last lecture Flashcards
HIV + lateral tongue
hairy leukoplakia
hairy tongue - general
clinical description
dorsal - elngation of filiform
CD4
t helper
cd8 = c cytotoxic
HIV viral load
if 156,000
if over 100000 copy – patient is in productive infection phase
reverse cd4 and cd 8
at risk for?
high risk for viral, fungal and cancer infections
antibiotic prophy relates to
neutrophil count
protease inhibitor function
inhibit activity of viral protein assembly
muscle co contraction / protetive co contraction
remove cause
like extract wisdom tooth
fix high occlusal contact
local muscle soreness
tx
NSAIDs 600 mg 3x day for 10 days
muscle relaxants - 5mg for 10 days 3x day
local muscle soreness
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
acupuncture for?
muscle / joint problems
muscle relaxant for
up to 10 days max
with reduction
occlusal splint ice applicatin NSAIDs mouth movement limitations soft diet
without reduction
manipulate jaw
chronic – refer to OS to inject lubrication into joint space
occlusal splint
inflammatory joint in TMJ?
usually with disc displacement - same therapy
osteoritis in TMJ
overloading the joint is most common cause
occlusal splint
soft diet
burxism
protection
occlusal splints
first picture on review
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)
atrophic filiform papilla
if focal affect ?
if homogenouss – think more systemic problem going on
pernicious anemia - hidden risks?
atrophic changes to stomach mucosa - high risk for gastric cancer
normal papillfform - red spots all over dorsal
candida
PAS staining/
candida albicans
- tubular structure of the candida albicans
picture 3
geogrpahic tongue
biopsy on candida?
no
same with pernicious anemia
raised on palate - nodular
kapscio
hemangioma
grows very fast
mainly in children
hemangioma
grows very fast
mainly in children
HSV 8 + HIV
kapocis sarcoma
tx for kaposci
AZT
reverse transcrption inhibitor
picture 5
common lesion
ulceration with surrounding erythematous base
non keratinized
recurrent apthous ulceration
location of herpes in mouth
mainly on heavily keratinized mucosa
tx of recurrent apthous ulcer
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
topical steroid? use with?
anti fungal prophylaxis
can raise risk for candida infection in that location
picture 6
recurrent herpes simplex cvirus
if in mouth - heavil keratinized
recurrent herepes can present?
bilaterally
picture 7
herpes zster / shingles
tx for shingles
anti-virus
acyclovirr
herpes zoster is what type
DNA virus
can acylovir prevent?
no - only stops curent
cant get the virus out of the trigmenial nerve
renal function important for
half life of acyclovir
picture 8
pigmented lesion
- lower lip
hx
melanotic macule
what to ask for pigmented lesion
change? size shape
already had for many years? –> follow the lesion but take photograph
melanotic macule
benign
only increase in melanin - not increase in melanocytes
dx with melanotic macule
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
any pigmented lesion?
take photogpah
if patient does not know hoe long had lesion / pigmentation
come back periodocally 3 months every 5 years
take photos everytime
erythema multiform simplex?
antibody ?
IgM and C3 complex
IgG usually?
later response in immune complex
superficial tissue ?
blood vessel efects in ulceration - bloody and crusty
acute immune response to certain antigen tx?
steroid
anti- inflammatory
predisone
predisone tx protocal
high dose - up to 60 mg
1x day early morning before 8 am
short course
- like 5 days
taper off
- take 5mg day
steroud use for
anti-inflammation
picture 9
white lesion
attached gingiva
can be whipred away and leave bleeding base
thrush
candida infection – pseudomembraneous
anti- gungal
if have candida first thing to do
get HIV test
many red spots on tongue
candida infection
white / grey area = normal filiform papilla
14 days for?
finish course for antifungal against candida
