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red lesions Flashcards

1
Q

t/f. a vesicle can turn into an ulceration

A

true. but you cant go from an ulceration to a vesicle

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2
Q

t/f. there is no lymphadenopathy with AI diseases

A

true

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3
Q

epidermolysis bullosa

A

congenital defect in the attachment mechanisms of the epithelial cells

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4
Q

tx of epidermolysis bullosa

A

no cure, management: supportive (avoid trauma)

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5
Q

types of lesions in epidermolysis bullosa

A

vesicles and bullae due to minor trauma and oral lesion

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6
Q

t/f. viral diseases typically have slow onset

A

false. actue (fast)

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7
Q

features of viral diseases

A

lymphadenopathy (not in recurrent herpes or zoster), ulcers, vesicle stage (except mono)

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8
Q

HHV1

A

herpes simplex 1

typically infects oral region

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9
Q

HHV2

A

herpes simplex 2

typically infects genital region

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10
Q

herpes simplex oral cavity “history”

A

primary: exposure, often asymptomatic, but if symptomatic: gingivostomatosis
latency period
recurrent: epithelium supplied by sensory ganglion, usually symptomatic, asymptomatic viral shedding

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11
Q

primary herpetic gingivostomatosis

A

lymphadenopathy with multiple sesicles and ulcers anywhere in the oral cavity
may present subclinical

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12
Q

primary herpes features

A

pinhead vesicles develop, central ulcerations, yellow fibrin may coalesce into larger ulcers, involves keratinized and nonkeratinized mucosa

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13
Q

tx for primary herpes

A

acyclovir (zovirax) antiviral: adults - 200mg

resolves in 10-14 days

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14
Q

recurrent herpes simplex prodrome (early symptoms)

A

tingling, burning, paresthesia

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15
Q

recurrent herpes features of vesicles and ulcers

A

small clusters, perioral skin and keratinized oral mucosal surfaces, recur in the same location each time

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16
Q

t/f lymphadenopathy is present in recurrent herpes

A

false. it is not present

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17
Q

t/f. primary herpes only occurs on keratinized tissue

A

false. keratinized and non keratinized. recurrent is only keratinized

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18
Q

tzank cell

A

free floating epithelial cells

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19
Q

tx for recurrent herpes

A

effective at prodrome: valacyclovir (valtrex) (Rx)

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20
Q

prophylactic maintenance for recurrent herpes

A

acyclovir

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21
Q

t/f. zoster represents a recurrence

A

true. shingles is a recurrence of varicella (chickenpox)

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22
Q

t/f zoster only manifests at the terminal end of a nerve

A

false. the entire length of the nerve (shingles=dermatomes)

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23
Q

t/f. shingles is usually unilateral

A

true. follows the peripheral nerve distribution

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24
Q

post herpatic nerualgia

A

chronic severe pain in nerve distribution after zoster lesions resolve

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25
HHV4
EBV (epstein-barr)/ infection mononucleosis
26
ebv is also associated with these 3 diseases
burkitts lymphoma, nasopharyngeal carcinoma, hairy leukoplakia
27
lab features of ebv
leukocytosis, lymphocytosis with atypical T cells, positive serology
28
oral mucosa features of ebv
erythmatous, petechiae on palate, ulcers without vesicles
29
etiology of hand foot and mouth
coxsackie virus group A
30
hand foot and mouth lesions
vesicles and ulcers throughout oral cavity | macules and vesicles on hands and feet
31
etiology of herpangina
coxsackie virus group A
32
herpangina lesions
vesicales and ulcers on posterior oral cavity: soft palate, uvula, tonsillar pillar
33
what virus family is measles in?
paramyxo (RNA)
34
how does measles spread
respiratory droplets
35
kopliks spots
erythmatous mucosal spots annd small blue/white macules in measles that looks like grains of salt
36
onset of AI diseases
gradual: weeks to months | progressive
37
t/f. AI diseases cant be cured but can be controlled with corticosteroids
true
38
t/f lymphadenopathy is present in AI diseases
FALSE
39
tx for non-microbial mucositis
topical: dexamethasone, triamcinolone acetonide systemic: prednisone intralesional: trimcinolone acetonide (inject 10-40 mg)
40
prednisone tx for non-microbial mucositis
30-60mg A.M.a for 5 days followed by 20mg AM QOD
41
cause of erosive lichen planus
immune abnormality involving T lymphocytes lichenoid drug rxns GvH rxns
42
features of erosive lichen planus
erythmatous ulcers with white striae along periphery vesicles are rare bilateral; focal or generalized
43
etiology of pemphigus vulgaris
autoabs to intercelluar protein in desmosomes
44
features of pemphigus vulgaris
fragile blisters that rupture easily, multifocal
45
nikolsky sign
able to induce an ulceration by touching or blowing air on it sometimes presents in pemphigus vulgaris
46
microscopic features of pemphigus vulgaris
tzanck cells | direct immunofluorescence on biopsy
47
2 biopsy specimens needed for pemphigus vulgaris
1 submitted in formalin, the other in michels solution
48
tx for pemphigus vulgaris
corticosteroids: | dexamethasione, trimcinolone acetonide, prednisone
49
mucous membraine pemphigoid etiology
abs against basal lamina (hemidesmosomes) that attack the conjunctiva (eye)
50
where do pemphigoid lesions occur
conjunctiva (may cause blindness)
51
tx for mucous memb pemphigoid
corticosteroids: | dexamethasone, timcinolone acetonide, prednisone
52
etiology of bullous pemphigoid
autoabs against basal lamina
53
t/f bullous pemphigoid is the most common AI blistering condition
true
54
BP compared to MMP
BP more limited (skin) with NO scarring
55
SLE
multisystem diesase with increased activity of B cells and abnormal T cell function
56
CCLE
chronic cutaneous lupus erythematosus or "discoid lupus" | confined to skin and oral cavity
57
SCLE
subacute cutaneous lupus (intermediate lupus)
58
SLE effects what organs
kidneys (kidney failure) | heart (cardiac involvement)
59
CCLE features
scaley erythematous patches on skin, scarring and pigmentation
60
SCLE features
no scarring or pigmentations, renal changes absent with arthritis
61
chronic desquamative gingivitis presents as
diffuse sloughing of gingiva
62
acute erythematous candidosis features
most common form generalized pain, burning and erythema follows broad spectrum antibiotics
63
chronic erythematous candidiasis is seen in
denture wearers | "denture stomatitis"
64
t/f denture stomatitis may not be caused by candida
true
65
other features included in denture stomatitis
poorly fitting dentures, prolonged wearing of denture, poor hygiene
66
t/f angular chelitis typically occurs with reduced vdo but does not have to be
true. (saliva pools in the corner of the mouth)
67
microbes associated in angular chelitis
20% candida alone, 20% s. aureus alone, 60% candida and s. aureus
68
microbe causing syphilis
treponema palladium
69
primary phase of syphilis
chancre at site of innoculation, solitary lesion
70
secondary syphilis
cutaneous rash, condyloma lata
71
tertiary syphilis
cns and cv probs
72
hutchinsons triad
hutchinsons teeth, ocular intersitital keratitis, 8 nerve deafness
73
apthous ulcers have what kind of reaction
t-cell mediated immunologic rxn | canker sore
74
types of apthous ulcers
minor, major, and herpetiform
75
apthous ulcers are found on what type of tissue
non keratinized
76
features of minor apthous ulcers
size bt 3-10mm heal in 1-2wks no scarring
77
features of major apthous ulcers
size bt 1-3cm heal up to 6 wks more frequent recurrence may cause scarring
78
features of herpetiform apthous ulceration
non keratinized (herpes in on keratinized) size 1-3mm heal in 7-10 days
79
microscopic features of apthous ulcers
cant see anything: biopsy is not diagnostic | diagnosis is based on history and clinical features
80
tx of apthous ulcers
mild: corticosteroids major: more potent steroids
81
behcets syndrome
serious multisystem disease that consists of apthous like oral ulcers, genital ulcers, ocular inflammation, and skin pustules
82
erythema multiforme
acute onset AI disease with unknown cause with blistering, ulcerative mucocutaneous condition black necrotic tissue on lips
83
in 50% of cases, erythema multiforme is preceded by
herpes or pneumonia
84
forms of erythema multiforma
minor, major, and toxic epidermal necrolysis
85
features of erythema multiforme
``` ACUTE ONSET (key feature) target lesion (erythematous macule) diffuse painful oral ulcers ```
86
stevens johnson syndrome
more severe erythema multiforme with lesions that involve skin, conjunctiva, oral mucosa, and genital mucosa
87
granulomatosis with polyangiitis
granulomas around bvs glomerulonephritis systemic vasculitis
88
c-ANCA test
test for ab in Granulomatosis with polyangiitis
89
if a pt has chrons, what should you warn them of
ulcerations could also manifest in the mouth as well as the GI sys
90
erythroplasia/plakia
asymptomatic, persistent, red, or red/white lesion not ulcerated microscopically diagnosed
91
erythroplasia can be diagnosed as
dysplasia, carcinoma-in-situ, or superficial squamous cell carcinoma
92
what should you include in a differential with pemphigoid
pemphigus, erosive luchen planus, lupus, and erythema multiforme
93
how can you clinically differentiate erythema multiforme from pemphigus, pemphigoid, erosive lichen planus, lupus
erythema multiforme is acute onset

oral path 1 (11 decks)

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