Oral Path CUdental ulcers
Terms
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- Traumatic ulcers are caused by al trauma, chemical/thermal burns, iatrogenically or are _________ meaning self induced. These ulcers can be difficult to differentiate from ______, for this reason if there is no obvious etiology consider an immediate biop
- factitial, SCCA
- TUGSE is short for "traumatic ulcerative granuloma with stromal epithelia" and is used to describe _______ ulcers which usually have elevated margins with minimal pain.
- chronic traumatic
- ________ disease is due to the traumatic ulceration to the anterior tongue of infants with natal teeth.
- Riga-Fede
- Which is not considered an immunologic-mediated ulcer: aphthous ulcers, erythema multiforme, lupus, rxn, contact allergies, Wegner's granulomatosis, midline lethal granuloma, cyclic neutropenia, chronic granulomatous disease.
- all are immunologic
- Apthous ulcers are to __________ mucosa as recurrent herpes is to _________.
- non-keratinized non-attached, keratinized attached
- Aphthous ulcers; major, minor or herpetiform: most common.
- minor
- Aphthous ulcers; major, minor or herpetiform: heal with scaring in 1-2 months
- major aka Sutton's disease
- Aphthous ulcers; major, minor or herpetiform: often on soft palate.
- major
- Aphthous ulcers; major, minor or herpetiform: TX = systemic steroids.
- major
- Aphthous ulcers; major, minor or herpetiform: heal without scaring in 7-10 days.
- minor
- Aphthous ulcers; major, minor or herpetiform: recurrent crops of very small ulcers.
- herpetiform
- Aphthous ulcers; major, minor or herpetiform: attached gingiva or hard palate.
- none⬦gotcha ha!, that would be herpes
- Aphthous ulcers; major, minor or herpetiform: non-keratinized unattached mucosa.
- all the above
- Aphthous ulcers; major, minor or herpetiform: TX = topical steroids.
- minor
- Aphthous ulcers; major, minor or herpetiform: pain out of proportion to size of lesion.
- all the above
- Which medical conditions are associated with aphthous ulcers: celiac and crohn's disease, PFAPA, behcet's, Reiter's, HIV.
- all the above, HIV = large atypical ulcers
- PFAPA stands for ______________.
- periodic fever, aphthous stomatitis, pharyngitis and cervial adenitis. TX: corticosteroids
- Behcet's disease + aphthous ulcers is characterized by recurrent aphthous ulcers plus which 2 of the following: genital ulceration, eye lesions, skin lesions, positive pathergy test.
- 2 of any from the list
- Nick Coles presents with aphthous ulcers along with a triad of lower limb arthritis, non-specific urethritis and conjunctivitis. He also divulges that being such "p-i-m-p" left him with an STD, which likely caused the above sx's due to an abnor
- Reiter's syndrome TX: NSAIDS
- A patient presents with target-like skin lesions caused by a allergy. She is most likely suffering from ______.
- Erythema multiforme
- Erythema multiforme; minor, major, toxic epidermal necrolysis: aka Stevens Johnson syndrome
- major
- Erythema multiforme; minor, major, toxic epidermal necrolysis: most severe always triggered.
- TEN
- Erythema multiforme; minor, major, toxic epidermal necrolysis: skin, oral, ocular and genital lesions.
- major. Hint: aka Stevens-Johnson⬦..genitals, they both start with juh, perv!
- Erythema multiforme; minor, major, toxic epidermal necrolysis: young patients, acute onset, 2-6 weeks.
- minor
- Erythema multiforme; minor, major, toxic epidermal necrolysis:
- requires hospitalization
- Erythema multiforme; minor, major, toxic epidermal necrolysis: like a burn patient.
- TEN
- The most common reactions are caused by: sulfa , ______ and gold injections (arthritis).
- local anesthetics
- A patient presents with rapid, diffuse, painless swelling of the lips, neck and face. He must be treated quickly to avoid respiratory distress. He said he had shellfish with peanut sauce for lunch. He is most likely suffering form angioedema caused by __
- an IgE mediated allergic response to food
- Which of the following may cause contact allergies: cinnamon, denture acrylic, silver amalgam, cheap crowns, meluca oil and tartar control tooth paste.
- all the above T-cell mediated response (type IV)
- A patient presents with a triad of systemic inflammation (necrotizing vasculitis and granulomatous) involving the URT, kidneys and lungs. Despite his sx's you proceede with the exam and find "strawberry gingivitis." You know it's ________ but d
- Wegener's granulomatosis TX: steroids
- A patient presents with a destructive process of the palate and midface which perforates the nasal septum. His medical history states he has peripheral T-cell lymphoma. He is most likely suffering from a ___________. You refer this one to an OMFS and go
- Lethal Midline Granuloma
- _________ is a rare inherited dyscrasia which leaves the patient neutropenic every 21 days causing severe perio making the perio dept happy.
- cyclic neutropenia
- Which is not a deep fungal disease: Coccidiodomycosis, histoplasmosis, Blastomycosis, Tuberculosis, Cryptococcosis.
- TB
- Deep fungal infections are contracted via inhalation of spores typically causing _________ lung involvement and _______ non-healing ulcers, yet in many cases the patient may be asymptomatic.
- granulomatous, chronic
- A patient presents with a chronic non-healing ulcer and is otherwise asymptomatic. You find out he has been farming in the Mississippi-Ohio river valley. You suspect he is suffering from the most common fungal infection in the US ___________.
- histoplasmosis
- A patient presents with URTI sx's and a chronic ulcer. You find he was camping in the San Juachin Valley last month . He is most likely suffering from _______ akaValley fever.
- Coccidiodomycosis
- Other rare fungal infections include blastomycosis and cryptococcus, which is found in people with T-cell deficiencies specially AIDS?
- cryptococcus
- This fungal infection found on vegetables infects the sinuses, brain, orbit and lungs of patients with immune disorders especially diabetics. Oral manifestations include palatal perforations.
- mucormycosis
- This opportunistic fungal infection commonly causes allergic fungal sinusitis.
- aspergillosis
- Syphilis, gonorrhea or TB: Treponema pallidum
- syphilis
- Syphilis, gonorrhea or TB: Hutchinson's triad = interstitial keratitis, 8th nerve deafness, dental anomalies including Hutchinson's (notched) incisors and mulberry molars.
- congenital syphilis
- Syphilis, gonorrhea or TB: Your patient presents with generalized stomatits of the pharynx. Due to your "thorough" head and neck exam you find the patient is also suffering from dysuria and has a yellow-white-green "drip-drip-drip" di
- gonorrhea (sx's occur 2-5 days after infeciton)
- Syphilis, gonorrhea or TB: re-activation --> hemoptysis, rare oral chronic ulcers and osteomyelitis
- TB
- Syphilis, gonorrhea or TB: 3 stages including primary chancre, secondary mucous patches, rash and condyloma lata and tertiary gummas.
- syphilis ***primary and secondary are infectious
- Syphilis, gonorrhea or TB: localized lung infection aka "Ghon complex"
- TB
- Syphilis, gonorrhea or TB: may cause perforation of the palate and glossitis
- syhilis
- Syphilis, gonorrhea or TB:
- Syphilis, gonorrhea or TB: causes blindness of newborns
- gonorrhea
- Syphilis, gonorrhea or TB: most common
- TB > gonorrhea > syphilis
- T/F A patient with latent TB is infectious; a patient with acitve TB should not be treated.
- False; True
- Mucormycosis, lethal midline granuloma and syphilis may all cause ________ of the palate.
- perforation
- A patient presents with a draining sinus tract on the skin. "Sulfur granules" are present in the exudate. What bacteria may be causing these sx's?
- Actinomyces israelii (Actinomycosis)
- While volunteering in a S. American clinic a mal-nourished patient presents with a rapidly progessing, ulcerating necrotic lesion of the lips and cheek. Surrounding gingival tissue presents as ANUG. The patient may be suffering from ________ aka cancrum
- Noma