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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?

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
Q

What lesion?

Antivirals should be administered during day 2 or 3 for best effect

A

Primary herpetic gingivostomatitis

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26
Q

Where does HSV-1 remain latent?

A

Trigeminal ganglion

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27
Q

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

A

Cytologic smear

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28
Q

What are the 2 antiviral prescriptions for primary herpetic gingivostomatitis?

A

Valacyclovir (Valtrex)
Acyclovir (Zovirax)

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29
Q

Which antiviral prescription?

Rx: 1 g
Disp: 14 tabs
Sig: 1 tab q 12h until finished

A

Valacyclovir (Valtrex) for primary herpetic gingivostomatitis

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30
Q

Which antiviral prescription?

Rx: 400 mg
Disp: 21 tabs
Sig: 1 tab TID until finished

A

Acyclovir (Zovirax) for primary herpetic gingivostomatitis

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31
Q

What lesions?

Caused by reactivation of HSV-1

A

Recurrent herpes labialis
Recurrent intraoral herpes simplex

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32
Q

What lesions have the following risk factors?

Advanced age
UV light
Physical/emotional stress
Dental tx

A

Recurrent herpes labialis
Recurrent intraoral herpes simplex

33
Q

What lesion?

Can recur multiple times

A

Recurrent herpes labialis

34
Q

What is the worldwide prevalence of HSV-1 in individuals under 50?

35
Q

What lesion?

May experience prodrome 6-24 hrs before lesions appear (pain, burning, itching, tingling, localized warmth, erythema)

A

Recurrent herpes labialis

36
Q

What lesion?

Multiple, small, erythematous papules form clusters of fluid-filled vesicles

A

Recurrent herpes labialis

37
Q

What lesion?

Affects vermillion border and skin adjacent to lips

A

Recurrent herpes labialis

38
Q

What lesions?

Tx = antivirals, but for pts with frequent recurrence, can provide rx to have on hand at home

A

Recurrent herpes labialis
Recurrent intraoral herpes simplex

39
Q

What lesions?

Heals in 7-10 days

A

Recurrent herpes labialis
Recurrent intraoral herpes simplex

40
Q

What are the 2 antiviral prescriptions for recurrent herpes labialis?

A

Valacyclovir (Valtrex)
Acyclovir (Zovirax)

41
Q

Which antiviral prescription?

Rx: 500 mg
Disp: 7 tabs
Sig: take 4 initially, 2 at 12 hrs, then 1 at 24 hrs

A

Valacyclovir (Valtrex) for recurrent herpes labialis

42
Q

Which antiviral prescription?

Rx: 800 mg
Disp: 6 tabs
Sig: take 3 initially, then 2 at 12 hrs, then 1 at 24 hrs

A

Acyclovir (Zovirax) for recurrent herpes labialis

43
Q

When must antiviral prescriptions be taken for a pt with recurrent herpes labialis?

A

Must be taken at earliest prodromal symptom

44
Q

What lesion?

Affects keratinized mucosa bound to bone (attached gingiva and hard palate)

A

Recurrent intraoral herpes simplex

45
Q

What lesion?

Small vesicles that collapse to form cluster of erythematous macules

A

Recurrent intraoral herpes simplex

46
Q

What lesion?

Reactivation of Varicella Zoster Virus (HHV-3)

A

Herpes zoster (“shingles”)

47
Q

What lesion?

Recurs once

A

Herpes zoster (“shingles”)

48
Q

What lesion?

Incidence increases with age

A

Herpes zoster (“shingles”)

49
Q

What lesion?

Immunosuppression increases susceptibility

A

Herpes zoster (“shingles”)

50
Q

What lesion?

Prodrome: severe neuralgia with or without fever, malaise, and headache

A

Herpes zoster (“shingles”)

51
Q

What lesion?

Acute: clusters of vesicles w/ erythematous base, terminates at midline

Chronic: post-herpetic neuralgia

A

Herpes zoster (“shingles”)

52
Q

What lesion?

Pain and lesions tend to occur along one dermatome

A

Herpes zoster (“shingles”)

53
Q

What lesion?

Start antiviral within 3 days of onset

A

Herpes zoster (“shingles”)

54
Q

What lesion?

Symptomatic relief includes NSAIDs, Diphenhydramine, Gabapentin, and Steroids

A

Herpes zoster (“shingles”)

55
Q

What lesion?

Prevention = Shingrix vaccine recommended for adults 50+

A

Herpes zoster (“shingles”)

56
Q

What are the 2 antiviral prescriptions for herpes zoster (“shingles”)?

A

Valacyclovir (Valtrex)
Acyclovir (Zovirax)

57
Q

Which antiviral prescription?

Rx: 500 mg
Disp: 42 tabs
Sig: 2 tabs TID until finished

A

Valacyclovir (Valtrex) for herpes zoster (“shingles”)

58
Q

Which antiviral prescription?

Rx: 400 mg
Disp: 70 tabs
Sig: 2 tabs 5x daily until finished

A

Acyclovir (Zovirax) for herpes zoster (“shingles”)

59
Q

What lesion?

Caused by enterovirus infection

A

Hand-foot-and-mouth disease

60
Q

What lesion?

Most common in children

A

Hand-foot-and-mouth disease

61
Q

What lesion?

Oral lesions arise first, then can get cutaneous lesions as well

A

Hand-foot-and-mouth disease

62
Q

What lesion?

If oral: multiple aphthous-like ulcerations

A

Hand-foot-and-mouth disease

63
Q

What lesion?

Most common oral locations are buccal mucosa, labial mucosa, and tongue

A

Hand-foot-and-mouth disease

64
Q

What lesion?

If cutaneous: erythematous macules become vesicles

A

Hand-foot-and-mouth disease

65
Q

What lesion?

Most common cutaneous locations are hands and feet

A

Hand-foot-and-mouth disease

66
Q

What lesion?

Diagnosed clinically and by PCR confirmation if needed

A

Hand-foot-and-mouth disease

67
Q

What lesion?

Tx = none (self-limiting)

A

Hand-foot-and-mouth disease

68
Q

What lesion?

Caused by fusobacterium nucleatum (and others)

A

Necrotizing ulcerative gingivitis

69
Q

What lesion?

Most frequent among young and middle-aged adults

A

Necrotizing ulcerative gingivitis

70
Q

What lesion has the following risk factors?

Psychologic stress
Immunosuppression
Smoking
Local trauma
Poor nutrition
Poor OH
Inadequate sleep
Recent illness

A

Necrotizing ulcerative gingivitis

71
Q

What lesion?

Interdental papilla blunted, inflamed, edematous, and hemorrhagic

A

Necrotizing ulcerative gingivitis

72
Q

What lesion?

“Punched out” crater-like necrosis covered with gray pseudomembrane

A

Necrotizing ulcerative gingivitis

73
Q

What lesion?

Fetid odor and severe pain
May be accompanied by lymphadenopathy, fever, and malaise

A

Necrotizing ulcerative gingivitis

74
Q

What lesion?

Diagnosed clinically

(histopathology is not specific, so biopsy does NOT establish diagnosis)

A

Necrotizing ulcerative gingivitis

75
Q

What lesion?

Tx = scaling, curettage, or ultrasonic inflammation

A

Necrotizing ulcerative gingivitis

76
Q

What lesion?

Tx = CHX rinse, antibiotics if fever/lymphadenopathy present, evaluation for underlying cause of immunosuppression (HIV)

A

Necrotizing ulcerative gingivitis

77
Q

Unilateral condition, extending to midline

A

Herpes zoster (“shingles”

78
Q

Unilateral condition, but does NOT extend to midline

A

Recurrent intraoral herpes simplex

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