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Oral Med > oral med general > Flashcards

oral med general Flashcards

1
Q

what are tori?

A

exostosis - completely normal bone formation - swelling of bone

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2
Q

how do tori grow?

A

grow and enlarge with growth of the mandible and maxilla

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3
Q

how to tori appear?

A

symmetrical smooth and covered in mucosa

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4
Q

what are fordyce spots?

A

sebaceous glands

occur on vermillion border and buccal/lingual mucosa

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5
Q

when do fordyce spots become prominent?

A

age

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6
Q

what is leukodaema?

A

white and grey areas
odeama in superficial mucosal layers
gives a white appearance

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7
Q

what are other names for geographic tongue?

what are the symptoms of geographic?

A

erythema migrams, benign migratotry glossitus

can be asympotmatic or irritated by spicy/salty/acidic/rough foods

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8
Q

what is hairy tongue and what is it caused by?

A

brown/black tongue
staining from smoking, tea, coffee, chx mw
hypoplasia of filiform papillae

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9
Q

how is the appearance of a hairy tongue removed?

A

tongue brushing
sucking a peach stone
sucking a pineapple
suck vit c tabs

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10
Q

what are vascular lesions and malformations?

A

long lasting
normal part of circulation
test by encouraging blanching
not prone to rupture because CT layer covering

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11
Q

what are signs that a lesion could be a malignant melanoma?

A

occur on palatal and maxillary mucosa commonly

border not well defined, colour intensity and varies, quite large, satellite lesions, erythema and ulceration

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12
Q

what bacteria can cause fungal infections?

A

c. albicans
c. tropicalis
c. galbreta

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13
Q

what are the classifications of candida albicans?

A
  1. acute pseudomembranous - thrush
  2. acute erythematous
  3. chronic erythematous
  4. chronic hyperplastic
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14
Q

what are associated lesions of candida albicans?

A

angular chelitis
denture stomatitis
median rhomboid glossitis

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15
Q

describe acute pseudomembranous thrush?

A

removeable upper layer of superficial epithelium affected by candida - white yellow plaques - leaves area of inflammation

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16
Q

what are some possible underlying causes of candidiasis?

A 
anaemia
haematinic deficiency - B12 folate iron 
type 2 diabetes
asthma - steroid/inhalers
immunodeficiency 
antibiotics
HIV/AIDS
dry mouth
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17
Q

what is chronic hyperplastic candida?

A 
inside angle of mouth - comissure 
firmly adherent plaques
homogenous appearance inter areas of redness
asymptomatic/symptomatic
potential malginant mucosal disorder
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18
Q

what is denture stomatitis?

A

erythme confined to denture wearing area
poss slight hyperplastic appearance
localised/generalised

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19
Q

what is angular chellitis?

A

cracking, erythema, crusting, bleeding,
denture wearers
underlying systemic conditions

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20
Q

what bacterial infection can cause angular chellitis?

A

staph aureus

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21
Q

what is medial rhomboid glossitis?

A

inflammation in middle of tongue

asymptomatic or symptomatic

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22
Q

what meds can treat candidiasis?

A

topical intra oral and extra oral creams
systemic capsules
chx/hypochlorite mw

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23
Q

how to treat stomatitis?

A

remove at night
soak in hypochlorite or chx
fluconazole OM gel
nystatin of contra indicated

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24
Q

what is a genodermatoses?

A 
white sponge naevus
any area of OM affected 
rough surface
blend with surrounding normal area
asymptomatic
nasal and genital mucosa also affected
no malignant potential
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25
Q

what is frictional/traumatic keratosis?

A

linear alba
wipe away to leave inflammation
sheets of necrotic epithelium

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26
Q

what is chemical trauma?

A

apsirin burns can cause/etch burn
wipe away to leave inflammation
sheets of necrotic epithelium

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27
Q

what is stomatitis nicotina?

A

generalised whitening
combo thermal/chemical trauma
not potentially malignant

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28
Q

what is the incidence of lichen planus?

A 
affects 2/100 people
checks, tongues. gingivae, FOM, palate 
risk of SCC
associated with hepC
usually bilateral but not symmetrical 
seen with lupus and graft versus host disease
asymptomatic
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29
Q

what is non erosive lichen planus?

A

no ulceration
reticulrar LP
white plaques/patches
atrophy of epithelium

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30
Q

what is erosive LP?

A

ulceration

white striation and erythema

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31
Q

where do skin lesions of LP appear on the body and how do they present?

A

raised red purple patches
scalp = alopecia
nails = vertical ridging/splitting
genitals = discomfort, scarring

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32
Q

how to treat symptomatic LP?

A

analgesic/antibacterial MW, benzydamine - MW OM spray
chx MW
topical steroids - betamethasone, clenil modulate, hydrocortisone

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33
Q

what drugs can cause lichenoid?

A 
antihypertensives
oral hypoglycaemics
NSAIDs
2nd line anti arthritics 
xanthine oxidase inhibitors 
pyschoactive drugs 
antiparastic
antimicrobial
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34
Q

how do thermal or chemical ulcers present?

A

white patches

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35
Q

what is TUGSE?

A

traumatic eosinophillic ulcer and stomal eosinophillia
delayed healing
mimics SCC

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36
Q

what drugs can induce oral ulcers?

A

NSAIDs
methotrexate
nicorandil

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37
Q

what are recurrent oral apthous ulcers?

A

recurrent oral ulcers seen in abscess of systemic disease

similar lesions seen with systemic disease including GI disease

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38
Q

what are the types of recurrent apthous ulcers?

A

minor
major
herpetiform

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39
Q

describe minor apthous ulcerations?

A 
Non K areas 
>10 lesions at a time
<1cm 
10-14 days to heal
oval, erythema border, yelow base
40
Q

describe major apthous ulcerations?

A 
K non K areas
>1 cm 
heal with scarring
4 or more weeks to heal
>3 lesions at a time
41
Q

describe herpetiform ulcers?

A 
small
>2mm
numerous at a time >100
non K
10-14 days to heal
42
Q

what do ulcers occur in response to?

what are the phases of ulceration?

A

cell mediated immunie response
pre ulcerative phase - topical steroids most effective
ulcerative phase
healing phase

43
Q

causes of ulceration?

A 
stress
menstrual cycle
sensitivity to foods
GI disease
anaemia
haematinic deficiency
drug history
smoking cessation
family history
44
Q

what GI diseases cause oral ulceration?

A

crohns

coeliac

45
Q

what can anaemia and haematinic deficiencies?

A

epithelial atrophy
compromised cell mediated response
cytoxicity of leucocytes reduced

46
Q

when does the cause of recurrent apthous ulceration become important?

A

when pt’s age is outwith norm range and if they seem unexplained - poss increase in severity

47
Q

where do we get B12 and folate from in the diet?

A

meat and animal produce

green leafy veg

48
Q

what percent of coeliac patients present first with recurrent apthous ulceration?

A

6%

49
Q

what is the tx of Recurrent apthous ulceration?

A 
chlorhexidine
hydrocortisone oral tabs
SLS free toothpaste
betamethasone MW
clenil modulate
doxycylcline MW
benzydamine MW spray
lidocaine ointment
50
Q

what can non healing mouth ulcers be a sign of?

A

neoplastic cells

squamous cell carcinomas

51
Q

what is the appearance of SSC?

A

red and granular

yellow and smooth

52
Q

what herpes simplex disease is most common orally? and how is it transmitted?

A

HSV1
skin to skin direct contact
droplets - body excretions
sharing cups etc

53
Q

when a child first encounters HSV1?

A

infection can be subclinical or clinical

54
Q

what are clinical features

A 
general feeling of unwell - fever, lymphadenopathy
inflammation orally
vesicles - small blisters (under few mm)
bulla - > few mm
bullae rupture and become ulcers
55
Q

where does PHGS affect?

A

mucosal surfaces including external lips

gingivae - erythematous and vesicles

56
Q

who is PHGS most common in?

A

children and young infants

57
Q

how long does PHGS last?

A

10-14 days

58
Q

what is the tx of PHGS?

A 
analgesics - paracetamol
diflam - analgesic MW
chx gluconate - dilute half and half
bland soft diet and fluids
avoid direct physical contact and other individuals esp babies and immunocompromised
systemic aciclovir
59
Q

what is herpes labialis?

A

HSV1 reactivated in 40% of patients
HSV1 lies in trigeminal nucleus and lies dormant. Travels down sensory neurones and effects epithelium and surrounding tissue

60
Q

what are the first signs of a coldsore developing?

A

burn and tingle in area that coldsore will develop

61
Q

what is a coldsore?

A

vesicle rupturing to form area of ulceration

62
Q

when does aciclovir cream work best for coldsore tx?

A

works best with burn/tingle phase

63
Q

what is herpetic whitlow?

A

herpetic infection of the skin adjacent to the nail bed

64
Q

what are the primary and secondary infections of varicella zoster?

A

primary - chicken pox

secondary - herpes zoster and shingles

65
Q

where does a shingles rash present?

A

follows distribution of the trigeminal nerve - e.g opthalmic, maxillary, mandibular

66
Q

what type of pain comes form pre lesion of shingles?

A

pre herpetic pain

67
Q

what does a shingles rash comprise of?

A

vesicles and bullae

68
Q

what can persist after shingles?

A

residual burning in area of rash

>3 months and still persisting = post herpetic pain

69
Q

what is ramsay hunt syndrome?

A

facial palsy associated with varicella zoster
geniculate ganglion affected
rash in external ear

70
Q

what is epstein barr?

A

glandular fever HHV4
petechial palatal haemorrhages
ulceration
hairy leukoplakia

71
Q

what can coxsackie virus cause?

A

herpangina
hand food mouth disease
acute lymphoodular pharyngitis

72
Q

how does hand foot and mouth disease?

A 
pre clincal - generally unwell
lesions on hands fingers and mouth
gingivae unaffected, stomatitis
paracetamol and diflam
10-14 days
73
Q

what presents orally with measles?

A

koplicks spots

74
Q

what presents orally with mumps?

A

facial swelling
bilateral swelling or unilateral salivary gland swelling
trismus

75
Q

what can HPV cause orally?

A

squamous cell papilloma
verrucus vulgaris
condylema acumination

76
Q

where can squamous cell papilloma’s occur?

A

any area of oral mucosa
cauliflower projection like wart
cryotherpay

77
Q

what is an ulcer?

A

breach in epithelium to expose underlying CT

78
Q

what is a vesicle?

A

small fluid filled lesion

79
Q

what is a bulla?

A

larger fluid filled swelling

80
Q

what is the appearance of Kaposi’s sarcoma?
who are these common in?
found most commonly where?
can also present with what lesions?

A

dark/red/purple/blue lesion
present in over 50% of AIDS patients
palate
ocular and skin lesion

81
Q

how can you tell if something is a vascular lesion?

A

blanches with pressure

82
Q

what is a haemangiomata?

A

developmental lesion present from birth

83
Q

what is an erythroplakia?

A

atrophic red velvety patch

84
Q

what might cause a traumatic white lesion?

A

aspirin burn

85
Q

what is a leukoplakia?
uncommonly found where?
leukoplakias are premalignant, what % go on to be cancerous?

A

adherent white patch that cannot be categorised as any other morphological or histological diagnosis
gingivae
4%

86
Q

what areas of the mouth are risky to have a white patch?

what appearance would you be worried about?

A

FOM/ventral surface tongue - greater chance of being cancerous
dense verroucous surface
ulceration, hyperplastic

87
Q

what are some potential causes of a white patch?

A 
smoking
alcohol
betel nut
chronic trauma
radiation
88
Q

what is leukokeratosis?

A

white sponge naevus = developmental anomaly

non malignant

89
Q

how might a squamous cell carcinoma present?

A

white/red patches
warty/granular lesions
ulcers or swelling

90
Q

types of candidiasis?

A
  • acute pseudomembranous - white removable plaque with erythematous surface
  • acute atrophic - diffuse red (meds)
  • chronic hyperplastic - angular chelitis
  • chronic mucotaneous - affecting tongue and nails
  • chronic erythematous - diffuse erythem mimicing denture stomatitis - may be seen in HIV and AIDS
91
Q

what are local risk factors for candidiasis?

systemic?

A

local - denture wearing, xerostomia, topical steroids

systemic - medication, diabetes, haematininc deficiency

92
Q

how does an amalgam tattoo present?

A

flat grey blue discolouration of the mucosa = bc amalgam particles

93
Q

where do malignant melanomas commonly present from?

A

30% arise from area of hyperpigmentation

94
Q

how does dequamative gingivitis present?

A

redness/fiery red
smooth shiny thinned gingivae
with or without lichenoid striae, ulceration or vesicles/bullae

95
Q

what is lichen planus?

what may it present with?

A

mucotaneous inflammatory condition

may present as desquamative gingivitis with or without non ulcerating white lichenoid striae

96
Q

what can be seen orally with addisons disease?

A

diffuse brown pigmentation of gingivae

Oral Med (1 decks)

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