Quiz 2: Mouth and Throat

Question 1

Mucocele or Angular Chelitis?
A. Soft cyst, clear or bluish bubble 1-2cm, rubbery, mucin filled cavity, most not painful
B. Deep cracks at labial commissure, often bilateral
C. Etio: candida, dentures, allergy to denture materials, deficiency of B2, B12
D. Commonly from biting lip, trauma

Answer 1

Mucocele
Angular Chelitis
Angular Chelitis
Mucocele

Question 2

Oral SCC, Melanoma, or Fordyce’s Spots?
A. Benign neoplasms (growths) from sebaceous glands
B. Pigmented lesions
C. Multiple white to yellow 1-2 mm papules, often cluster
D. Growing out or ulcerated, indurated w rolled border

Answer 2

A. Fordyce’s Spots
B. Melanoma
C. Fordyce’s Spots
D. Oral SCC

Question 3

Oral SCC, Melanoma, or Fordyce’s Spots?
A. Most on floor of mouth or ventral/lateral tongue, cheek
B. Early usu painless, ulcerated usu painful
C. Most common 20-30 yo, M=F
D. 90% are smokers, alcohol is also risk factor

Answer 3

A. Oral SCC
B. Oral SCC
C. Fordyce’s Spots
D. Oral SCC

Question 4

3 DDx for aphthous ulcers

Answer 4

Secondary herpetic ulceration - history of vesicles preceeding ulcers, a location on periosteum-bound mucosa and crops of lesions
Trauma, pemphigous vulgaris, cicatricial pemphigoid
Systemic disorders: Crohn’s neutropenia, sprue

Question 5

2 features of Oral Erythema Multiforme

Answer 5

Hypersensitivity rxn to HSV, other organisms, drugs, or ?
Bullae that rupture –> raw painful friable surfaces then form crusts with red base
Target lesions

Question 6

2 features of Chancre

Answer 6

Lesions - painless ulcerations formed during primary stage of syphilis (21 days after exposure)
Form on lips, tongue, anus, penis, vagina
Indurated border, single lesion,
Tender cervical LA

Question 7

2 features of Frictional hyperkeratosis

Answer 7

Caused by chronic friction
Hyperkeratotic white lesion
Leads to white line - linea alba

Question 8

2 features of Epulis Fissura

Answer 8

Denture hyperplasia

Painless folds of fibrous connective tissue around denture

Question 9

2 features of Irritation Fibroma

Answer 9

Most common benign oral soft tissue neoplasm
Soft lesion from chronic irritation
Painless, lighter in color

Question 10

2 features of Angioedema

Answer 10

Rapid onset, Allergic response
Urticaria (itchy raised bumps), hand swelling
Painless, non-pruritic (if non-allergic), non-pitting, may progress to complete airway obstruction

Question 11

2 features of Palatal or Mandibular Torus

Answer 11

Non-neoplastic, slowly growing nodular protuberance of bone on palate or mandible
F>M 2:1 peak occurance at 30 yo

Question 12

2 features of Hemangioma

Answer 12

Proliferation of blood vessels, often congenital
Flat or raised lesions with deep red or bluish-red color
Can undergo ulceration and secondary infx

Question 13

2 features of Varicosities

Answer 13

Tortuous veins in the oral cavity are attributed to increased hydrostatic pressure
Ventral surface of tongue
Blue veins, blanche when compressed

Question 14

2 features of Papilloma

Answer 14

ASx well-circumscribed usu. pedunculated benign growths with numerous small finger like projections
Usu. < 1 cm diam and solitary

Question 15

2 features of Lipoma

Answer 15

Painless, benign, slow-growing mass of adipose tissue (cheek, tongue)
Yellow, non-tender, rubbery/soft, mobile
Hereditary component

Question 16

Sialadenitis, Sialolisthesis, Sjogren’s, or Xerostomia?
A. General term including many causes of dry mouth
B. Salivary duct stones, most common in submand glands
C. Usu painless benign swelling seen w systemic dz’s
D. Usu. pain w mumps, malignancy, infx

Answer 16

A. Xerostomia
B. Sialolisthesis
C. Sialadenitis
D. Sialadenitis

Question 17

Sialadenitis, Sialolisthesis, Sjogren's, or Xerostomia?
A. Systemic inflammation, auto-immune
B. Pain and swelling with eating
C. Dry eyes, mouth and mucous membranes
D. Associated w tooth decay

Answer 17

A. Sjogren’s
B. Sialolisthesis
C. Sjogren’s
D. Xerostomia

Question 18

Gingivitis, Vincent’s Angina, Periodontitis or Caries?
A. Pain with hot, cold, sweet foods
B. “Punched out” lesions w gray membrn bleed easily
C. Inflam. in gums w redness, swelling, pocket formation
D. Infx & Inflammation of periodontal ligament

Answer 18

A. Caries
B. Vincent’s Angina
C. Gingivitis
D. Periodontitis

Question 19

Gingivitis, Vincent’s Angina, Periodontitis or Caries?
A. Etiology: Severe gingivitis deep pockets harbor organisms leading to bone loss
B. Etiology: fusiform bacteria, poor oral hyg. severe stress, malnutrition
C. Seen w methampetamines “meth mouth”
D. Acute painful infx w swelling, sloughing of tissue, odor

Answer 19

A. Periodontitis
B. Vincent’s Angina
C. Caries
D. Vincent’s Angina

Question 20

Serious concomitant Sx for toothache and infection

Answer 20

HA, fever, swelling or tenderness in floor of mouth, cranial nerve abnormalities

Question 21

Name and describe 3 causes of Toothache and Infx that are EMERGENCIES

Answer 21

1. Apical absess - infx deep in root
2. Ludwig’s Angina - Cellulitis of mouth floor from dental infection
3. Cavernous Sinus Thrombosis - infx in cav sinus leads to development of blood clot–> brain; eyes bulge

Question 22

Recurrent Herpes Labialis, Herpetic Gingivostomatitis, or Recurrent Aphthous Stomatitis?
A. Cold sore
B. Vessicles along vermillion border, ulceration, crusting
C. Shallow ulcers w red border no vessicles or crusting
D. Canker sore
E. Vessicular lesions/erosions w red base, crusting

Answer 22

A. RHL, HG
B. RHL
C. RAS
D. RAS
E. HG

Question 23

Recurrent Herpes Labialis, Herpetic Gingivostomatitis, or Recurrent Aphthous Stomatitis?
A. Triggers: Trauma, emotional stress
B. Prodrome of pain burning tingling
C. Triggers: UV light, trauma, fatigue, stress, menses
D. Triggers; Trauma, chemical irritant, thermal injury, allergy, vit deficiency, Crohn’s, celiac

Answer 23

A. HG
B. RHL, HG, and occasionally RAS
C. RHL
D. RAS

Question 24

Recurrent Herpes Labialis, Herpetic Gingivostomatitis, or Recurrent Aphthous Stomatitis?
A. Painful
B. Involves unmoveable mucosa
C. Fever, malaise, LA, painful eating
D. Multiple/clustered vessicles

Answer 24

A. RAS, HG
B. HG
C. HG
D. RHL, HG, RAS (RAS can also be solitary)

Question 25

Oral Lichen Planus, Leukoplakia, Erythroplakia, Candidiasis
A. Red macule/plaque w sharp edges & soft texture
B. Lace-like white patches/papules/streaks
C. Solid white patches or raised plaque
D. Slightly raised soft white plaques, “thrush”, fungal

Answer 25

A. Erythroplakia
B. Oral Lichen Planus
C. Leukoplakia
D. Candidiasis

Question 26

Oral Lichen Planus, Leukoplakia, Erythroplakia, Candidiasis
A. Pre-CA
B. Etiology: Trauma, syphilis, vitamin deficiency
C. Risk factors: smoking, EtOH
D. Etiology ?, poss. drug rxn, Hep C, worse w/ stress

Answer 26

A. Oral Lichen Planus, Leukoplakia, Erythroplakia
B. Leukoplakia
C. Erythroplakia
D. Oral Lichen Planus

Question 27

Oral Lichen Planus, Leukoplakia, Erythroplakia, Candidiasis
A. Can be rubbed off
B. Non-erosive lesion, usu. painless, not contagious
C. >90% in >40 yo M
D. Often on floor of mouth, tongue, palate

Answer 27

A. Candidiasis
B. Oral Lichen Planus
C. Leukoplakia
D. Erythroplakia

Question 28

2 features of Carcinoma of the lips (SCC)

Answer 28

Painless lesion, sharply demarcated, elevated, indurated with ulcerated base
May be irregular (cauliflower-y) or plaque-like
Slow-growing, fails to heal, can bleed, high risk of metastasis