Mouth 3

Question 1

Salivary gland disorder without inflammation (just a stone)

Answer 1

Sialolithiasis

Question 2

Salivary gland disorder w/ inflammation or infection

Answer 2

Sialadenitis

Question 3

Etiology of Sialolithiasis / Sialadenitis

Answer 3

Uncertain, but is related to:

• reduced salivary flow
• inflammation
• localized injury

Question 4

Most stones of sialolithiasis / sialadenitis occur where?

Answer 4

Wharton duct

Question 5

Pain, swelling caused by eating or anticipation of eating

Answer 5

Sialolithiasis / Sialadenitis

Question 6

Conservative tx for Sialolithiasis / Sialadenitis

Answer 6

• Hydrate
• Heat
• Massage
• “milk” by massaging duct

Question 7

Sialagogues

Answer 7

Have pt suck on something to tx sialolithiasis / sialadenitis

Question 8

Which type of infection would you monitor for in patients w/ Sialolithiasis / Sialadenitis?

Answer 8

S. aureus

Question 9

What would you give a pt w/ either Sialolithiasis or Sialadenitis?

What tests would you order?

Answer 9

• IV or Oral abx
• US or CT to look at duct

Question 10

Acute infection of parotid gland

Answer 10

Suppurative (pus) Parotitis

Question 11

Is Suppurative Parotitis viral or bacterial?

Answer 11

Either

Question 12

Salivary stasis allows retrograde flow w/ the oral flora

Answer 12

Suppurative Parotitis

Question 13

Sudden onset of firm, erythematous swelling of pre/post auricular areas extending to angle of mandible

Answer 13

Suppurative Parotitis

Question 14

• Severe pain/tenderness
• Trismus (diff opening mouth)
• Dysphagia
• Fever/chills

Answer 14

Suppurative Parotitis

Question 15

• Associated w/ elevated amylase
• US, CT, MRI
• Surgical I&D if no improvement in 48 hrs

Answer 15

Suppurative Parotitis

Question 16

Complications:

• Massive neck swelling
• septicemia (sepsis)
• osteomyelitis (bone infection)

Answer 16

Suppurative Parotitis

Question 17

Most common “neck space” infection

Answer 17

Ludwig’s Angina

Question 18

Cellulitis of sublingual and submaxillary spaces

Answer 18

Ludwig’s Angina

Question 19

Arises from infection of tooth roots of mandible

Answer 19

Ludwig’s Angina

Question 20

• Edema, erythema, induration of upper neck & floor of mouth
• Fever, fatigue, neck pain, elevated tongue
• Airway compromise

Answer 20

Ludwig’s Angina

Question 21

• Get a CT
• Secure/Monitor airway
• Tracheostomy may be needed
• Hospitalize
• IV abx

Answer 21

Tx for Ludwig’s Angina

Question 22

Lateral soft tissue neck constriction of upper airway

Answer 22

Ludwig’s Angina

Question 23

> 90% of oral cancer is which type?

Answer 23

Squamous Cell Carcinoma (SCC)

Question 24

Cancer of oral cavity associated w/ ulcers or masses which do not heal.

Answer 24

Squamous Cell Carcinoma

(NEED biopsy)

Question 25

What causes up to 80% of all SCC of head/neck?

Answer 25

Tobacco and Alcohol

Question 26

Papules, plaques, erosions, ulcers which do not resolve

Answer 26

Clinical presentation of SCC

Question 27

How is SCC diagnosed?

Answer 27

Biopsy by ENT

Question 28

Male or female?

• Oral cavity/pharynx cancers
• Thyroid cancers

Answer 28

• Males
• Females

Question 29

What is associated w/ SCC of tongue, tonsils, and pharynx in 46% of post mortem specimens?

Answer 29

HPV (16, 18, 31)

Question 30

Most common genetic abnormality in head/neck cancers. (smoking/alcohol cause mututation in the gene)

Answer 30

P53 Tumor Suppressor Gene

Question 31

• Mass in neck
• Hoarse for over 2 weeks
• Lump below/in front of ear
• Persistent oral ulcer/lesions

Answer 31

Refer to specialist