Mouth Flashcards
<p>Pharyngitis - Complication</p>
<p>Rheumatic fever, otitis media, peritonsillar abscess</p>
<p>Pharyngitis - Etiology</p>
<p>Virus (Rhinovirus, adenovirus, influenza)
| Bacteria (Group A/C B hemolysis strep, N. gonorrhea, C. diptheria, mycoplasma, anaerobic bacteria)</p>
<p>Strep Pharyngitis - Presentation</p>
<p>Pain, difficulty swallowing, erythema, gever, exudate, ervical adenopathy</p>
<p>Viral Pharyngitis - Presentation </p>
<p>EBV/adeno - exudative pharyngitis
| Coxsackie/HSV - vesicles</p>
<p>Pharyngitis - Diagnosis</p>
<p>Distinguish viral vs strep
Rapid strep, throat culture
Hx - no cough, tonsil exudate, tender anterior cervical adenopathy</p>
<p>Pharyngitis - Tratment</p>
<p>Penicillin V 500 mg (x10)
Amoxicillin 50 mg (x10)
Benzathine</p>
<p>Viral URI - Etiology</p>
<p>Common cold, parainfluenza, rhinovirus, airborne droplets, kids</p>
<p>Viral URI - Presentation</p>
<p>12-72 hour incubation, rhinitis, sneezing, sore throat, cough, laryngitis, fever, fatigue, hoarse virus, 2 weeks</p>
<p>Viral URI - Treatment</p>
<p>rest, clear fluids, decongestants, NSAIDs, throat losenges</p>
<p>Acute laryngotracheobronchitis - Etiology</p>
<p>kids 3-36 months, parainfluenza, rhinovirus, enterovirus, mycoplasma pneumonia, subglottic inflammation</p>
<p>Acute laryngotracheobronchitis - Presentation</p>
<p>Inflamed subglottic area, larynx, trachea, hoarse, cough, characterisitc stridor, calmed by cold air, tachycardia</p>
<p>Acute laryngotracheobronchitis - Diagnosis</p>
<p>Clinical
| Steeple sign</p>
<p>Herpes Simplex Virus - Etiology</p>
<p>Most people exposed by 20, reactivation via sun, smoke, stress, fever</p>
<p>Herpes Simplex Virus - Primary Infection Presentation</p>
<p>multiples lesions of the mucus membranes
discrete vesicles coalesce into one
Tender lymph nodes, fever, malaise</p>
<p>Herpes Simplex Virus - Recurrent Presentation</p>
<p>Vesicles, painful papules on the hard palate, lip, and gum which break and crust
Itching 1-2 weeks before outbreak</p>
<p>Herpes Simplex Virus - Diagnosis</p>
<p>Clinical presentation
Tznack smear
Viral culture</p>
<p>Herpes Simplex Virus - Treatment</p>
<p>Acyclovir, valacyclovir
| Symptomatic: NSAID, viscous Lidocaine</p>
<p>Oral Candidias - Etiology</p>
<p>Immunosuppression: pregnancy, AIDs, diabetes, anemia
| Dentures</p>
<p>Oral Candidias - Presentation</p>
<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>
<p>Oral Candidias - Treatment</p>
<p>Antifungals</p>
<p>Laryngitis - Etiology</p>
<p>Previous URI (virus, M. Cat, H. Influ, HPV, irritant)</p>
<p>Laryngitis - Presentation</p>
<p>Hoarse and harsh voice
Previous URI
Inflamed larynx
Cough</p>
<p>Epiglottitis - Complication</p>
<p>Airway risk</p>
<p>Epiglottitis - Etiology</p>
<p>Inflamed epiglottis
H. Influenza (vax), strep, staph
Diabetic (virus/bacteria)
2-4 year old</p>
<p>Epiglottitis - Presentation</p>
<p>Fever, sore throat
Dyspnea, dysphagia
Irritable
Lean forward, drool, tripod</p>
<p>Epiglottitis - Diagnosis</p>
<p>Visualize under anesthesia
Increased leukocytes and blood cultures
X-ray</p>
<p>Epiglottitis - Treatment</p>
<p>Maintain airway (intubate)
ABX and corticosterois
Antimicrobial
Prophylaxis <4 at home</p>
<p>Tonsilitis - Etiology</p>
<p>GABHS </p>
<p>Tonsilitis - Presentation</p>
<p>lymph enlargement
white purple tonsil exudate
Sore throat</p>
<p>Tonsilitis - Diagnosis</p>
<p>Rapid strep,
Monospot
Throat culture</p>
<p>Sialolithiasis - Etiology</p>
<p>Saliva stagnation Injured duct Gland inflamed Harden deposit Submandibular (wharton)>Parotid (stensen)</p>
<p>Sialolithiasis - Presentation</p>
<p>Pain on eating
Swelling
Wharton stone radiopaque</p>
<p>Sialolithiasis - Treatment</p>
<p>Remove stone Lemon drop Warm compress NSAID Water I &amp; D (ENT)</p>
<p>Parotitis + Sialdentitis - Etiology</p>
<p>Clogged duct, inflame, infect salivary
Dehydrated patient
Bacteria move back (S.aur, strep, anaerobe)</p>
<p>Parotitis + Sialdentitis - Presentation</p>
<p>Swelling/ pain gland
Decreased saliva
Drain pus from duct
Increase with meal</p>
<p>Parotitis + Sialdentitis - Treatment</p>
<p>Remove stone Lemon drop Warm compress NSAID Water + gum I &amp; D (ENT)</p>
<p>Aphthous Stomatits - Etiology</p>
<p>Unclear
Family Hx, Immunocomp
Meds, Underlying disease
Smoking ?</p>
<p>Aphthous Stomatits - Presentation</p>
<p>Recurrent ulcer
Yellow white pseudomembrane
Red halo
Pain >> size</p>
<p>Aphthous Stomatits - Minor </p>
<p> <1cm, 10-14 days, no scar, cheek lip</p>
<p>Aphthous Stomatits - Major</p>
<p>1-3 cm, deep, 2-6weeks, scar, tongue, tonsil, soft palate</p>
<p>Aphthous Stomatits - Herpetic</p>
<p>Greater number, recurrent, 1-3mm, 7-10 days any surface</p>
<p>Aphthous Stomatits - Diagnosis</p>
<p>Hx + PE
| Biopsy to rule out DDx</p>
<p>Aphthous Stomatits - Treatment</p>
<p>Topical corticosteroids
Chlorohexadine mouthwash
Analgesic (lidocaine)</p>
Oral Lichen Planus - Etiology
Unknown more in females 30-60
Oral Lichen Planus - Reticular
asymptomatic, Wick’s striae (lacy network of papula or striae) symmetrical
Oral Lichen Planus - Erythema
Wick’s striae, muscular atrophy, red patches, symmetrical
Oral Lichen Planus - Erosive
desquamaous gingiva, ulcers, and erosion, rupture bullae
Oral Lichen Planus - Diagnosis
Hx and PE, biopsy to rule out cancer, consider Hep C
Oral Lichen Planus - Treatment
Increase oral hygiene, decrease alcohol intake, topical corticosteroids
Leukoplakia - Risk factore
Smoking,smoking, UV, previous oral infections, tertiary syphilis, candida, HPV 16/18; over 40
Leukoplakia - Presentation
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
Leukoplakia - Diagnosis
Biopsy at most significant site for dysplasia
Leukoplacia - Treatment
Stop risk factor behaviors, Evaluate every 6 months for dysplasia (excision if positive)
Erythroplakia - Risk factors
Age 65-74, smoking, UV, previous oral infections
Erythroplakia - Presentation
well-demarcated, soft (velvety) erythematous, asymptomatic macule/plaque on floor of mouth, ventral tongue, soft palate
Erythroplakia - Treatment
Stop risk factor behaviors, Evaluate every 6 months for dysplasia (excision if positive) More likely to turn than leukoplakia (Female nonsmokers esp)
Oral Squamous Cell Carcinoma - Risk factors
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
Oral Squamous Cell Carcinoma - Warning signs
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
Oral Squamous Cell Carcinoma - Diagnosis
Biopsy! Direct scope for secondary, head/neck/chest CXR, check nodes for metastatis
Oral Squamous Cell Carcinoma - Treatment
IMMEDIATE REFERAL, clinical staging (high mortality)
Surgical excision, radiation +/- chemo
