Mouth/Throat Disorders Flashcards
You are examining a patient and notice a thickened, white patch underneath the patient’s tongue on one side. You cannot scrape the lesion off. What broad term describes this condition?
Leukoplakia
A patient presents with a red, velvety, non-ulcerated growth along the side of his tongue. On examination, you find that the affected area is hardened. How would you describe this lesion?
Erythroplakia
A patient presents with a round, smooth, red “patch” on the top of his tongue. He states that it is painless, but is concerned because the spot seems to move around on his tongue periodically. What is the most likely diagnosis?
Geographic tongue
A PA student presents with a round, white ulcer on the unattached tissue inside her cheek. There is a red halo around the lesion. She states that she’s had them before, often during finals in undergrad, and that they resolve within a week or so. What is your diagnosis, and what treatment do you recommend?
Apthous ulcer, lysine
A patient with a history of heart transplant presents with a sore throat. On examination, you notice creamy white lesions on the soft palate. When you scrape them for culture, the white substance comes off. What is the most likely diagnosis?
Oral candidiasis
A pediatric patient presents with severe sore throat, high fever, and painful swallowing. Upon entering the exam room, you find the patient sitting upright, leaning forward, and drooling. He appears quite anxious. The patient is the child of migrant farm workers and does not receive routine medical care. You have a high index of suspicion for what condition?
Epiglottitis
A patient with poor dental health presents with fever, dysphagia and trismus. On exam, you note swelling under the chin that crosses the midline and that the tongue is displaced upward. What is the likely diagnosis, and what triage priority might you assign this condition (routine, urgent, or emergent)?
Ludwig’s angina, emergent
A patient presents with sore throat, dysphagia, fever, and cervical lymphadenopathy. On exam, you find the oropharynx edematous and erythematous with exudate. What is the probable diagnosis?
Strep pharyngitis
What two tests might you use to confirm a diagnosis of strep pharyngitis?
Rapid strep test, throat culture
What is the most common etiology of strep pharyngitis?
Group A beta hemolytic streptococcus
A patient being treated for strep pharyngitis develops a rash on the trunk and palms and soles of the feet. You suspect which complication has developed?
Scarlet fever
An 18 year-old female patient presents with sore throat, dysphagia, trismus, fever, and a “hot potato” voice. On exam, you find that the uvula is laterally displaced. What is the most likely diagnosis?
Peritonsillar abscess
A patient presents with what he calls “chapped” skin in the corners of his mouth. What is the most likely diagnosis, and what is the etiology of this disorder?
Angular chelitis, fungal
A patient presents with cough and hoarse voice. Oropharyngeal exam is unremarkable. What is the most likely diagnosis?
Laryngitis
A pediatric patient presents with ulcerative lesions in the mouth, along with blisters to the hands and feet. He has also had diarrhea. What is the most likely diagnosis, and what is its etiology?
Hand, foot, and mouth disease, coxsackie virus
A patient presents with white, lacy patches on the underside of his tongue. What is the most likely diagnosis?
Oral lichen planus
A patient presents with unilateral vesicular lesions on the border of the lip. What is the most likely diagnosis?
Oral herpes simplex
A patient with a history of anorexia presents with fever and swelling of the left parotid gland. On exam, you find that pus is excreted through the parotid duct when pressure is placed on the gland. What disorder do you suspect?
Sialadenitis
A patient with poor dental hygiene presents with fever of unknown origin. On examination, you notice a foul smell in the mouth, swollen gums, and a “chopped off” appearance to the papillae between the teeth. What disease do you suspect?
Acute necrotizing ulcerative gingivitis
What term describes salivary gland swelling that is, among other things, a key feature in mumps infection?
Parotitis
A patient presents with sore throat and dysphagia. On exam, you note that the tonsils are red and inflamed, but the rest of the oropharynx appears normal. What is the most likely diagnosis?
Tonsillitis
Most cases of laryngitis are ______ (viral/bacterial) and ______ (do/don’t) require antibiotic treatment.
Viral, don’t
What is your most immediate concern for a patient with suspected epiglottitis?
Airway compromise
What is probably the most significant risk factor for developing oral candidiasis?
Immunocompromise
Erythroplakia almost always portends what ominous diagnosis?
Squamous cell carcinoma
A patient had a molar removed and later developed a white, hardened spot from contact with the tooth above. What word would you use to describe this condition?
Hyperkeratosis
The rapid strep test has a ______ (high/low) false negative rate.
High
