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otolaryngology > Mouth Diseases > Flashcards

Mouth Diseases Flashcards

1
Q

Describe herpes simplex virus

A

An enveloped double stranded DNA virus

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2
Q

How is HSV1 transmitted

A

Oral secretions during close contact

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3
Q

Who gets primary gingivostomatitis

A

Primary school children

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4
Q

Clinical presentation of primary gingivostomatitis

A

Systemic upset (fever, local lymphadenopathy)
Vesicles and ulcers on lips, buccal mucosa and hard palate
May take up to 3 weeks to resolve

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5
Q

Most frequent manifestations of a primary HSV infection

A

Pharyngitis, gingivostomatitis

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6
Q

When do primary infections present following HSV exposure

A

2-12 days

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7
Q

Pathophysiology of HSV infection

A

Inoculation at mucosal surfaces
Viral replication in epidermis and dermis and infection of nerve endings
Latent infection establishes in the sensory ganglia
Reactivates intermittently

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8
Q

What can cause reactivation of a latent HSV infection

A

Immunodeficiency, stress, exposure to sunlight, fever, trauma

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9
Q

Recurrent form of HSV infection

A

Herpes labialis

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10
Q

What’s another name for herpes labialis

A

Cold sores

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11
Q

What is herpetic whitlow

A

HSV infection of the finger

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12
Q

Risk factors for herpetic whitlow

A

Occupational hazards for dentists and anaesthetists

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13
Q

How can we prevent herpetic whitlow

A

WEAR GLOVES

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14
Q

Complication of HSV

A

Herpes simplex encephalitis

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15
Q

Clinical presentation of herpes simplex encephalitis

A

Rapid onset of fever, headache, seizures, focal neurological signs, impaired consciousness

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16
Q

Investigation for HSV

A

Swab and PCR

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17
Q

Management of symptoms of HSV

A

Acyclovir

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18
Q

What is herpangina

A

Viral infection which causes fever and faithful papilla-vesiculo-ulcerative oral exanthem

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19
Q

What commonly causes herpangina

A

Coxsackie virus (enterovirus)

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20
Q

How do we transmit coxsakie virus

A

Oral ingestion of virus that is shed from the GI or URT of infected individuals

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21
Q

who does herpangina usually affect

A

Children

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22
Q

Clinical presentation of herpangina

A

High fever
Vesicles and ulcers in the soft palate
Hyperaemia and yellow/greyish papulovesicular lesions

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23
Q

Investigation of herpangina

A

PCR

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24
Q

Management of herpangina

A

Supportive: usually self limiting

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25
Q

What causes hand foot and mouth disease

A

Coxsackie virus

26
Q

How does hand foot and mouth disease present

A

Oral exanthem and a macular, maculopapular or vesicular rash of the hands and feet

27
Q

Investigation for hand foot and mouth disease

A

PCR

28
Q

Management of hand foot and mouth disease

A

Supportive

29
Q

How do we acquire primary syphillis

A

Direct sexual contact with the infectious lesions of another person

30
Q

Clinical presentation of primary syphillis

A

Mainless indurated ulcers at the site of entry of bacterium treponema pallidum

31
Q

Where is primary syphillis usually seen

A

Most commonly genital but can also be oral and pharyngeal

32
Q

Where (geographically) is mucosal leishmaniasis usually seen

A

Africa and the americas

33
Q

How does mucosal leishmaniasis present

A

Involvement of mucosal tissues of the nose, oral cavity, and the pharynx by leishmania spp

34
Q

Where is Behçet’s disease commonly seen

A

Middle East and Asia

35
Q

Most common feature of Behçet’s disease

A

Recurrent oral ulcers

36
Q

Other features of Behçet’s disease

A

Genital ulcers and uveitis

37
Q

How is Behçet’s diagnosed

A

Recurrent oral ulcers at least 3 times a year plus 2 of the following:
Recurrent genital ulcers, eye lesions, skin lesions, positive pathergy test

38
Q

Name some drugs which can cause mouth ulcers

A

NSAIDs, beta blockers and sulfonamides

39
Q

Name some skin diseases that can present with oral ulcers

A

Lichen planus, pemphigus, pemphigoid

40
Q

What’s another name for aphthous uclers

A

Canker sores

41
Q

What are aphthous ulcers

A

Recurrent small, shallow, painful sores that form on the inside of the mouth

42
Q

Where in the mouth can you get aphthous ulcers

A

Inside of the lips and cheeks or underneath the tongue

43
Q

When do aphthous ulcers begin

A

In childhood

44
Q

Risk factors of recurrence of aphthous ulcers

A

Genetics, trauma, stress, smoking cessation, hormonal imbalance, diet

45
Q

What other condition are aphthous ulcers linked to

A

Coeliac disease

46
Q

How long do aphthous ulcers last

A

Less than 3 weeks

47
Q

Clinical presentation of aphthous ulcers

A

Ulcers are round and have inflammatory halos
Confined to mouth
No systemic disease

48
Q

What is another name for candidiasis

A

Oral thrush

49
Q

What is candidiasis

A

Fungal mouth infection

50
Q

What causes candidiasis

A

Candida albicans

51
Q

Risk factors for candidiasis

A

Post antibiotics, immunosuppression, smokers, inhaled steroids

52
Q

Clinical presentation of candidiasis

A

White patches on red, raw mucous membranes in the throat and mouth

53
Q

Management of candidiasis

A

Nystatin or fluconazole

54
Q

What does squamous cell papilloma arise from

A

Stratified squamous epithelium

55
Q

Incidence of squamous cell papilloma

A

<5 years and between 20-40

56
Q

What is squamous cell papilloma linked to

A

HPV exposure - types 6,11

57
Q

How does squamous cell papilloma present

A

Painless lesion

58
Q

Where do squamous cell papilloma commonly present

A

Mucosa of the hard and soft palate

59
Q

What do squamous cell papillomas look like macroscopically

A

Exophytic, sessile or pedunculated mass

60
Q

Microscopic presentation of squamous cell papilloma

A

Finger like projection, fibrovascular core covered by stratified squamous epithelium

61
Q

Management of squamous cell papilloma

A

Most cases do nothing
Management options: cryotherapy, topical salicylic acid and surgical excision

otolaryngology (18 decks)

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