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Clinical Medicine 1 > Mouth & Throat > Flashcards

Mouth & Throat Flashcards

2
Q

How does Leukoplakia present?

A

White patch or plaque that cannot be rubbed off

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3
Q

What causes Leukoplakia?

A

oftenhyperkeratosiesoccurringinresponsetochronicirritation

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4
Q

Leukoplakia treatment/plan

A

-Early referral (5% dysplasia/early invasive squamous cell carcinoma -Biopsy -stop tobacco -stop ETOH

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5
Q

How does hairy leukoplakia present?

A

Slightly raised lekoplakic areas with a corrugated or “hairysurface” Filaform papilla on the tongue(lateral) will elongate and look likelittle hairs Common early finding in HIV infection Developes quickly

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6
Q

How does Erythroplakia present?

A

Slow-growing, erythematous, velvety red lesion with well-defined margins, occurring on a mucous membrane, most often in the oral cavity. -Older males – 65-75yo

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7
Q

Where are the most common sites for Erythroplakia?

A

Lateral tongue Floor of mouth Soft palate Alveolar ridge

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8
Q

How does Oral Lichen Planus present?

A

Lesions may appear as: -Lacy, white, raised patches of tissues -Red, swollen, tender patches of tissues -Open sore

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9
Q

What causes Oral Lichen Planus?

A

Chronic inflammatory autoimmune disease

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10
Q

Oral Lichen Planus treatment?

A

O Managing pain and discomfort O Corticosteroids O Cyclosporines and retinoids O Low rate (1%) of SCC arising within lichen planus if correctly diagnosed

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11
Q

What is the most common form of oral cancer?

A

Oral squamous cell carcinoma (OSCC O Accounts for more than 90% of all oral cancers

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12
Q

What are the initial stages of oral cancer?

A

O Erytholeukoplastic area O Without symptoms

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13
Q

What are the advanced stages of oral cancer?

A

O Ulcers and lumps with irregular margins, which are rigid topalpation

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14
Q

oral cancer S/Sx?

A

O Ear pain O Chronic sore throat, hoarseness or change in voice O Remarkable weight loss O Unexplained bleeding in the mouth O Change in the way of fitting the teeth and dentures O Difficulty to chew, speak, swallow to move the jaw or tongue O Constant sores on the face, mouth or neck that bleed easily and do not heal within two weeks O A feeling that something is caught in the back of the throat O Presence of velvety red, white or speckled color of patched in the mouth O Unexplained numbness or loss of feeling O Pain and softness in any area of the mouth, neck or face O Thickness or swelling, crusts, rough sports and eroded areas on the gums, lips and other areas inside the mouth

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15
Q

How do Apthous Ulcers present?

A

Recurrent small, round, or ovoid ulcers with circumscribedmargins, erythematous haloes, and yellow or gray floors. O Restricted to the mouth O Typically starts in childhood or adolescence

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16
Q

Are labs ordered for Apthous Ulcers?

A

Yes, but only if they are recurrent

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17
Q

Apthous Ulcer treatment?

A

O Vitamin B12 used orally may have some effect O Topical corticosteroids (TCs) remain the mainstays of treatment O Topical tetracyclines may reduce the severity of ulceration, O Chlorhexidine gluconate mouth rinses O Anti-inflammatory agents

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18
Q

How does Geographic Tongue present?

A

Patches on the tongue; Tongue - patchy; Benign migratoryglossitis

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19
Q

What causes Geographic Tongue?

A

O Unknown O May be caused O Vitamin B deficiency O Irritation from hot or spicy foods, or alcohol O The condition appears to be less common in smokers

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20
Q

What are the S/Sx of Geographic Tongue?

A

O Map-like appearance to the surface of the tongue O Patches that move from day to day O Dunuded appearing O Soreness and burning pain (in some cases)

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21
Q

What are the S/Sx of Oral Candidiasis?

A

O White patches in mouth or on tongue O Cottage or mild curds O Sore mouth and tongue and/or difficulty swallowing O Poor appetite O Burning feeling in mouth and throat (at start of a thrush infection) O Bad taste in mouth O Typically only mild pain

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22
Q

What other symptom can be caused by Oral Candidiasis in infants?

A

Diaper rash May develop because yeast may be in stool

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23
Q

What is Oral Candidiasis also known as?

A

Thrush

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24
Q

What is Candida albicans?

A

a fungus that causes Thrush

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25
Q

Oral Candidiasis treatment?

A

Treatunderlyingcause O DM O HIV O Immunosuppresion O Antibiotic use O SteroidInhalers Nystatin(antifungal), Gentian violet, Magic Mouthwash

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26
Q

What is a irretation fibroma?

A

Slow-growing fibrous nod ules on the oral mucosa, resulting from irritation caused by cheek biting or objects such as dentures and fillings.

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27
Q

What is Epulis Fissurata

A

Mucosal hyperplasia from low grade trauma ie. dentures.

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28
Q

What areFordyce’s Granules

A

Sebaceous glands found in the mouth O Small yellow dots in the oral mucous membrane O Misplaced sebaceous glands

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29
Q

Fordyce’s Granules treatment

A

Once properly diagnosed, no treatment is necessary

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30
Q

What is a Hemangioma

A

Abnormal build-up of blood vessels in the skin or internal organs

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31
Q

What is a Papilloma?

A

Benign epidermal tumor that grows out of the skin.

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32
Q

What can cause Oral Herpes Simplex Virus

A

Stress, Chemothreapy, Infection

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33
Q

Oral Herpes Simplex Virus treatment?

A

PO or topical antivirals

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34
Q

What do salivary glands secrete?

A

amylase

35
Q

What increases risk for Sialadenitis

A

Dehydration, Radiation, Immunosuppression

36
Q

What bacteria cause Sailadenitis?

A

O Staphylococcus aureus – most common O Streptococcus viridans O Haemophilus influenzae O Streptococcus pyogenes O Escherichia coli

37
Q

Sialadenitis treatment?

A

Antibiotics, steroids, warmth

38
Q

What causes Parotitis?

A

Can be either bacterial or viral. S. aureus is the most common. Viral can be from mumps(paramyxovirus) or non-mumps.

39
Q

What is bilateral Parotitis likely caused from?

A

Mumps

40
Q

What is Sialolithiasis?

A

Salivary stones. They often block the salivary gland duct opening

41
Q

What is Ranula

A

A mucocele on the floor of the mouth

42
Q

What is Epulis?

A

A mucocele on the gums

43
Q

Pharyngitis S/Sx?

A

O Sore throat O Dysphagia O Odynophagia O Fever O Headache O Abdominal pain O Nausea/vomiting

44
Q

What symptoms suggest a viral pharyngitis?

A

Coryza, Conjunctivitis, Hoarseness

45
Q

What can be complications of group A beta hemolytic streptococcal infection (GABHS)

A

1)Rheumatic Fever 2)Acute proliferative glomerulonephritis

46
Q

What can Rheumatic Fever cause?

A

O Arrythmias O Damage to heart valves O Endocarditis O Heart failure O Pericarditis O Sydenham chorea

47
Q

What is Acute proliferative glomerulonephritis?

A

Inflammation of the glomeruli in the kidney which can lead torenal failure and hypertensive enceophalopathy

48
Q

What symptoms suggest GABHS pharyngitis?

A

O Fever >38°C O Tender anterior cervical adenopathy O Lack of cough O Pharyngotonsillar exudate O Sore throat – may be severe O Odynophagia O Palatal petechiae O Tender cervical adenopathy O Elevated WBC and left shift possible O Headache O Chills (rigors) O Flushed face

49
Q

What are S/Sx of Scarlet Fever?

A

Sandpaper rash with onset 24 to 48hrs post strep throat symptoms Strawberry tongue

50
Q

How is Strep transmitted?

A

direct person contact (saliva, nasal secretions) and may be transmitted with food preparation

51
Q

How long is incubation for strep pharyngitis

A

2-5days

52
Q

When can a child with strep return to school?

A

After 24 hours with no fever (usually 1-3 days)

53
Q

What labs are ordered to confirm strep?

A

Streptococcal Rapid Antigen Test. If negative then a culture is done to confirm negative result.

54
Q

What can be consequences if strep goes untreated?

A

O Acute rheumatic fever O Acute post streptococcal glomerulonephritisis O Peritonsillar abscesses.

55
Q

Strep Treatment?

A

Symptomatic management First line Abx= Penicillin VK Second line= Augmentin

56
Q

What is mono caused by?

A

Epstein-Barr virus infecting B cells

57
Q

How long is mono incubation?

A

4-8 weeks

58
Q

What are the S/Sx of mono

A

O Exudative pharyngitis(>97%) O Prominent cervical lymphadenopathy (>97%) O Posterior cervical: most common O Pharyngeal erythema and edema(85%) O Splenomegaly (75%) O Palatal petechiae (50%)

59
Q

What labs test for mono?

A

O Throat Culture O Lymphocyte predominance O Lymphyocyte atypia – very specific O Heterophil antibody test (Monospot test)

60
Q

What is involved in the management of mono?

A

O Rest O Non-caffeinated fluids for adequate hydration O NSAIDs O Avoid strenuous exercise or sport

61
Q

How long does a person with mono need to avoid strenuous exercise?

A

Moderate training allowed after 3 weeks. Strenuous activity allowed after 4 weeks.

62
Q

When would you use Abx with mono?

A

only indicated if coexisting strep (rash develpes in 90% of EBV pts on Abx)

63
Q

Complications of Mono?

A

O Meningoencephalitis O Guillain-Barre Syndrome O Bell’s Palsy O Pneumonitis O Myocarditis

64
Q

What is Quinsy?

A

Peritonsillar Abscess-Infection of the tonsil(s) that spreads to surrounding areas with a pocket of infected material.

65
Q

What often causes a Peritonsillar abscess?

A

Group A strep

66
Q

What are S/Sx of peritonsillar abscess?

A

Trismus(clenched teeth) Drooling Muffled voice Unilateral throat pain Uvula deviates to opposite side

67
Q

What tests are ordered for a peritonsillar abscess?

A

O Labs to r/o mono & strep O I&D or aspiration w/ C&S O CT scan

68
Q

peritonsillar abscess treatment?

A

O Antibiotics O I&D O Pain meds

69
Q

Peritonsillar Abscess complications?

A

O Airway obstruction O Cellulitis O Endocarditis/pericarditis O Pneumonia

70
Q

Symptoms of Retropharyngeal Abscess?

A

O Neck pain out of proportion to findings O Dysphagia O High fever

71
Q

Retropharyngeal abscess tests?

A

Lateral neck Xray showing bulging of posterior pharyngeal wall

72
Q

Retropharyngeal Abscess management?

A

O Hospitalize O Airway observation O IV Antibiotics O Early ENT consultation

73
Q

Epiglottitis S/Sx

A

Shortness of breath Drooling “Sniffing Position”

74
Q

what will a Xray show with Epiglottitis?

A

Thumbprint sign

75
Q

Epiglottitis treatment

A

O Avoid tongue depressor or other oral instruments O Epiglottitis irritation may lead to obstruction O Keep patient calm O Airway management ASAP! O Do not attempt to intubate!! O Do not lay person down! O Hospitalization O Antibiotics O Anti-inflammatory meds (steroids)

76
Q

What can cause Laryngitis?

A

O Viral infection (Most common cause of acute) O Bacterial infection O Gastroesophageal reflux disease (GERD) O Nerve damage, sores, polyps, nodules on the vocal cords

77
Q

What is the most common cause of acute Laryngitis?

A

Viral infection

78
Q

What is the most common cause of chronic laryngitis?

A

GERD

79
Q

Laryngitis S/Sx

A

O Hoarseness O Aphonia (voice breaks intermittently) O Upper respiratory infection (URI) symptoms variably present O Leukocytosis, if bacterial

80
Q

Laryngitis treatment

A

O Increased household humidity O Rest voice (including asking patient to not whisper) O Increase hydration O Analgesics O Treat underlying cause such asGERD

81
Q

What indicates a ENT referral for Laryngitis?

A

Hoarseness persisting beyond 2 weeks

Clinical Medicine 1 (4 decks)

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