Mouth Flashcards by Casey Hamilton

Pharyngitis - Complication

Rheumatic fever, otitis media, peritonsillar abscess

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Pharyngitis - Etiology

Virus (Rhinovirus, adenovirus, influenza)

| Bacteria (Group A/C B hemolysis strep, N. gonorrhea, C. diptheria, mycoplasma, anaerobic bacteria)

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Strep Pharyngitis - Presentation

Pain, difficulty swallowing, erythema, gever, exudate, ervical adenopathy

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Viral Pharyngitis - Presentation

EBV/adeno - exudative pharyngitis

| Coxsackie/HSV - vesicles

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Pharyngitis - Diagnosis

Distinguish viral vs strep
Rapid strep, throat culture
Hx - no cough, tonsil exudate, tender anterior cervical adenopathy

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Pharyngitis - Tratment

Penicillin V 500 mg (x10)
Amoxicillin 50 mg (x10)
Benzathine

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Viral URI - Etiology

Common cold, parainfluenza, rhinovirus, airborne droplets, kids

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Viral URI - Presentation

12-72 hour incubation, rhinitis, sneezing, sore throat, cough, laryngitis, fever, fatigue, hoarse virus, 2 weeks

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Viral URI - Treatment

rest, clear fluids, decongestants, NSAIDs, throat losenges

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Acute laryngotracheobronchitis - Etiology

kids 3-36 months, parainfluenza, rhinovirus, enterovirus, mycoplasma pneumonia, subglottic inflammation

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Acute laryngotracheobronchitis - Presentation

Inflamed subglottic area, larynx, trachea, hoarse, cough, characterisitc stridor, calmed by cold air, tachycardia

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Acute laryngotracheobronchitis - Diagnosis

Clinical

| Steeple sign

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Herpes Simplex Virus - Etiology

Most people exposed by 20, reactivation via sun, smoke, stress, fever

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Herpes Simplex Virus - Primary Infection Presentation

multiples lesions of the mucus membranes
discrete vesicles coalesce into one
Tender lymph nodes, fever, malaise

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Herpes Simplex Virus - Recurrent Presentation

Vesicles, painful papules on the hard palate, lip, and gum which break and crust
Itching 1-2 weeks before outbreak

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Herpes Simplex Virus - Diagnosis

Clinical presentation
Tznack smear
Viral culture

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Herpes Simplex Virus - Treatment

Acyclovir, valacyclovir

| Symptomatic: NSAID, viscous Lidocaine

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Oral Candidias - Etiology

Immunosuppression: pregnancy, AIDs, diabetes, anemia

| Dentures

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Oral Candidias - Presentation

Throat and mouth pain increasing on swallowing
Burning sensation of tongue, throat, cheek
White curd-like pseudomembrane that peels off (red and bleeding)

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Oral Candidias - Treatment

Antifungals

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Laryngitis - Etiology

Previous URI (virus, M. Cat, H. Influ, HPV, irritant)

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Laryngitis - Presentation

Hoarse and harsh voice
Previous URI
Inflamed larynx
Cough

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Epiglottitis - Complication

Airway risk

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Epiglottitis - Etiology

Inflamed epiglottis
H. Influenza (vax), strep, staph
Diabetic (virus/bacteria)
2-4 year old

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Epiglottitis - Presentation

Fever, sore throat Dyspnea, dysphagia Irritable Lean forward, drool, tripod

Epiglottitis - Diagnosis

Visualize under anesthesia Increased leukocytes and blood cultures X-ray

Epiglottitis - Treatment

Maintain airway (intubate) ABX and corticosterois Antimicrobial Prophylaxis <4 at home

Tonsilitis - Etiology

GABHS

Tonsilitis - Presentation

lymph enlargement white purple tonsil exudate Sore throat

Tonsilitis - Diagnosis

Rapid strep, Monospot Throat culture

Sialolithiasis - Etiology

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Saliva stagnation Injured duct Gland inflamed Harden deposit Submandibular (wharton)>Parotid (stensen)

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Sialolithiasis - Presentation

Pain on eating Swelling Wharton stone radiopaque

Sialolithiasis - Treatment

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Remove stone Lemon drop Warm compress NSAID Water I & D (ENT)

```

Parotitis + Sialdentitis - Etiology

Clogged duct, inflame, infect salivary Dehydrated patient Bacteria move back (S.aur, strep, anaerobe)

Parotitis + Sialdentitis - Presentation

Swelling/ pain gland Decreased saliva Drain pus from duct Increase with meal

Parotitis + Sialdentitis - Treatment

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Remove stone Lemon drop Warm compress NSAID Water + gum I & D (ENT)

```

Aphthous Stomatits - Etiology

Unclear Family Hx, Immunocomp Meds, Underlying disease Smoking ?

Aphthous Stomatits - Presentation

Recurrent ulcer Yellow white pseudomembrane Red halo Pain >> size

Aphthous Stomatits - Minor

<1cm, 10-14 days, no scar, cheek lip

Aphthous Stomatits - Major

1-3 cm, deep, 2-6weeks, scar, tongue, tonsil, soft palate

Aphthous Stomatits - Herpetic

Greater number, recurrent, 1-3mm, 7-10 days any surface

Aphthous Stomatits - Diagnosis

Hx + PE | Biopsy to rule out DDx

Aphthous Stomatits - Treatment

Topical corticosteroids Chlorohexadine mouthwash Analgesic (lidocaine)

Oral Lichen Planus - Etiology

Unknown more in females 30-60

Oral Lichen Planus - Reticular

asymptomatic, Wick's striae (lacy network of papula or striae) symmetrical

Oral Lichen Planus - Erythema

Wick's striae, muscular atrophy, red patches, symmetrical

Oral Lichen Planus - Erosive

desquamaous gingiva, ulcers, and erosion, rupture bullae

Oral Lichen Planus - Diagnosis

Hx and PE, biopsy to rule out cancer, consider Hep C

Oral Lichen Planus - Treatment

Increase oral hygiene, decrease alcohol intake, topical corticosteroids

Leukoplakia - Risk factore

Smoking,smoking, UV, previous oral infections, tertiary syphilis, candida, HPV 16/18; over 40

Leukoplakia - Presentation

white paper-like lesions that do not scrape off; mainly on lip vermillion, buccal mucosa, gingiva but ventral tongue and oral floor higher risk re cancer; early/mild are white/gray, translucent, fissured or wrinkled

Leukoplakia - Diagnosis

Biopsy at most significant site for dysplasia

Leukoplacia - Treatment

Stop risk factor behaviors, Evaluate every 6 months for dysplasia (excision if positive)

Erythroplakia - Risk factors

Age 65-74, smoking, UV, previous oral infections

Erythroplakia - Presentation

well-demarcated, soft (velvety) erythematous, asymptomatic macule/plaque on floor of mouth, ventral tongue, soft palate

Erythroplakia - Treatment

Stop risk factor behaviors, Evaluate every 6 months for dysplasia (excision if positive) More likely to turn than leukoplakia (Female nonsmokers esp)

Oral Squamous Cell Carcinoma - Risk factors

Tobacco, alcohol, female, black, plummer vinson syndrome (iron def), vit A def Exposures: phenolic agents , UV light, radiation, betal quid teriary syphilis, HPV, immunosuppression Lip vermillion: fair skin, UV, lower lip, crusted, slow growing, swollen submental nodes Intraoral: tongue (posterior lateral or ventral), oral floor

Oral Squamous Cell Carcinoma - Warning signs

``` Lesions don't/pain resolve in 14 days Lump/thickening, numbness, voice changes, Ear pain, swollen oral cavity, Bleeding mouth/throat, Red/white lesions on mouth/lips, Rersistent bad breath ```

Oral Squamous Cell Carcinoma - Diagnosis

Biopsy! Direct scope for secondary, head/neck/chest CXR, check nodes for metastatis

Oral Squamous Cell Carcinoma - Treatment

IMMEDIATE REFERAL, clinical staging (high mortality) | Surgical excision, radiation +/- chemo

Mouth Flashcards

(60 cards)