Brainscape's Knowledge GenomeTM

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


See full index

BDS4 Oral Medicine > Ulceration > Flashcards

Ulceration Flashcards

1
Q

What is ulceration

A
  • localised deffect of surface mucosa
  • results in area of exposed connecitve tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the different between ulcer and erosion

A

erosion is more superficial

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

What are the main causes of ulceration

A
  • infective
  • traumatic
  • idiopathic
  • associated with systemic disease
  • associated with dermatological diseases
  • neoplastic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What viruses can be linked to ulceration

A

Most commonly herpes & coxsackie

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

What herpes viruses can cause oral ulceration

A

Herpes simplex
Ebstein-barr virus
Varicella zoster virus

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

When herpes reactivates and causes oral ulceration, what is this referred to as

A
  • recurrent herpetic lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What viruses can cause the recurrent herpetic lesions

A

HSV1, HSV2, Zoster (shingles)

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

How does the recurrent herpetic lesions present

A
  • ulceration is limited to one nerve group/branch on one side
  • usually in hard palate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How can you differentiate the viral cause in recurrent herpetic lesions

A
  • pain suggests shingles –> tend to experience discomfort before vescicles burst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What should we use to treat recurrent herpetic lesions

A

*aciclovir (systemic)
give prophylactially if severe issue

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

What is the aciclovir prescription for HSV

A
  • for immunocompromised & severe infections
  • 200mg, 5 times daily, 5 day regiment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the aciclovir prescription for herpes zoster - shingles

A

800mg
5 times daily
5 day regimen

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

What disease does coxsackie virus cause

A

hand foot and mouth disease
common childhood illness

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

What bacterial conditions result in ulceration

A

NUP/NUG

P.intermedia, fusobacterium and more associated

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

What is the most common traumatic cause for ulcers

A

mechanical e.g sharp cusp

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

What criteria should be fulfilled to be certain an ulcer is caused by trauma

A
  • identify cause of trauma
  • does the cause fit the size, shape and site of the ulcer
  • on removal of the cause, there should be signs of healing within 10 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When is a biopsy indicated for traumatic ulcer

A

no healing seen within 10 days

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

What are the types of trauma other than mechanical that could result in ulceration

A
  • chemical
  • acute thermal trauma - common in palate
  • radiotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Should traumatic ulcers be recurrent

A

should be single episode
unless source not removed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is recurrent apthous stomatitis

A
  • particular type of ulceration which is recurrent and generated by an immunological process in the epithelium and connective tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the 3 types of ulcers

A
  • minor apthous
  • major apthous
  • herpetiform

diagnose based off worst ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What size are minor apthous ulcers

A

<10mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How long do minor apthous ulcers usually last

A

2 wks
usually heal with no scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What tissues do the minor apthous ulcers effect

A

Non keratinized
* cheek
* ventral surface of tongue
* floor of mouth
* lip
* soft palate

25
Q

What is the presentation of the minor apthous ulcer

A

grey/yellow base with erythematous margins

26
Q

Do minor apthous ulcers respond to topical steroids

A

yes
good response

27
Q

If a patient asks for the prognosis of their minor apthous ulcers, what can you advise

A

the longer they are ulcer free
the lower hte morbidity

28
Q

What is the most common type of apthous ulcer

A

minor

29
Q

What size are major apthous ulcers

A

> 10mm

30
Q

Where do major apthous ulcers appear

A
  • keratinized and non keratinized tissue effected
  • can occur anywhere
31
Q

How do the major apthous ulcers heal

A

may heal with scarring
tend to extend into deeper tissues
tend to recur in less than monthly intervals meaning less time ulcer free

32
Q

How do major apthous ulcers present

A

crater like ulcers
rolled margins
margins are indurated on palpation due to underlying fibrosis

33
Q

How do major apthous ulcers respond to topical steroids

A

poor response

34
Q

What is herpetiform ulceration

A

multiple small pinhead sized ulcers (1-2mm)

35
Q

How long do herpetiform ulcers take to heal

A

2 weeks

36
Q

Why can herpetiform ulcers be difficult to diagnose

A

the small ulcers can join together to resemble large ulcers
in the early stages it can resemble primary herpetic gingivostomatits

37
Q

Where does herpetiform ulceration occur

A

only on non keratinized

38
Q

How can you diffentiate herpetiform ulceration and primary herpetic gingivostomatits

A

PHG involves keratinized and non-keratinized tissues
HU only non-keratinized

39
Q

What are predisposing factors for apthous ulcers

A
  • genetic predisposition
  • systemic disease
  • stress
  • mechanical injury
  • deficiency - haematinic deficiency often implicated
  • viral/bacterial infection e.g streptococci, adenovirus & VZV
  • hormones
40
Q

Describe the immunopathology for apthous ulcers

A
  • the process occurs at the epithelium/connective tissue junction i.e the basement membrane
  • the ulcers occur as the basal cells are damaged and dont produce further epithelial replacement cells
  • the existing cells move up the surface and an ulcer will appear as no new cells are present
41
Q

What investigations may you do for an ulcer

A
  • blood test
  • allergy test
42
Q

What things would you test in the blood

A
  • haematinics
  • coeliac disease
43
Q

What is the management of ulcers

A
  • correct any deficiency
  • refer for investigation if coeliac is positive
  • avoid dietary triggers and SLS toothpaste
  • prescription
44
Q

What can you prescribe to a patient with ulcers

A
  • chlorhexidine/hydrogen peroxide mouthwash - for OH when pain prevents
  • tetracycline mouthwash can be useful in RAS
  • benzydamine mouthwash/spray or lidocaine ointment/spray for LA
  • topical steroids
45
Q

What is the prescription for tetracycline mouthwash

A

doxycycline tablets
dissolve in water to create mouthwash

46
Q

Who should tetracycline mouthwash not be prescribed to

A

<12
pregnant women
hepatic problems
warfarin px

47
Q

Who should steroid therapy be prescribed to

A
  • those with disabling lesions
48
Q

What steroids can be prescribed to px with ulcers

A
  • beclometasone pressurised inhaler
  • betamethasone tablets (mouthwash)
  • hydrocortisone oro-mucosal tablets
49
Q

When can children commonly experience apthous ulcers

A
  • periods of rapid growth
  • 8-11 and 13-16 most common ages
  • usually respond to iron
50
Q

What is Behcets syndrome characterised by

A

RAS & at least two of the following
* genital ulcers
* eye lesions
* skin lesions
* rapid acute inflammation to minor trauma
* joint problems

51
Q

What is the management of behcets

A
  • tx RAS
  • systemic immunomodulators
  • involve rheumatology
52
Q

How does crohn disease ulcers present

A
  • mixture of ulcer types
  • apthous type ulcers associated with haematinic deficiency
  • linear ulcers present at depth of sulcus
  • full of crohn’s associated granuloma
  • persist for months
53
Q

What is the ulcer history

A
  • where
  • size/shape
  • blister or ulcer
  • how long for? Each individual ulcer should not last >2 wks
  • recurrent?
  • painful?
54
Q

What should you look at in examination

A
  • margins
  • base
  • surrounding tissue
  • systemic illness/any other symptoms
55
Q

How can the margins of an ulcer appear

A
  • flat
  • raised
  • rolled
56
Q

How can the base of an ulcer appear

A
  • soft
  • firm
  • hard
57
Q

How can the surrounding tissue of an ulcer appear

A

inflamed
keratotic
normal

58
Q

When should you refer a px with ulcers

A
  • try to arrange simple investigations in primary care
  • give topical tx (non steroidal for infrequent ulcers and steroid based for more disabling lesions)
  • refer after these have been achieved with no good result or if they are <12 YO

BDS4 Oral Medicine (17 decks)

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