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D2 Spring > Oral Path Exam 3 - Acute and Chronic Ulcerative Lesions > Flashcards

Oral Path Exam 3 - Acute and Chronic Ulcerative Lesions Flashcards

1
Q

What lesion?

Necrosis secondary to administration of LA

A

Anesthetic necrosis

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2
Q

What lesion?

May result from ischemia or faulty technique

A

Anesthetic necrosis

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3
Q

What lesion?

Pt who recently received oral LA

A

Anesthetic necrosis

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4
Q

What lesion?

Well-circumscribed ulcer at site of previous injection

A

Anesthetic necrosis

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5
Q

What lesions?

Most common site is hard palate

A

Anesthetic necrosis
Necrotizing sialometaplasia

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6
Q

What lesion?

Clinical diagnosis based on hx of recent LA injection

A

Anesthetic necrosis

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7
Q

What lesion?

Tx = heals with time

A

Anesthetic necrosis

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8
Q

What lesion?

Ischemia of salivary tissue leads to local infarction

A

Necrotizing sialometaplasia

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9
Q

What lesion has the following predisposing factors?

Trauma
Dental injections
Ill-fitting dentures
Eating disorders w/ binge-purging
Upper respiratory tract infection

A

Necrotizing sialometaplasia

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10
Q

What lesion?

Non-ulcerated, painful swelling initially

A

Necrotizing sialometaplasia

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11
Q

What lesion?

Within 2-3 weeks, a crater-like ulcer forms and pain is reduced

A

Necrotizing sialometaplasia

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12
Q

What lesion?

Diagnosed by biopsy (a malignant process must be excluded)

A

Necrotizing sialometaplasia

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13
Q

What lesion?

Tx = none; heals in 5-6 weeks

A

Necrotizing sialometaplasia

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14
Q

What lesion?

Initial infection of HSV-1

A

Primary herpetic gingivostomatitis

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15
Q

What lesion?

Affects children 6 months - 6 years old, but can occur in adults too

A

Primary herpetic gingivostomatitis

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16
Q

What lesion?

Acute onset, may have fever and lymphadenopathy

A

Primary herpetic gingivostomatitis

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17
Q

What lesion?

Multiple small vesicles progress to ulceration of oral mucosa, lips, and perioral skin (moveable and attached oral mucosa affected)

A

Primary herpetic gingivostomatitis

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18
Q

What lesion?

Painful, erythematous gingiva

(and marginal gingivitis)

A

Primary herpetic gingivostomatitis

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19
Q

What lesions? (4)

Diagnosed clinically, viral culture, PCR, cytologic smear, or biopsy

A

Primary herpetic gingivostomatitis
Recurrent herpes labialis
Recurrent intraoral herpes simplex
Herpes zoster (“shingles”)

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20
Q

Which test for primary herpetic gingivostomatitis?

Slower

A

Viral culture

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21
Q

Which test for primary herpetic gingivostomatitis?

Faster

A

PCR

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22
Q

Which test for primary herpetic gingivostomatitis?

Least invasive, most cost effective

A

Cytologic smear

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23
Q

What lesion?

Lesions heal spontaneously in 2 weeks

A

Primary herpetic gingivostomatitis

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24
Q

What lesion?

Symptomatic relief includes NSAIDs and lidocaine rinse (in adults)

A

Primary herpetic gingivostomatitis

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25
What lesion? Antivirals should be administered during day 2 or 3 for best effect
Primary herpetic gingivostomatitis
26
Where does HSV-1 remain latent?
Trigeminal ganglion
27
Which test for primary herpetic gingivostomatitis? Lightly moisten tongue depressor with water, gently remove cells by scraping the area. Spread accumulated cells on microscope slide, spray slide with fixative, and submit to pathologist
Cytologic smear
28
What are the 2 antiviral prescriptions for primary herpetic gingivostomatitis?
Valacyclovir (Valtrex) Acyclovir (Zovirax)
29
Which antiviral prescription? Rx: 1 g Disp: 14 tabs Sig: 1 tab q 12h until finished
Valacyclovir (Valtrex) for primary herpetic gingivostomatitis
30
Which antiviral prescription? Rx: 400 mg Disp: 21 tabs Sig: 1 tab TID until finished
Acyclovir (Zovirax) for primary herpetic gingivostomatitis
31
What lesions? Caused by reactivation of HSV-1
Recurrent herpes labialis Recurrent intraoral herpes simplex
32
What lesions have the following risk factors? Advanced age UV light Physical/emotional stress Dental tx
Recurrent herpes labialis Recurrent intraoral herpes simplex
33
What lesion? Can recur multiple times
Recurrent herpes labialis Recurrent intraoral herpes simplex
34
What is the worldwide prevalence of HSV-1 in individuals under 50?
67%
35
What lesion? May experience prodrome 6-24 hrs before lesions appear (pain, burning, itching, tingling, localized warmth, erythema)
Recurrent herpes labialis
36
What lesion? Multiple, small, erythematous papules form clusters of fluid-filled vesicles
Recurrent herpes labialis
37
What lesion? Affects vermillion border and skin adjacent to lips
Recurrent herpes labialis
38
What lesions? Tx = antivirals, but for pts with frequent recurrence, can provide rx to have on hand at home
Recurrent herpes labialis Recurrent intraoral herpes simplex
39
What lesions? Heals in 7-10 days
Recurrent herpes labialis Recurrent intraoral herpes simplex
40
What are the 2 antiviral prescriptions for recurrent herpes labialis and recurrent intraoral herpes simplex?
Valacyclovir (Valtrex) Acyclovir (Zovirax)
41
Which antiviral prescription? Rx: 500 mg Disp: 7 tabs Sig: take 4 initially, 2 at 12 hrs, then 1 at 24 hrs
Valacyclovir (Valtrex) for recurrent herpes labialis and recurrent intraoral herpes simplex
42
Which antiviral prescription? Rx: 800 mg Disp: 6 tabs Sig: take 3 initially, then 2 at 12 hrs, then 1 at 24 hrs
Acyclovir (Zovirax) for recurrent herpes labialis and recurrent intraoral herpes simplex
43
When must antiviral prescriptions be taken for a pt with recurrent herpes labialis?
Must be taken at earliest prodromal symptom
44
What lesion? Affects keratinized mucosa bound to bone (attached gingiva and hard palate)
Recurrent intraoral herpes simplex
45
What lesion? Small vesicles that collapse to form cluster of erythematous macules
Recurrent intraoral herpes simplex
46
What lesion? Reactivation of Varicella Zoster Virus (HHV-3)
Herpes zoster ("shingles")
47
What lesion? Recurs once
Herpes zoster ("shingles")
48
What lesion? Incidence increases with age
Herpes zoster ("shingles")
49
What lesion? Immunosuppression increases susceptibility
Herpes zoster ("shingles")
50
What lesion? Prodrome: severe neuralgia with or without fever, malaise, and headache
Herpes zoster ("shingles")
51
What lesion? Acute: clusters of vesicles w/ erythematous base, terminates at midline Chronic: post-herpetic neuralgia
Herpes zoster ("shingles")
52
What lesion? Pain and lesions tend to occur along one dermatome
Herpes zoster ("shingles")
53
What lesion? Start antiviral within 3 days of onset
Herpes zoster ("shingles")
54
What lesion? Symptomatic relief includes NSAIDs, Diphenhydramine, Gabapentin, and Steroids
Herpes zoster ("shingles")
55
What lesion? Prevention = Shingrix vaccine recommended for adults 50+
Herpes zoster ("shingles")
56
What are the 2 antiviral prescriptions for herpes zoster ("shingles")?
Valacyclovir (Valtrex) Acyclovir (Zovirax)
57
Which antiviral prescription? Rx: 500 mg Disp: 42 tabs Sig: 2 tabs TID until finished
Valacyclovir (Valtrex) for herpes zoster ("shingles")
58
Which antiviral prescription? Rx: 400 mg Disp: 70 tabs Sig: 2 tabs 5x daily until finished
Acyclovir (Zovirax) for herpes zoster ("shingles")
59
What lesion? Caused by enterovirus infection
Hand-foot-and-mouth disease
60
What lesion? Most common in children
Hand-foot-and-mouth disease
61
What lesion? Oral lesions arise first, then can get cutaneous lesions as well
Hand-foot-and-mouth disease
62
What lesion? If oral: multiple aphthous-like ulcerations
Hand-foot-and-mouth disease
63
What lesion? Most common oral locations are buccal mucosa, labial mucosa, and tongue
Hand-foot-and-mouth disease
64
What lesion? If cutaneous: erythematous macules become vesicles
Hand-foot-and-mouth disease
65
What lesion? Most common cutaneous locations are hands and feet
Hand-foot-and-mouth disease
66
What lesion? Diagnosed clinically and by PCR confirmation if needed
Hand-foot-and-mouth disease
67
What lesion? Tx = none (self-limiting)
Hand-foot-and-mouth disease
68
What lesion? Caused by fusobacterium nucleatum (and others)
Necrotizing ulcerative gingivitis
69
What lesion? Most frequent among young and middle-aged adults
Necrotizing ulcerative gingivitis
70
What lesion has the following risk factors? Psychologic stress Immunosuppression Smoking Local trauma Poor nutrition Poor OH Inadequate sleep Recent illness
Necrotizing ulcerative gingivitis
71
What lesion? Interdental papilla blunted, inflamed, edematous, and hemorrhagic
Necrotizing ulcerative gingivitis
72
What lesion? "Punched out" crater-like necrosis covered with gray pseudomembrane
Necrotizing ulcerative gingivitis
73
What lesion? Fetid odor and severe pain May be accompanied by lymphadenopathy, fever, and malaise
Necrotizing ulcerative gingivitis
74
What lesion? Diagnosed clinically (histopathology is not specific, so biopsy does NOT establish diagnosis)
Necrotizing ulcerative gingivitis
75
What lesion? Tx = scaling, curettage, or ultrasonic inflammation
Necrotizing ulcerative gingivitis
76
What lesion? Tx = CHX rinse, antibiotics if fever/lymphadenopathy present, evaluation for underlying cause of immunosuppression (HIV)
Necrotizing ulcerative gingivitis
77
Unilateral condition, extending to midline
Herpes zoster ("shingles"
78
Unilateral condition, but does NOT extend to midline
Recurrent intraoral herpes simplex

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