Oral Cavity, Throat, and Neck Flashcards
Halitosis
breath odor
Xerostomia
dry mouth
Recurrent Herpes Labialis
- what happens?
- what are some reactivation triggers?
LIPS
hsv-1
prodromal itching/burning/tingling -> eruption of clustered vesicles on vermillion border -> rupture, ulceration, crusting
reactivation: UV light, trauma, fatigue, stress, menstruation
Carcinoma of the lips
- possible etiology
- sxs
- dx
LIPS
often SCC
etiology: tobacco, alcohol, sunlight, pott hygiene
sxs: lesion is PANLESS, demarcated, elevated,. slow growing, fails to heal, may bleed
biopsy to dx
Mucocele
Ranula
etiology, sxs
LIPS
soft cyst, mucin-filled cavity with mucus glands lining epithelium. common on lips or under tongue (ranula)
etiology: minor injury to ductal system
sxs: thick saliva creates bluish bubble, movable, may rupture.
Cheilitis
-etiology
LIPS
chapped lips (erythema and scaling) etiology-use of retinoids, windburn, allergis, lip licking
angular cheilitis
sxs, etiology, labs
LIPS
etiology => elderly, poor oral hygiene, nutritional deficit
sxs= deep cracks at labial commisure, may bleed or form shallow ulcers. mauybecome infected with c. albicans
lab= KOH to assess for candida
Oral lichen planus
- erosive?
- etiology
MUCOSAL LESION
nonerosive, usu PAINLESS, vary from white patches on buccal mucosa to erosions on gingiva. not contag
- erosive form can erupt into violet papules
- chronic –> oral cancer
etiology unknown, possible drug rxn, hep C, stress
Leukoplakia
What is it? MvF? Age?
Etiology? SxS? PE?
Dx? DDX?
MUCOSAL LESION
white patches on oral mucosa that CANNOT be rubbed off
- precancerous 20%
- seen in nonmalig inflammatory conditions
- M>F, 90% >40
etiology; trauma from habitual biting, dentures, tobacco..
ssx; on tongue, mandibular alveolar ridge, and buccal mucosa in most.
lesion intensity varies, surface often shriveled and rough.
may have red specks
color varies white-brown/gray
pe: lesions CANNOT be wiped away with gauze
dx: biopsy
ddx: candidiasis and aspirin burn (can be wiped)
Which white lesions can be wiped away with gauze? Which cannot?
Can: candidiasis, aspirin burn
Cannot: leukoplakia, keratosis, leukoedema, lichen planus, SLE, SCC
Erythroplakia
etiology
MOUTH LESION
- red plaques with well demarcated edges
- often on floor of mouth, tongue, palate
etiology unknown
- precancer 40%
Oral Squamous Cell Carcinoma
epidemiology
ssx
dx
MOUTH LESION
30,000/yr in US, 90% smokers
subset associated with HPV-16
most on floor of mouth or ventral/lateral surface of tongue
ss: looks like leuko/erthryoplakia
exophytic or ulcerated, indurated with a roller border
may be asymp at first, ulceration lesions often painful
metastatic mass in neck may be 1st symp (nontender)
biopsyy
Melanoma
ssx, ddx
MUCOSAL LESION
pigmented lesions with concerning signs:
asymmetry, irregular borders, variable coloration, increasing diameter, lesion wont blanch
DDX: melanosis- symmetric, ppl w dark skin
oral melanotic macules- symmetric, stable sharply delimited dark macules on lips.oral muc
Fordyce’s Spots
benign neoplams from sebaceous glands
20-30, M=F
ssx: asymptomatic, multiple yellow-white 1-2mm, in cluster. most common on vermillion/buccal border. DONT WIPE OFF
ddx: C.albicans- wipe off.
stomatitis, etiology
inflammation of the oral tissue from infection, deficiency, trauma, hypersensitivity
Oral Candidiasis
risks, ssx, dx
STOMATITIS
“Thrush”
fungal yeast C. albicans, glabrata, tropicalis
risks= immunodeficiency ssx= lesion that is slightly raised and white, CAN BE WIPED. xerostomia, bleeding dx= KOH prep
Reccurent Aphthous Stomatitis
etiology
ssx
ddx
STOMATITIS
“Cancer Sore”
- acute, painful, reccuring, necrotizing ulcerations on oral mucosa
- t cell ediated localized destruction of oral mucosa
etiology= provocations, trauma most common trigger (physical, chemical, etc.)
ssx= painful lesions, prodromal burn/tingle
ulcers shallow, round-oval, red border on non-keratin, MOVABLE mucosa
continuous- 2-4outbreaks/yr
ddx= 2’ herpatic ulcerations, trauma, systemic disorders
Hereptic Gingivostomatitis
ssx
lab
ddx
STOMATITIS
“cold sore”
primary HSV-1 infection, painful eruptions of the UNMOVABLE mucosa and verilion border.
triggered by trauma and emotional stress
ssx: prodromal pain, burning, tingling, fver, malaise, LA
eruprion of multiple interoral vesicular lesions and erosions, erthematousbase, crusting
self limited in 1-2wks
kids- fever, drool, decreased oral intake due to pain
Lab: Tzank smear, direct immunofluroescence smear, or viral culture
DDX: apthous stomatitis, erythema multiforme, drug eruptions, pemphigus
