Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med I > Mouth, throat, head and neck > Flashcards

Mouth, throat, head and neck Flashcards

1
Q

aphthous stomatitis

A
  • aka cancer sore
  • most common acute oral lesion
  • often recurrent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

classification of aphthous stomatitis

A
  • simple- 1 to several episodes lasting 14 days in oral mucosa
  • complex-oral and genital lesions, more numerous and last 4-6 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

risk factors for aphthous stomatitis

A
  • smoking
  • genetics
  • trauma
  • hormones
  • stress
  • food/ drug hypersensitivity
  • immunodeficiency or other GI disorders
  • vit b12, folic acid, or Fe deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

clinical presentation of aphthous stomatitis

A
  • round, oval, clearly defined ulcers
  • erythematous rim with yellow center
  • usually small
  • painful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

management of aphthous stomatitis

A
  • oral hygiene
  • no alcohol mouthwash, soft tooth brush
  • pain control- viscous lidocaine
  • swish and spit steroids
  • for complex cases can have intralesional steroids, colchisine, dapsone, immunomodulators
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

oral leukoplakia

A
  • benign
  • white gray lesions that cant be scraped off
  • clinical significance depends on degree/presence of dysplasia
  • associated with HPV
  • common in smokeless tobacco users and pure inflammatory conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

clinical manifestations of oral leukoplakia

A
  • white gray lesions
  • in trauma prone regions
  • thin areas show more dysplasia
  • not painful
  • flat and not well defined
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

diagnosis of oral leukoplakia

A
  • history and PE

- if indurated should be biopsied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

management of oral leukoplakia

A
  • doesnt require tx
  • can surgically remove
  • cryoprobe
  • chemoprevention
  • oral retinoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Herpes

A
  • more common in women
  • usually transmitted by people who dont know they have it
  • recurrent infection common
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Herpes primary infection

A
  • highly variable
  • usually severe with systemic sx
  • Fever, LAD, drooling, decreased PO intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Herpes recurrent infections

A
  • usually less severe

- more localized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

clinical manifestations of herpes

A
  • affects gingiva
  • multiple oral vesicular lesions on erythematous base
  • herpetic gingivastomatitis most common
  • prodrome of burning, tingling, pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

management of herpes

A
  • systemic antivirals
  • swish and spit miracle mouthwash
  • supportive
  • popsicles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

oral candida

A
  • aka thrush

- involves mucous membranes- oropharyngeal and esophageal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the most common cause of oral candida

A
  • candida albicans
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the types of oral candida

A
  • pseudomembranous- most common, forms white plaques

- atrophic- aka denture stomatitis, erythema without plaques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

epidemiology of oral candida

A
  • young infants
  • older adults who wear dentures
  • abx or chemo
  • radiation to head and neck
  • immunodeficiency
  • inhaled steroids
  • xerostomia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

clinical manifestations of oral candida

A
  • dry mouth, loss of taste
  • white plaques
  • erythema without plaques if denture wearer
  • pain with swallowing or eating if esophageal
  • beefy red tongue with dentures
  • painful fissuring on sides of mouth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

diagnosis of oral candida

A
  • clinical
  • white plaques removable
  • KOH
  • if refractory test for HIV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

management of oral candida in health patients

A
  • local therapy
  • nystatin swish and swallow
  • clomitrazole troches
  • miconazole buccal tabs
  • PO diflucan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what type of cancer is mainly found in the head and neck?

A
  • squamous cell carcinomas
  • arise from mucosal surfaces
  • generally have good prognosis if detected early
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what type of head and neck cancers respond best to treatment

A
  • HPV associated cancer

- HPV cancers usually seen in younger patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

categories of oropharynx cancer

A
  • carcinoma of oral cavity proper
  • carcinoma of oropharynx
  • carcinoma of lip vermillion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

risk factors for oropharyngeal cancers

A
  • smoking**
  • alcohol abuse **
  • HPV infection**
  • EBV
  • diet
  • immune status
  • environmental/ occupational pollutants
  • genetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

anterior oral cavity cancers

A
  • SCC
  • ulcerative
  • painful later in disease
  • may be mass with raised, rolled boarder
  • tongue is common site
  • often see lesions on floor of mouth as well
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the biggest risk factor for anterior oral cancers

A
  • alcohol abuse

- tobacco abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

posterior oral cancers

A
  • SCC
  • mostly associated with erythema rather than lesions
  • pt presents with neck mass, sore throat, dysphagia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the biggest risk factor for posterior oropharyngeal cancers

A
  • HPV (16 and 18)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

clinical presentation of oropharyngeal cancers

A
  • leukoplakia or erythroplakia*
  • speckled erythroplakia
  • dentures that no longer fit properly*
  • most DONT have hx of premalignant lesions
  • pain
  • possible airway obstruction
  • loosening of teeth
  • LAD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the best imaging to dx oropharyngeal cancers?

A
  • CT
  • need chest CT if there is distant metastasis
  • f/u with MRI or PET scan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

treatment and prognosis of localized oropharyngeal cancers

A
  • curative intent
  • surgery for smaller lesions
  • radiation preferred in laryngeal lesions
  • survival is good
  • if recurrence usually happens if first two years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

treatment and prognosis of advanced oropharyngeal cancers

A
  • curative intent
  • combo of surgery, radiation, and chemo
  • can do chemo and radiation at the same time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

treatment and prognosis of recurrent/ metastatic oropharyngeal cancers

A
  • usually palliative intent
  • poor prognosis
  • poor response to chemo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is the most common cause of viral tonsillitis/ pharyngitis

A
  • rhinovirus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

clinical manifestations of viral tonsillitis/ pharyngitis

A
  • sore throat
  • coryza*
  • cough*
  • N/V/ abdominal pain
  • malaise/ fever/ hoarseness
  • more erythematous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

clinical manifestations of mono

A
  • may appear similar to viral tonsillitis
  • inclused posterior LAD
  • kissing tonsils
  • hepatosplenomegaly
38
Q

diagnosis of viral tonsillitis/ pharyngitis

A
  • no tests

- rapid flu and rapid mono testing

39
Q

treatment of viral tonsillitis/ pharyngitis

A
  • supportive
  • warm water gargle
  • antipyretics and analgesia
  • +/- single dose steroids
  • +/- IV fluids
  • if mono- no contact sports
  • if flu- tamiflu
40
Q

what is the most common cause of bacterial tonsillitis/ pharyngitis

A
  • s. pyogenes
41
Q

clinical manifestations of bacterial tonsillitis/ pharyngitis

A
  • LACK of coryza, cough, or other URI sx
  • sudden onset sore throat*
  • anterior LAD
  • petechiae on soft palate
  • n/v/ abdominal pain
  • malaise, fever, hoarseness
42
Q

what is the centor criteria used to diagnose

A
  • strep throat
43
Q

what are the components of the centor criteria

A
  • fever
  • anterior LAD
  • tonsillar exudate
  • absence of cough
44
Q

scores of centor criteria

A
  • 0-1= likely not strep, no testing
  • 2-3= confirm with rapid strep test
  • 4= treat for strep
45
Q

diagnosis of strep

A
  • use centor criteria
  • rapid antigen detection testing
  • culture
  • may also want to r/o pharyngitis caused by diptheria, gonorrhea, and chlamydia
46
Q

treatment of bacterial tonsillitis/ pharyngitis

A
  • Pen VK 500 mg BID X 10 days

- if PCN allergy use cephalexin or macrolide

47
Q

classic symptoms of scarlet fever

A
  • strawberry tongue

- sandpaper like rash on trunk or armpits

48
Q

peritonsillar abscess

A
  • collection of pus between palatine tonsils and pharyngeal muscles
  • pharyngitis -> cellulitis -> abscess
  • usually unilateral
49
Q

what is the most common cause of peritonsillar abscesses?

A
  • s. pyogenes
50
Q

clinical manifestations of peritonsillar abscesses

A
  • severe unilateral sore throat*
  • ipsilateral ear pain*
  • muffled/ “hot potato voice” *
  • contralateral uvula deviation
  • trismus and decreased PO intake
  • neck pain with movement
  • drooling and blocked airway if severe
  • fowl breath
  • erythema/ exudate on tonsil
51
Q

differential dx for peritonsillar abscess

A
  • retropharyngeal abscess
  • ludwig angina
  • dental infection
  • peritonsillar cellulitis
  • mono
52
Q

diagnosis of peritonsillar abscess

A
  • almost always just clinical dx
  • can get CT or ENT consult if uncertain
  • intra-oral US
  • lateral soft tissue xray to r/u epiglottitis
53
Q

treatment of peritonsillar abscess

A
  • secure airway
  • drain via needle aspiration or I&D
  • empiric abx- augmentin
  • antipyretics
  • analgesia
  • +/- steroid
54
Q

complications of peritonsillar abscess

A
  • airway obstruction
  • internal jugular seeding of infection
  • septicemia
55
Q

rheumatic fever

A
  • sequelae of s. pyogenes pharyngitis
  • spreads to heart, joints, subq tissue
  • cardiac complications may be permanent
56
Q

cardiac involvement in rheumatic fever

A
  • more often in kids
  • mitral valve affected
  • can see new murmur, CHF sx, pericardial friction rub
57
Q

migratory arthritis in rheumatic fever

A
  • usually in teens/ adults

- asymmetric involvement of knees, elbows, wrists

58
Q

erythema marginatum in rheumatic fever

A
  • usually in kids

- non-pruritic erythematous eruption on trunk

59
Q

Jones criteria

A
  • used to dx rheumatic fever in addition to evidence of recent strep infection
  • need 2 major sx OR
  • 1 major and 2 minor sx OR
  • 3 minor sx
  • also get rapid strep or throat culture if needed
  • imaging- EKG, chest XR, echo
60
Q

major sx of jones criteria

A
  • migratory arthritis
  • carditis/ valvitis
  • sydenham chorea
  • erythema marginatum
  • subq nodules
61
Q

minor sx of jones criteria

A
  • arthralgia
  • fever
  • elevated ESR or CRP
  • prolonged PR interval
62
Q

treatment of rheumatic fever

A
  • pen VK 500 mg BID X 10 days
  • aspirin for joint pain
  • +/- steroids
  • bed rest until fever is gone, labs and EKG normalize
63
Q

secondary prophylaxis for rheumatic fever

A
  • PCN IM q4 weeks
  • without carditis- for 5 years
  • with carditis- for 10 years
64
Q

sx of post-streptococcal glomerulonephritis

A
  • edema
  • hematuria
  • HTN
  • proteinuria
  • majority of pts have at least two of the sx
  • nonspecific malaise, weakness, anorexia, n/v
65
Q

diagnosis of post-strep glomerulonephritis

A
  • urine dip and microscopy*
  • streptozyme test
  • renal function tests*
  • renal biopsy- last resort
66
Q

treatment of post-strep glomerulonephritis

A
  • treat underlying cause
  • mostly supportive
  • restrict salt and water intake
  • +/- diuretics
  • HTN control
  • limited activity
  • dialysis if severe
67
Q

laryngitis

A
  • inflammation of vocal cords
  • typically resolves in 7-10 days
  • mostly viral cause
68
Q

chronic laryngitis

A
  • > 3 weeks
69
Q

clinical manifestations of laryngitis

A
  • preceding or concurrent URI
  • hoarseness
  • odynophonia
  • odynophagia
70
Q

diagnosis of laryngitis

A
  • clinical

- ENT may use fiber optic laryngoscope for chronic cases

71
Q

treatment of laryngitis

A
  • voice rest

- inhaled humidifier

72
Q

sialadenitis

A
  • usually viral- mumps
  • may be related to HIV infection
  • duration varies
73
Q

parotitis

A
  • secondary to mumps infection
  • acute parotid swelling
  • see more cases in college aged students d/t waning immunity to vaccine
74
Q

clinical manifestations of mumps

A
  • bilat parotid gland inflammation
  • flu like prodrome
  • unilateral testicular swelling and tenderness
75
Q

complications of mumps

A
  • deafness
  • orchitis
  • meningitis
  • fetal congenital abnormalities
76
Q

treatment of mumps

A
  • supportive
  • bed rest and hydration
  • sialagogues
  • scrotal sling for testicular pain
  • warm or cold compress
  • analgesia
  • live MMR vacine +/- booster
77
Q

diagnosis of sialadenitis

A
  • PE
  • mumps titer
  • HIV RNA detection if indicated
  • if unclear or unimproved get US, CT, or sialadenoscopy
78
Q

other causes of sailadenitis

A
  • stones
  • elderly, malnourished, or post op (dehydration in all)
  • s aureus
  • usually more unilateral involvement
79
Q

what causes dental caries

A
  • strep mutants

- demineralization exceeds saliva and remineralization -> progressive breakdown

80
Q

what are the top four complaints of drug seekers

A
  • HA/migraine
  • back pain
  • tooth ache
  • kidney stones
81
Q

what should happen before you d/c a patient with an oral infection

A
  • consult dentist

- definitive f/u care scheduled prior to d/c

82
Q

risk factors for oral infectiosn

A
  • low SES
  • poor access to care
  • poor oral hygiene and nutrition
  • prior trauma or many dental procedures
  • inadequate fluoride
  • decreased salivary flow
  • anticholinergic medications
83
Q

how do you prevent oral infections

A
  • prevent bacterial infection
  • regular floss, brushing with fluoride tooth paste, biannual cleaning
  • no smoking
  • control systemic diseaseS
84
Q

what causes most oral infections

A
  • usually strep mutans
  • often polymicrobial infections with anaerobes
  • caregivers can vertically transmit infections
85
Q

periodontal disease and DM

A
  • severe periodontal disease and DM increases risk of worsening glycemic control
  • DM is a risk factor for periodontal disease
86
Q

pregnancy gingivitis

A
  • d/t hormonal changes

- pyogenic granulomas can occur

87
Q

si/sx of dental infections

A
  • sensitivity to hot or cold stimuli*
  • pain on biting*
  • pain at site or refered to jaws, ears, cheeks, sinuses
  • bleeding or purulent d/c
  • if severe can have systemic sx
88
Q

what should kids < 4 years old with stiff neck, sore throat, and dysphagia be worked up for

A
  • retropharyngeal abscess
89
Q

diagnosis of oral infections

A
  • clinical
  • no labs unless acutely ill
  • can use xrays but not usually necessary
  • CT to determine extend and density of swelling, location of abscess
90
Q

treatment for oral infections

A
  • anti-inflammatories for pain***
  • nerve block for severe pain
  • Pen VK (or amoxicillin) loading dose 1000 mg then 500 mg QID X 7-10 days
  • use clindamycin or erythromycin for PCN allergy
  • +/- IV fluids
  • admit if necessary
  • educate about good oral hygiene
  • warm salt water rinses
91
Q

ludwig’s angina

A
  • sublingual cellulitis
  • +/- tracking abscess
  • potential for airway issue
  • possible complication of oral infections
92
Q

vincent’s angina

A
  • acute necrotizing ulcerative gingivitis
  • aka trench mouth
  • possible complication of oral infections

Clin Med I (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions