SM_22b: Oral Cavity / Oropharynx Flashcards
Person reports a history of wearing glasses for vision deficit, cataracts, hearing loss, and joint hyperflexibility and has a child with cleft palate. This person has ____ syndrome
Person reports a history of wearing glasses for vision deficit, cataracts, hearing loss, and joint hyperflexibility and has a child with cleft palate. This person has Stickler syndrome.
Environmental risk factors for cleft lip and palate are ____, ____, and ____
Environmental risk factors for cleft lip and palate are maternal medication ingestion, exposures, and maternal disease
- Anticonvulsant medication
- Medications derived from retinoic acid
- Folic acid antagonists / deficiency
- Corticosteroids
- Tobacco / alcohol ingestion
- Maternal diabetes
Cleft lip and palate have ____ and ____ risk factors
Cleft lip and palate have environmental and genetic risk factors
- Association with syndromes: 30% of cleft lip ± palate and 50% of cleft palate alone
Stickler syndrome involves ____ and ____
Stickler syndrome involves cleft lip / palate and ocular abnormalities
- Ocular abnormalities: myopia, glaucoma, cataracts, retinal detachment (higher chance with some types)
- Hearing loss
- Defects in collagen genes
Van der Woude Syndrome involves ____ and ____
Van der Woude Syndrome involves lip / palate and lip pits
22q11 deletion syndrome is ____, and DiGeorge syndrome involves ____, ____, and ____
22q11 deletion syndrome is autosomal dominant, and DiGeorge syndrome involves absent thymus (immunodeficiency), hypocalcemia, and cardiac defects
Goldenhar Syndrome (hemifacial microsmia) results from ____ and commonly presents with ____ and ____
Goldenhar Syndrome (hemifacial microsmia) results from abnormal unilateral craniofacial development of 1st and 2nd branchial arch derivatives and commonly presents with auricular (middle / inner ear) abnormalities and cervical vertebral anomalies
CHARGE syndrome commonly presents with ____ and ____
CHARGE syndrome commonly presents with cleft palate and linear antihelical fold
- CHARGE: coloboma, heart defects, choanal atresia (nasopharynx), retarded CNS development, genitourinary abnormalities, and ear anomalies
Pierre Robin Sequence involves ____ and ____ and primarily presents as ____
Pierre Robin Sequence involves hypoplasia and retrognathia and primarily presents as airway distress in infancy
- Initiating insult: mandibular hypoplasia -> displacement of tongue superiorly -> abnormal palate development (clefting)
An 83 year old male hospitalized for dehydrattion develops unilateral parotid swelling and tenderness. You express purulence from the parotid duct. Most likely etiology of his parotitis is ____
An 83 year old male hospitalized for dehydrattion develops unilateral parotid swelling and tenderness. You express purulence from the parotid duct. Most likely etiology of his parotitis is infectious
Infectious sialadenitis results from ____ and ____ is a common risk factor in the elderly
Infectious sialadenitis results from stasis of secretions in duct and dehydration is a common risk factor in the elderly
- Other risk factors are postoperative, radiation / chemo, Sjogren’s
- Swelling of gland (ear proptosis if parotitis), warmth, erythema, tenderness, purulence at salivary duct
Mumps presents as ____, ____, ____, ____, ____, and ____ and is common in ____
Mumps presents as parotid swelling, orchitis, fever, malaise, headache, abdominal pain and is common on college campuses
Autoimmune sialadenitis includes ____ and ____
Autoimmune sialadenitis includes uveoparotid fever (Heerfordt’s syndrome) and Sjogren’s syndrome
Uveoparotid fever (Heerfordt’s syndrome) presents with ____, ____, ____, ____, and ____
Uveoparotid fever (Heerfordt’s syndrome) presents with uveitis, parotid enlargement, facial nerve dysfunction in 50%, sensorineural hearing loss, and fever
Post-obstructive sialadenitis most commonly results from ____ stones
Post-obstructive sialadenitis most commonly results from submandibular stones
- Higher incidence in gout and smoking
- 90% of submandibular stones appear on imaging
- 90% of parotid stones DO NOT appear on imaging
90% of ____ stones appear on imaging
90% of submandibular stones appear on imaging
90% of ____ stones DO NOT appear on imaging
90% of parotid stones DO NOT appear on imaging
Post-radiation salivary gland fibrosis occurs in at around ____ Gy exposure and can result in significant ____
Post-radiation salivary gland fibrosis occurs in at around 40-50 Gy exposure and can result in significant xerostomia (dry mouth)
(treatment is hydration and oral lubricants)
Pediatric obstructive sleep apnea is most commonly caused by ____
Pediatric obstructive sleep apnea is most commonly caused by hypertrophy of tonsils (palatine) and adenoids (in nasopharynx)
(sometimes lingual tonsils)
Pediatric obstructive sleep apnea is characterized by ____, ____, ____, ____, ____, and ____
Pediatric obstructive sleep apnea is characterized by increased systemic inflammation, insulin resistance, hypertension, increased cardiac load, attention deficit disorders, and behavior issues
Adult obstructive sleep apnea is most commonly caused by ____
Adult obstructive sleep apnea is most commonly caused by obesity
A 27 year old woman presents to your clinic with this color change. You would refer her to ____
A 27 year old woman presents to your clinic with this color change. You would refer her to Gastroenterology to rule out Puetz-Jeghers syndrome and gastrointestinal polyps
Oral cavity lesions can be categorized as ____, ____, or ____
Oral cavity lesions can be categorized as benign pigmented, infectious, or autoimmune / systemic
Focal white lesions on the tongue are ____
Focal white lesions on the tongue are leukoplakia (benign pigmented)
- 5-20% chance of premalignancy or malignancy
- Consider malignant etiology especially with history of tobacco, betel nut, alcohol use
- Can be due to local trauma (ill fitting dentures or appliances)
Focal red lesions on the tongue are ____
Focal red lesions on the tongue are erythroplakia (benign pigmented)
- 25% chance of malignancy
Anemia can manifest on the tongue as a ____ lesion
Anemia can manifest on the tongue as a benign pigmented lesion
Bismuth intoxication is ____
Bismuth intoxication is benign pigmented
- Commonly used to treat dyspepsia and gastritis
Lead intoxication is ____
Lead intoxication is benign pigmented
Peutz-Jeghers syndrome is associated with ____ and ____
Peutz-Jeghers syndrome is associated with gastrointestinal polyposis and increased risk of malignancy
(benign pigmented)
Black hairy tongue involves ____ and occurs due to ____, ____, and ____
Black hairy tongue involves elongated filiform papillae and occurs due to smoking, immunocompromise, and poor oral hygeine (benign pigmented)
Telangiectasia presents as ____ or ____
Telangiectasia presents as telangiectasias (capillary dilations) or arteriovenous malformation in respiratory tract, GI tract, brain and CNS, or liver
- Benign pigmented
- Epistaxis (nosebleeds), subclinical GI bleeds (resulting in anemia), hypoxemia, hemoptysis
Addison’s Disease involves ____
Addison’s Disease involves hyperpigmentation
Herpetic gingivostomatitis presents as ____, ____, ____, and ____ in primary infection and ____ in secondary infection
Herpetic gingivostomatitis presents as fever, malaise, anorexia and cervical adenopathy in primary infection and reactivation within trigeminal ganglion in secondary infection
- Reactivation triggered by UV light, pregnancy, stress, immunosuppression, trauma, surgery
- Treat with acyclovir and valacyclovir for prophylaxis in immunocompromised and acute treatment
Oral candidiasis results from ____, ____, ____, ____, and ____
Oral candidiasis results from long-term antibiotics, immunosuppression, local or systemic corticosteroids, radiation and chemotherapy, local irritation, and young / old age
____ and ____ branch at 90 degrees
Mucor and Candida branch at 90 degrees
____ branches at 45 degrees
Aspergillus branches at 45 degrees
Squamous papilloma due to HPV is the ____ of the oral cavity and is ____ and ____
Squamous papilloma due to HPV is the most common benign lesion of the oral cavity and is well demarcated and painless
Syphilis is the ____
Syphilis is the great imitator (can be primary, secondary, or tertiary syphilis)
Autoimmune causes of oral cavity lesions include ____, ____, ____, and ____
Autoimmune causes of oral cavity lesions include erythema multiforme, Stevens Johnson syndrome, lichen planus, and pemphigoid lesions
Behcet’s Disease is an ____ that presents with ____ associated with ____ and ____
Behcet’s Disease is an idiopathic vasculitis involving large and small vessels that presents with recurrent painful aphthous ulcers associated with genital ulcers and ocular inflammation
