Oral lesions

Question 1

What is cancer of the oral cavity associated with

Answer 1

ulcers or masses that do not heal

Question 2

presentation of cancer on the tongue and lips

Answer 2

exophytic or ulcerative

Question 3

Aphthousstomatitis

Answer 3

recurrent aphthous stomatitis, “canker sore”

Question 4

Alternative name for simple aphthous

Answer 4

Mikulicz

Question 5

Morphology of aphthous ulcers

Answer 5

minor ulcer <1cm
major ulcer >1cm
herpetiform 1 to 2 cm in clusters

Question 6

Pathogenesis of aphthous lesions

Answer 6

-likely multifactorial
-immune dysregulation
-exaggerative proinflammatory process
-weak anti inflammatory response
-possible genetic predisposition
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Question 7

Risk factors of developing aphthous lesion

Answer 7

SMOKING CESSATION

• familial tendency
• trauma
• hormonal
• emotional stress
• food or drug hypersensitivity
• immunodeficiency

Question 8

Clinical presentation of aphthous lesions

Answer 8

round clearly defined ulcers with erythematous rim and central yellowing

Question 9

first line management of aphthous lesions

Answer 9

-oral hygiene
-pain control
viscous lidocaine
diphenhydramine
dyclonine losenges

Question 10

treatment for refractory apthous lesions

Answer 10

topical steroids
dexamethason elixir
clobetasol gel
triamcinolone paste

Question 11

Management for complex aphthous lesions

Answer 11

• intralesional or oral glucocorticoids
• colchicine
• dapsone
• pentoxifyline
• thalidomide in HIV pts

Question 12

Where do leukoplakic lesion appear

Answer 12

trauma prone regions where the mucosa is thicker (cheek, dorsum of tongue)

Question 13

Leukoplakia

Answer 13

whitish grey lesions that cannot be scraped off

early premalignant lesion

Question 14

Treatment of leukoplakia

Answer 14

not usually needed

• surgical removal
• cryoprobe
• ? oral retinoids

Question 15

What is hairy leukoplakia associated with

Answer 15

EBV, not premalignant

Question 16

What population does hairy leukoplakia occur in

Answer 16

HIV infected

Question 17

How is the majority of HSV-1 transmitted

Answer 17

individuals that do not know that they have the disease

Question 18

Two types of HSV infection

Answer 18

primary infection- more severe systemic sx

recurrent infection- less severe local sx

Question 19

Most common clinical manifestation of primary HSV-1 infection

Answer 19

herpetic gingivastomatitis

Question 20

How do young children with primary HSV-1 disease present

Answer 20

• fever
• LAD
• drooling
• decreased oral intake

Question 21

risk factors for HSV-1

Answer 21

• sulight exposure
• stress
• trauma

Question 22

Diagnosis of HSV-1

Answer 22

• confirmed by Tzanck smear, immunofluorescence smear or viral cx
• serology for HSV by PCR

Question 23

Management for HSV-1

Answer 23

• systemic antivirals (acyclovir, valacyclovir, famiciclovir)
• swish and spit miracle mouthwash
• supportive

Question 24

Who gets oral candida

Answer 24

• young infants
• older adults who wear dentures
• cancer pts
• immunodef

Question 25

What pathogens cause oral candida

Answer 25

• c albicans
• c glabrata
• c krusei
• c tropicalis

Question 26

Pseudomembranous oral candida

Answer 26

-most common form

white plaques on buccal mucosa, palate, tongue and oropharynx

Question 27

Atrophic oral candida (denture stomatitis)

Answer 27

found under upper dentures, erythema without plaques

Question 28

Clinical presentation of oral candida

Answer 28

• dry mouth
• loss of taste
• pain
• beefy, red tongue
• angular chelitis

Question 29

Diagnosis of oral candida

Answer 29

• removable white plaques
• fungal culture
• KOH prep

Question 30

What should you test for in refractory thrush

Answer 30

HIV

Question 31

Oral candida managment in pts w/o HIV

Answer 31

• local therapy
• nystatin swish and swallow
• clotrimazole
• miconazole tabs
• difulcan PO