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Senoir 21-2 > MOUF! > Flashcards

MOUF! Flashcards

1
Q

White lesion in the mouth that cannot be removed with rubbing of the mucosa

Think

A

Leukoplakia

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2
Q

What should be FNA in a pt with leukoplakia or erythroplakia ?

A

Cervical lymph nodes!

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3
Q

What is oral lichen planus and what is the Tx for it

A

Autoimmun dz very similar to leukoplakia

Requires a Bx

Tx: analgesics
, +corticosteroids
+tacrolimus

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4
Q

If a pt has RAISED, firm white lesions with ulcers at the base

In the mouth

Think

A

Oral CA

Get a Bx

If less than 2 cm local resection

If >2 cm then resection down to the neck AND radiation

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5
Q

What does ABCDE mean for oral cancer

A 
Asymmetry 
Borders 
Color 
Diameter 
Elevation
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6
Q

What is the tx and Bx for candidiasis

A

Testing not usually required

Wet prep with potassium hydroxide (KOH)
-Non-septate mycelia

Biopsy
-Intraepithelial pseudomycelia

Consider test for HIV
-Thrush can be first sign of HIV

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7
Q

What is the 1st line Rx for uncomplicated Thursh pts

A

-any of the Azoles for 7 days

+ nystatin rinse daily

And chlorhexidine for pain

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8
Q

What is the tx for HIV pts with thrush

A

Longer course of fluconazole
(2-3 weeks minimum)- first line

If refractory- Itraconazole 200 mg/day

Still resistant- Voriconazole

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9
Q

What is the tx for glossitis

A

(Smooth tongue)

Treat underlying cause

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10
Q

When should you get an MRI of the brain in a pt iwth glossodynia

A

MRI if unilateral, s/s are not associated with any medication
Or there are cranial neuropathies

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11
Q

A pt presents with fever, halitosis, gingival bleeding and necrosis

Think

A

NUG!

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12
Q

What is the tx approach for NUG

A

Peroxide rinse 3x a day .

May require dental curet

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13
Q

A yellow gray ulceration with a red center..

think

A

Aphthous ulcer

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14
Q

What are the risk fx for aphtous ulcers

A

Stress, Viral URI , or bed time after 2300

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15
Q

What are the treatment options for recurrent apthous ulcers in HIV pts

A

Thalidomide

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16
Q

What are the general treatments for aphtous ulcers

A

Corticosteroids

Diclofenac gel

Doxycycline-cyanocrylate

Amexanox oral paste

Prednisone tapers

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17
Q

A pt presents with vessicles on a erythematous base, think?

A

Herpes!

18
Q

What is the most common cause of pharyngitis/ Tonilitis

A

VIRAL ! Rhino, flu, adenovirus

Bacterial causes are less : 
Group A Beta Strep 
Gonorrhea/ Chlamydia 
Diphtheria 
Or mono
19
Q

What is the CENTOR criteria used to identify GABHS ?

A

1 point each for:

  • Lack of cough
  • Cervical Adenopathy
  • Fever over 100.4 (38C)
  • Tonsillar exudate

Modified Centor-

  • Add 1 point if age <15
  • Subtract 1 point if age >44
20
Q

CENTOR criteria of 1 =

A

No test, no treatmetn for GABHS

21
Q

CENTOR score of 2=

A

Rapid antigen test for GABHS

22
Q

When should you start to emperically treat fro GABHS

A

CENTOR score of 3 or more

23
Q

What is the tx approach to pharyngitis/ tonsillitis

A

Analgesics/ NSAIDs

Benzocaine lozenges

Salt water gargles

And Prednisone

24
Q

What is the tx approach to GABHS

A

Penicillin or cefuroxime is 1st line
(x 10 days) (PO)

If PCN allergy then Erythromycin!
AVOID CEPHALOSPORIN!

25
Q

When should you admit a pt with pharyngitis

A

In unable to swallow due to pain

26
Q

In a pt with rheumatic fever what is the tx approach

A

Continuous course of PCN or E-mycin for 5 years

27
Q

What is the agent of MONO

A

EBV

28
Q

A pt presents with marked lymphadenopathy
Shaggy purple/ white exudates and hepatosplenomegaly

In a young adult

Think

A

MONO

29
Q

What is the most sensitive finding in mono

A

Lymphocyte to WBC ratio greater than 35%

Or Monospot

30
Q

What is the tx approach to mono

A

Avoid amoxicillin and ampicillin (rash)

Treat s/s and avoid contact sports

31
Q

An alcoholic pt presentes with gray psuedomembrane on exam with a low grade fever

Think

A

Diphtheria

32
Q

What are the S/s of Peritonsillary abcesses

A

Severe sore throat

Painful swallowing

And trismus

33
Q

A pt presents with a hot potato voice, and medial deviation of the soft palate

With a inferior and medially displaced uvula

Think

A

Abcess

34
Q

What is the tx for a peritonsillar abcess

A

S/s Tx with I/D and culutre
+ ABX :
Amoxicillin or clinda

I/D: 119-21 gauge needle, medial to the molar, only 1cm deep .

35
Q

What is the most common organism in saliva gland d/o

A

Staph aureus

36
Q

What is the tx for sialadenitis

A

Nafacillin

X 10 days

37
Q

What is the tx approach to suppurative sialadenitis

A

Immediate referral and Nafacillin
+ clinda or metro

If immuno comp - Vanc

38
Q

Where is the most common location for a salivary stone

A

Whartons duct

39
Q

What is the dif. Of a stone in whartons vs stensons duct

A

Wharton stones- large, radiopaque

Stensen stones- smaller, radiolucent

40
Q

A pt presents with a medially deviated soft palate
With a CN palsy and a mass in the salivary gland

Think

A

Get an MRI, CA UPO

41
Q

If a tumor is the most likey DX for a salivary gland d/o

What is the tx

A

Resection of gland
-In parotid tumor, dissect the facial nerve to preserve it

FNA biopsy
-Only if negative results will prevent surgery

Senoir 21-2 (77 decks)

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