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Clin Med I Exam #2 > L1: Oral Lesions > Flashcards

L1: Oral Lesions Flashcards

1
Q

What is Leukoplakia? Is it precancerous?

A

Adherent white patches/plaques on oral mucosa or tongue. Can be associated with inflammatory/autoimmune disease.
Usually benign.. HOWEVER can become SCC

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2
Q

Risk factors for Leukoplakia?

A

Tobacco and alcohol use

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3
Q

Diagnosis and tx for Leukoplakia?

A

Dx: Biopsy.
Tx: Prevent/decrease risk of oral SCC

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4
Q

What is Erythroplakia? Is it cancerous?

A

Red, velvety patch usually on mouth floor, ventral aspect of tongue, soft palate.
Very high risk of malignant transformation!!! EMERGENCY

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5
Q

What is Leukoerythroplakia?

A

White mucosal plaques with red, speckled apperance

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6
Q

What is oral hairy leukoplakia? Is it malignant

A

Vertically corrugated adherent white lesions on lateral surface of the tongue, painless. Separate from Leukoplakia… NOT premalignant!

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7
Q

What can cause oral hairy leukoplakia? Treatment for this?

A

Induced by Epstein-Barr virus and immunosuppressed individuals.
Tx: usually not indicated.

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8
Q

Risk factors for oral SCC?

A

Tobacco use, alcohol use are main factors!!

others include UV light, radiation exposure, HPV

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9
Q

How do oral SCC’s present?

A

Ulcers or masses that don’t heal!!
On tongue/lip- exophytic or ulcerative lesions, often painful.
Dysphagia, odynophagia, sore throat, hoarseness, weight loss

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10
Q

How to Dx and Tx Oral SCC?

A

Dx: Biopsy
Tx: ENT referral ( will do sx or radiation)

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11
Q

How does Melanoma present?

A

If pigmented oral lesion.. MUST consider!! remember your ABCDE’s bitches.

Painless bleeding mass, area of ulceration, region of discoloration, or w/ ill fitting dentures

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12
Q

Dx and Tx of Melanoma?

A

Dx: Endoscopic evaluation for paranasal disease, CT/MRI of primary site and CT/PET for lymph node involvement

Tx: Excision w/ clear margins or radiation therapy

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13
Q

What are mucoceles?

A

Pinkish/blue soft papule or nodules (filled w/ gelatinous fluid) lining the epithelium. May rupture.
From oral trauma!

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14
Q

Dx and Tx of Mucoceles?

A

Dx: clinical
Tx: Avoid cheek/lip biting. Can remove w/ cryotherapy/excision if symptomatic. Also CO2 laser vaporization

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15
Q

Most common HSV manifestation in childhood?

A

Herpectic gingivostomatitis (HSV-1)

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16
Q

Clinical presentation of oral HSV? Primary and recurrent infection.

A

Primary: Can be asymptomatic/symptomatic. Grouped vesicles on erythematous base, painful! Viral shedding is greatest.

Recurrent infection: Prodrom- pain/burning/tingling 6-48hrs before lesion appears fatigue, low grade fever.

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17
Q

How to Dx and Tx HSV?

A

Dx: clinical and viral culture if active lesion
Tx: Oral antiviral and supportive care (miracle mouthwash, fluids, analgesics), patient education!!

18
Q

Etiology of hand foot and mouth disease? Clinical presentation?

A

Coxsackie A16 virus.

Painful oral lesions, spares gingiva & lips (unlike HSV)!!!

19
Q

Tx of Hand foot mouth?

A

Supportive (hydration, analgesics).

20
Q

Etiology of Oropharyngeal Candidiasis? What kind of infection is this?

A

Also known as Thrush.
Etiology: candida albicans
Is an opportunistic infection!

21
Q

How does oropharyngeal candidiasis present?

A

Mouth pain. Creamy white patches, plaques with underlying erythematous mucosa. “THRUSH WILL BRUSH BABY”

22
Q

Dx and Tx of oropharyngeal candidiasis?

A

Dx: KOH prep (if esophageal requires further investigation for underlying disease)

Tx: Topical anitfungal (nystatin) and patient education

23
Q

Etiology of Erythema Multiforme Major?

A

HSV. Is acute, immune-mediated condition

24
Q

Presentation of erythema multiform major?

A

Target-like lesions on skin. On mucosal erythema, painful erosions or bullae

25
Q

Tx of erythema multiforme major?

A

Should resolve w/in 2 weeks. Symptomatic relief (topical corticosteroids, oral antihistamines, miracle mouthwash). If sever can consider systemic glucocorticoids. If ocular involvement–> refer to ophthalmology IMMEDIATELY!

26
Q

How dx and treat oral SJS/TEN?

A

Dx: clinical
Tx: stop inciting medication, admit, supportive care

27
Q

How to tx pemphigus and pemphigoid? (i’m not doing a flashcard on what they are you should already f*ckn know these)

A

For pemphigus- systemic corticosteroids, immunosuppressants

For phemigoid- topical and/or systemic corticosteroids, derm referral

28
Q

What is the most common cause of mouth ulcers?

A

Aphthous Ulcers.. also known as canker sores, ulcerative stomatitis

29
Q

How do aphthous ulcers present?

A

Shallow, round/oval, painful w/ grayish base on buccal/labial mucosa

30
Q

How to tx aphthous ulcers?

A

Heal w/in 10-14 days. Avoid irritating food/drink. Topical steroid (triamcinolone oropharyngeal paste)

31
Q

How does Behcet syndrome present?

A

Recurrant oral and genital ulcers. Painful, shallow or deep w/ central yellowish necrotic base.
Neurtrophilic inflammatory disorder

32
Q

How to dx and tx Behcet Syndrome?

A

Dx: Recurrent oral ulcers (>3x/ year) AND 2 other clinical findings (ie. positive pathergy test, optic lesions, genital lesions, or cutaneous lesions)

Tx: Refer to rheumatology

33
Q

What is the Pathergy test?

A

Nonspecific hyperactivity of the skin following minor trauma. Intradermal injection. Positive if an erythematous sterile papule develops w/in 48 hrs.

34
Q

Etiology of oral lichen planus?

A

Chronic inflammatory disorder affecting skin and mucous membranes. May increase risk for oral cancer

35
Q

Presentation of oral lichen planus?

A

Wickham’s striae (reticular lacy white plaques).

Can have painful erythematous red patches and erosive ulcers.

36
Q

Dx and Tx of oral lichen planus?

A

Dx: Biopsy (ENT referral)
Tx: relief of pain, topical corticosteroids

37
Q

How does Black hairy tongue present? Is it malignant?

A

Elongated filiform papillae, yellowish white to brown dorsal tongue.
Is benign.

38
Q

Tx of Black hairy tongue?

A

Brush affected area of tongue w/ toothpaste BID-TID

39
Q

Presentation of geographic tongue? Tx?

A

Erythematous patches on dorsal tongue w/ circumferential white borders.

Tx: reassurance

40
Q

Presentation and tx of Atrophic Glossitis?

A

Appears smooth, glossy, erythematous tongue.

Tx: Address underlying condition

41
Q

Etiology of atrophic Glossitis?

A

Inflammatory disorder leads to atrophy of filiform papillae.
Can be from nutritional def, dry mouth, celiac disease, oral candida infection, Sjrogen’s syndrome

42
Q

How to use medications in the oral cavity?

A
  • Use gel for few localized lesion.
  • use rinse for widespread/ generalized erythema
  • educated about possibility of oral candidiasis w/ topic immunosuppressants
  • systemic therapy for more severe lesions

Clin Med I Exam #2 (6 decks)

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