Oral disease Flashcards

1
Q

Oral ulceration?

A

Discontinuity in oral mucosa

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2
Q

Solitary ulcer?

A

Trauma (physical or chemical)
Malignancy (oral squamous cell carcinoma)
Infective (TB, tertiary syphilic)

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3
Q

Multiple ulcers?

most common cause

A

RAU (recurrent aphthous ulceration)
Usually well - no systemic disease
Exclude iron deficiency & GI disease
Major, minor, herpetiform

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4
Q

Minor aphthous ulcers?

A

Most common
<10mm
Heal within 14 days, no scarring
Rarely affect dorsum tongue or hard palate

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5
Q

Major aphthous ulcers?

A

> 10 mm
Weeks/ months
Heal with scarring

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6
Q

Bechets?

A

Multisystem condition
Hereditary systemic vasculitis (inflammation of blood vessels)
Almost identical ulcers to RAU
+ Genetic ulceration, uveitis, erythema nodosum

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7
Q

Anaemia?

A
Mucosal pallor
Oral ulceration
Glossitis (inflammation of tongue)
Angular chellitis
Predisposition to candida
Disturbed taste
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8
Q

Other causes of multiple ulcers?

A

Mucocutaenous disorders

  • Lichen Planus
  • Lupus erythematous
  • Vesiculobullos disease (pemphigus and pemphigoid)
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9
Q

Lupus erythematosus?

A

Discoid or systemic (AI)
Ulceration
White patches, red and white
Similar appearance to lichen P

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10
Q

Vesiculobullos disease - pemphigus vulgaris?

A

Oral manifestations 1st
Painful, extensive oral ulcers
Preceded by blisters
Nikolsky sign

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11
Q

Vesiculobullos disease - pemphigoid?

A

Autoimmune
Blisters
Painful oral ulceration
Affects mucous membranes of other organs e.g. eyes

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12
Q

What are oral manifestations of GI disease due to?

A

Underlying malabsorption & consequent haematinic deficiency

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13
Q

Gi diseases with oral manifestations?

A

Crohn’s
UC
Peutz jeghers
Gardners syndrome

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14
Q

Oral manifestations of Crohn’s?

A
May precede abdominal symptoms
Cobble-stone mucosa
Localised mucogingivitis
Linear ulceration
Tissue tags/ polyps
Diffuse swelling (lips)
Pyostomatitis vegetans
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15
Q

Pyostomatitis vegetans?

A

Erythema and oedema of the mucosa and numerous small, superficial yellow pustules

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16
Q

Oral manifestations of UC?

A

Oral ulceration
Pyostomatitis vegetans
Angular stomatitis
Reflects UC severity

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17
Q

White patches that can be wiped off?

A

Usually pseudomembranous candidiasis/ thrush

18
Q

Candidiasis?

A

Fungal infection due to any type of candida (yeast type)

19
Q

White patches that can’t be wiped off?

A

Trauma
Epithelial dysplasia
Neoplasia
Chronic mucocutaneous candidiasis

20
Q

Lichenoid inflammation (white patches)

A

Chronic inflammation along base of epithelium in band like distribution with some damage to keratinocytes in basal layer of epithelium

21
Q

Trauma causing white patches?

A

White mucosa as epithelium produced keratin in response as protective mechanism

22
Q

Causes of trauma?

A

Cheek chewing
Jagged edges of teeth
Ill-fitting dentures

23
Q

Leukoplasia?

A

Persistent white patches
SMOKING & alcohol
Pre-malignant
Biopsy & histology

24
Q

Transient white patches?

A

Candida infection

Systemic lupus erythematosus

25
Q

When is oral candidiasis seen?

A

After broad spectrum antibiotics
Inhaled steroids
Diabetes, seriously ill, immunocompromised

26
Q

Oral pigmentation?

A
Racial
Melanotic macules (lip freckle)
Malignancy 
Smoking
Addison’s disease
27
Q

Addisons disease?

A

Excess ACTH/MSH released from pituitary in response to reduced cortisol levels

28
Q

Xerostomia?

A

Dry mouth
SE of drugs, radiation therapy
Can be due to Sjogren’s syndrome

29
Q

Sjogren’s syndrome?

A

Autoimmune disease
Dry eyes and mouth
Primary or secondary

30
Q

Oral manifestations of Sjogren’s syndrome?

A

Enlarged salivary glands

Dry mouth causing caries (decay), depapillated tonugue, red, dry wrinkley mucosa

31
Q

Dental erosion?

A

Loss of surface of teeth due to acid

32
Q

Leukemia?

A
Gingival enlargement
Petechiae (tiny, purple/red spots)
Mucosal bleeding
Ulceration
Boggy gingivae
33
Q

Lymphoma?

A

Palpable lymph nodes
Diffuse swelling (extra/ intramural)
Ulceration
Tooth migration/ mobility

34
Q

Oral manifestations of HIV?

A
Ulceration
Kaposi's sarcoma
HPV lesions
Salivary gland swelling
As result  of immunosuppression 
Inc malignancy risk
35
Q

Kaposi’s sarcoma?

A

Type of cancer that can form masses in the skin, lymph nodes, or other organs.
Usually purple

36
Q

Are red or white patches more concerning?

A

Red

37
Q

Common high risk sites?

A

Lateral borders of tongue
Ventral tongue surface
Floor of mouth

38
Q

Biggest risk factors for oral disease?

A

Smoking & drinking

39
Q

Where do HPV associated cancers commonly occur?

A

Tonsils

40
Q

Pre-malignant lesions?

A

Leucoplakia (white)
Lichen Plans
Submucous fibrosis
Ertythroplakia (red)