62
Q

•Red area of variable size and shape.•Usually in patches

A

Erythema:

63
Q

(yields to pressure but keeps its shape)

A

Firm

64
Q

Small (<1 cm) circumscribed area of color change•Brown, black, blue, red•Not elevated or depressed•Ex: freckle (=ephelis)

A

Macule

65
Q

round red pinpoint areas of hemorrhage.Usually cause by trauma, viral infection or bleeding problems

A

PETECHIA(E)

66
Q

Dialated blood vessels on the ventral surface of the tongue

A

lingual varicosities

67
Q

What symptoms accompany SEVERE PRIMARY INFECTIONS of PRIMARY HERPES GINGIVOSTOMATITIS

A

ACCOMPANIED BY HIGH FEVER, MALAISE, CERVICAL

LYMPHADENOPATHY AND DEHYDRATION

68
Q

• The ulcerations measure between 3-10mm
in diameter, oval, and heal without scatting
in 7-14 days.
• Usually, 1-5 lesions and the pain is often
out of proportion for the size of the ulceration.
• Buccal and labial mucosa are affected
most frequently followed by the ventral
surface of the tongue.
• Recurrence rate is highly variable, ranging
from one ulceration every few years to two
episodes per month.

A

MINOR APHTHOUS ULCERATIONS

69
Q

Reddened, pebbled surface of tongue.

dry and cracked corners of the mouth.
Red or parched mucosal tissues

A

Clinical Assessment of xerostomia

70
Q

What are three clincial variations of Aphthous Lesions

A

Minor,

Major, Herpetiform.

71
Q

separate, not running together or blending

A

Discrete •

72
Q

soft and leaves indentation -edema

A

Pitting =

73
Q

A large vesicle •>1 cm.•= large blister•Contains serum•Usually at the mucosal – submucosal junction•Ex: Pemphigus, 2nd degree burn

A

Bulla•

74
Q

covered with or full of wart-like growths; cauliflower-like surface.

A

VERRUCOSE (AKA VERRUCOUS) LESION

75
Q

In the past. Primary herpetic gingivostomatitis was treated
symptomatically; however, if the infection is diagnosed early,______ ______
can have a significant influence.

A

antiviral medications

76
Q

Interlacing white striae (Wickham) with erythema of the surrounding mucosa.• usually appearing bilaterally•Painful erythematous erosions and ulcers may also occur.

A

LICHEN PLANUS•

77
Q

Large (>1 cm) circumscribed area of color or texture change (or both)•Not elevated or depressed•Ex: port wine stain

A

Patch•

78
Q

Lesion of the hard palate.•Lesion is white, rough, asymptomatic, and leathery appearing•Contains numerous red dots or macules

A

NICOTINE STOMATITIS•

79
Q 
For Aphthous Lesions, Although no single triggering
agent is responsible, the
mucosal destruction appears
to represent a \_\_\_\_\_\_ mediated
immunologic reaction.
A

T-cell

80
Q

Bony lump(s)•Asymptomatic•More common w/ bruxism?•8-16% of people•Males = females•No tx necessary•Unless need dentures

A

Torus Mandibularis•

81
Q

Most common Candidiasis

•Tongue, buccal mucosa,
floor 
•Creamy white patches 
•Easily wipe off leaving an
erythematous base 
•Pain w/ spicy / acidic foods 
•Xerostomia 
•Dysphagia
A

Acute Pseudomembranous Candidiasis

82
Q

a sloughing (shedding) of epithelium caused by disease, trauma, or chemical burn•i.e., aspirin bu

A

Eschar•

83
Q

Antibodies to _______ decrease the chance of
infection with HSV-2 or lessen the severity of the
clinical manifestations.

A

HSV-1

84
Q

THE LESIONS OFTEN HEAL IN ONE AREA AND
THEN MOVE (MIGRATE) TO A DIFFERENT PART
OF THE TONGUE.

ALSO CALLED GEOGRAPHIC TONGUE
. 
USUALLY ASYMPTOMATIC BUT CAN CAUSE
DISCOMFORT, PAIN OR BURNING SENSATION
IN SOME CASES, OFTEN RELATED TO EATING
SPICY OR ACIDIC FOODS
A

BENIGN MIGRATORY GLOSSITIS

85
Q

Ways to treat Candidiasis

A 
• Oral hygiene 
• Yogurt, acidophilus 
• Avoid alcohol,
simple sugars 
• Medications
• Nystatin
•rinse and tablets 
• Ketaconozole 
• Fluconozole
86
Q

Herpes Simplex that IS SEEN MAINLY IN CHILDREN AND IS CAUSED BY HS1 IN MOST CASES.

A

PRIMARY HERPES GINGIVOSTOMATITIS

87
Q

Caused by the Epstein-Barr virus and is usually associated
HIV infection or other immunosuppressive conditions.

Typically occurs on the lateral border of the tongue. Either
unilateral or bilateral. White rough patches.

A

Hairy Leukoplakia

Patient Care Exam 1 (2 decks)

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