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Clinical Med B > Oral cavity triggers > Flashcards

Oral cavity triggers Flashcards

1
Q

due to HSV 6

A

aphthous stomatitis

aka canker sore

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2
Q

stress as a major predisposing factor

A

aphthous stomatitis

aka canker sore

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3
Q

small ulceration with yellow-gray center that is painful. surrounded by red halos

A

aphthous stomatitis

aka canker sore

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4
Q

viscous lidocaine with topical steroids such as triamcinalone acetonide

A

aphthous stomatitis

aka canker sore

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5
Q

magic mouthwash

A

aphthous stomatitis

aka canker sore

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6
Q

tx options for aphthous stomatitis

A

Viscous lidocaine
Topical corticosteroids (triamcinolone)
Prednisone for 1 week if severe
Magic mouthwash

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7
Q

90% caused by HSV1 10% by HSV2

A

herpes gingivostomatitis (cold sore)

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8
Q

Can be caused by sunburn, oral trauma, stress or fever

A

herpes gingivostomatitis (cold sore)

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9
Q

small vesicles that rupture and form scabs that are associated with a burning sensation may present with CERCIVAL LAD

A

herpes gingivostomatitis (cold sore)

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10
Q

may present with cervical adenopathy, odynophagia, and drooling if severe

A

herpes gingivostomatitis (cold sore)

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11
Q

What are the three diagnostic options for herpes gingivostomatitis (cold sore)

A
  • clinical (MC)
  • PCR DNA test
  • Tznack Smear (shows multinucleated giant cells)
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12
Q

acyclovir and valcyclovir as tx

A

herpes gingivostomatitis (cold sore)

also seen in hairy leukoplakia

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13
Q

common in infants, HIV patients, people undergoing chemo

A

oral candidiasis (thrush)

also seen in:
denture wearers
DM
immunocomp
peopel on abx or steroirds

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14
Q

common in denture wearers, DM, or people on steroids or ABX

A

oral candidiasis (thrush)

also seen in:
common in infants, HIV patients, people undergoing chemo

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15
Q

Creamy white patches that can be scraped off with a tongue depressor.

A

oral candidiasis (thrush)

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16
Q

presents with a painful and burning tongue

A

oral candidiasis (thrush)

also seen in Glossodynia

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17
Q

presents with beefy red tongue

A

oral candidiasis (thrush)

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18
Q

Dx with a wet prep with KOH

A

oral candidiasis (thrush)

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19
Q

in what diagnosis would you want to boil pacifiers and bottle nipples after use and also treat the mothers breasts if she is breast feeding

A

oral candidiasis (thrush)

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20
Q

treatment with nystatin or fluconazole

A

oral candidiasis (thrush)

note: nystatin is in magic mouthwash! so its actually used alot

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21
Q

best diagnostic tool for herpes gingivostomatitis

A

tznack smear

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22
Q

found in elderly d/t maceration and in children d/t thumb sucking/drooling/lick lipping

A

Angular cheilitis
MC in elderly!

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23
Q

what diagnosis commonly has a secondary candidal infection

A

angular cheilitis dueto candidiasis infecting the open wounds

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24
Q

treatment with clotrimazole or miconazole

A

angular cheilitis for the secondary candidal infection.

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25
Q

smooth surfaced tongue

A

glossitis

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26
Q

caused by nutritional deficiencies, drugs, dehydration

A

glossitis

also seen in:
autoimmune reactions
psoriasis

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27
Q

caused by irritants, psoriasis, possibly autoimmune reactions

A

glossitis

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28
Q

inflammation of the tongue that does NOT present with pain

A

glossitis

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29
Q

treated with empiric nutritional replacement therapy

A

glossitis

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30
Q

loss of filiform papillae on te tongue

A

glossitis

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31
Q

burning sensation in the mouth with no known cause

A

glossodynia

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32
Q

most common in post menopausal women

A

glossodynia without glossitis

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33
Q

no specific treatment known. but clonazepam, TCAs and behavioral therapy are often used.

A

glossodynia

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34
Q

white patchy lesion that cannot be scraped off of surface

A

leukoplakia

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35
Q

hyperkeratosis occuring in response to chronic irritation such as by dentures or tobacco

A

leukoplakia

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36
Q

can be a precursor to dysplasia or invasive squamous cell carcinoma

A

leukoplakia

also erythroplakia which are 90% either dysplasia or carcinomas

37
Q

you must ALWAYS biopsy this oral disease if the patient reports a history of tobacco use?
why?

A

oral leukoplakia

to determine epithelial dysplasia or carcinomas

38
Q

only treatment known is srugical removal

A

leukoplakia
erythroplakia too!

39
Q

erythematous lesion(s) that can not be scraped off of the surface of the tongue

A

erythoplakia

40
Q

bright red patch with sharp margins on the floor of the mouth

A

erythroplakia

powerpoint description:
Fiery red, sharply demarcated patch on the floor of the mouth, ventral tongue, or soft palate.

41
Q

90% of these are dysplasia or carcinoma and therefore carry high risk for malignancy

A

erythroplakia

42
Q

pt presents with the side of his tongue showing a raised area that has “peach fuzz” on it

A

hair leukoplakia

definition in powerpoint: Slightly raised, leukoplakic areas with a hair surface, often on the LATERAL aspects of the tongue.

43
Q

commonly found in early HIV also is associated with EBV and long term steroid use

A

hairy leukoplakia

44
Q

no treatment is technically needed. HAART can be used. valacyclovir and acyclovir show modest improvement

A

hair leukoplakia

also can use topical podophyllin

45
Q

no treatment needed but can use topical podophyllin and antivirals

A

hairy leukoplakia
can also use HAART

46
Q

pt presents with a reticular white rash on her tongue that she reports started a while ago and has spread. when the rash first started it was PAINLESS. it is now PAINFUL

A

lichen planus

powerpoint description:
usually asymptomatic, pain progresses as rash does. reticular or lacey patterns of white lines, papules or plaques.

47
Q

there is no cure for this but can be treated with Clobetasol or triamcinolone (high potency topical steroids) 1st line

A

oral lichen planus

if severe treat with oral prednisone

48
Q

a patient with a white rash on tongue reports she was treated with a topical steroid “clobetasol,” however her symptoms have since gotten worse. you determine her status is now severe, what do you treat her with

A

first of all this is oral lichen planus

oral prednisone 4-6 weeks

49
Q

pt has a rash on her dorsal and lateral tongue with well demarcated areas that have “white scalloped” borders. when you go out to google what she has and come back, the rash has changed locations and pattern (creeeeeppppyyyyy and grooosss)

what does she have, how is it treated?

A

geographic tongue aka benign migratory glossitis

usually this is asymptomatic and there is no treatment necessary

50
Q

an african american male who reports a pMHx of addison’s disease presents with “something wrong with my tongue”

on further questioning he reports a hx of depression which he takes antidepressants for and uses pepto-bismol frequently.

what is likely wrong with his tongue?

A

black tongue

MC in darker skinned people

can be caused by:
tetracycline, linezolid, antidepressants, pepto bismol, PPIs and addisons disease

51
Q

retnetion of keratin on tips of filiform papillae

A

hairy tongue

52
Q

due to smoking, poor oral hygiene, TEA OR COFFEE (thats us, rip)

what is it and how is it treated

A

hairy tongue.

tx: improve oral hygiene, smoking cessation, USE A TONGUE SCRAPER

seriosuly this is just so gross

53
Q

calculus formation of a salivary duct

A

sialolithiasis

54
Q

MC in Wharton’s duct

A

sialolithiasis

can also be seen in stensen’s duct which drains the parotid gland

55
Q

elevated serum calcium can contribute to the development of this disease

A

sialolithiasis

precise reason unknown but tragnation of salivary flow and increased calcium contributes

56
Q

pt presents with complaints of pain when she eats that worsens when she is done eating. she also reports she has had some swelling to the inside of her mouth

what does she have? how would you treat her?

A

sialolithiasis

sialogogues or sour candy or maybe PICKLLLLESSSS! to increase salivary secretion! crazy.

also could use heat, massage and hydration!

if super severe or large stone you either have to incise the duct to remove it or remove the duct entirely

57
Q

CT is imaging of choice for diagnosis in this oral disease

A

sialolithiasis

58
Q

MCC is staph Aureus

A

suppurative parotitis aka sialadenitis

also caused by anaerobes and is often polymicrobial

59
Q

caused by mumps, flu, EBV, CMV

A

non-suppuratiev parotitis

60
Q

caused by CF, Gout, tumors, DM or alcohoolism

A

non-infectious parotitis

61
Q

seen in elderly postoperative pts who have been intubated or dehydrates

A

suppurative parotitis

also seen in :
recent intesnive teeth cleaning
anticholinergic use
malnutrition
ductal obstruction

62
Q

malnutrition, anticholinergic use and intensive teeth cleaning are all causes of

A

suppurative parotitis

63
Q

pt presents with unilateral face swelling that is worse after he eating. he also reports locking of the jaw and a fever of 100.9.

what does he have?
what will further PE and labs show?

A

he has suppurative parotitis

PE will show pus from opening of stensens duct w masssage

labs will show leukocytosis

64
Q

imaging of choice is ultrasound or CT

A

suppurative parotitis

65
Q

elevated serum amylase seen in which diagnosis

A

suppurative parotitis

66
Q

needle aspiration and culture of material in which diagnosis

A

suppurative parotitis

67
Q

tx for suppurative parotitis

A
  1. IV Nafcillin or 1st gen ceph PLUS metronidazole or clinda

if MRSA suspected use vanc

  1. once improvement is seen:
    oral clinda PLUS cipro
    OR augmentin alone
  2. surgical I&D if no response after 48hrs of IV abx
68
Q

can lead to respiratory obstruction, septicemia, and osteomyelitis.

A

complications of suppurative parotitis

69
Q

bilateral swelling of the face that resolves within 5-10 days

A

non-suppurative parotitis

70
Q

presents with redness and swelling of the submandibular gland that is tender.

A

sialadenitis

71
Q

tx for sialadenitis

A
  1. IV Nafcillin or 1st gen ceph PLUS metronidazole or clinda

if MRSA suspected use vanc

  1. once improvement is seen:
    oral clinda PLUS cipro
    OR augmentin alone
  2. surgical I&D if no response after 48hrs of IV abx
72
Q

MCC is strep mutans

A

dental caries

73
Q

flouride option for 6mo-16 years

A

oral drops, chewable tablets

74
Q

flouride option for >6 years of age

A

lozenges
gel, paste or rinse

75
Q

treatment for hypersensitive teeth

A

flouride varnish, also used for dental caries

76
Q

risk factor includes sjogrens and radiation of the head and neck

A

dental caries

77
Q

a patient with dental caries reports the pain has become more severe and persisitent, what has likely occurred?

A

the infection has spread to the pulp and caused pulpitis

78
Q

on oral exam you find a spot on the gums above the canines that appears to contain pus. what is this?

A

dental abscess

79
Q

presents with gingival edema and eryhema as well as themral hypersensitivity and sooth pain

A

sental abscess

80
Q

treatment for small dental abscesses

A

PCN VK +/- metronidazole

PCN allergy = clindamycin

81
Q

presents with bad breath, lymphadenopathy and fever

A

acute necrotizing ulcerative gingivitis

also presents with gum inflammation and ulceration.

note: halitosis = bad breath

82
Q

metronidazole or clinda or augmentin as tx

A

acute necrotizing ulcerative gingivitis

also uses chlorihexadine rinses

83
Q

chlorhexidine rinse

A

acute necrotizing ulcerative gingivitis

84
Q

damages alveolar bone and periodontal ligaments

A

periodontitis

85
Q

increases risk for preterm birth

A

periodontitis

86
Q

when do you use PCN VK

A

dental abscess
Dry socket

87
Q

this is considered a chronic inflammatory autoimmune disease of the mouth

A

oral lichen planus

88
Q
A

Clinical Med B (22 decks)

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