Mouth 2 Flashcards
1
Q
Apthous ulcers
A
Canker sores
2
Q
- Clinical dx
- Supportive tx, resolves in 2 - 3 days
- Common in children
- Low grade fever, malaise, abd pain, URI sxs
- PAPULES on erythematous base over tongue and hard palate
A
HFM - Coxsackie A16 virus
3
Q
Irritants of this condition:
- Dentures
- Tobacco
- Lichen planus
A
Oral leukoplakia
4
Q
What are the 2 forms of Oral Herpes Simplex Virus?
A
- Herpetic gingivostomatitis
- Herpes labialis (cold sores)
(2 forms of the same virus)
5
Q
- Common in children
- LESIONS over posterior soft palate
- Caused by Coxsackie virus
- Lesions limited to mouth
- Supportive tx
A
Herpangina
6
Q
Sudden onset of painful vesicular lesions on red base
A
HSV
7
Q
- Etiology is uncertain, but is associated w/ HHV-6
- Also associated w/ Celiac, IBD, HIV
- Usually single lesion
- Recurrent
A
Aphthous ulcers
8
Q
Diagnosis for Bechet’s
A
- Recurrent oral ulcers 3+ per year along w/ recurrent genital ulcers, eye lesions, skin lesions
9
Q
- Ulcerative lesions of gingiva/mucous membranes in mouth
- Perioral vesicular lesions
- Fevers
A
Sxs of Herpetic Gingivostomatitis
10
Q
- Small, painful, shallow, round ulcer
- Gray base surrounded by red halo
- Triggered by stress
- HHV-6 (human herpes virus)
A
Aphthous Ulcer (canker sore)
11
Q
What are the 4 tongue conditions?
A
- Fissured tongue
- Black tongue
- Black hairy tongue
- Geographic tongue
12
Q
Chronic, infammatory autoimmune disease
A
Oral Lichen Planus
13
Q
Triggers:
- Sunlight
- Fever
- Menstruation
- Stress
- Trauma
A
Triggers of HSV
14
Q
Referral to ENT, head/neck surgeon, radiation oncology
A
Oral leukoplakia
15
Q
Pt education for Oral Candidiasis (thrush)
A
- Rinse mouth out after inhaling steroids
- Good oral hygiene w/ denture use
16
Q
- Benign, resolve on own
- May rupture spontaneously
- Remove w/ cryotherapy or excision of cyst
A
Mucoceles
17
Q
- Primary HSV infection
- 1st outbreak is severe
- Recurrent outbreaks = cold sores
A
Herpetic gingivostomatitis
18
Q
Seen in mild oral trauma such as “biting lip” and so can be seen on labia
A
Mucoceles
19
Q
- Topical corticosteroids in an adhesive base
- Topical analgesics
A
Tx for aphthous ulcers
20
Q
Tx for Bechet’s
A
Refer to rheumatologist
21
Q
Benign, seen after dental fillings w/ silver
A
Amalgam tattoo (seen adjacent to amalgam filling)
22
Q
- Normal
- Caused by meds like: Abx, Pepto, GERD meds
A
Black tongue
23
Q
- Clinical dx
- KOH wet prep
- Culture
- Biopsy
A
Diagnositcs for Oral Candidiasis (thrush)
24
Q
- Reticular white plaques
- Mucosal erythema
- erosions/ulcerations
- Hyperkeratotic plaques
- Painless or Painful
A
Clinical presentation of Oral Lichen Planus
25
* Inflammatory disorder
* Recurrent oral and genital aphthae (ulcers) in 75%
* Lesions can occur at multiple sites
Bechet's
26
* Difficult to diagnose
* Exfoliative cytology or biopsy
Oral Lichen Planus
27
White lesion which _cannot be removed by scraping_
Oral leukoplakia
28
What condition is caused by **chronic irritation** and is **precancerous?**
Oral leukoplakia
29
Hyperplasia of squamous epithelium
Oral Leukoplakia
30
* Benign bony lesion, usually on hard palate
* Midline and does not enlarge
* Common, starts in childhood
Torus palatinus
31
With which condition do we need to particularly worry about squamous cell carcinoma? What will the PE findings be?
Oral Lichen Planus
-Oral lichen w/ erosions/ulcerations
32
33
3 tx options for HSV
1. Antivirals
2. Analgesics (pain meds)
3. Fluid management (bc/ pt hesitant to eat/drink)
34
* Caused by Epstein-Barr virus
* Almost exclusively seen w/ HIV
Hairy Leukoplakia
35
Can be _dysplastic_ (abnormal cells) or _early invasive squamous cell carcinoma_
Oral leukoplakia
36
What causes dental caries which:
* Metabolize sugars into acid
* Acid demineralizes enamel
* Cavity development
Strep mutans
37
Most common HSV?
Type 1
38
MUST be biopsied and referred to ENT
Erythroplakia
39
Etiology of Thrush
Candida albicans
40
\>90% represent malignant change
Erythroplakia
41
With bechet's, are oral or genital lesions more common?
Genital
42
How do you dx HSV?
* Mostly clinical (obvious presentation)
* Viral culture
* Serology
* Immunofluorescence microscopy for antigens
43
* Painful, creamy-white curd like patches over erythematous base
* May present like angular cheilitis
* Scrapes off easily w/ tongue blade
* "cotton mouth"
* Loss of taste
Oral Candidiasis (thrush)
44
What virus causes HFM?
Coxsackie virus
45
* Initial outbreak of HSV lasts how many days?
* Recurrent outbreaks of HSV, how many days?
* 10 - 14
* 5 days
46
Similar to mucoceles. Caused by trauma.
Fibroma and Check Bite
47
* Dentures
* Poor oral hygiene
* DM
* Anemia
* Chemo
* Corticosteroid use (inhaled steroids)
* Abx
* HIV
Risk factors for oral candidiasis
48
Biopsy or exfoliative cytologic exam
Oral leukoplakia
49
Fluid filled cavities w/ mucous glands lining the epithelium
Mucoceles
50
* Normal
* Raised papillae of tongue
* Waxes/Wanes
Geographic tongue
51
Which 2 groups are more at risk for getting thrush (oral candidiasis)
* Breast-feeding infants
* Older adults w/ dentures
52
* White, painless plaques, cannot be scraped off
* Lateral tongue
* Not premalignant
* No tx necessary, but can tx w/ antivirals
Hairy leukoplakia
53
Can be associated w/ **HPV**
Oral leukoplakia
54
Labs for:
* HIV
* Glucose
Diagnostics for Oral Candidiasis (thrush)
(if recurrent test for HIV)
(if concerned for DM, get glucose)
55
* Red, velvety plaque-like lesion
* Common in tobacco and alcohol users
Erythroplakia
56
* Poor oral hygiene
* Thrush
* Meds
Black hairy tongue
