last lecture

Question 1

HIV + lateral tongue

Answer 1

hairy leukoplakia

Question 2

hairy tongue - general

Answer 2

clinical description

dorsal - elngation of filiform

Question 3

CD4

Answer 3

t helper

cd8 = c cytotoxic

Question 4

HIV viral load

Answer 4

if 156,000

if over 100000 copy – patient is in productive infection phase

Question 5

reverse cd4 and cd 8

at risk for?

Answer 5

high risk for viral, fungal and cancer infections

Question 6

antibiotic prophy relates to

Answer 6

neutrophil count

Question 7

protease inhibitor function

Answer 7

inhibit activity of viral protein assembly

Question 8

muscle co contraction / protetive co contraction

Answer 8

remove cause

like extract wisdom tooth

fix high occlusal contact

Question 9

local muscle soreness

Answer 9

tx
NSAIDs 600 mg 3x day for 10 days

muscle relaxants - 5mg for 10 days 3x day

Question 10

local muscle soreness

Answer 10

tx
NSAIDs 600 mg 3x day for 10 days

muscle relaxants - 5mg for 10 days 3x day

dont want to stop whole jaw movement

massaging
stabalization appliances

Question 11

acupuncture for?

Answer 11

muscle / joint problems

Question 12

muscle relaxant for

Answer 12

up to 10 days max

Question 13

with reduction

Answer 13

occlusal splint 
ice applicatin
NSAIDs
mouth movement limitations 
soft diet

Question 14

without reduction

Answer 14

manipulate jaw

chronic – refer to OS to inject lubrication into joint space

occlusal splint

Question 15

inflammatory joint in TMJ?

Answer 15

usually with disc displacement - same therapy

Question 16

osteoritis in TMJ

Answer 16

overloading the joint is most common cause

occlusal splint
soft diet

Question 17

burxism

Answer 17

protection

occlusal splints

Question 18

first picture on review

Answer 18

pernicious anemia - vit b12 deficiency– will also see RBC count hemoglobin

iron deficiency - may see decrease hemoglobina and changes in RBC

• in erythema candida you still see the filiform papilla - (

in anemia you see atrophic / smooth / bald tongue changes)

Question 19

atrophic filiform papilla

Answer 19

if focal affect ?

if homogenouss – think more systemic problem going on

Question 20

pernicious anemia - hidden risks?

Answer 20

atrophic changes to stomach mucosa - high risk for gastric cancer

Question 21

normal papillfform - red spots all over dorsal

Answer 21

candida

Question 22

PAS staining/

Answer 22

candida albicans

- tubular structure of the candida albicans

Question 23

picture 3

Answer 23

geogrpahic tongue

Question 24

biopsy on candida?

Answer 24

no

same with pernicious anemia

Question 25

raised on palate - nodular

Answer 25

kapscio

Question 26

hemangioma

Answer 26

grows very fast

mainly in children

Question 27

hemangioma

Answer 27

grows very fast

mainly in children

Question 28

HSV 8 + HIV

Answer 28

kapocis sarcoma

Question 29

tx for kaposci

Answer 29

AZT

reverse transcrption inhibitor

Question 30

picture 5
common lesion

ulceration with surrounding erythematous base

non keratinized

Answer 30

recurrent apthous ulceration

Question 31

location of herpes in mouth

Answer 31

mainly on heavily keratinized mucosa

Question 32

tx of recurrent apthous ulcer

Answer 32

not a lot of choice
most time they just go away

but a lot of pain / symptoms –> use pain relief topical gels or topicla steroid

Question 33

topical steroid? use with?

Answer 33

anti fungal prophylaxis

can raise risk for candida infection in that location

Question 34

picture 6

Answer 34

recurrent herpes simplex cvirus

if in mouth - heavil keratinized

Question 35

recurrent herepes can present?

Answer 35

bilaterally

Question 36

picture 7

Answer 36

herpes zster / shingles

Question 37

tx for shingles

Answer 37

anti-virus

acyclovirr

Question 38

herpes zoster is what type

Answer 38

DNA virus

Question 39

can acylovir prevent?

Answer 39

no - only stops curent

cant get the virus out of the trigmenial nerve

Question 40

renal function important for

Answer 40

half life of acyclovir

Question 41

picture 8
pigmented lesion
- lower lip
hx

Answer 41

melanotic macule

Question 42

what to ask for pigmented lesion

Answer 42

change? size shape

already had for many years? –> follow the lesion but take photograph

Question 43

melanotic macule

benign

Answer 43

only increase in melanin - not increase in melanocytes

Question 44

dx with melanotic macule

Answer 44

melano acanthoma
- clinical lesion involving melanin - involve the langerhan cell in epithelium – and consider them foregin body

melanin containing langerhan cell in epithelial layer is evident

this may be slightly raised as opposed to macule that is flat

Question 45

any pigmented lesion?

Answer 45

take photogpah

Question 46

if patient does not know hoe long had lesion / pigmentation

Answer 46

come back periodocally 3 months every 5 years

take photos everytime

Question 47

erythema multiform simplex?

Answer 47

antibody ?

IgM and C3 complex

Question 48

IgG usually?

Answer 48

later response in immune complex

Question 49

superficial tissue ?

Answer 49

blood vessel efects in ulceration - bloody and crusty

Question 50

acute immune response to certain antigen tx?

Answer 50

steroid
anti- inflammatory

predisone

Question 51

predisone tx protocal

Answer 51

high dose - up to 60 mg
1x day early morning before 8 am

short course
- like 5 days

taper off
- take 5mg day

Question 52

steroud use for

Answer 52

anti-inflammation

Question 53

picture 9
white lesion
attached gingiva
can be whipred away and leave bleeding base

Answer 53

thrush
candida infection – pseudomembraneous

anti- gungal

Question 54

if have candida first thing to do

Answer 54

get HIV test

Question 55

many red spots on tongue

Answer 55

candida infection

white / grey area = normal filiform papilla

Question 56

14 days for?

Answer 56

finish course for antifungal against candida