Mod 7 Pathology ulcers & ulcer like lesions

Question 1

What is Actinomycosis?

Answer 1

bacterial infection that develops from trauma (EX: dental surgery) it is an indurated, ulcerative lesion that develops into a fistula. It is caused by Actinomyces israelii bacterium. Treat with penicillin.

Question 2

A Chancre may occur during which stage of Syphillis?

Answer 2

Primary Stage

Question 3

Least common spot to have an ulceration with Lupus

Answer 3

Ventral surface of the tongue.

Question 4

An ulcer caused by self-induced injury is called?

Answer 4

Factitial

Question 5

T/F: Erosive lesions are depressed lesions usually with a red border and yellowish center.

Answer 5

True

Question 6

T/F: Erosive lesions penetrate into the epithelium and extend into the dermis?

Answer 6

False, that would be an ULCER

Question 7

T/F: Erythema Multiforme may be caused by exposure to certain viral, bacterial, and fungal infections, plus some medications?

Answer 7

True

Question 8

T/F: Erythema Multiforme MINOR is also referred to as Stevens-Johnson syndrome?

Answer 8

False, that is Erythema MAJOR

Question 9

T/F: Lupus Erythematosus is an autoimmune disease and Type III hypersensitivity reaction.

Answer 9

True

Question 10

T/F: Lupus can affect skin surfaces, organs, joins, and serous membranes?

Answer 10

True

Question 11

Of the (3) RAU’s which is the most common?

Answer 11

RAU minor

Question 12

T/F: RAU-Minor lesions are less than1cm in diameter and do not leave a scar?

Answer 12

True

Question 13

What is the largest RAU?

Answer 13

RAU-Major

Question 14

What is the name of the disease that is associated with RAU-Major?

Answer 14

Sutton’s Disease

Question 15

Which RAU has 1-10 lesions that are 1-3 cm in diameter, with irregular borders, are deeper crater-like, and cause scarring?

Answer 15

RAU-Major

Question 16

Which RAU as a prodromal stage, 1-5 lesions and zero scarring?

Answer 16

RAU-Minor

Question 17

What disease is Neisseria Gonorrhoeae associated with?

Answer 17

Gonorrhea

Question 18

Neoplasms, infectious diseases-bacterial, viral or fungal, immune disease and hypersensitivity can all cause ________________?

Answer 18

ulcers to form.

Question 19

Types of trauma that can cause ulcers?….

Answer 19

Factitial, Iatrogenic, chemical, chronic, and acute.

Question 20

What is an example of a Chronic trauma that could cause an ulcer?

Answer 20

Sharp edge of broken tooth. Remove sharp etch and tissue can finally heal.

Question 21

What is an example of Acute Trauma?

Answer 21

Pizza burn

Question 22

What is Necrotizing Sialometaplasia?

Answer 22

trauma caused by surgery or local anes. At junction of hard & soft palate. Salivary gland ischemia that causes tissue necrosis-usually heals 1-3 months.

Question 23

What is Spirochete Treponema pallidum?

Answer 23

The causative agent of Syphillis.

Question 24

How many stages of ulcers are associated with Syphillis?

Answer 24

3

Question 25

Primary Stage:

Answer 25

chancre *very infectious*

Question 26

Secondary Stage:

Answer 26

mucous patch *very infectious* (flu-like symptoms)

Question 27

Tertiary Stage:

Answer 27

Gumma-soft, non-cancerous. starts off indurated then turns to ulcer. Gummas are a type of granuloma.

Question 28

Clinical signs of Hutchinson's Triad:

Answer 28

*inflamm of cornea *deafness *mulberry molars *notched incisors

Question 29

T/F: Gonorrhea can cause blindness.

Answer 29

True. If an area where they don't put antibiotics in eyes at birth.

Question 30

Predisposing factors of N.U.G

Answer 30

*stress *poor nutrition *systemic probs *poor HC

Question 31

What causes NUG, and what are some Oral manifestations?

Answer 31

*Multiple oral spirochetes involved *Gingival bleeding, *ulcerations, *tissue necrosis, *PAIN, * punched-out papilla, *gray pseudomembrane over necrotic tissue, * fetid breath*

Question 32

Treatment of NUG?

Answer 32

*soft diet *salt water rinse *3% peroxide/water rinse *gentle cleaning *reduce stress *chlorhexidine *antibiotics? -stay away from irrigating devices!

Question 33

What are some sources of fungal infections?

Answer 33

*soil *bird/bad poop *decaying vegetation

Question 34

T/F: some fungal infections can produce oral ulcerations?

Answer 34

True. Rare, mostly medical compromised patients. This can indicate a very serious disease-need referral

Question 35

What type of tissue do Apthous ulcers usually appear?

Answer 35

non-keratinized

Question 36

T/F: Apthous ulcers are infectious?

Answer 36

False, they are of immune etiology.

Question 37

Manifestations of apthous ulcers:

Answer 37

*stress *hormonal changes *trauma *genetics *dental work *food allergies *B12 deficiency

Question 38

3 RAU names?

Answer 38

RAU-Minor RAU-Major RAU Herpetiform

Question 39

RAU that is smaller (1-3mm), 10-100 in clusters that coalesce, and usually found ventral side of tongue and floor of mouth?

Answer 39

RAU Herpetiform

Question 40

Erythema Multiforme

Answer 40

associate with exposure to certain viral, bacterial, & fungal infections plus some medications (penicillins & barbiturate)

Question 41

Two types of Erythema Multiforme

Answer 41

Erythema Minor Erythema Major

Question 42

round, distinct lesions lighter red on edges darker red in center 50% will have oral lesions are all characteristics of which type or erythema multiforme?

Answer 42

Erythema Minor

Question 43

*AKA Steven's-Johnson Syndrome. *often triggered by meds *lesions in oral cavity, conjunctiva, & genitalia, *lesions on lip are crusty, bleedy ulcers *5-15% MORTALITY RATE

Answer 43

Erythema Major

Question 44

2 "types" of Lupus Erythematous.

Answer 44

DLE: Discoid Lupus Erythematous: chronic form that makes up 70% of cases. SLE: Systemic Lupus Erythematous: Acute form that affects multiple organs @ a time.

Question 45

Clinical features of Lupus Erythematous

Answer 45

*butterfly rash on bridge of nose & cheeks *Type III hypersensitivity reaction *autoimmune disease *affect skin surfaces, organs (esp kidneys) joints, and serous membranes *gingiva may have desquamative appearance *oral lesions 20-40% of time

Question 46

Important note about Lupus if on Medical History!!!

Answer 46

* Lupus may cause damage to heart valves, pt will need PREMED

Question 47

*From mouth ~ anus *lobular oral lesions can be ulcerated *higher incidence of apthous ulcers *slow healing are characteristics of what disease?

Answer 47

Crohn's disease

Question 48

T/F: the most common oral cancer is Squamous cell carcinoma?

Answer 48

True

Question 49

*Erythroplakia lesions are usually either dysplastic or malignant. *Speckled Erythroplakia are mixed red/white lesions

Answer 49

Squamous cell carcinoma details

Question 50

signs that are HIGHLY suspicious and can be squamous cell carcinoma:

Answer 50

*ulcerated erythroplakia *speckled erythroplakia

Question 51

MOST FREQUENT SITES FOR SQUAMOUS CELL CARCINOMA?

Answer 51

*ventral side of tongue *lateral border of tongue *floor of mouth & adj ling tissue *retromolar areas *oral pharynx & tonsillar regions