Diseases of the Mouth and Salivary Gland Flashcards

Question

Mucoceles

Answer 1

Cystic lesions found in the mouth, usually lower lip (oral mucousa!) Common, benign develop following trauma (self-biting) or obstruction of a minor salivary gland

Answer 2

Variable in size, contains gelatinous fluid Nodule, with a thick roof Chronic lesions = firm, inflamed, poorly circumscribed nodules; bluish, translucent; fluctuant

Answer 3

clinical, biopsy if needed

Answer 4

Avoid any further trauma = resolution Excision if not improving, bothersome or progressing

Answer 5

found under tongue! May be small and well circumscribed or “plunging” similar to mucocele

Answer 6

can be excised but need to go down to base to avoid recurrence resolve on their own if small usually

Answer 7

Inflammatory disorder of the tongue loss of filiform papillae rarely painful

Answer 8

smooth, glossy appearance with red or pink background

Answer 9

Nutritional deficiencies (B12, Niacin, Riboflavin, Iron, Vit E) Drug reactions Dehydration Malnutrition- protein/calorie deficit Certain irritating foods and liquids Autoimmune disorders- Sjogren’s, Celiac

Answer 10

underlying cause / improve nutritional diet

Answer 11

AKA “Burning Mouth Syndrome" or burning tongue Burning and pain of the tongue +/- glossitis MC in post-menopausal women

Answer 12

Diabetes Mellitus Drugs (diuretics) Tobacco Xerostomia (dry mouth) Candidiasis

Answer 13

underlying causes, change long-term meds, smoking cessation Meds (if needed): clonazepam Behavioral therapy may be helpful If occurring on only one side of tongue, neurologic lesions need to be ruled out

Answer 14

Deep grooves located on the midline or evenly distributed on the tongue surface Can be a normal tongue variant seen in adults

Answer 15

generally asymp. although if irritation from entrapped debris occurs, brushing the tongue may be helpful

Answer 16

malnutrition, Down Syndrome, Vitamin B deficiency predisposing factor for halitosis

Answer 17

Hyperpigmentation of the tongue and oral mucosa commonly seen in dark-skinned individuals

Answer 18

drugs (tetracyclines, bismuth subsalicylate) proton pump inhibitors Addison disease pellagra (niacin deficiency)

Answer 19

harmless, temporary cond. - tongue discoloration Buildup of dead cells on the papillae papillae easily trap bacteria, yeast, tobacco, food or other substances

Answer 20

Resolves by eliminating cause & by practicing good oral hygiene

Answer 21

Acute or chronic inflammation of the labial mucosa at the lateral commissures

Answer 22

Excessive moisture from saliva - (secondary infxn = candidiasis or S. aureus) More common in older age, denture wearers, poor oral hygiene Nutritional deficiencies, in younger patients- lip licking, thumb sucking, drooling

Answer 23

Erythema, maceration, scaling, fissuring painful, usually bilateral ulceration, crusting, cracking

Answer 24

clinical culture? KOH prep?

Answer 25

improve denture fit/hygiene, optical oral hygiene, barrier creams/ointment, topicals

Answer 26

AKA benign migratory glossitis Recurrent inflammatory disorder - unknown etiology - affects the dorsum of the tongue areas of atrophy lesions change location, pattern, size, and migrate

Answer 27

usually asymp. sometimes sensitive or painful w/ certain foods/ drinks may be associated w/ atopy, psoriasis, or reactive arthritis

Answer 28

clinical bx for DDX

Answer 29

none necessary

Answer 30

NOT premalignant common early finding of HIV also seen in organ transplant pts

Answer 31

Slightly raised leukoplakic areas with a “hairy” surface commonly lateral border of tongue

Answer 32

nonspecific improves w/ antiretroviral meds to treat HIV

Answer 33

develop as a result of inflammation in response to long-standing gingivitis in children OR due to certain medications

Answer 34

phenytoin, cyclosporine, calcium channel blockers

Answer 35

if isolated - consider bx

Answer 36

MC form of periodontal gum dz (precursor to periodontitis)

Answer 37

Inflammatory (red/ swelling) bleeding may occur w/ brushing/flossing

Answer 38

Good, regular, oral hygiene Regular dental check-ups and removal of tartar/plaque

Answer 39

Gingival inflammation accompanied by loss of supportive connective tissue chronic form MC in adults - lead to destructino of periodontium and tooth loss

Answer 40

microbs that make acids on tooth surface from di/monosaccharides demineralization of enamel tooth decay

Answer 41

initially asymp. pain temp. sensitivity

Answer 42

regular dental care (fluoride toothpaste) dietary changes

Answer 43

Infxn, pocket of pus, around tooth - untreated cavity, an injury or from prior dental work

Answer 44

tip of root

Answer 45

in the gums at the side of the tooth root

Answer 46

toothache temp. sensitivity swelling face/cheek swollen/tender lymph nodes

Answer 47

X-rays, CT for extent of infxn (can lead to airway compromise if untxed)

Answer 48

oral abx abx rinses I&D, root canal, dental extraction page Dentistry not ENT

Answer 49

Suppurative odontogenic infection which extends to the facial spaces BILATERAL submandibular spaces!!

Answer 50

Usually secondary to infected 2nd or 3rd mandibular molar Aggressive, rapidly spreading cellulitis WITHOUT lymphadenopathy WITH potential for airway obstruction

Answer 51

clinical CT imaging of choice palpate floor of mouth!! which should be elevated

Answer 52

1st- MANAGE AIRWAY IV abx if abscess - drain

Answer 53

white lesion, patch or plaque of the oral mucosa CANNOT be removed by rubbing the mucosal surface benign, 6% dysplastic or early SCC

Answer 54

to chronic irritation (dentures, smokeless tobacco, lichen planus) lateral mouth, inside lip, lateral tongue

Answer 55

Bx to rule out cancer (esp. if enlarging, indurated or ulcerative and extending deeper than submucosa)

Answer 56

thrush, lichen planus

Answer 57

nothing specific

Answer 58

Red, mucosal plaques definite erythematous component (unlike leukoplakia - similar tho)

Answer 59

older men lateral tongue, floor of mouth, soft palate, alveolar ridge

Answer 60

Bx - 90% malignant (look for erythroplakia in leukoplakia!)

Answer 61

nothing specific

Answer 62

Chronic inflammatory autoimmune disease

Answer 63

Lacy/Reticular leukoplakia , may be erosive can vary significantly May mimic other diseases (candidiasis, hyperkeratosis, SCC)

Answer 64

bx required to prove dx and rule out other dz

Answer 65

manage pain and discomfort topical CS

Answer 66

Any cancer arising within the oral or oropharyngeal cavity

Answer 67

90% Squamous Cell Carcinoma

Answer 68

Increased age (esp >45) Tobacco use (chewing and smoking) Alcohol use

Answer 69

Any area of erythroplakia Any enlarging area of leukoplakia Any lesion that has submucosal depth on palpation Ulcerative lesions

Answer 70

Lateral tongue Floor of the mouth Gingiva Buccal area Palate Tonsillar fossa + palpation of the neck for enlarged lymph nodes

Answer 71

as leukoplakia or erythroplakia - larger, with invasion into the tongue (may be palpable or ulceration)

Answer 72

early - painless and subtle physical changes majority - ant 2/3 of tongue and floor of mouth

Answer 73

early detection key! <4mm = less likely metatasize <2cm = local resection Larger lesions = combo resection, neck dissection, and external beam radiation

Answer 74

dependent on stage at dx stage 1 about 90%, higher stages about 60%

Answer 75

soft palate, tonsils, base of tongue, pharyngeal wall and vallecular

Answer 76

SCC and presents later than oral cavity CA

Answer 77

similar to oral CA

Answer 78

HPV infxn (70%) - respond well to RADIATION

Answer 79

unilateral throat masses (1 large tonsil = abnormal) painful swallowing weight loss ipsilateral cervical lymphadenopathy persist. sore throat, diffi. swallowing, voice changes, cough, lump in throat/neck

Answer 80

bx eval for metastases

Answer 81

surgical resection tumors + external beam rad +/- chemo

Answer 82

Acute infection of the salivary gland MC parotid or submandibular Retrograde bacterial contamination from the oral cavity

Answer 83

Ductal obstruction -> mucous plug -> salivary stasis -> secondary infection

Answer 84

strep species, H. influ

Answer 85

Acute swelling of the gland Bad taste Fever Dry mouth Increased pain and swelling with meals due to duct obstruction Tenderness and erythema of the duct opening

Answer 86

IV/oral abx Hydration warm compresses Sialagogues (lemon drops, sour candy or Pilocarpine) Gland massage imaging and refer if no improvement I&D?

Answer 87

Abscess Stricture Stone Tumor Suppurative sialadenitis

Answer 88

Acute infection of the parotid gland

Answer 89

neck swelling - parotid tail rides low look inside mouth and press - purulence draining from parotid duct rule out mumps in kids w/ parotid/facial swelling

Answer 90

typically non-surgical

Answer 91

Typically one major salivary gland is affected Usually the parotid

Answer 92

Pain and swelling of the affected gland Induration Tenderness Massage of the gland may express pus from intraoral orifice

Answer 93

warm compresses sialogagues oral hygiene oral abx (augmentin)

Answer 94

Formation of a stone in the salivary ductal system Most common: Wharton duct- submandibular gland

Answer 95

Large, radiopaque Less common- Stensen duct- parotid gland Smaller, radiolucent post-prandial pain and local swelling may have recent history of sialadenitis

Answer 96

NCCT if stone not palpable (imaging of choice)

Answer 97

Hydration Warm compresses Sialogogues Analgesics Refer to ENT for removal or if severe symptoms and not responding

Answer 98

Inflammatory or infiltrative Unilateral or bilateral parotid gland enlargement Lymphoephithelial/granulomatous diseases: - Sjogren’s - Sarcoidosis

Answer 99

Alcoholism DM Vitamin def.

Answer 100

Thioureas, iodine, cholinergics Any medication that stimulates salivary flow and causes more viscous saliva

Answer 101

MC site : parotid gland (80%) benign 80% - MC tumor = pleomorphic adenoma (but potential to become malign.) tumors of submandibular 40-50% malig

Answer 102

Mucoepidermoid carcinoma Adenoid cystic carcinoma

Answer 103

slow growing painless masses facial n. involve strongly corresponds to malign

Answer 104

fine needle aspiration (FNA) vs. excision FNA is old or too unhealthy for surgery

Answer 105

5 yr survival rate about 72% varies on stage and type

Answer 106

AKA "dry mouth" Salivary glands do not make enough saliva to lubricate the mouth

Answer 107

Med SE: Antihistamines, antidepressants, antipsychotics, parkinson’s disease medications, diuretics, neuroleptics, anti-cholinergic medications untreated depression Radiation of head or neck

Answer 108

Sialogogues Freq. sips water Ice chips, Saliva substitutes- sprays (biotene) Change/adj meds oral pilocarpine cavity prevention - overnight fluoride trays

Answer 109

dental caries parotid gland enlargement fissuring lips oral candidiasis halitosis ulcers/inflamm of tongue

Answer 110

Bony overgrowth (exostosis) -midline of the hard palate very common - develops during childhood and enlarges over time slowly

Answer 111

a bony, hard, nodular, lobular, or spindle-shaped mass covered with normal mucosa

Answer 112

gen. asymp. rapid change/growing, not on midline, or atypical appearance = refer for imaging/bx

Answer 113

surgical removal (symptomatic or protruding fit of dental devices)

Answer 114

lingual, More common than torus palatinus

Diseases of the Mouth and Salivary Gland Flashcards

(143 cards)