Oral Cavity diseases

Question 1

When is HSV 1 most infectious?

Answer 1

Highest infectivity when vesicles rupture

Question 2

How do you treat the prodrome of HSV?

Answer 2

acyclovir cream for 1 week dec course

Question 3

How do you prevent chicken pox? (VZV)?

Answer 3

Vaccination; Valacyclovir and Famciclovir

Question 4

The most common dermatome for VZV infection/reactivation?

Answer 4

CNV 3

Question 5

Tx for Candidiasis

Answer 5

Mild acute: topical nystatin
Mild chronic: topical nystatin + clotrimazole troche
Refractory/Immunocompromised w/o systemic: nystatin + oral fluconazole
Systemic: Amphotericin B +/- oral fluconazole

Question 6

Common causes of thrush

Answer 6

immunosuppression, debility, Abx, steroids

Question 7

Describe a Apthous ulcer

Answer 7

Cancker sore;
Ulcer: small, shallow w/ narrow hyperemic rim
Painful, recurrent superficial ulcers which spontaneously resolve

Question 8

Signs of Oral Neoplasms

Answer 8

1. Non-healing ulcers
2. Dysphagia
3. Odynophagia
4. Trismus

Question 9

Sites of SCC and BCC

Answer 9

SCC usually bottom lip

BCC usually upper lip

Question 10

Which has a better prognosis in a SCC pt, HPV + or HPV -?

Answer 10

HPV +

Question 11

Common pathogens for acute sinusitis

Answer 11

H. flu, Moraxella catarrhalis, Strep. pneumo

Question 12

Prefered imagaing for Acute bacterial sinusitis

Answer 12

CT; only use MRI for chronic or invasive fungal sinusitis

Question 13

Sinusitis staging

Answer 13

Acute: <4 weeks
Subacute: 4-12 weeks
Chronic: >12 weeks
Recurrent acute: ≥4 episodes in a year

Question 14

Tx for chronic sinusitis

Answer 14

Amoxicillin + Clavulanic acid for 3 weeks

Refer to ENT: 3-4 infections/year, infection that does NOT respond to 2 3-week courses of Abx, nasal polyps

Question 15

Most common cause of allergic fungal rhinosinusitis

Answer 15

Aspergillus fumigatus

Question 16

Common organisms that cause mucomycosis

Answer 16

Aspergilus (MC) and Saprophyticus

Question 17

Unilateral sinusitis

Answer 17

Consider inverting papilloma, SCC, lymphoma, angiofibroma

Question 18

Usefulness of antihistamine nasal sprays

Answer 18

Azelastine: inhibits secretions, serotonin, LTs, & histamine
Cetirizine: mild sedation, no liver metabolism, good for both early & late phase
Fexofenadine: NOT anticholinergic, use w/ BPH, no sedation

Question 19

Usefullness of decongestants

Answer 19

Improve airway, NO help w/ nasal drainage/itching/sneezing

Question 20

Usefullness of steroid nasal sprays

Answer 20

Can cause septal perforation – monitor every 3 months

SSx: whistling, nasal deformity, epistaxis

Question 21

Allergy testing

Answer 21

Prick testing: well tolerated, not very accurate, CANNOT be on β-blockers
Skin End Point Titration (SET): gold standard, uncomfortable, CANNOT be on β-blockers

Question 22

SSx of Parapharyngeal absess

Answer 22

trismus (lock-jaw), fever, muffled voice, dysphagia

Question 23

Peritonsilar Absess

Answer 23

Spread of infection into peritonsillar space

SSx: unilateral otalgia, uvular deviation, odynophagia

Question 24

Herpangina

Answer 24

Cause: Coxsackie A virus
Small oropharyngeal vesicular or ulcerative lesions
Tx: oral hygiene

Question 25

Mononucleosis

Answer 25

Cause: EBV
SSx: high grade fever, posterior triangle lymphadenopathy