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Clin Med Exam 2 (Lauren) > Oral Lesions > Flashcards

Oral Lesions Flashcards

1
Q

Name this :

Atrophy of filiform papillae

Tongue appears smooth, glossy, erythematous

A

Atrophic glossitis

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2
Q

If a patient uses topical immunosuppressants or steroid inhalers, what do you need to talk to them about?

A

The possibility of oral candidiasis

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3
Q

Name this:

Target lesions on skin

Mucosal erythema

Painful erosions and bullae

A

Erythema multiforme major

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4
Q

What patient population tends to have oral hairy leukoplakia?

A

HIV+

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5
Q

What is the treatment for oral lichen planus?

A

Pain relief

Topical steroids (high potency- clobetasol or triamcinolone oral (Oralone)

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6
Q

What is the concern with oral lichen planus?

A

May be precancerous

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7
Q

Name this:

Grouped vesicles on an erythematous base

A

Herpes Simplex

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8
Q

Where else can erythema multiforme major affect other than skin and mucous membranes?

A

genitals and eyes

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9
Q

What is another name for aphthous ulcers?

A

Canker sores

Ulcerative stomatitis

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10
Q

What are the predisposing factors for oropharyngeal candidiasis?

A

Antibiotics

Corticosteroids

Infancy

Dentures

HIV/AIDS

Diabetes

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11
Q

What is the difference between erythema multiforme major and minor

A

Minor does not involve mucosa

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12
Q

If oral lesions have a few localized lesions, what form of medication should you prescribe?

A

Gel

Pt should dry area before applying and avoid eating and drinking for 30 min

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13
Q

Name this:

Recurrent oral and genital ulcers

Painful, shallow or deep with central yellow necrotic base

A

Behcet syndrome

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14
Q

Is leukoplakia painful?

A

No

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15
Q

What is in “magic mouthwash?”

A

Diphenhydramine (Benadryl)

Antacids

(Sometimes lidocaine)

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16
Q

Name this:

Pinkish/blue soft papules or nodules (filled with gelatinous fluid

A

Mucocele

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17
Q

What does the pt experience before the appearance of a herpes simplex virus lesion (cold sore)

A

Pain/tingling 6-48 hrs before

Fatigue

Low grade fever

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18
Q

What is an important DDx for leukoplakia?

A

Oral Hairy Leukoplakia (separate disorder, not premalignant)

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19
Q

What is the clinical presentation of oral lichen planus (3 steps)

A

Reticular- lacy white plaques with Wickham’s striae less painful

Erythematous-red patches of atrophy PAINFUL

Erosive-erosions/ulcers PAINFUL

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20
Q

Name the diagnosis:

Adherent white patches/plaques on oral mucosa or tongue

Not painful

May be red or speckled

A

Leukoplakia

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21
Q

How could you tell the difference between intraoral herpes zoster and herpes simplex?

A

Herpes zoster will only be on ONE side

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22
Q

What should you be worried about if an oral ulcer or mass won’t heal?

A

Squamous Cell Carcinoma

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23
Q

Is leukoplakia considered precancerous?

A

Yes, SCC

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24
Q

Does oropharyngeal candidiasis (thrush) hurt?

A

YES

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25
If a leukoplakia is red or speckled, what does that say about the prognosis?
Higher risk of cancer
26
Can you brush off thrush?
Yes
27
WHat can cause atrophic glossitis?
``` Nutritional deficiencies Dry mouth Sjögren’s syndrome Oral candida infection Celiac disease ```
28
What do you need to educate your pt about if they have oropharyngeal candidiasis?
Clean dentures better Rinse mouth after using steroid inhalers
29
What is an amalgam tattoo?
Blue-black staining of mucosa next to amalgam filling (ddx for melanoma)
30
Name this: | Erythematous patches on dorsal tongues with circumferential white borders
Geographic tongue (benign migratory glossitis)
31
What is the etiology oropharyngeal candidiasis?
Candida albicans, part of our normal flora
32
Is black hairy tongue a big deal?
No it is benign
33
Is the reticular phase of oral lichen planus painful?
No, gets painful in the erythematous and erosive phases
34
90% of SJS cases involve what part of body?
Mucosa
35
For severe lesions and symptoms in the mouth, what kind of treatment should you prescribe?
Systemic therapy
36
What are the risk factors for leukoplakia?
Tobacco use (esp chewing) Alcohol use HPV
37
If someone has thrush in their esophagus, gets thrush all the time, or gets thrush for no reason, what should you do?
Consider HIV or Diabetes
38
What Topical antifungals can be given for oropharyngeal candidiasis?
Nystatin oral suspension Clotrimazole lozenges/troches
39
What causes mucoceles?
Minor oral trauma
40
Is the pattern of geographic tongue constant?
No the lesions can change location, pattern and size within minutes
41
What usually induces erythema multiforme major eruption
infection (Herpes simplex virus most common)
42
What is the treatment for thrush (general)
Disinfect toothbrushes, pacifiers etc Topical antifungal Patient Education
43
What is the treatment for erythema multiforme major?
Symptomatic relief (topical steroids for skin lesions, oral antihistamines, magic mouthwash, systemic steroids if very bad)
44
If a patient has widespread or generalized erythema in the mouth, what form of mediation should you prescribe?
A rinse that they swish and spit after holding in mouth for 3 minutes
45
WHat is the treatment for geographic tongue
Reassurance
46
When does Candida albicans overgrow and cause oropharyngeal candidiasis?
When conditions are right for overgrowth | **opportunistic infection***
47
What is the treatment for black hairy tongue?
Brush it with a toothbrush 🤮
48
What should you be worried about if a pt’s dentures suddenly don’t fit?
SCC
49
What is the treatment of Herpes Simplex (general)
Antiviral (at onset of prodrome) Supportive care
50
What does exophytic mean?
Lesion grows outward from an epithelial surface
51
Name this: shallow round/oval lesion, painful with grayish base
Aphthous ulcer (canker sore)
52
Name this: Creamy white patches/plaques with underlying erythematous mucosa
Oropharyngeal candidiasis (thrush)
53
What can cause black hairy tongue?
Antibiotics Candida albicans infection Poor oral hygiene
54
What is the treatment for aphthous ulcers?
Avoid irritating food/drink Symptomatic relief (triamcinolone oral paste) Typically heal in 10-14 days
55
Is Stevens Johnson syndrome life threatening?
Yes
56
Name this: Elongated filiform papillae Yellowish white to brown dorsal tongue surface
Black hairy tongue
57
What is the other name for Hand Foot and Mouth Disease?
Coxsackie virus
58
If erythema multiforme major has involved the eyes, what should you do?
Immediately refer to ophthalmology
59
How do you diagnose Behcet syndrome
Recurrent oral ulcers (3+ per year) AND 2 other clinical findings (i.e. recurrent genital ulcers, ocular lesions, cutaneous lesions, and a Positive Pathergy test***)
60
What is the pathergy test?
A nonspecific hyperreactivity of the skin following minor trauma (stab with 20g needle, and if a red papule develops in 48hrs, it’s positive)
61
What does apthae mean
Ulcer
62
Does erythema multiforme major go away on its own?
Yes about 2 weeks
63
What does stomatitis mean?
Inflammation of the mucous membranes of the mouth
64
What antivirals can be prescribed for herpes simplex at the onset of the prodrome?
Acyclovir Valacyclovir Famciclovir
65
What should you do if you discover a pigmented oral lesion?
Consider melanoma in the DDx, and try to rule it out
66
What is the other name for oropharyngeal candidiasis?
Thrush
67
What is the treatment for atrophic glossitis?
Address the underlying condition. There’s always something else going on
68
How do you diagnose oropharyngeal candidiasis other than clinical presentation?
KOH prep will show budding yeats +/- pseudohyphae
69
Other than clinical presentation, how else would you diagnose herpes simplex?
Viral culture of active lesion Tzanck Smear
70
What is the treatment for Coxsackie virus (HFM disease)
Supportive: Maintain hydration (popsicles) Analgesics (APAP/ibuprofen) Wash hands to prevent spread
71
What is the most common cause of mouth ulcers?
Recurrent aphthous stomatitis
72
What will you see on the Tzanck smear of a herpes lesion?
Multinucleated giant cells

Clin Med Exam 2 (Lauren) (6 decks)

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