Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical skills- Clinical application > Oral Ulcerations > Flashcards

Oral Ulcerations Flashcards

1
Q

What is an ulcer?

A

Loss of epithelium
Can affect cutaneous or mucosal tissue
Usually painful and may require topical drug therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cause of oral ulceration

A

Traums/ immunological/ infection/ systemic/ poor diet/ fmailial traits/ stress/ virus/ Uknown-idiopathic / allergies/ malignaces/ drug therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ulcers occurrence can be?

A

Occurrence- single / recurrent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Infective ulcers:

A

Herpes/ tuberculosis/ syphilis/ Measles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Non- infective ulcers:

A

traumatic ulcers. Recuurent apthous stomatitis/ leukaemia/ Behcets disease/ hiv/ lupus erythematosus/ pemphigus vulgaris/ erythema multiforme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Two types of Herpes

A

Primary herpetic stomatitis-primary infection, a single occurrence
Herpes labialis- latent, recurrect, reactivated in 20-30% of patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Primary herpetic stomatitis

A

-primary infection, a single occurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Herpes labialis

A
  • latent, recurrent, reactivated in 20-30% of patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name Primary herpetic stomatitis and route of transmission?

A

Herpes simplex virus- transmission through close contact, more common in immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is herpetic whitlow, or whitlow finger?

A

is an abscess of the end of the finger caused by infection with the herpes simplex virus (the cold sore virus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clinical features of Primary herpetic stomatitis?

A

Clinical features, can affect any part of the oral cavity, hard palate and dorsum of tounge- common
Vesicles 2-3mm, which rupture and form sallow ulcers
Yellowish grey with red margins, swollen gingival margins, enlarged lymph nodes,
Persists 7-10 days- longer in immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

define Herpes labials?

A

Herpes labials: after the primary infection it may remain latent and reactivate in 20-30%- presents as herpes labialis- cold sores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what can trigger Herpes labials?

A

Trigger: common cold, febrile infections, sunshine, menstruation, stress, trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Symptoms and clincial presenation of Herpes labials?

A

Symptoms and clinical presentation: burning sensation, tingling, erythema at site, formation of vesicles, enlarge and coalesce then weep exudate, crust over, scab and finally heal, cycle may take up to day 10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What will help in the treatment of Herpes labials?

A

Acyclovir ASAP at tingling stage may prevent vesicle formation, shorten duration of vesicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Herpetic cross infection?

A

Primary and secondary infection are contagious
Mouth to mouth
Droplet spread virus in saliva and in vesicles
Mouth to finger results in herpetic whitlow
Mouth to eye- through aerosol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tuberculosis and oral lesion is ……… and a complication of ………….
What areas are affect?

A

oral tuberculosis is rare and a complication of oral pulmonary tuberculosis
Typical lesion is an ulcer mid dorsal surface the tongue
Lip and other areas less affected
Painless in early stages lymph nodes NAD
Oral ulceration heal following drug therapy for the pulmonary infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Oral cancer-
most common locations

may present in the

A 
Lower lip most frequent site
Lateral borders of the tongue
Floor of mouth
70% oral cancers found in above sites
May present as oral ulcer, red patch, white patch, red and white patch or atrophic area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Immunological causes of ulcers?

A

unclear aetiology, suppressed immune system, leukaemia, behcet’s syndrome, lupus erythematosus, pemphigus vulgaris, erythema multiforma

20
Q

Leukaemia-
Major effects:

Oral and peri oral effects:

A

major effects- raised susceptibility to infection, bleeding tendency
Oral and peri oral effects- gingival swelling, mucosal ulceration, cytoxic drugs, immunodenfiency, purpura, cervial lymphadenopathy

21
Q

Bechet’s syndrome-
common in which part of the population?
General effects?
Oral and peri oral effects?

A

rare in UK common in turkey and japan M>F 20-40 years,
general effects- genital lesions, ocular disease, skin lesions, arthritis
Oral and peri oral effects- oral ulceration- recurrent TRT is different

22
Q

Patients with HIV are susceptible to ……….

A

…..RAS(Recurrent Aphthous stomatitis), candidal infection, hairy leukoplakia, NUG

23
Q

Lupus erythematosus is a

Trt options:

A

disease of connective tissue, 2 types, both can present oral lesions, systemic- oral lesions 20% rashes, joint pain, TRT-systemic steroids

24
Q

Discoid eczema can also present as

Trt options:

A
  • oral lesions in up to 25%
    Essentially a skin disease
    TRT topical corticosteroids
25
Q

Pemphigus vulgaris is a

A

autoimmune disease, uncommon, vesicles on skin and mucous membrane, first lesion appear in the mouth, fatal if left untreated

26
Q

Erythema multiforme is a

Trt options:

A
  • mucocutanious disease (aetiology unknown) oral lesions, the most prominent, general lesions, body rashes, ocular damage, rarely blindness and renal failure
    Lasts for 3-4 weeks with recurrence of several months over a period of 1-2 years
    Usually runs a limited course
    TRT- systemic corticosteroids and antibiotics
27
Q

Chemotherapeutic drugs:

A

Immunosuppressants (cyclosporin) - liver heart transplants
Antimetabolites (methotraxate) - cancer drugs, tumours, leukaemia, meningeal cancer
Alkaloids (morphine)- nitrogen containing substances produced by plants
-many alkaloids are important drugs

28
Q

Management of all oral ulcers

A

Attempt to identify the cause, inform the dentist, record the details: location/size/colour/ margins and base
Note the date and Monitor progress
Follow up if not healed within 2-3 weeks (most intra oral ulceration will heal within 2 weeks- the elderly and medically compromised will have slower healing)
OHI
If still present with no signs of healing report to supervising clinician immediately

29
Q

Causes of Traumatic ulcers

A

Mechanical
Thermal
Chemical

30
Q

Chemically induced causes

A

analgesia (aspirin burn)
Recreational drugs (cocaine)
Cocaine- quickly absorbed by the mucosal lining in the oral cavity
Tissue degeneration evident after a few regular application

31
Q

Mechanically indiced clincial presentation

A
  • slightly depressed and oval in shape with an erythematous zone at the periphery which lightens with keratinization. Centre is usually yellow/grey.
32
Q

Thermally induced clinical presentation

A
  • erythematous and raised
33
Q

Chemically induced clinical presentation

A
  • less well-defined with mucosal sloughing
34
Q

Recurrent Aphthous stomatitis RAS

A

Recurrent episode of intraoral ulcers, may be single or crops of multiple ulcers, children and young adults, smokers are less affected, ovoid or round, yellowish centre, inflammatory halo

35
Q

Aeitology- of Recurrent aphthous stomatitis

A

unknown 90% idiopathic, menstraution, ?food allergy, nuts, choc, 20% of patients with RAS have a nutritional deficiency, folic acid, iron, vitamin B12, nutritional deficiencies need addressing

36
Q

3 types of RAS

A

minor, major, herpetiform

37
Q

Type 1- Minor Aphthae

A

usually 1-5 present, less than 10mm, labial and buccal mucosa, heal with no scarring

38
Q

Type 2- Major Aphthae

A

exaggerate variant of minor, larger, more destructive and lasts longer >10mm, soft palate, tonsillar fauces, labial/buccal mucosa and tongue, red raised boarder with deep erosion of tissue, heal with scarring

39
Q

Type 3- Herpetiform Aphthae:

A

Recurrent focal ulceration, resembles herpes. Numerous pin-head size grey-white erosions that enlarge and coalesce- become ill-defined. 1-2 mm in clusters of 10-100. Adjacent mucosa is erythematous. Any part of oral cavity can be effected. May or may not scar

40
Q

Treatment of RAS

Type 1- minor:
Type 2- Major:

Type 3- Herpetiform:

A

all benefit from chlorohexidine 0.2% m/w and good oral hygiene
: usually self healing
: may require antiobotics to prevent secondary infection, corticosteriods
: if large surface area effected as per type 2

41
Q

Thermally induced causes

A

Irradiation: site specific
Hot food or drink
Usually on the palate
Pizza!

42
Q

Mechanically induced clinical appearance and causes?

A 
Typical raised boarders
Keratotic boarders
Necrotic centre
Depressed centre
Food-sharp, hard food
Denture/orthodontic appliance: pressure or friction
Tooth brushing trauma: clumsy, wrong type of brush
Dental treatment: LA, instrument trauma
Bites: eating, fits
Habits: neuroses
43
Q

Secondary :

A

Oral lesions present as: mucous patches, split papules, snail track ulcers, highly infections, rash on palms and soles, coppery Trt penicillin

44
Q

Tertiary:

A

Oral lesions present as: glossitis, gumma (mid-line on palate)
Non-infectious

45
Q

KOPLIK’s Spots

A

Prodromal stages of measles
White spots in buccal sulcus and palate
lymphhadenopathy

Clinical skills- Clinical application (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions