Oral Dan Flashcards Preview

Medical dermatology Dan > Oral Dan > Flashcards

Flashcards in Oral Dan Deck (213):
1

Fordyce spots on the vermillion or buccal mucosa are an unusual anatomical variant

False
common - seen in up to 80%
also found on outer labia and shaft of penis or scrotum other free sebaceous glands are;
Tyson's glands on the foreskin or labia minora
Meibomian glands around the eye
Montgomery's tubercles of the areola

2

Geographic tongue occurs in 10% of people

False
1-3%

3

Geographic tongue is more common in women

False
M=F

4

Geographic tongue is always confined to the tongue

False
Rarely - can affect buccal mucosa/labial mucosa/soft palate

5

Geographic tongue has well demarcated erythematous patches with thin scalloped white borders on the lateral and dorsal tongue

True

6

Geographic tongue (benign migratory glossitis) is a type of psoriasiform mucositis of unknown aetiology which 5x more comon in psoriatics then the general population

True

7

Geographic tongue does not occur with fissured (scrotal) tongue

False
Can occur together

8

Geographic tongue is usually asymptomatic

True
but can cause buring or stinging, worse w/ spicy food
Rarely causes burning mouth syndrome
Rx by avoid triggers and potent TCS

9

Scrotal tongue occurs equally in males and females

True

10

Scrotal tongue is often associated with geographic tongue

True
But only a few cases of geographic tongue are associated with scrotal tongue

11

Scrotal tongue occurs in about 15% of adults

True
2-30%
unusual in children

12

Black hairy tongue is an exceptionally rare condition mainly affecting men

False
is common
affects M=F

13

Black hairy tongue is due to retention of keratin at tips of filiform papillae on dorsal tongue

True

14

Black hairy tongue is due to an underlying systemic disease and needs investigation

False
Due to low food intake or soft dietexacerbated by smoking, poor oral hygeine, tetracyclines, hot drinks, oxidizing mouthwashes
Not due to candida or other infection

15

Black hairy tongue can causeBad breathBad tasteGagging sensation when tongue touches palate

True

16

Black hairy tongue can be normal in dark skinned individuals

False
dark skinned people may have pigmented papillae presenting a smultiple, unoformly spaced tiny brown papules esp on the lateral surface and tip - not on dorsum like BHT

17

Treatment of Black hairy tongue involvesfirm regular dietstop smokinggood oral hygeinecan use bicarb mouthwashcan use tongue scraperrefer to dentist or hygeinist

True

18

Simple glossitis involves loss of filliform papillae with pain and swelling

False
Loss of filiform papillae is atrophic glossitisIn glossitis there is pain, irritation, burning, hypogeusia, dysgeusia
Rx w/ bland soft diet and analgesia

19

Atrophic glossitis involves inflammation with loss of filliform papillae

True

20

Median rhomboid glossitis is Well demarcated rhomboid shaped area in midline of posterior dorsal tongue which is erythematous and smooth w/ loss of filiform papillae

True

21

Median Rhomboid Glossitis afects 1% of adults and children

False
1% of adults but very rare in kids

22

Median Rhomboid Glossitis is associated with candidiasis, HIV, smoking and wearing dentures

True

23

Median Rhomboid Glossitis is a congenital defect

False

24

Median Rhomboid Glossitis is associated with inflammation of the corresponding area of the palate

True
but only in rare cases and should consider HIV or other immunosuppression in these cases

25

It is necessary to take candidal swabs in all cases of Median Rhomboid Glossitis

True
Candida is number one cause

26

Improving oral hygeine is sufficient treatment for Median Rhomboid Glossitis

False
usually insuffucient
swab and treat for candida
stop smoking, see dentist, may need new dentures
consider HIV or other immunosuppression

27

White sponge nevus is due to an autosomal dominant muattion in Keratin 3 or 14

False
AD
Keratin 4 or 13

28

white sponge naevus is noticed at birth or in childhood and affects the buccal mucosa bilaterally

True
Painless shaggy or folded white lesionscan affect resp tract, genitalia, anus

29

white sponge naevus is premalignant

False
Completely benign
No Rx required
tetracycline swish and spit may help to clear

30

White oral lesions may be seen in Howel-Evans syndrome

True 

31

The diffuse white oral lesions in Dyskeratosis congenita can resemble leukoplakia or lichen planus clinically and histologically

True

32

Oral lesions of Dyskeratosis congenita are benign with no malignant potential

False
Can become malignant

33

Oral mucosal hyperpigmentation is a rare feature of Dyskeratosis congenita

True
Can also get hypocalcified teeth 

34

Oral keratosis is a rare feature of Pachyonychia Congenita

False
Occurs in 60%
also1
6% natal (neonatal) teeth
10% angular stomatitiscandida common
No Rx for keratosis but pts need ongoing dental care

35

Gingival hyperkeratosis can occur in Unna-Thost variety of PPK

True

36

Periorificial keratoderma is a feature of Naegeli–Franceschetti–Jadassohn syndrome

False
Characteristic feature of Olmsted’s syndrome
is fissured resembling rhagades

37

KID syndrome can get dental dysplasia, persistent oral ulcers and mucocutaneous candidiasis 

True
Also sometimes get oral carcinoma

38

In Darier disease oral lesions occur in 50% of those with skin lesions esp if severely affected skin

True
flattish, coalescing red plaques that eventually turn white
affect dorsum of tongue, palate and gingiva
may get salivary duct anomalies

39

Early loss of teeth is a feature of Papillon Lefevre

True
Deciduous teeth usually lost by 5 and permanent teeth by 16
Also
Downs
diabetes
EDS type 8

40

Materia alba is due to smoking

False
White plaques on gums due to build up of mucosa cells and bacteria if poor oral hygeine

41

A Cutaneous dental sinus is really a fistula which most commonly arises from the maxillary teeth

False
Is really a fistula but mandibular teeth more commonly then maxillary

42

A Cutaneous dental sinus arising from the mandibular molars or premolars will most commonly form a discharging skin lesion on the chin or submental region

False
Most common sites of skin lesions are;
Maxillary incisors and canines - cheek
Maxillary molars and premolars – inner canthus, nose, nasolabial fold, upper lip
Mandibular incisors and cuspids – chin or submental region
Mandibular molars and canines – posterior mandible or submandibular regions

43

The main differentials of a Cutaneous dental sinus areneoplasmpyogenic granulomacervicofacial actinomycosis

True

44

Desquamative gingivitis presents with painful haemorrhagic necrotic gingivae w/ classic ‘punched out’ interdental papillae

False
This is Necrotizing (Ulcerative) Gingivitis

45

Necrotizing (Ulcerative) Gingivitis is caused by mixed bacterial infection in susceptible hosts w predisposing risk factors

True
Immunosuppression
malnutrition
stress
smoking
poor oral hygiene

46

Necrotizing gingivitis occurs in young/middle aged adults and can cause;Generalized oedema, erythema and haemorrhageFever, malaise, lymphadenopathyfoul odournoma (cancrum oris)

True 

47

Swabs are diagnostic in Necrotizing (Ulcerative) Gingivitis

False
Swabs cultures are non specific
Mainly clinical diagnosis
Should still swab and look for underlying causes and predisposing factors
Refer to dentist for debridement, then broad spectrum AB
Chlorhex oral rinses for bact load, warm salt water rinses for comfort

48

chronic ulcerative stomatitis affects young men

False
Very rare condition mainly seen in older white womenrare in other groups

49

Chronic ulcerative stomatitis is due to Autoantibodies to DeltaNp63alpha protein on keratinocyte nuclei

True
Detect on mucosal biopsy IMF or ELISA blood

50

Dental amalgam foreign body tattoos are the most common cause of acquired pigmentation in the oral mucosa

True

51

Labial melanotic macules occur in 20% of the normal population

False
up to 3% of normal people

52

The commonest systemic causes of acquired oral pigmentation are Addison’s, Kaposi’s sarcoma and melanoma

True

53

Intramucosal (intradermal) naevi account for 50% of mucosal naevi

True
Blue naevi account for one third

54

Amalgam is the only cause of oral lichenoid contact dermatitis

False
Cinnamates (cinnamon flavouring) are the orher main cause
Full list;
Mercury (amalgam)
Gold
Copper
Nickel
Cinnamates
Musk ambrette
Aminoglycoside antibiotics
Chemicals for colour photograph developing
Methacrylic acid esters used in the car industry

55

Lichenoid contact stomatitis causes a thicker histological band of lichenoid change than native oral LP

True

56

Resurfacing of amalgam fillings is an option for amalgam lichenoid contact stomatitis

True
But is it fails need to remove filings and use composite or porcelain fillings

57

in Recurrent Apthous Stomatitis one third of cases have a family history

True

58

simple oral ulcers are more comon in young women

False
more common in men in teens and 20s

59

Simple ulcers are more common than complex ulcers

True

60

simple ulcers are divided into 3 types;
Minor
Major
Herpetiform

True

61

Minor (Mikulicz) ulers the most common type of oral ulcers and should be

False
Are most common but should be Heal w/out scar in 1-2wksRecurrence is usual but infrequent

62

Major (Sutton's) oral ulcers are 1-3cm diameter, deep and very painful.  Heal slowly with scarring

True
Heal in 4 weeks rather than 1-2 for minor ulcerscan be fever/malaise

63

Herpetiform simple ulcers are caused by HSV

False
Very uncommon condition
seen more in women
1-2mm ulcers up to 100
resemble HSV but swab negativeulcers heal w/out scarring but are often continuously present

64

Simple ulcers are found on the dorsal tongue

False
Usually only occur on NON keratinized mucosa (unlike HSV which can affect anywhere) so not seen on dorsal tongue, hard palate or inner gingivaecommon on underside of tongue and can occur on buccal mucosa of cheeks and in sulcus (often linear here)

65

The folowing makes oral ulcers worse
sodium lauryl sulphate (toothpaste, mouthwash)
smoking
pregnancy

False
get better in pregnancy
worse with other 2

66

Simple Recurrent Apthous Stomatitis means 1-2 ulcers occuring up to 3 times per year
Complex Recurrent Apthous Stomatitis mean 3 or more oral or genital ulcers occuring almost continuously

True

67

Complex apthous ulcers are usually large

False
usualy small like simple minor ulcers
MUST investigate for associations 

68

75% of Behcets pts get oral ulcerations

false
99% do
Multiple lesions,

69

Thalidomide ca be used for recaltritant ulceration in Behcet's disease

True
Treatment ladder;
Rx of ulcers – tetracyclines, TCS, general measures
Systemic Rx of Behcets;
Topical steroids
NSAIDs
Systemic; colchicine, steroids, AZA, CsA , SSKI
Infliximab
Thalidomide for recalcitrant orogenital ulceration

70

Aspirin can cause irritant contact stomatitis

True
Also
vit C tabs, battery acid, bleach, phenol, silver nitrate, petrol, rubbing alcohol 

71

Fibroepithelial polyps are the most common oral cavity tumour

True 

72

Fibroepithelial polyps occur in children

False
adults in 30s-50s (4th-6th decade)
twice as common in women

73

A pregnancy epulis is a Fibroepithelial polyp

False
An epulis is a lesion arising from the gums - usually a fibroepithelial polypA 'pregnancy epulis' is a pyogenic granuloma arising from the gums on a b/g of pregnancy gingivitis

74

Fibroepithelial polyp often occur along the biteline of the buccal mucosa

True
Also on labial mucosa/tongue/gingivae

75

A fibroepithelial polyp is the same as an oral fibroma

False
fibrous polyps (fibroepithelial polyps) are often referred to as fibromas but are not true fibromas
A true fibroma is rare in the mouthIt is a neoplastic proliferation of fibroblasts
Needs wide, deep, total excision

76

Intraoral Fibroepithelial polyps are often symptomatic

False
Asymptomatic unless persistently irritated/traumatizedRx surgery
Also rules out ddx of neoplasm

77

Morsicatio Buccarum means chronic cheek chewing

True

78

Traumatic ulcers in the mouth can mimic oral SCC

True

79

Xerostomia is uncomfortable but doesnt have serious consequences

False
saliva important for neutralizing food acids and forming bolus
Need meticulous dental hygeine as increased risk of caries and take care when chewing and swallowing

80

Nothing can be done for Xerostomia

False
meticulous dental hygeine
Sugarless gum to activate salivary production
Pilocaprine to stimulate residual salivary flow

81

Cheilitis Glandularis is a rare Inflammatory hyperplasia of lower labial salivary glands

True
Mainly affects men - UV, smoking, chronic irritationGet slight hypertrophy of lower lip with nodular enlargement and lip eversionUsually dysplastic cheilitis of exposed lip
Increased risk of SCCRx w/ vermillionectomy

82

A Ranula is  a mucocele located on the floor of mouth

True

83

Mucoceles are most common on the upper labial mucosa

False
lower labial mucosa

84

Mucocele is caused by a disrupted minor salivary gland duct w/ mucous spilling into submucosal tissue

True
Can be Assoc w trauma/oral LP/oral lichenoid GVHD

85

Any apparent lesion on retromolar area (arising from the mandible behind the last molar tooth) needs bx

True
mucoepidermoid carcinoma often presents there

86

Mucocoeles resolve spontaneously

True
But may need surgical excision to completely resolve as can cyclically rupture and refill

87

A mucoecele is a salivary gland tumour

False
Different things

88

Salivary gland tumour mainly arise from minor salivary glands

False
Minor glands only 15% of all salivary gland tumours

89

The most common benign alivary gland tumour is a pleomorphic adenoma

True
salivary gland equivalent of chondroid syringoma (benign mixed tumour of the skin)

90

The most common malignnat salivary gland tumour is adenocarcinoma

False
Mucoepidermoid carcinomaBut benign tumours are more common than malignant

91

Leukoplakia is most common premalignant condition of oral cavity

True
must bx to assess for degree of dysplasia and SCC

92

Leukoplakia is assoc w/ alcohol consumption

True
Also Tobacco esp smoking and sanguinaria (bloodroot)

93

Leukopakia has 1-5% population prevalence and is common in the over 30s esp women

False
All true but more common in men

94

In leukoplakia, non-homogenous lesions and tongue or floor of mouth lesions have higher risk of malignancy

True

95

leukoedema is the same as leukoplakia

False
Its grey/white buccal mucosa, fades w/ stretching, normal variant

96

Erythroplakia is a rare harmless red plaque of the buccal mucosa

False
Rare red plaque which is more dysplastic when biopsied than leukoplakia

97

90% of erythroplakia are severely dysplastic AK, IEC or SCC

True

98

Erythroplakia occurs at a younger age than leukoplakia

False
older age group
M=F

99

Erythroleukpplakia is an intraoral plaque with both white and red areas

True
often highly dysplastic/SCC

100

Mildly dysplastic leukoplakia can be monitored

True
But mod/severe dysplastic need treatment

101

leukoplakia has recurrence rate of 30% or more even afte complete clearance

True
adjuvant immiquimod should be used after surgery or cryotherapy or CO2 laser

102

Oral Hairy Leukoplakia is due to EBV

True

103

Oral Hairy Leukoplakia is seen in immunocompetent individuals mainly

FalseT
ypicaly assoc w/ HIV
can be other immunocompromised
Only occasionally immunocompetent pts

104

Oral hairy leukoplakia affects parakeratinized mucosa on lateral surface of tongue because o the localised candida

False
affects this area because keratinocytes here have EBV receptors.

105

50% of cases of Oral hairy leukoplakia alos have candida

True

106

The pathology of oral Hairy Leukoplakia shows hyperparakeratosis, hyperplasia and ballooning of prickle cells and a dense inflammatory infiltarte

False
hyperparakeratosis
hyperplasia
ballooning of prickle cells
Only sparse inflammatory infiltrate

107

Oral leukoplakia is caused by HPV

False
Causal link hasnt been proven although types 6, 11, 16 and 18 have been associated with leukoplakia

108

Proliferative Verrucous Leukoplakia is a rapidly progressive variant of oral leukoplakia

False
Often present for decades but when it eventually transforms into SCC or verucous cancer is is refractory to treatment
15% alive and disease free @ 12yrs

109

Proliferative Verrucous Leukoplakia has the same risk factors as common oral leukoplakia

False
women not men
not assoc w/ ETOH, smoking or HPV

110

Nicotine Stomatitis is the appearance of a grey-white mucosa w/ umbilicated papules w/ central red puncta due to the action of nicotine on the mucosa

False
description correct but due to heat not nicotine
seen in pipe smokers

111

90% of mouth/oropharynx cancers are SCC

True

112

SCCs commonly occur on the upper lip vermillion

False
SCC on Lower lip vermillion
BCC more common on upper lip

113

Oral SCC is associated with smoking, alcohol,betal nut chewing (india), HPV infection (16/18), HSV, poor dentition and immunosuppression

True

114

Diet rich in fruit/veg is protective against oral SCC

True

115

Oral SCC most commonly occurs on the dorsal tongue and buccal mucosa

False
Lip most common - 30%
25% on tongue esp lateral and ventral tonguefloor of mouth

116

Oral SCC can present as an ulcer, an exophytic mass or an endophytic process w/ induration

True
Beware and bx anything lasting >3wks!

117

EGFR inhibitors increasingly used for head and neck SCC

True
often with surgery and/or XRT

118

Retinoids can help with prevention of recurrence or  secondary lesions of oral SCC

True

119

Following treatment of oral SCC, 90% of recurrences occur within the first 5 years

False
90% in first 2 years

120

Oral SCC is far more aggressive than SCC of skin and diagnosed later

True

121

In oral SCC, 5yr survival rate for stage III/IV disease is 10%

False
5yr survival rates
III/IV = 30%
5yr survival rates
I/II disease = 80%

122

After an oral SCC there is a 2-3% annual risk of developing second primary SCC in same region

True

123

Oral verrucous carcinoma is an uncommon variant of SCC mainly seen in men >50

True

124

Oral verrucous carcinoma is low grade and slow growing

True

125

Oral verrucous carcinoma is a white, exophytic warty tumour which often ulcerates

Falser
arely ulcerates

126

The diagnosis of verrucous carcinoma is easily made on histopathology?

False
Shows
hyperkeratosis w/ ancathotic well differentiated epithelium w papillary/verrucous surface
Dense chronic inflamm infiltrate
Minimal atypia and rare mitotic figures
Must examine multiple sections as 25% show foci of typical SCC

127

Foci of typical SCC can be found in 25% of verrucous carcinomas

True

128

Vaerrucous carcinoma can be terated with XRT

False
treat with wide local excisionXRT can increase risk of transformation to anaplastic SCCCan use adjunctive immiquimod/oral retinoids (etretinate)

129

Oral kaposis sarcoma most often affects the palate

True
hard/soft palatethen gingiva
then dorsal tongue
then anywhere else in oral cavity

130

Oral akposi sarcoma will often regress with HAART

True

131

Oral kaposi sarcoma can be terated with XRT

True
Also laser and intralesional vinblastine

132

Oral melanoma accounts for

True

133

oral melanoma affects women more than men

False
M>F

134

oral melanoma is usually in horizontal growth phase at time of diagnosis

False
usually in vertical growth phase
unclear if due to minimal radial phase or just late diagnosis

135

Oral melanoma is more common on the upper gums than the lower

True
But hard palate most common site

136

Oral melanomas may be amelanotic and present as erythroplakia or a lesion resembling pyogenic granuloma or SCC

True

137

Oral melanoma has 5yr survival=5%, median survival of 2yrs

False
5 year survival is 15%
median survival of 2yrs

138

Hodgkins disease can arise in the oral cavity

False
Non hodgkins lymphoma can
head and neck is second most common site after GIT
seen more in HIV pts
soft/rubbery-firm slow growing mucosa-coloured or purplish swelling
May ulcerate or have surface telys

139

A fixed drug eruption can present as recurrent oral apthae

True

140

Drug-induced gingival hyperplasia starts after several years on the drug

False
Enlargement during 1st year of drug administration

141

Drug-induced gingival hyperplasia is most frequently associated with ciclosporin

False
Phenytoin most often
phenytoin (50%),
nifedipine (25%),
CsA (25%)

142

Drug Related Gingival Hyperplasia starts at the interdental papillae of the anterior teeth on the labial (external) side

True

143

Poor oral hygeine incerases susceptibilty to Drug Related Gingival Hyperplasia

True

144

Causes of gingival hyperplasia include lithium, bactrim, pregnnacy and scurvy

True
Also leukaemia, sarcoidosis, Amyloidosis, Wegeners, kaposis, Crohns, Acromegally
Also erythromycin  phenytoin and other anticonvulsants, nifedipine and other Ca channel blockers and CsA

145

Recombinant human keratinocyte growth factor (palifermin) reduces severity of mucositis.  Used in pts given high dose chemo and XRT for HSCT

True

146

Mucositis usually occurs in the first week of radiotherapy

False
3rd week

147

Mucositis occurs in pts who receive chometherapy induicng neutropenia

True
Ulcers occur 4-7 days after administration of chemo

148

Pts with cyclic neutropenia get crops of oral apthae coinciding with nadir of neutropenia

True

149

Venous lakes can only be treated with lasers

False
LN2 cryo (closed clold probe technique)
hyfrecation (fine needle diathermy)
infrared coagulation
LASER - Nd:YAG best, can use  PDL w/ stacked pulses
IPL
excision

150

Melkersson-Rosenthal syndrome is a triad ofgranulomatous cheilitisfacial palsy or ptosis andscrotal tongue

True
although not all cases have all 3 features

151

The full triad of Melkersson-Rosenthal syndrome occurs in 50% of cases

False
only 25% of cases
facial nerve palsy in 13-50%

152

What is orofacial granulomatosis?

Non caseating, non infectious granulomatous inflammation of lips, face or oral cavity
Includes granulomatous cheilitis, Crohn's, sarcoidosis

153

(Idiopathic) Granulomatous cheilitis (cheilitis granulomatosis, ‘orofacial granulomatosis’) affects the ower lip more commonly than the upper lip

False
Upper lip more common

154

(Idiopathic) Granulomatous cheilitis (cheilitis granulomatosis, ‘orofacial granulomatosis’) causes symmetrical sweling

False
assymetrical

155

(Idiopathic) Granulomatous cheilitis (cheilitis granulomatosis, ‘orofacial granulomatosis’) has a sudden onset

True

156

(Idiopathic) Granulomatous cheilitis (cheilitis granulomatosis, ‘orofacial granulomatosis’) is thought to be due to an immune complex vasculitis

False
Thought to be to cell-mediated hypersensitivty food/food additives/certain flavourings (esp cinnamate aldehyde)

157

The causes of a Granulomatous cheilitis includeidiopathic including Melkersson-RosenthalCrohnssarcoidosisallergic contact dermatitis/mucositis

True

158

Granulomatous cheilitis usually has florid granulomas on histo

False
often sparse
Non caseating, non infectious type

159

ILCS provide long term cure in idiopathic granuloamtous cheilits (orofacial granulomatosis)

False
can work but tendency to relapse
Other Rx;
dapsone, clofazimine, HCQ, tetracyclines, thalidomide, TNF alpha inhibitors

160

granuloamtous cheilits affects younga dults mainly and M=F

True

161

Oral involvement is common in Crohns disease

False
Uncommon - 5-15%

162

Oral Crohns most often presents as cobblestone elsions of the buccal mucosa

False
Linear ulceration of buccal vestibule most common
Also can be;
granulomatous cheilitis
Persistent firm painless swelling of labial/buccal mucosa or facial tissuesoral apthae
cobblestone lesions
pysostomatitis vegetans
fibrosis and adhesions

163

Oral Crohns responds to systemic Rx of Crohns but ILCS may be required

True
e.g. steroids, AZA, 6-mercapto, MTX, TNFα inhibitors

164

Strawberry gums may be seen in Wegener's granulomatosis

True
petechial haemorrhage superimposed on friable micropapular surface
Pathognomonic

165

Wegener's granulomatosis can affect the naspharynx causing epistaxis, sinusitis, nasal obstruction and saddle nose deformity

True

166

Wegener's granulomatosis affecting the oral mucosa and skin is usually part of a superficial mucocutaneus form of the disease w/out systemic involvement

False
Superficial form exists but more often it is a presentation of systemic disease - need full investigation

167

Gingival pain and bleeding are uncommon in oral Wegener's

False
these are common complaints

168

Macroglossia affects up to 5% of pts with primary systemic amyloidosis

False
20%

169

Amyloidosis can cause haemorrhagic papules/plaques of tongue or other oral mucosal sites

True
can also cause;
macroglossia with or w/out ulcerationtaste disturbance / dysguesia
xerostomia from salivary gland involvement 

170

Pernicious anaemia is 20x more likely in those with an affected close relative

True
most common cause of B12 def
affects 2% of population over 60 esp women

171

Pyostomatitis Vegetans commonly affects the dorsum of the tongue

False
dorsum usually spared
affcets lips, gums and buccal mucosa mainly

172

Pyostomatitis Vegetans is associated with UC more than Crohn's disease

True

173

The typical appearance of pyostomatitis vegentans is multiple ‘snail track’ linear arrays of pustules and small erosions on diffuse mucosal erythema

True

174

Pyostomatitis Vegetans affects man and women equally

false
Men more oftenage range 20-60 usually

175

Important differentials for pyostomatitis vegetans include HSV, apthae, syphylis and oral pemphigus vulgaris

True
herpetiform simple apthae
HSV
oral pemphigus vulgaris/vegetans
candida
secondary syphylis (also snail track lesions)

176

Oral LP is up to 8x more common than cutaneous LP

True

177

Oral LP can cause loss of filiform papillae on the tongue

True

178

Chronic erosive or atrophic oral LP carries a 5% risk of SCC over 10 yrs

True
need close follow up

179

Histopath of oral LP is identical to skin LP

False
similar but saw-tooth rete ridges are rare

180

Typical LS occurs in the oral mucosa

False
can get LP/LS overlap
Histo similar to LP but; epithelial atrophy, hyperkeratosis, oedema of the papillary corium and lymphocytic infiltrate is not as close to the epithelium as in LP

181

Oral lesions are common in IgA pemphigus

True
all types

182

Oral lesions ocur in 50% of SLE pts

True

183

oral lesions in SLE are typically red patches that break down leaving slit like ulcers

True
can also get oral petechiae

184

DLE lesions can occur on oral mucosa

True

185

Oral HSV is unusual in SLE pts

False
common

186

Angular stomatitis is a  common feature of chronic mucocutaneous candidiasis

True

187

Primary herpetic stomatitis usually due to HSV1

True

188

10% of cases of HSV stomattis become chronic

False
One third do

189

herpes labialis (cold sores) are due to recurrence of oral HSV

True
Primary disease causes herpes stomatitis or rarely herpetic geometric glossitis

190

Incubation period for oral primary HSV is 3-7 days

True

191

Herpetic geometric glossitis causes a painless deep longitudinal groove and shallower lateral fissures

False
appearance is correct but very painful

192

VZV stomatitis can cause gingivitis but primary oral HSV stomatitis does not

False
Other way around

193

Zoster of the maxillary branch of CNV affects hard palate, upper gingiva and buccal sulcus unilaterally

True
a few lesions may cross the midline

194

Zoster of the mandibular branch of CNV affects the hard palate, lateral tongue, and lower labial and buccal mucosa

False
affects floor of mouth, lateral tongue, and lower labial and buccal mucosamaxillary branch zoster affects hard palate

195

Herpangina is a syndrome of fever, sore throat, cluster of 2-4mm vesicles turning into ulcers at back of throat/tonsils or soft palate

True

196

Herpangina is caused by HSV2

False
coxsackie viruses (mainly A can be B)

197

Hand, foot and mouth disease is caused by coxsackie A

True
coxsackie A, sometimes B and enteroviruses

198

Hand, foot and mouth disease is worse in childhood

False
Adults become sicker but self limiting usually

199

Encephalitis is a frequent complication of hand, foot and mouth disease

False
very rare

200

CMV can cause persistant oral ulceration in HIV pts

True

201

EBV (glandular fever) presenting with severe sore throat is called anginose type EBV

Truecan cause laryngeal obstruction

202

All types of syphylis can affect the oral region

True
Primary - chancre
secondary - split papule perleche, mucous patches (30%), small oral ulcers, syphylitic sore throat
Tertiery - leukoplakia, gummata
Congenital - rhagades, Hutchinsons teeth, oral ulcers (rare)

203

A gumma of the tongue or palate is the most common presentation of tertiery syphylis in the mouth

False
Gumma is the characteristic lesion but premalignant leukoplakia is most common

204

A swab for spirochetes is reliable in the diagnosis of oral syphylis

False
spirochetes are normally found in the mouthclean surface with sterile gauze then scrape with spatula

205

Mucous patches of the buccal mucosa are seen in 60% of cases of secondary syphylis

False
30%

206

Oral hairy leukoplakia has fine white hairs growing out of it

False
No hairs just a white corrugated appearance

207

a dorsal tongue ulcer is the most common presentation of oral TB

True

208

Minor (simple) recurrent apthus ulcers account for half of all caes

False
80% of apthus ulcers
Types of simple apthus ulcers are
Minor
Major
Herpetiform

209

Complex oral apthosis is defined as;Almost constant presence of at least 3 (oral/genital) – In the absence of Behcet’s disease

True

210

Simple apthous ulcers are cremy white with an erythematous halo

True
turn grey when healingmajor ulcers may have oedema
herpetiform are more punched out

211

simple apthous ulcers usually number les than 6 with attacks up to 3 times per year

True

212

simple apthous ulcer disease can be exacerbated by stress, cessation of smoking, immunodeficiency and the menstural cycle

True

213

Depression and anxiety are common causes of burning mouth syndrome

True
30-70%