oral med general Flashcards
(96 cards)
1
Q
what are tori?
A
exostosis - completely normal bone formation - swelling of bone
2
Q
how do tori grow?
A
grow and enlarge with growth of the mandible and maxilla
3
Q
how to tori appear?
A
symmetrical smooth and covered in mucosa
4
Q
what are fordyce spots?
A
sebaceous glands
occur on vermillion border and buccal/lingual mucosa
5
Q
when do fordyce spots become prominent?
A
age
6
Q
what is leukodaema?
A
white and grey areas
odeama in superficial mucosal layers
gives a white appearance
7
Q
what are other names for geographic tongue?
what are the symptoms of geographic?
A
erythema migrams, benign migratotry glossitus
can be asympotmatic or irritated by spicy/salty/acidic/rough foods
8
Q
what is hairy tongue and what is it caused by?
A
brown/black tongue
staining from smoking, tea, coffee, chx mw
hypoplasia of filiform papillae
9
Q
how is the appearance of a hairy tongue removed?
A
tongue brushing
sucking a peach stone
sucking a pineapple
suck vit c tabs
10
Q
what are vascular lesions and malformations?
A
long lasting
normal part of circulation
test by encouraging blanching
not prone to rupture because CT layer covering
11
Q
what are signs that a lesion could be a malignant melanoma?
A
occur on palatal and maxillary mucosa commonly
border not well defined, colour intensity and varies, quite large, satellite lesions, erythema and ulceration
12
Q
what bacteria can cause fungal infections?
A
c. albicans
c. tropicalis
c. galbreta
13
Q
what are the classifications of candida albicans?
A
- acute pseudomembranous - thrush
- acute erythematous
- chronic erythematous
- chronic hyperplastic
14
Q
what are associated lesions of candida albicans?
A
angular chelitis
denture stomatitis
median rhomboid glossitis
15
Q
describe acute pseudomembranous thrush?
A
removeable upper layer of superficial epithelium affected by candida - white yellow plaques - leaves area of inflammation
16
Q
what are some possible underlying causes of candidiasis?
A
anaemia haematinic deficiency - B12 folate iron type 2 diabetes asthma - steroid/inhalers immunodeficiency antibiotics HIV/AIDS dry mouth
17
Q
what is chronic hyperplastic candida?
A
inside angle of mouth - comissure firmly adherent plaques homogenous appearance inter areas of redness asymptomatic/symptomatic potential malginant mucosal disorder
18
Q
what is denture stomatitis?
A
erythme confined to denture wearing area
poss slight hyperplastic appearance
localised/generalised
19
Q
what is angular chellitis?
A
cracking, erythema, crusting, bleeding,
denture wearers
underlying systemic conditions
20
Q
what bacterial infection can cause angular chellitis?
A
staph aureus
21
Q
what is medial rhomboid glossitis?
A
inflammation in middle of tongue
asymptomatic or symptomatic
22
Q
what meds can treat candidiasis?
A
topical intra oral and extra oral creams
systemic capsules
chx/hypochlorite mw
23
Q
how to treat stomatitis?
A
remove at night
soak in hypochlorite or chx
fluconazole OM gel
nystatin of contra indicated
24
Q
what is a genodermatoses?
A
white sponge naevus any area of OM affected rough surface blend with surrounding normal area asymptomatic nasal and genital mucosa also affected no malignant potential
25
what is frictional/traumatic keratosis?
linear alba
wipe away to leave inflammation
sheets of necrotic epithelium
26
what is chemical trauma?
apsirin burns can cause/etch burn
wipe away to leave inflammation
sheets of necrotic epithelium
27
what is stomatitis nicotina?
generalised whitening
combo thermal/chemical trauma
not potentially malignant
28
what is the incidence of lichen planus?
```
affects 2/100 people
checks, tongues. gingivae, FOM, palate
risk of SCC
associated with hepC
usually bilateral but not symmetrical
seen with lupus and graft versus host disease
asymptomatic
```
29
what is non erosive lichen planus?
no ulceration
reticulrar LP
white plaques/patches
atrophy of epithelium
30
what is erosive LP?
ulceration
| white striation and erythema
31
where do skin lesions of LP appear on the body and how do they present?
raised red purple patches
scalp = alopecia
nails = vertical ridging/splitting
genitals = discomfort, scarring
32
how to treat symptomatic LP?
analgesic/antibacterial MW, benzydamine - MW OM spray
chx MW
topical steroids - betamethasone, clenil modulate, hydrocortisone
33
what drugs can cause lichenoid?
```
antihypertensives
oral hypoglycaemics
NSAIDs
2nd line anti arthritics
xanthine oxidase inhibitors
pyschoactive drugs
antiparastic
antimicrobial
```
34
how do thermal or chemical ulcers present?
white patches
35
what is TUGSE?
traumatic eosinophillic ulcer and stomal eosinophillia
delayed healing
mimics SCC
36
what drugs can induce oral ulcers?
NSAIDs
methotrexate
nicorandil
37
what are recurrent oral apthous ulcers?
recurrent oral ulcers seen in abscess of systemic disease
| similar lesions seen with systemic disease including GI disease
38
what are the types of recurrent apthous ulcers?
minor
major
herpetiform
39
describe minor apthous ulcerations?
```
Non K areas
>10 lesions at a time
<1cm
10-14 days to heal
oval, erythema border, yelow base
```
40
describe major apthous ulcerations?
```
K non K areas
>1 cm
heal with scarring
4 or more weeks to heal
>3 lesions at a time
```
41
describe herpetiform ulcers?
```
small
>2mm
numerous at a time >100
non K
10-14 days to heal
```
42
what do ulcers occur in response to?
| what are the phases of ulceration?
cell mediated immunie response
pre ulcerative phase - topical steroids most effective
ulcerative phase
healing phase
43
causes of ulceration?
```
stress
menstrual cycle
sensitivity to foods
GI disease
anaemia
haematinic deficiency
drug history
smoking cessation
family history
```
44
what GI diseases cause oral ulceration?
crohns
| coeliac
45
what can anaemia and haematinic deficiencies?
epithelial atrophy
compromised cell mediated response
cytoxicity of leucocytes reduced
46
when does the cause of recurrent apthous ulceration become important?
when pt's age is outwith norm range and if they seem unexplained - poss increase in severity
47
where do we get B12 and folate from in the diet?
meat and animal produce
| green leafy veg
48
what percent of coeliac patients present first with recurrent apthous ulceration?
6%
49
what is the tx of Recurrent apthous ulceration?
```
chlorhexidine
hydrocortisone oral tabs
SLS free toothpaste
betamethasone MW
clenil modulate
doxycylcline MW
benzydamine MW spray
lidocaine ointment
```
50
what can non healing mouth ulcers be a sign of?
neoplastic cells
| squamous cell carcinomas
51
what is the appearance of SSC?
red and granular
| yellow and smooth
52
what herpes simplex disease is most common orally? and how is it transmitted?
HSV1
skin to skin direct contact
droplets - body excretions
sharing cups etc
53
when a child first encounters HSV1?
infection can be subclinical or clinical
54
what are clinical features
```
general feeling of unwell - fever, lymphadenopathy
inflammation orally
vesicles - small blisters (under few mm)
bulla - > few mm
bullae rupture and become ulcers
```
55
where does PHGS affect?
mucosal surfaces including external lips
| gingivae - erythematous and vesicles
56
who is PHGS most common in?
children and young infants
57
how long does PHGS last?
10-14 days
58
what is the tx of PHGS?
```
analgesics - paracetamol
diflam - analgesic MW
chx gluconate - dilute half and half
bland soft diet and fluids
avoid direct physical contact and other individuals esp babies and immunocompromised
systemic aciclovir
```
59
what is herpes labialis?
HSV1 reactivated in 40% of patients
HSV1 lies in trigeminal nucleus and lies dormant. Travels down sensory neurones and effects epithelium and surrounding tissue
60
what are the first signs of a coldsore developing?
burn and tingle in area that coldsore will develop
61
what is a coldsore?
vesicle rupturing to form area of ulceration
62
when does aciclovir cream work best for coldsore tx?
works best with burn/tingle phase
63
what is herpetic whitlow?
herpetic infection of the skin adjacent to the nail bed
64
what are the primary and secondary infections of varicella zoster?
primary - chicken pox
| secondary - herpes zoster and shingles
65
where does a shingles rash present?
follows distribution of the trigeminal nerve - e.g opthalmic, maxillary, mandibular
66
what type of pain comes form pre lesion of shingles?
pre herpetic pain
67
what does a shingles rash comprise of?
vesicles and bullae
68
what can persist after shingles?
residual burning in area of rash
| >3 months and still persisting = post herpetic pain
69
what is ramsay hunt syndrome?
facial palsy associated with varicella zoster
geniculate ganglion affected
rash in external ear
70
what is epstein barr?
glandular fever HHV4
petechial palatal haemorrhages
ulceration
hairy leukoplakia
71
what can coxsackie virus cause?
herpangina
hand food mouth disease
acute lymphoodular pharyngitis
72
how does hand foot and mouth disease?
```
pre clincal - generally unwell
lesions on hands fingers and mouth
gingivae unaffected, stomatitis
paracetamol and diflam
10-14 days
```
73
what presents orally with measles?
koplicks spots
74
what presents orally with mumps?
facial swelling
bilateral swelling or unilateral salivary gland swelling
trismus
75
what can HPV cause orally?
squamous cell papilloma
verrucus vulgaris
condylema acumination
76
where can squamous cell papilloma's occur?
any area of oral mucosa
cauliflower projection like wart
cryotherpay
77
what is an ulcer?
breach in epithelium to expose underlying CT
78
what is a vesicle?
small fluid filled lesion
79
what is a bulla?
larger fluid filled swelling
80
what is the appearance of Kaposi's sarcoma?
who are these common in?
found most commonly where?
can also present with what lesions?
dark/red/purple/blue lesion
present in over 50% of AIDS patients
palate
ocular and skin lesion
81
how can you tell if something is a vascular lesion?
blanches with pressure
82
what is a haemangiomata?
developmental lesion present from birth
83
what is an erythroplakia?
atrophic red velvety patch
84
what might cause a traumatic white lesion?
aspirin burn
85
what is a leukoplakia?
uncommonly found where?
leukoplakias are premalignant, what % go on to be cancerous?
adherent white patch that cannot be categorised as any other morphological or histological diagnosis
gingivae
4%
86
what areas of the mouth are risky to have a white patch?
| what appearance would you be worried about?
FOM/ventral surface tongue - greater chance of being cancerous
dense verroucous surface
ulceration, hyperplastic
87
what are some potential causes of a white patch?
```
smoking
alcohol
betel nut
chronic trauma
radiation
```
88
what is leukokeratosis?
white sponge naevus = developmental anomaly
| non malignant
89
how might a squamous cell carcinoma present?
white/red patches
warty/granular lesions
ulcers or swelling
90
types of candidiasis?
- acute pseudomembranous - white removable plaque with erythematous surface
- acute atrophic - diffuse red (meds)
- chronic hyperplastic - angular chelitis
- chronic mucotaneous - affecting tongue and nails
- chronic erythematous - diffuse erythem mimicing denture stomatitis - may be seen in HIV and AIDS
91
what are local risk factors for candidiasis?
| systemic?
local - denture wearing, xerostomia, topical steroids
| systemic - medication, diabetes, haematininc deficiency
92
how does an amalgam tattoo present?
flat grey blue discolouration of the mucosa = bc amalgam particles
93
where do malignant melanomas commonly present from?
30% arise from area of hyperpigmentation
94
how does dequamative gingivitis present?
redness/fiery red
smooth shiny thinned gingivae
with or without lichenoid striae, ulceration or vesicles/bullae
95
what is lichen planus?
| what may it present with?
mucotaneous inflammatory condition
| may present as desquamative gingivitis with or without non ulcerating white lichenoid striae
96
what can be seen orally with addisons disease?
diffuse brown pigmentation of gingivae
