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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
Q

If a leukoplakia is red or speckled, what does that say about the prognosis?

A

Higher risk of cancer

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26
Q

Can you brush off thrush?

A

Yes

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27
Q

WHat can cause atrophic glossitis?

A 
Nutritional deficiencies
Dry mouth
Sjögren’s syndrome
Oral candida infection
Celiac disease
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28
Q

What do you need to educate your pt about if they have oropharyngeal candidiasis?

A

Clean dentures better

Rinse mouth after using steroid inhalers

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29
Q

What is an amalgam tattoo?

A

Blue-black staining of mucosa next to amalgam filling (ddx for melanoma)

30
Q

Name this:

Erythematous patches on dorsal tongues with circumferential white borders

A

Geographic tongue (benign migratory glossitis)

31
Q

What is the etiology oropharyngeal candidiasis?

A

Candida albicans, part of our normal flora

32
Q

Is black hairy tongue a big deal?

A

No it is benign

33
Q

Is the reticular phase of oral lichen planus painful?

A

No, gets painful in the erythematous and erosive phases

34
Q

90% of SJS cases involve what part of body?

A

Mucosa

35
Q

For severe lesions and symptoms in the mouth, what kind of treatment should you prescribe?

A

Systemic therapy

36
Q

What are the risk factors for leukoplakia?

A

Tobacco use (esp chewing)

Alcohol use

HPV

37
Q

If someone has thrush in their esophagus, gets thrush all the time, or gets thrush for no reason, what should you do?

A

Consider HIV or Diabetes

38
Q

What Topical antifungals can be given for oropharyngeal candidiasis?

A

Nystatin oral suspension

Clotrimazole lozenges/troches

39
Q

What causes mucoceles?

A

Minor oral trauma

40
Q

Is the pattern of geographic tongue constant?

A

No the lesions can change location, pattern and size within minutes

41
Q

What usually induces erythema multiforme major eruption

A

infection (Herpes simplex virus most common)

42
Q

What is the treatment for thrush (general)

A

Disinfect toothbrushes, pacifiers etc

Topical antifungal

Patient Education

43
Q

What is the treatment for erythema multiforme major?

A

Symptomatic relief (topical steroids for skin lesions, oral antihistamines, magic mouthwash, systemic steroids if very bad)

44
Q

If a patient has widespread or generalized erythema in the mouth, what form of mediation should you prescribe?

A

A rinse that they swish and spit after holding in mouth for 3 minutes

45
Q

WHat is the treatment for geographic tongue

A

Reassurance

46
Q

When does Candida albicans overgrow and cause oropharyngeal candidiasis?

A

When conditions are right for overgrowth

opportunistic infection*

47
Q

What is the treatment for black hairy tongue?

A

Brush it with a toothbrush 🤮

48
Q

What should you be worried about if a pt’s dentures suddenly don’t fit?

A

SCC

49
Q

What is the treatment of Herpes Simplex (general)

A

Antiviral (at onset of prodrome)

Supportive care

50
Q

What does exophytic mean?

A

Lesion grows outward from an epithelial surface

51
Q

Name this:

shallow round/oval lesion, painful with grayish base

A

Aphthous ulcer (canker sore)

52
Q

Name this:

Creamy white patches/plaques with underlying erythematous mucosa

A

Oropharyngeal candidiasis (thrush)

53
Q

What can cause black hairy tongue?

A

Antibiotics

Candida albicans infection

Poor oral hygiene

54
Q

What is the treatment for aphthous ulcers?

A

Avoid irritating food/drink

Symptomatic relief (triamcinolone oral paste)

Typically heal in 10-14 days

55
Q

Is Stevens Johnson syndrome life threatening?

A

Yes

56
Q

Name this:
Elongated filiform papillae

Yellowish white to brown dorsal tongue surface

A

Black hairy tongue

57
Q

What is the other name for Hand Foot and Mouth Disease?

A

Coxsackie virus

58
Q

If erythema multiforme major has involved the eyes, what should you do?

A

Immediately refer to ophthalmology

59
Q

How do you diagnose Behcet syndrome

A

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
Q

What is the pathergy test?

A

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
Q

What does apthae mean

A

Ulcer

62
Q

Does erythema multiforme major go away on its own?

A

Yes about 2 weeks

63
Q

What does stomatitis mean?

A

Inflammation of the mucous membranes of the mouth

64
Q

What antivirals can be prescribed for herpes simplex at the onset of the prodrome?

A

Acyclovir

Valacyclovir

Famciclovir

65
Q

What should you do if you discover a pigmented oral lesion?

A

Consider melanoma in the DDx, and try to rule it out

66
Q

What is the other name for oropharyngeal candidiasis?

A

Thrush

67
Q

What is the treatment for atrophic glossitis?

A

Address the underlying condition. There’s always something else going on

68
Q

How do you diagnose oropharyngeal candidiasis other than clinical presentation?

A

KOH prep will show budding yeats +/- pseudohyphae

69
Q

Other than clinical presentation, how else would you diagnose herpes simplex?

A

Viral culture of active lesion

Tzanck Smear

70
Q

What is the treatment for Coxsackie virus (HFM disease)

A

Supportive:

Maintain hydration (popsicles)

Analgesics (APAP/ibuprofen)

Wash hands to prevent spread

71
Q

What is the most common cause of mouth ulcers?

A

Recurrent aphthous stomatitis

72
Q

What will you see on the Tzanck smear of a herpes lesion?

A

Multinucleated giant cells

Clin Med Exam 2 (Lauren) (6 decks)

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