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2017 EENT Clin Med Group > Mouth > Flashcards

Mouth Flashcards

1
Q

<p>Pharyngitis - Complication</p>

A

<p>Rheumatic fever, otitis media, peritonsillar abscess</p>

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2
Q

<p>Pharyngitis - Etiology</p>

A

<p>Virus (Rhinovirus, adenovirus, influenza)

| Bacteria (Group A/C B hemolysis strep, N. gonorrhea, C. diptheria, mycoplasma, anaerobic bacteria)</p>

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3
Q

<p>Strep Pharyngitis - Presentation</p>

A

<p>Pain, difficulty swallowing, erythema, gever, exudate, ervical adenopathy</p>

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4
Q

<p>Viral Pharyngitis - Presentation </p>

A

<p>EBV/adeno - exudative pharyngitis

| Coxsackie/HSV - vesicles</p>

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5
Q

<p>Pharyngitis - Diagnosis</p>

A

<p>Distinguish viral vs strep
Rapid strep, throat culture
Hx - no cough, tonsil exudate, tender anterior cervical adenopathy</p>

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6
Q

<p>Pharyngitis - Tratment</p>

A

<p>Penicillin V 500 mg (x10)
Amoxicillin 50 mg (x10)
Benzathine</p>

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7
Q

<p>Viral URI - Etiology</p>

A

<p>Common cold, parainfluenza, rhinovirus, airborne droplets, kids</p>

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8
Q

<p>Viral URI - Presentation</p>

A

<p>12-72 hour incubation, rhinitis, sneezing, sore throat, cough, laryngitis, fever, fatigue, hoarse virus, 2 weeks</p>

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9
Q

<p>Viral URI - Treatment</p>

A

<p>rest, clear fluids, decongestants, NSAIDs, throat losenges</p>

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10
Q

<p>Acute laryngotracheobronchitis - Etiology</p>

A

<p>kids 3-36 months, parainfluenza, rhinovirus, enterovirus, mycoplasma pneumonia, subglottic inflammation</p>

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11
Q

<p>Acute laryngotracheobronchitis - Presentation</p>

A

<p>Inflamed subglottic area, larynx, trachea, hoarse, cough, characterisitc stridor, calmed by cold air, tachycardia</p>

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12
Q

<p>Acute laryngotracheobronchitis - Diagnosis</p>

A

<p>Clinical

| Steeple sign</p>

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13
Q

<p>Herpes Simplex Virus - Etiology</p>

A

<p>Most people exposed by 20, reactivation via sun, smoke, stress, fever</p>

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14
Q

<p>Herpes Simplex Virus - Primary Infection Presentation</p>

A

<p>multiples lesions of the mucus membranes
discrete vesicles coalesce into one
Tender lymph nodes, fever, malaise</p>

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15
Q

<p>Herpes Simplex Virus - Recurrent Presentation</p>

A

<p>Vesicles, painful papules on the hard palate, lip, and gum which break and crust
Itching 1-2 weeks before outbreak</p>

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16
Q

<p>Herpes Simplex Virus - Diagnosis</p>

A

<p>Clinical presentation
Tznack smear
Viral culture</p>

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17
Q

<p>Herpes Simplex Virus - Treatment</p>

A

<p>Acyclovir, valacyclovir

| Symptomatic: NSAID, viscous Lidocaine</p>

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18
Q

<p>Oral Candidias - Etiology</p>

A

<p>Immunosuppression: pregnancy, AIDs, diabetes, anemia

| Dentures</p>

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19
Q

<p>Oral Candidias - Presentation</p>

A

<p>Throat and mouth pain increasing on swallowing
Burning sensation of tongue, throat, cheek
White curd-like pseudomembrane that peels off (red and bleeding)</p>

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20
Q

<p>Oral Candidias - Treatment</p>

A

<p>Antifungals</p>

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21
Q

<p>Laryngitis - Etiology</p>

A

<p>Previous URI (virus, M. Cat, H. Influ, HPV, irritant)</p>

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22
Q

<p>Laryngitis - Presentation</p>

A

<p>Hoarse and harsh voice
Previous URI
Inflamed larynx
Cough</p>

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23
Q

<p>Epiglottitis - Complication</p>

A

<p>Airway risk</p>

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24
Q

<p>Epiglottitis - Etiology</p>

A

<p>Inflamed epiglottis
H. Influenza (vax), strep, staph
Diabetic (virus/bacteria)
2-4 year old</p>

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25
Q

<p>Epiglottitis - Presentation</p>

A

<p>Fever, sore throat
Dyspnea, dysphagia
Irritable
Lean forward, drool, tripod</p>

26
Q

<p>Epiglottitis - Diagnosis</p>

A

<p>Visualize under anesthesia
Increased leukocytes and blood cultures
X-ray</p>

27
Q

<p>Epiglottitis - Treatment</p>

A

<p>Maintain airway (intubate)
ABX and corticosterois
Antimicrobial
Prophylaxis <4 at home</p>

28
Q

<p>Tonsilitis - Etiology</p>

A

<p>GABHS </p>

29
Q

<p>Tonsilitis - Presentation</p>

A

<p>lymph enlargement
white purple tonsil exudate
Sore throat</p>

30
Q

<p>Tonsilitis - Diagnosis</p>

A

<p>Rapid strep,
Monospot
Throat culture</p>

31
Q

<p>Sialolithiasis - Etiology</p>

A 
<p>Saliva stagnation
Injured duct 
Gland inflamed
Harden deposit
Submandibular (wharton)>Parotid (stensen)</p>
32
Q

<p>Sialolithiasis - Presentation</p>

A

<p>Pain on eating
Swelling
Wharton stone radiopaque</p>

33
Q

<p>Sialolithiasis - Treatment</p>

A 
<p>Remove stone
Lemon drop
Warm compress
NSAID
Water
I &amp;amp; D (ENT)</p>
34
Q

<p>Parotitis + Sialdentitis - Etiology</p>

A

<p>Clogged duct, inflame, infect salivary
Dehydrated patient
Bacteria move back (S.aur, strep, anaerobe)</p>

35
Q

<p>Parotitis + Sialdentitis - Presentation</p>

A

<p>Swelling/ pain gland
Decreased saliva
Drain pus from duct
Increase with meal</p>

36
Q

<p>Parotitis + Sialdentitis - Treatment</p>

A 
<p>Remove stone
Lemon drop
Warm compress
NSAID
Water + gum
I &amp;amp; D (ENT)</p>
37
Q

<p>Aphthous Stomatits - Etiology</p>

A

<p>Unclear
Family Hx, Immunocomp
Meds, Underlying disease
Smoking ?</p>

38
Q

<p>Aphthous Stomatits - Presentation</p>

A

<p>Recurrent ulcer
Yellow white pseudomembrane
Red halo
Pain >> size</p>

39
Q

<p>Aphthous Stomatits - Minor </p>

A

<p> <1cm, 10-14 days, no scar, cheek lip</p>

40
Q

<p>Aphthous Stomatits - Major</p>

A

<p>1-3 cm, deep, 2-6weeks, scar, tongue, tonsil, soft palate</p>

41
Q

<p>Aphthous Stomatits - Herpetic</p>

A

<p>Greater number, recurrent, 1-3mm, 7-10 days any surface</p>

42
Q

<p>Aphthous Stomatits - Diagnosis</p>

A

<p>Hx + PE

| Biopsy to rule out DDx</p>

43
Q

<p>Aphthous Stomatits - Treatment</p>

A

<p>Topical corticosteroids
Chlorohexadine mouthwash
Analgesic (lidocaine)</p>

44
Q

Oral Lichen Planus - Etiology

A

Unknown more in females 30-60

45
Q

Oral Lichen Planus - Reticular

A

asymptomatic, Wick’s striae (lacy network of papula or striae) symmetrical

46
Q

Oral Lichen Planus - Erythema

A

Wick’s striae, muscular atrophy, red patches, symmetrical

47
Q

Oral Lichen Planus - Erosive

A

desquamaous gingiva, ulcers, and erosion, rupture bullae

48
Q

Oral Lichen Planus - Diagnosis

A

Hx and PE, biopsy to rule out cancer, consider Hep C

49
Q

Oral Lichen Planus - Treatment

A

Increase oral hygiene, decrease alcohol intake, topical corticosteroids

50
Q

Leukoplakia - Risk factore

A

Smoking,smoking, UV, previous oral infections, tertiary syphilis, candida, HPV 16/18; over 40

51
Q

Leukoplakia - Presentation

A

white paper-like lesions that do not scrape off; mainly on lip vermillion, buccal mucosa, gingiva but ventral tongue and oral floor higher risk re cancer; early/mild are white/gray, translucent, fissured or wrinkled

52
Q

Leukoplakia - Diagnosis

A

Biopsy at most significant site for dysplasia

53
Q

Leukoplacia - Treatment

A

Stop risk factor behaviors, Evaluate every 6 months for dysplasia (excision if positive)

54
Q

Erythroplakia - Risk factors

A

Age 65-74, smoking, UV, previous oral infections

55
Q

Erythroplakia - Presentation

A

well-demarcated, soft (velvety) erythematous, asymptomatic macule/plaque on floor of mouth, ventral tongue, soft palate

56
Q

Erythroplakia - Treatment

A

Stop risk factor behaviors, Evaluate every 6 months for dysplasia (excision if positive) More likely to turn than leukoplakia (Female nonsmokers esp)

57
Q

Oral Squamous Cell Carcinoma - Risk factors

A

Tobacco, alcohol, female, black, plummer vinson syndrome (iron def), vit A def
Exposures: phenolic agents , UV light, radiation, betal quid teriary syphilis, HPV, immunosuppression
Lip vermillion: fair skin, UV, lower lip, crusted, slow growing, swollen submental nodes
Intraoral: tongue (posterior lateral or ventral), oral floor

58
Q

Oral Squamous Cell Carcinoma - Warning signs

A 
Lesions don't/pain resolve in 14 days
Lump/thickening, numbness, voice changes, 
Ear pain, swollen oral cavity, 
Bleeding mouth/throat, 
Red/white lesions on mouth/lips, 
Rersistent bad breath
59
Q

Oral Squamous Cell Carcinoma - Diagnosis

A

Biopsy! Direct scope for secondary, head/neck/chest CXR, check nodes for metastatis

60
Q

Oral Squamous Cell Carcinoma - Treatment

A

IMMEDIATE REFERAL, clinical staging (high mortality)

Surgical excision, radiation +/- chemo

2017 EENT Clin Med Group (13 decks)

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