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1. SBA > oral diseases > Flashcards

oral diseases Flashcards

1
Q

A 70 year old male patient is diagnosed with T1N0M0 squamous cell carcinoma in the left lateral tongue. He has well-controlled hypertension, raised cholesterol and type 2 diabetes. He has smoked for 50 years and regularly consumes more than 14 units of alcohol per week.

Which factor has the greatest impact on prognosis?

A

Stage of the disease.

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2
Q

48 year old male who attends C/O pain in his upper centrals. He has noticed his face becoming red and OE you can see blistering/rashes on the hard palate.

What is the most probable diagnosis?

A

Shingles

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3
Q

19 year old female with RMH including the recent removal of intestinal polyps and strong family history of cancers. She has marked peri-oral pigmentation but IO exam is otherwise normal.

What is the most likely diagnosis?

A

Peutz-Jegher’s Syndrome

(rare genetic disorder characterised by noncancerous hamartomatous polyps in the digestive tract and pigmented spots on the lips/mouth/fingers).

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4
Q

46 year old male presenting with pain in LR jaw on biting, pointing to LR6. You do a sensibility test which is normal but the tooth is TTP. The radiograph shows bifurcation.

What is the most likely reason for this tooth being TTP?

A

Bifurcation Lesion

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5
Q

17 year old male presents with bouts of 3-4 ulcers which occur on his tongue and buccal mucosa, healing within 2 weeks.

What type of ulceration is this likely to be?

A

Minor RAS

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6
Q

50 year old female CO dry mouth and dry eyes for the last 6 months. Her rheumatologist recently completed blood tests which came back positive for the anti-Ro antibody.

Which autoimmune disease is the patient likely to have?

A

Sjögren’s Syndrome

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7
Q

76 year old male presents with denture stomatitis. RMH includes recent DVT and taking warfarin, denture hygiene is good.

Which of the following is the most appropriate treatment for the condition?

A

Nystatin Oral Suspension

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8
Q

Sublingual haematoma is found in which fracture?

A

Mandibular

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9
Q

28 year old male presenting with recurrent bouts of 20+ ulcers under his tongue which are painful and heal within 2 weeks.

What is the most likely diagnosis?

A

Herpetiform RAS

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10
Q

27 year old male presenting with pain and swelling underneath the right side of his mandible. Symptoms get worse at mealtimes - you manage this acute episode and refer to Oral Surgery.

What would be the most appropriate initial investigation to perform in secondary care?

A

Mandibular Occlusal Radiograph

(focuses on the mandible and surrounding structures, useful for examining hard to visualise areas)

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11
Q

Base of skull fractures commonly present with:

A

Raccoon eye bruising.

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12
Q

A 7 year old child has just undergone the XLA of LLE, what post-op analgesic should you recommend?

A

250mg Paracetamol

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13
Q

What is the most common aetiology for facial fractures in the UK?

A

Interpersonal Violence

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14
Q

Which medication prescribed for cardiac disease has been reported to cause oral ulceration?

A

Nicorandil - used to treat angina.

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15
Q

65 year old pt complains of tongue sticking to the roof of mouth with a lobulated appearance.

Which condition are they at a greater risk of developing?

A

Oral Candidiasis

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16
Q

What is oedema?

A

Collection of fluid in or between layers of the skin which causes swelling.

17
Q

What type of patient does ANUG typically occur in?

A

Smokers and immunocompromised patients.

18
Q

Clinical features of ANUG?

(think of the name)

A
  1. Soreness and bleeding of the gingivae.
  2. Crater like ulcers due to necrosis of the interdental papillae.
  3. Halitosis.
19
Q

Cause of ANUG?

A

Unknown cause.

20
Q

Predisposing factors for ANUG

A
  1. Poor OH
  2. Stress
  3. Smoking
  4. Depressed Immune Response
21
Q

3 ways to manage ANUG

A
  1. Plaque control (supra PMPR)
  2. Antibiotics - 400mg Metronidazole every 8 hours for 3 days.
  3. Smoking cessation.

suspect systemic causes if this does not work

22
Q

What are 2 things to remember before prescribing metronidazole?

2 warnings not to do whilst on the medication

A
  1. No alcohol can be consumed.
    (metronidazole blocks alcohol metabolism)
  2. Can’t prescribe if the pt is pregnant.
23
Q

Which bacterium causes syphilis?

A

Treponema Pallidum

(gains entry via mucous membranes and skin abrasions).

24
Q

What are 2 clinical features of primary syphilis?

A

Primary lesions on any part of the oral mucosa +/- genital lesions.

Cervical lymph node enlargement which is not tender.

25
Q

3 clinical features of secondary syphilis.

(type of ulcers and lymph nodes)

A
  1. Grey-white ulcers covered by thick slough.
  2. Snail trail ulcers.
  3. Palpable lymph nodes which are not tender.
26
Q

What are 4 clinical features of tertiary syphilis?

A
  1. Syphilitic leukoplakia.
  2. ‘Gumma’ chronic granuloma (usually palatal which breaks down to cause a tissue defect).
  3. Firbosing glossitis.
  4. Osteomyelitis of the jaw (bacterial infection of the bone)
27
Q

Which 2 developmental anomalies are found alongside congenital syphilis?

A

Hutchinson’s Incisors and Moons Molars

(it’s giving MIH)

28
Q

How do moon molars or Hutchinson’s incisors occur in congenital syphilis?

A

The tooth germ is invaded by spirochaetes.

29
Q

How is syphilis diagnosed?

A

Serology

30
Q

Which antibiotics would be given to treat syphilis?

A

High dose penicillin or erythromycin/tetracycline if allergic.

31
Q

Treatment for angular chelitis.

A

Miconazole cream for mild infection.
OR
Fusidic acid ointment if there is evidence of staph aureus infection.

32
Q

What treatment should be provided if angular chelitis is unresponsive?

(another tx with the existing)

A

Hydrocortisone with miconazole cream.

(hydrocortisone = corticosteroid)

33
Q

What is NEOPLASIA?

A

The new and abnormal development of cells that may be benign or malignant?

34
Q

Which virus is associated with Kaposis Sarcoma?

A

HHV 8 (human herpes virus 8)

35
Q

Describe the presentation of Kaposis Sarcoma?

A

Pigmented neoplasm which is non-painful, slightly modulated lesion of the oral mucosa.

36
Q

Name as many possible causes of burning mouth syndrome as you can.

A
  1. xerostomia
  2. nutritional deficiencies
  3. diabetes mellitus
  4. medications
  5. acid reflux
  6. hormonal imbalances
  7. allergy
  8. anaemia
  9. inflammatory conditions (e.g: lichen planus)
37
Q

What is angular chellitis and its cause?

A

Fissuring / cracking at the corners of the mouth.

  • caused by a localised infection of both bacteria and fungi seen with systemic conditions/change in local environment.

1. SBA (28 decks)

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