week 2-teeth Flashcards
1
Q
what can poor oral hygine lead to?
A
GI, cardiovascular, respiratory and immune problems
2
Q
what is halitosis?
A
breath odar
3
Q
what does faintly sulferous breath indicate?
A
liver failure
4
Q
what does sweet breath indicate
A
diabetic ketoacidosis
5
Q
what does ammonia breath indicate?
A
renal failure
6
Q
what is fetor oris?
A
bad breath originating in the mouth that may be associated with appendicitis
7
Q
what is xerostomia
A
dryness of the mouth
8
Q
what can cause xerostomia?
A
mouth breathing, dehydration, diuretics, salivary disease, sialoliths
9
Q
what can a dark line on gingiva indicate?
A
heavy metal poisoning.
10
Q
Bruxism?
A
clenching and grinding of teeth
11
Q
what should we look for on teeth?
A
wearing down, cracks, loss or decay
12
Q
petechiae
A
broken capillary blood vessels
13
Q
what should we look at tongue for?
A
oral cancers, tongue movements, enlargement, papillae
14
Q
What are the 6 diagnoses that are possible on the lips?
A
Recurrent herpes labialis, carcinoma, mucocele, chelitis and angular chelitis
15
Q
what causes herpes labialis?
A
HSV 1
16
Q
characteristics of herpes labialis?
A
Prodrome itch or burn 12-36 hours, cluster of vesicles, rupture, crusting
17
Q
what is a trigger for reccurent herpes labialis
A
UV light, stress, trama, menstruation,
18
Q
what is a concern for those with herpes labialis?
A
auto inocculation to skin or eyes
19
Q
what type of cancer is ususally of the lip?
A
squamous cell carcinoma
20
Q
does squamous cell carcinoma spread?
A
High risk of metastasis
21
Q
what does SCC lip lesion look like?
A
painless, sharp edges, doesnt heal, grows slow, can bleed
22
Q
what is DDx for SCC of the lip?
A
may look like a plaque or verrucous
23
Q
how would SCC be diagnosed?
A
biopsy
24
Q
what is a mucocele?
A
soft cyst, mucin filled cavity with mucus glands lining cavity,
25
where is a mucoele most common
lip, and under tongue
26
what is the cause of a mucoele?
minor injury to ductal system of labial or sublingual salivary gland
27
main features, of mucoele?
clear or bluish bubble, movable, 1-2cm, it can burst and reappear
28
what is chelitis?
chapped lips
29
what could cause chapped lips?
wind burn, allergies, lip licking and retinoids
30
danger of chapped lips?
may become infected
31
what is angular chilitis?
deep cracks at labial commissure , spits, bleedin and shallow ulcers possible.
32
what could cause angular chilitis?
ill fitting dentures, bite change, poor oral hygine, dry mouth, Deficiency of B2, B12 and iron def anemia
33
what lab would be used to confirm angular chelitis?
KOH to rule out candida
34
what is plummer vinson syndrome
syndrom with chelitis, iron def anemia and upper esophagus web
35
what are the 16 mouth diagnosis?
oral lichen planus, leukoplakia, erythoplakia, oral SCC, Melanoma, fordyce spots, stomatitis, oral candidiasis, pseudomembranous stomatitis, recurrent apthous stomatitis, minor-major form apthous ulcers, herpetiform ulces, heretic gingivostomatis, oral erythema multiforme, chancer
36
oral lichen planus looks like what?
non erosive, lace like white papule or streak, like white marbling
37
where is oral lichen planus mostly?
buccal to gingival margin, so inner cheek mostly
38
what should you try to help confirm oral lichen planus?
try to wipe it off, it should not wipe off.
39
What is leukoplakia?
white patches or plaques that cannot be wiped off
40
where can leukoplakia be found?
all over the mouth.
41
why would we biopsy to confirm leukoplakia?
to make sure it isn't SCC, verrucous carcinoma etc.
42
if something looks like leukoplakia but wipes off, what could it be?
candidiasis or an asprin burn
43
Characteristics of leukoplakia patches?
white, grey or yellowish, flaking paint so sort of thick., may be rough if palpable
44
what can cause leukoplakia
trauma, dentures, tobacco, alcohol, syphilis, vit deff, endocrine, AIDs
45
erythroplakia is what
red macule or plaque with a soft texture and and demarcated edge
46
what is concerning about leukoplakia
precancerous hyperplasia of squamous epi, may turn to cancer slowly
47
what is concerning about erythroplakia?
precancerous cancer in 40%of cases
48
what causes erythroplakia?
unknown but its from epithelial displasis
49
Oral squamous cell carcinoma looks like what?
has red border, may look like leukoplakia or erythroplakia, and be ulcerated.
50
what could be the first indication of oral SCC?
mass in neck.
51
who gets oral SCC
smokers, alcoholics and HPV 16
52
why is it importaint to biopsy any persisten papules, plaques, erosions or ulcers?
SCC
53
Melanoma looks like what
pigmented lesions, assymetric, irregular border, variable color, diameter increasing, and E
54
DDX for melanoma is what?
oral melontic maccules
55
what happens if you press on a melanoma?
it doesn't blanch
56
what are fordyces spots?
benign neoplasm from sebaceous gland, they look like little grains
57
what do fordyce spots look like?
white to yellow tiny 1-2mm papules that are in a cluster, thinning as they move away.
58
when are fordyce spots more common
20-30yo
59
what is a stomatitis?
inflammation of oral tissues from local or systematic conditions.
60
what def could cause stomatitis?
vit B, vit C, iron.
61
what is oral candidiasis also called
thrush
62
what is oral candidiasis and what is it caused by?
oral fungal infection by candida albicans, glabrata or tropicalis.
63
what does oral candidiasis look like
slightly raised soft white plaque that may have burning sensation associated with it.
64
how could you make sure that oral candidiasis wasn't leukoplakia?
oral candidiasis wipes away altough it may cause a bit of bleeding.
65
how could you confirm oral candidiasis?
KOH prep
66
what would recurrent persistent oral candidiasis warrant?
immune status evaluation
67
what is pseudomebranous stomatitis?
inflammatory reaction, produces a membrane like exudate
68
what are some symptoms that go along with pseudomembrane stomatous
can be localized but may have feaver, malaise also
69
what would cause pseudomembranous stomatitis?
chemical irritants or bacterial infections.
70
what is a recurrent apthosus stomatitis?
acute necrotizing ulcerations or oral mucosa - cancre sore,
71
description of apthosus stomatitis
painful, round/oval, grey shallow ulcers with red boarder on movable mucosa
72
can apthosus stomatitis have a prodrome
yep, burning or tingling
73
what may cause apthosus stomatitis?
trama, tooth brush, bite, allergies to food or chemicals, stress, celiac IBS
74
what def could cause apthosis stomatitis?
Vitamin B12, Iron, and Folic acid. This is slightly different from stomatitis in general
75
what could possible mediate apthosis stomatitis?
T-cell mediated is possible
76
what are the three types of apthous ulcers?
herpetiform ulcers, minor form aphthous and major form aphthosus.
77
what type of aphthous ulcers are more common in childhood
minor form aphthous ulcers
78
what type of aphthous ulcers are more common after puberty
major form aphthous ulcers.
79
how long do mino aththous ulcers last
up to 7-10 days without scarring
80
how long to major apthosis ulcers last?
up to 6 weeks with scarring
81
size of minor aphthous ulcers
less than 1 cm and are oval
82
size of major aphthouss ulcers
up to 2 cm with ragged edges
83
color of minor for aphthous ulcers
yellow grey wit yellow raised border with red halo.
84
what is the most severe form of mouth ulcers?
herpetiform ulcers
85
what form of apthous ulcers are more common in females with adult onset
herpetiform ulcers
86
what do herpetiform ulcers look like
multiple pinpoint lesions under 3mm each in clusters that combine into ulcers.
87
how long do herpetifor ulcers last?
less than 1 month
88
which of the aphthous ulcers are singular
minor aphthous ulcers
89
DDx for herpetiform ulcers 5?
trauma, pemphigus vulgaris, cictrical pemphigoid, crohns, sprue
90
what is herpetic gingivostomatitis
cold sore also caused by HSV-1
91
does herpetic gingivostommatitis have prodromal symptoms?
yes, pain burning, feaver, maliase
92
what do herpetic gingivostomatitus lesions look like
eruption of vesicular lesions with an erythematous base that crusts
93
what mouth surface are gingivostomatitus lessions located on?
unmoveable oral mucosa
94
how long do oral cold sores last
1-2 weeks, maybe with fever
95
how are oral cold sores, herpetic gingivostomatitus diagnosed
Tzank smear, immunofloroesence, viral culture.
96
what could herpetic gingiovostomatitus DDX
apthous stomatitis, erythmatous multiforme, drug eruptions, pemphigus
97
Oral erythema multiforma is what
hypersensitivity reaction to HSV, organisms , drugs or idiopathic
98
what does erythema multiforma look like?
painfull stomatitus, sudden hemorrhagic vesicles with bullae and red base that burst leaving painful crusting.
99
does erythema multiforma have prodrome
sinusitis and rhinitis
100
other symptoms with erythema multiforma
high fever 4-5 days, severe systemic symptoms, and target lesions on rest of body
101
what could erythema multiforma DDX
apthous stomatitis, allergic stomatitis, pemphigus, herpes.
102
how could you tell that erythema multiforma isnt herpes?
I would look for the target lesions to confirm EM, and herpies is either on vermilian border ofouter lips or immovable mucosa , EM is on lips or any mucosa
103
how would you differentiate between erythema multiforma and apthous stomatitis?
aphthous stomatis all versions have ulcers without crusting
104
what is a Chancre
single ulcerated lesion formed during primary stages of syphillis
105
characteristics of Chancre
painless, single, no central necrotic tissue
106
how can we tell that a chancre isn't a aphthous stomatitis of some sort?
chancre doesn't have necrotic tissue in the center
107
what is the bacteria that causes canchre, syphillis
treponema pallidum
108
where can chancre be found
lips tongue or genitals, so if you find one, check genitals also
109
how can syphillis be diagnosed?
PCR
110
what are 5 more mouth irritation inflammation diagnoses
Frictional hyperkeratosis, epulis fissura, denture sore spot, irritation fibroma
111
what causes frictional hyperkeratosis
chronic friction from biting or dentures
112
what does frictional hyperkeratosis look like?
white, hyperkeratotic lesions, may be white like where teeth meet. Can look like leukoplakia
113
what should you do if unsure if its frictional hyperkeratosis
biopsy and concider it idiopathic leukoplakia
114
epulis fissura is what?
denture caused hyperplasia,
115
what does epulis fissurea look like
painless folds of tissure with denture edge impression, can be red or ulcerated.
116
what is texture of epulis fissurea?
firm or spongy
117
what does denture sore spot look like
ulcers, painful, overlying grayish necrotic membrane surrounded by red halo.
118
denture sore mouth?
exreamly red mucosa, under dentures, sharp demarkation, burning senstioan
119
what probably causes denture sore mouth
allergy to acrylic or denture glue, fungal infection
120
irritation fibroma is what
Painless swelling less than 1cm that is lighter than rest of mucosa on buccal, lat tongue or lower lip.
121
when is irritation fibroma most common?
20-49yo
122
what is the texture of irritation fibroma?
firm resilient or soft and spongy.
123
how is irritation fibroma DDx?
location - tongue, neurofibroma, granular cell tumor, lower lip buccal, lipoma, mucocele or salavary gland tumor
124
how would you determin its irritation fibroma not mucocele?
color of mucocele is clear or bluish and its 1-2cm so its larger
125
how would you determin its irritation fibroma not a lioma
color of lipoma is yellowish and made of fat, irritation fibroma is just swelling
126
what are 7 other mouth edema and other things
angioedema, hereditary angioedema, palatal/mandibular torus, hemangioma, varicosities, papilloma, lipoma,
127
what is angioedema
acute swelling of skin, mucosa and submucosa with rapid onset.
128
signs and sx of angioedema
painless, non puritis, non pitting, well circumscribed rapid onsed. , there may be itchy rash Edema.
129
what causes angioedema?
Allergic response, but not IgE, food, medication, stress, infection and autoimmuned disorders
130
why is angioedema a concern?
it may obstruct airway causing death
131
Hereditary angioedema
edema that is rare, autosomal dominant of face, airway hands and feet without an itch.
132
what can accopany a hereditary angioedema attack?
abdominal pain, vimiting, diarrhea and NON itchy rash
133
what is palatal or mandibular torus?
nodular bone protuberence, slow growing on upper or lower palate
134
who is most likely to get torus?
women before age 30
135
Hemangloma is what
proliferation of blood vessesl.
136
what does hemangloma look like?
flat or raised but deep red or bluish red, similar to blood blister
137
what is DDX for hemangloma
artervenous fistula if histry of trauma
138
concern for hemangloma
infection if its in a spot that causes biting.
139
varicosities are what
dilated tortuous veins in oral cavity, varicose veins.
140
what would cause mouth varicosities
increased hydrostatic pressure and poor tissue support
141
Papilloma is caused by what
HPV
142
what does papilloma look like
wart less than 1 cm, well circumscribed, pedunculated benign growth.
143
DDX for papilloma
verruciform xanthomas
144
lipoma is what?
painless benign slow growing mass of adipos tissue on cheek or tongue
145
what does lipoma look like
yellowish, tis rubbery and mobile
146
what are the 4 conditions of the salivary glands?
sialadenitis, sialolisthesis, sjogrens syndrome, xerostomia
147
what is sialadenitis
benign swelling seen in many systemic diseases ,infections etc.may or may not be painful
148
example that wiould have sialadenitis?
mumps,
149
what is sialolisthesis
salivary duct stones causing swelling associated with eating
150
what is sjogrens syndrome
systemic inflammation that is associated with dry eyes, mouth and mucus membranes
151
what can cause Xerostomia
drugs, diruetics sjogrens, dehydration mouth breating
152
why is xerostoma concerning
contributes to tooth decay
153
what are 6 concerns for teeth and gums?
gingivitis, vincents angina, periodontitis, caries, toothache , tooth loss,
154
what is gingivitis?
inflammation of gums with redness pocket formation,
155
signs and symptoms of gingivitis
bright red and swolen, receding gums, painless unless pressure, easily bleed.
156
prevention of gingivitis
good oral hygine,
157
what can cause gingivitis?
poor oral hygine, food impaction, mouth breething, drugs, phenytoin, and nifedipine
158
what two drugs are known to cause gingival hypertrophy
dilantin, phenytoin, and nifedipine
159
what is vencents angina
trench mouth, acute infection of gingiva
160
what causes vincints angina?
fusiform bacteria and spirochetes, poor hygine, stress, malnutrition
161
where is vincents angina most common
smokers, alcholicis and HIV
162
signs and symptoms of vincents angina
progressive, painfull infection with ulceration, swelling and sloughing off of dead tissues, effecting all gum tissue, bad odar. Punched out
163
what is peridontitis
infection of peridontium, inflammation of peridontal lig. Gingival cememtum and alveolar bone
164
what causees peridontitis, etiology.
progressive gingivitis, that allows for growth of anerobic bacteria in pockets that leads to bone loss.
165
risks of peridontis
poor hygine, diabetes II, leukemia, Chrons disease
166
signs and symptoms of peridontis
no pain unless acute, food impaction, tooth tender to percussion, visible plaque, red swollen gums with exudate.
167
what causes dental caries
bacteria in plaque release acids that erode enamel.
168
why do meth users lose their teeth
xerostoma, bruxism, poor nutrition and hygine.
169
symptoms of carries
pain with hot, cold , sweet or beverages.
170
what are serious concomitant symptoms with toothache?
headache, fever, swelling, tenderness at floor of mouth, CN abnormalities.
171
what can cause tooth ache
caries, peridontitis, wisdom teeth, teething, sinusitis
172
what should our response to apical absess be?
urgent dental referral
173
response to ludwigs Angina?
emergency room
174
Resonse to cavernous sinus thrombosis?
emergency room
175
what would an apical tooth absess look like?
infection of deep root, severe pain with possible swelling of mucosa over tooth.
176
what is ludwigs angina
cellulitis (skin infection)of mouth floor from infection
177
SSX of ludwigs angina
swelling, maliase, fever, dysphagia, stridor
178
SSX or cavernouus sinus thrombosis
headache, vision change, paralysis of cranial nerves.
179
what can cause cavernous sinus thrombosis
staph or strep infection that can clead to blood clot in cavernous sinus
180
why would adults lose teeth
trauma, decay, gum disease, meth
181
what are some problems with the tongue
difficulty moving, deviation, taste abnormalities, color changes, pain, hair, tremor, furrows, dry. Smooth, enlarged
182
what would cause deviation of tongue
CN XII, hypoglossal parylasis
183
what would cause tast abnormalities
facial or glossopharyngeal CN damage, medication side effect, trauma,
184
what def can cause taste abnormalities
B3, Zn deficiency
185
what conditons can cause taste abnormalitys
bells palsy, MS.
186
what is a geographic tongue?
localized area loss of filiform palille, leaving red patches with white or yellow borders.
187
DXX for geographic tongue?
leukoplakia, candidiasis, psorisis, lichen planus
188
white or yellow tongue from what
local irritation
189
what def can cause a red tongue
folic acid and B12
190
what conditions can cause a red tongue
celiac, scarlet fever, pellagra.
191
Hyperpigmentation of tongue
drugs, addisons disease
192
what causes a hairy tongue?
hyperplasia of filiform pa;illae.
193
what may cause hairy tongue?
oxidizing mouth wash, poor oral hygine, AIDs, drugs, tobacco
194
what can cause tongue pain
trauma, smoking, neuropathy, cancer, ulcers, leukoplakia, menopause burning tongue, dentures, refered pain from heart
195
Why can tongue tremor be a concern?
neurological disease of lower motor neurons, brain stem lesions or hypoglossal neuropathy.
196
what can a fine tongue tremor indicated
hyperthyroidism
197
what can a course tremor indicate
nervousness
198
what furrows in tongue are congenital
deep transverse
199
what should you concider with deep midline tongue furrows
dehydration of syphilis
200
dry tongue with furrows
dehydration
201
dry tongue without furrows think what
sjogrens
202
what does atrophic glossitis look like
atrophy of filiform papillae small, smooth glossy tongue that may be red and painful.
203
what could cause atrophy of filiform papillae
Low HCL, B12, folic acid, iron and proteind def., celiacs
204
What could cause enlarged tongue
allergic reactions, leukemia, downs, pellagra, strep
205
Glossitis is what
acute or chronic inflammation of tongue
206
what may indicacate pernicious anemia
inflammed tongue that is pale.
207
firey red tongue may indicate what?
B vit def.
208
throat conditions
acute pharyngitis, viral pharyngitis, bacterial pharyngitis, diptheria, tonsilitis, peritonsilar absess, arapharyngeal absess, retropharyngeal abscess, pharnyx infection, velopharyngeal insufficency, malignancies in pharynx
209
what type of pharyngitis is very common
viral, 90 percent of the time
210
what are two comon viral infectons that cause pharyngitis
adenovirus and epstin barr virus, mono)
211
adenovirus pharyngitis
throat is NOT red,no fever, painful, runny nose, modest node enlargment, 24-48 hour to get sore
212
Infectious mono
No fever, exudative tonsilitis, kissing tonsils, signifigant node swelling, splenomegaly, fatigue, weight loss,
213
what labs to detect mono?
CBC that show abnormal lymphocytes, and monospot
214
what is different between bacterial and viral pharygitis
bacterial onset is faster, fever, redder throat, and larger nodes
215
what is intersting about viral pharyngitis throat?
cobbelstoning
216
what does bacterial pharyngitis look like
beefy red, unilateral swelling, quick onset, high temp, headache,
217
what causes most bacterial pharyngitis?
Group A streptococus
218
what questions to determine GAS for bacterial pharyngitis?
Modified center criteria, absence of cough, tenter ant cervical, exudate gram stain culture.
219
what does rapid strep test do?
positive rules in strep, a negative doesn not rule out strep.
220
what is modified center criteria good for
terrible at ruling in, but good at ruling out strep.
221
what is dipthera caused by
corneybacterium mostly in other countries.
222
what does diptheria look like?
dirty grey speudomembrain, dyspenea, low fever, nausea and vomiting.
223
how is diptheria diagnosed?
gram stain.
224
what is complication of diptheria
myocarditis, NS toxicity
225
what is tonsilitis
acute inflammation of palatine tonsils
226
SSX of tonsilitis
sudden onset, hight fever, malise, vomiting, bad breath, enlarged tonsil, exudate
227
what causes tonsilitis
Bacterial, group A strep, viral, EBV , adenovirus
228
what are complications of tonsilitis?
peritonsilar absess, tonsillotolithis, hypertrophy of tonsils
229
what is peritonsilar absess?
absess between tonsil and pharyngeal constrictor muscle.
230
complications of strep
Pandas pediatric autoimmune neuropsychiatric disorder associated with strep, Rheumatic fever, toxic shock, glomerulonephritis
231
signs of peritonsilar absess?
worsening unilateral sorness that can be seen from INSIDE, fever, headache, high fever, limit mouth opeing
232
what is parapharyngeal absess
absess lateral to superior constrictor muscle and close to corodid
233
sign of parapharyngeal absess?
seen from OUTSIDE, swolen anterior triangle ofneck
234
what should we do if we see parapharyngeal absess
I don't know, its super serious, refer?
235
what should we do if we see a retropharyngeal abscess
refer to ER, medical emergency, including airway complcations.
236
whhat is retropharyngeal abscess
infection of deep space in neck., infection spreads from nose ,ears, sinus etc.
237
SSX or retropharyngeal abscess
pain, sore throat, pain on swallowing, jaw stiffness, lump in throat, chills, fever,
238
chronic irritatio nof pharynx causes what
cobbelstoning
239
what is velopharyngeal insufficiency?
incomplete closure of sphincter between oro an nasal pharyns, inpaired speech andeating.
240
what is the most common malignancy in the pharynx?
SCC
241
what does pharynx malignancy look like
mass in neck, pain by abnormal throat sticking, tumor is red smooth and can look similar to erythoplakia
242
what is hoarsness
structural changes to vocal cords that impair ability to vibrate.
243
why would child be horse
vocal abuse
244
laryngitis is what
hoarse voice or loss of voice because of vocal cord irritation.
245
what can cause laryngitis
infection, inflammation, coughing
246
what to do with epiglottitis
medical emergency, don?t examine
247
what is SSX of epiglottitis
fever, difficulty swallowing ,drooling, appers very ill and anxious.
248
who does epiglottitis mostly effect
2-5 yo
249
DXX for epiglottitis
group, peritonsilar abscess, retropharyngeal absess.
250
how would you know it was eppiglottitis not peritonsilar absess?
peritonsilar is after tonsilitis, rare in infants, droolin in eppi
251
how would you know it was epiglottitis not retropharangeal absess?
sore thhroat, jaw stiffness, for retropharangeal, still super serious!
252
vocal cord polyp
horseness, vocal abuse, allergies, irritants diagnosed by visualization and biopsy
253
what causes vocal cord contact ulcers
gastric reflux
254
what is the most common cancer in head and neck?
layrngeal scc
255
Lump in necks in kids?
tonsilitis, TB, brachial cysts
256
lump in adult necks
inflamatory or neoplastic nodules.
