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IPAP Senior ENT > Oral cavity & Pharynx > Flashcards

Oral cavity & Pharynx Flashcards

1
Q

precancerous oral lesion that appears as white patches/plaques/non-removable

A

Leukoplakia

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2
Q

leukoplakia steps in formation

A

hyperplasia–>dysplasia–>carcinoma in situ–>invasive malignant tumor

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3
Q

other conditions not associated w/malignancy associated w/ leukoplakia

A

hyperkeratosis from chronic irritation

eg, dentures, tobacco, etc.

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4
Q

Tx of Precancerous lesions

A

should be surgically removed ;

cryotherapy & laser ablation have been used

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5
Q

Most common oral cancer

A

Squamous Cell Carcinoma

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6
Q

oral pigmented lesions

A

Melanoma

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7
Q

fluid-filled cavities w/mucous glands lining epithelium after mild oral trauma on the lower lip

A

Mucoceles

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8
Q

two forms of lichen planus

A

Reticular

Erosive

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9
Q

white lacy striations (wickham’s striae) or papules on buccal mucosa (no pain)

A

Reticular :ichen PLanus

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10
Q

Zones of tender erythema & painful ulcers surrounded by white, radiating striae

A

Erosive Lichen PLanus

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11
Q

Tx of Asymptomatic Lichen Planus

A

regular follow-up

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12
Q

Tx of Symptomatic Lichen Planus

A

manage pain & discomfort

topical + systemic corticosteroids, cyclosporines, retinoids

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13
Q

erythema of oral cavity w/creamy-white, curd-like patches. Fluctuating mouth / throat discomfort

A

Oral Candidiasis

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14
Q

Tx of Thrush on infants

A

cleans everything nipples, pacifiers

Nystatin suspension x 2wks until 2-3 days after resolution

refractory gentian violet or oral fluconazole

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15
Q

Tx of mild thrush in older children

A

<50% mucosal involvement:
Topical nystatin QID or
Clotrimazole lozenges 10mg 5-6 x a day

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16
Q

Tx of Severe Thrush in older children

A

> /= 50% oral mucosal &/or deep erosive / refractory

Fluconazole 6mg/kg po on 1st day, 3mg/kg x 7-14 days

17
Q

Tx of Thrush in Adults

A

fluconazole 100mg PO x 7 day
Ketoconazole 200-400mg PO 7-14 days
Nystatin mouth ring 5mg swish before swallow

HIV+ Tx’d for longer

18
Q

prodromal pain, burning, &/or tingling x 24 hrs, clusters of small vesicles on vermilion border which rupture/ulcerate/& crust in 24-48 hrs

A

Herpetic Gingivostomatitis

HSV-1

19
Q

Diagnosis of Herpetic Gingivostomatitis

A

multinucleated giant cells on Tzanck smear

20
Q

Tx of Herpetic Gingivostomatitis

A

Acyclovir200-800mg PO 5 x day for 7-10 days

Valacyclovit 1000mg PO BID 7-10 days

21
Q

Tx of Herpetic Gingivostomatitis only effective if initiated w/in

A

24-48 hrs of prodromal Sx’s

22
Q

Criteria suggesting Group A Streptococcus (GAS) “Strep Throat”

A

Fever (>100.4)
Anterior cervical LAD
No Cough
Tonsillar Exudate

23
Q

Most common cause of pharyngitis

A

Viral agent

24
Q

Cough, rhinorrhea &/or lack of exudate

A

Viral pharyngitis

25
Q

Marked cervical LAD, palatal petechiae & SHAGGY white-purple tonsilar exudate

A

Mononucleosis

26
Q

Pharyngitis, malaise & low grade fever - GRAY tonsillar PSEUDOMEMBRANE

A

Diptheria

27
Q

Tx of GAS strep throat

A

Pen VK DOC
ADULTS- 500mg PO BID x 10days
Children- PVK 250mg PO BID/TID x 10 days

28
Q

Sx of peritonsillar cellulitis & Abscess

A

Sever sore throat, odynophagia
Trismus, medial deviation of soft palate/pertosillar fold
ABnormal voice muffled

29
Q

Dx of peritonsillar cellulitis & Abscess

A

US or CT

needle aspiration in pus present

30
Q

Tx of peritonsillar cellulitis no evidence of airway compromise/septicemia/severe trismus

A

ENT Consult

Empiric IV ABX to cover GABHS, S. aureus, & respiratory anaerobes

31
Q

Tx of peritonsillar Abscess no airways Sx’s does have fever, trimus, voice change, peritonsillar swelling, uvular deviation

A

Needle aspiration + admission w/o imaging x 24 hrs of hydration, ABX & analgesia

Tonsillectomy or I&D reserved for those that dont respond to Tx

32
Q

affects parotid/submandibular gland/duct with dehydration/chronic illness w/ ductal obstruction mucous plugs-salivary stasis & 2ndary infection S. aureus MC

A

Sialadenitis

33
Q

Sx of Sialadenitis

A

gland swelling
pain/swelling w/meals
tenderness/erythema of duct opening
exudate messaged from duct

34
Q

Tx of Mild Sialadenitis

A

increase salivary flow
hydration, warm compress, message gland
Sialagogues (lemon drops)

35
Q

Tx of less severe Sialadenitis

A

PO ABX to cover S. aureus

36
Q

Tx of severe Sialadenitis

A

IV ABX (Nafcillin 1gm IV q 4-6 hrs)followed by PO x 10days if no airway compromise

37
Q

Sialadenitis not responding to Tx

A

concern for suppurative Sialadenitis severe life-threatening
get US or CT
require I&D

38
Q

Tx of Parotitis

A

Immediate referral required
Hydration & IV ABX
Nafcillin & metronidazole or clinda
Vanc for immunocompromised

often dont respon need I&D to resolve

IPAP Senior ENT (7 decks)

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