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Pedo > Common ST Lesions in Children > Flashcards

Common ST Lesions in Children Flashcards

1
Q

What are the main effects associated with ankyloglossia for newborns?

A
  • Breast feeding difficulties
  • Restriction of tongue movt (ice cream, wind instrument)
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2
Q

What is the treatment for ankyloglossia?

A

Frenotomy for newborns w breastfeeding problems

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3
Q

What are some examples of palatal cysts of newborn and where are they usually found?

A
  • Bohn’s nodules (on palate)
  • Epstein pearls (mid-palatal raphe)
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4
Q

What is the treatment for palatal cysts of the newborn?

A

No treatment, spontaneously rupture & involute within few months

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5
Q

What is an eruption cyst?

A

Soft tissue swelling over crown of erupting tooth, originating from REE

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6
Q

What is the clinical presentation of an eruption cyst?

A
  • Sessile, dodome-shaped, translucent swelling
  • Soft, fluctuant
  • Pink/blue (if traumatised => filled w blood)
  • Location: overlying erupting tooth
  • Painless, unless infected
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7
Q

What is the management for eruption cyst?

A

No tx, will burst spontaneously as tooth erupts
- If failure to resolve/cause discomfort: removal of roof of cyst to encourage eruption

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8
Q

What is infantile hemangioma?

A

Vascular tumor due to rapid endothelial cell proliferation in early infancy (3-5 months)
F>M

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9
Q

What is the difference between vascular malformations and vascular tumors (infantile hemangioma)?

A
  • Infantile hemangioma involute over time while vascular malformations do not – they enlarge proportionately w growth of child
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10
Q

What are the classifications of types of vascular malformations?

A

Low flow: capillary, venous, lymphatic
High flow: arteriovenous

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11
Q

What syndrome is associated with vascular malformations?

A

Sturge-Weber syndrome

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12
Q

What is the clinical description of lymphangioma?

A
  • Pebbly surface resembling “frog eggs” or sago
  • 40-50% of cases on tongue
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13
Q

What is the tx for lymphangioma?

A

Observation, usually no surgery

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14
Q

What is the clinical presentation of benign migratory glossitis (geographic tongue?

A
  • Multiple oval/circular red patches
  • Surrounded by white, slightly elevated border
  • Atrophy/loss of filiform papillae
  • Pattern changes
  • Seen on tongue, labial & buccal mucosa and vermillion border of lip
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15
Q

What is the treatment for benign migratory glossitis?

A

No tx. Avoid spicy foods – may feel burning sensation

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16
Q

What is congenital epulis?

A
  • Fibro-epithelial lesion arising from mesenchymal cells
  • Present at birth
  • F > M (90% in females)
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17
Q

Where is congenital epulis commonly found?

A

Max anterior alveolar ridge (area of
developing lateral incisor & canine)

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18
Q

What is the treatment for congenital epulis?

A

Occasional spontaneous regression
If no regression, surgical excision under GA
Recurrence unlikely

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19
Q

What is the clinical presentation of leukoedema?

A
  • Diffuse, filmy white wrinkled mucosa due to intracellular oedema of superficial epithelial cell
  • Disappears when stretched
  • Location: bilateral buccal mucosa
  • Asymptomatic
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20
Q

What is the timeline of clinical presentation of Primary Herpes Gingivostomatitis?

A

Timeline (incubation 5-7 days before)
- Day -2 to 0: prodromal symptoms – fever, malaise, nausea
- Day 1 to 4: vesicles that can rupture → ulceration, fever ↓
- Day 5: start to feel better
- Day 10 to 14: resolution

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21
Q

Where do the vesicles of primary herpes gingivostomatitis usually form?

A

Keratinised & non-keratinised gingiva
(Secondary only keratinised mucosa)

22
Q

What is the treatment for primary herpes gingivostomatitis?

A
  • Self-limiting, resolves in 1-2 weeks
  • Symptomatic care: anti-pyretic & analgesic
  • Hydration & nutrition: encourage fluid intake, cool foods/drinks, soft diet
  • Anti-virals (e.g acyclovir): within 72h for severe/immunocompromised cases
23
Q

Which viruses causes HFMD?

A

Coxsackie A16, Enterovirus 71

24
Q

What are the clinical manifestations of HFMD?

A
  • Prodromal symptoms (flu-like): fever, anorexia, malaise
  • Oral lesions: multiple widespread shallow ulcers
  • Skin lesions: non-pruritic macules, papules, vesicles on
    extensor surfaces of hands & feet
25
Q

What is the treatment for HFMD?

A
  • Self-limiting, resolves in 1 week
  • Highly contagious => avoid spread to others
  • Symptomatic care
26
Q

What is the difference in clinical presentation of HFMD and herpangina?

A

Herpangina localised to posterior area of oral cavity only (oropharynx)

27
Q

Which types of HPV can cause SCC?

A

HPV 16, 18, 31

28
Q

What oral lesions result from HPV?

A
  • Squamous papilloma
  • Verruca vulgaris
  • Condyloma acuminatum
  • Heck’s disease
29
Q

What is the management for HPV lesions?

A
  • Excisional biopsy (for all except Heck’s)
  • Avoid self-inoculation
  • Vaccine for HPV 6, 11, 16, 18
  • CA associated w sexual abuse in kids => investigate
30
Q

What superficial fungal infection occur in children?

A
  • Pseudomembranous candidiasis
  • Angular cheilitis
  • Median rhomboid glossitis
31
Q

What is the treatment for superficial fungal infections?

A
  • Anti-fungal therapy (e.g nystatin, clotrimazole)
  • Maintain proper OH
  • Wash feeding utensils carefully & store in antiseptic solution
  • Identify underlying cause if suspected (e.g diabetes, appliance/
    prosthesis, antibiotics, immunosuppressive therapy)
32
Q

What is the presentation of linea alba?

A
  • Bilateral
  • White smooth to shaggy line
  • May be scalloped
  • Location: buccal mucosa, along occlusal plane
33
Q

What is another name for mucocele?

A

“Mucous retention phenomenon”

34
Q

What is the etiology of mucocele?

A
  • Trauma of minor salivary gland => mucous pooling in CT + inflammation
35
Q

What are the common locations for mucoceles?

A

Lower labial mucosa, buccal mucosa, ventral tongue

36
Q

What is the treatment for mucocele?

A

Excisional biopsy (excise minor salivary gland)

37
Q

What is the etiology for recurrent aphthous ulcers?

A
  • Immune-mediated
  • Stress, trauma, allergies, nutritional deficiencies,
    genetic deposition
  • F>M
38
Q

What is the clinical presentation for recurrent aphthous ulcers?

A
  • Ulceration w yellow-white fibrinopurulent membrane
  • Encircled by erythematous halo
39
Q

What are the common locations for recurrent aphthous ulcers?

A
  • Non-keratinised mucosa buccal & labial mucosa, ventral
    tongue, soft palate, floor of mouth)
  • Does NOT affect keratinised mucosa (e.g attached gingiva,
    vermillion of lips, hard palate)
40
Q

What are the classifications for recurrent aphthous ulcers?

A
  • Minor: 3-10mm (no.: 1-5)
  • Major: 1-3cm (no.: 1-10)
  • Herpetiform: cluster of 1-3mm ulcers (no.: up to 100)
41
Q

What is the treatment for recurrent aphthous ulcers?

A
  • Symptomatic treatment
  • Topical steroids
  • Eliminate triggering events
42
Q

What is erythema multiforme?

A
  • Blistering, ulcerative mucocutaneous
    condition of uncertain aetiopathognesis
  • Probably immune-mediated
43
Q

What is the clinical presentation of erythema multiforme?

A

Oral Lesions
- Erythematous patches undergo necrosis
- Form large shallow ulcers w irregular borders
Skin Lesions
- Concentric circular erythematous rings
- Look like target/bull’s-eye lesions

44
Q

What is the treatment for erythema multiforme?

A
  • Self-limiting, resolves in 2-6 weeks
  • Recurrence rate: 20%
  • Symptomatic tx: steroids
  • Antiviral prophylaxis
45
Q

What are the triggers for erythema multiforme?

A
  • Preceding infection in 50% of cases (e.g HSV,
    mycoplasma pneumonia)
  • Drugs (less common)
46
Q

What are the 5 Ps of lumps and bumps?

A
  • Pyogenic granuloma
  • Peripheral giant cell fibroma
  • Peripheral ossifying fibroma
  • Peripheral fibroma
  • Papilloma (has papillary surface)

Remaining 4 Ps require biopsy to differentiate

47
Q

What are some etiology for gingival enlargements?

A

Reactive
- Inflammatory
- Medication induced (e.g cyclosporine, nifedipine, phenytoin)
Developmental
- Hereditary gingival fibromatosis
Systemic Causes
- Hormonal changes
- Malignancies
- Granulomatous diseases

48
Q

What is Neuroectodermal Tumour of Infancy?

A
  • Rapidly growing
  • Can infiltrate & destroy surrounding structures (e.g nasal septum) => locally aggressive although benign
  • Rare
  • Usually occurs in children ≤1 y/o
  • Majority benign (1% malignant)
  • Neural crest origin
49
Q

What is the clinical presentation of Neuroectodermal Tumour of Infancy

A
  • Non-ulcerative, smooth-surface swelling
  • Firm, sessile
  • Location: max anterior alveolar ridge
  • Painless
50
Q

What is the treatment for Neuroectodermal Tumour of Infancy?

A
  • Surgical intervention
  • Recurrence rate: 10-60%
51
Q

What clinical presentation is usually associated with Acute myeloid leukemia (AML)?

A

Leukemic infiltrates of gingiva

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