Midterm Ch. 14 Flashcards
What is a canker sore
Shallow painful ulceration
< 5 mm thin exudate with red rim
7-10 days, do reoccur
Who is at risk for canker sores
Females < 20 years old, genetics, celiac disease, Behcet disease
Smoking, stress, trauma, fever
What is Apthous Ulcers
Avoid causative foods and trauma
NSIADS, corticosteroids for txt.
Vitamin B12
Herpes simplex virus how does it happen
Occurs during childhood age 2-4
80% asymptomatic
10-20% acute hermetic gingivostomatitis
Where do most adults have herpes simplex virus
Dormant, trigeminal ganglion
When reactivated called= Recurrent Herpetic Stomatitis
Which herpes is facial
HSV-1
HSV-2 is genital
what is oral candidiasis
Infection with Candida albicans
Tongue, cheeks, gums, tonsils
Gray/white pseudomembranes may be scaled off
Who is at risk for oral candidiasis
AIDS patients, infants
Txt. Broad spectrum antibiotics, diabetes
DDx. Leukoplakia, Candidemia, oral CA
AKA THRUSH
What is a oral fibroma
Modular mass following chronic irritation
Hyperplasia and fibrosis
MC along bite line
What is Pyogenic Granuloma
Hemangioma on gingiva, red/purple
FOund in pregnant women and children
HOrmanl factors, irritation
Rapid growth
Remove growth
What is leukoplakia
Raised white patches
CANT be scraped off
Epithelial hyperplasia and keratosis
Dysplasia
Affects 3% of population
Who is at risk for Leukoplakia
Tobacco, alcohol, candidiasis
Males 2x age 40-70 yrs old
Dx. Of exclusion
Rule out cancer by biopsy
25% pre cancerous- squamous cell carcinoma
What is erythroplakia
Red, velvety oral lesion
HIGH RISK, >50% transition into CA
Irregular borders
Risk- tobacco use, males 40-70 yrs old
What is the MC oral cancer
Squamous Cell Carcinoma 95%
Poor prognosis <50% long term survival
Risks alcohol, tobacco, >30yrs old, HPV-16 infx.
Where is the MC place for oral squamous cell carcinoma to invade
Cervical nodes
What is Xerostomia
Dry mouth, due to decreased saliva production
What is Sjogren syndrome
Autoimmune atttack on exocrine glands salivary and lacrimal
What is Sialadenitis
Inflammation and enlargement of salivary glands
What is the difference between viral and bacterial sialadenitis
Viral= Mumps virus parotid
In adults can result in pancreatitis and orchitis
Bacterial=MC staph aureus infxn.
What is Mucocele
Saliva collects within tissue= inflamed cyst
Follows ductal obstruction
Lower lip, poostprandial
Who is MC affected by salivary gland neoplasms
MC elderly 60-80 yr females
Parotid gland- 65-80% MC
Where is the MC malignant salivary gland neoplasms
Sublingual and minor salivary gland 50-90% malignant
A parotid gland neoplasm is
Localized mass large 4-6cm, rapid growth, MOBILE
What is Pleomorphic adenoma
Benign, 60% of all parotid tumors
May reoccur following excision
Mobile
what is carcinoma Ex Pleomorphic adenoma
Invasive, less mobile, 50% 5 yr survival
Parotid gland neoplasms
What is a Pleomorphic adenoma
Histology is heterogeneous
Cartilage and bony
What is zenkers diverticulum
Lower pharyngeal outpouching
Develops from increased pharyngeal pressure
Spasm of cricopharyngeus
May be large
Bolus accumulation= halitosis
How to diagnose a zenkers diverticulum
Barium swallow and video fluoroscopy
What are mechanical esophageal lesions
Atresia, tracheal fistula, stenosis
Regurgitation diagnosed after birth
What are ectopia esophageal lesions
Ectopic gastric mucosa upper 1/3
Asymptomatic MC, irritation, cancer risk
What are esophageal varices
Secondary to portal hypertension
What is achalasia
Failure of esophagus to relax
Chest pain “heartburn”
Weight loss
Dilates the esophagus
Tx= pneumatic dilation, botulinum toxin
The “bird-beak sign” is from
Achalasia
Using a barium swallow test
What is the MC achalasia
Primary- loss of inhibitory innervation of LES
Idiopathic
What is secondary achalasia
Impairs LES function
Chagas’ disease (T. Cruzi)
Irradiation, diabetes, polio
Inflammation near Auerbach’s plexus
Portal venous congestion affects
The distal esophagus
Dilated and tortuous vessels
Hepatic schistosomiasis occurs from
Flatworm infection
Esophageal varices are asymptomatic and
Risk for severe hemorrhage
What occurs from advanced cirrhosis
Liver failure toxins accumulate within CNS
Hepatic Encephalopathy (hepatic coma)
How often do esophageal varices kill
50% of 1st time bleeds are lethal
