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Medical dermatology Dan > Oral Dan > Flashcards

Oral Dan Flashcards

1
Q

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

A

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

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2
Q

Geographic tongue occurs in 10% of people

A

False

1-3%

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3
Q

Geographic tongue is more common in women

A

False

M=F

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4
Q

Geographic tongue is always confined to the tongue

A

False

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

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5
Q

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

A

True

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6
Q

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

A

True

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7
Q

Geographic tongue does not occur with fissured (scrotal) tongue

A

False

Can occur together

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8
Q

Geographic tongue is usually asymptomatic

A

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

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9
Q

Scrotal tongue occurs equally in males and females

A

True

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10
Q

Scrotal tongue is often associated with geographic tongue

A

True

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

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11
Q

Scrotal tongue occurs in about 15% of adults

A

True
2-30%
unusual in children

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12
Q

Black hairy tongue is an exceptionally rare condition mainly affecting men

A

False
is common
affects M=F

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13
Q

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

A

True

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14
Q

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

A

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

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15
Q

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

A

True

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16
Q

Black hairy tongue can be normal in dark skinned individuals

A

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

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17
Q

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

A

True

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18
Q

Simple glossitis involves loss of filliform papillae with pain and swelling

A

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

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19
Q

Atrophic glossitis involves inflammation with loss of filliform papillae

A

True

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20
Q

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

A

True

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21
Q

Median Rhomboid Glossitis afects 1% of adults and children

A

False

1% of adults but very rare in kids

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22
Q

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

A

True

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23
Q

Median Rhomboid Glossitis is a congenital defect

A

False

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24
Q

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

A

True

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

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25
Q

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

A

True

Candida is number one cause

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26
Q

Improving oral hygeine is sufficient treatment for Median Rhomboid Glossitis

A 
False
usually insuffucient
swab and treat for candida
stop smoking, see dentist, may need new dentures
consider HIV or other immunosuppression
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27
Q

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

A

False
AD
Keratin 4 or 13

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28
Q

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

A

True

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

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29
Q

white sponge naevus is premalignant

A

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

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30
Q

White oral lesions may be seen in Howel-Evans syndrome

A

True

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31
Q

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

A

True

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32
Q

Oral lesions of Dyskeratosis congenita are benign with no malignant potential

A

False

Can become malignant

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33
Q

Oral mucosal hyperpigmentation is a rare feature of Dyskeratosis congenita

A

True

Can also get hypocalcified teeth

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34
Q

Oral keratosis is a rare feature of Pachyonychia Congenita

A 
False
Occurs in 60%
also1
6% natal (neonatal) teeth
10% angular stomatitiscandida common
No Rx for keratosis but pts need ongoing dental care
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35
Q

Gingival hyperkeratosis can occur in Unna-Thost variety of PPK

A

True

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36
Q

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

A

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

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37
Q

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

A

True

Also sometimes get oral carcinoma

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38
Q

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

A

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

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39
Q

Early loss of teeth is a feature of Papillon Lefevre

A 
True
Deciduous teeth usually lost by 5 and permanent teeth by 16
Also
Downs
diabetes
EDS type 8
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40
Q

Materia alba is due to smoking

A

False

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

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41
Q

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

A

False

Is really a fistula but mandibular teeth more commonly then maxillary

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42
Q

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

A

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

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43
Q

The main differentials of a Cutaneous dental sinus areneoplasmpyogenic granulomacervicofacial actinomycosis

A

True

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44
Q

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

A

False

This is Necrotizing (Ulcerative) Gingivitis

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45
Q

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

A 
True
Immunosuppression
malnutrition
stress
smoking
poor oral hygiene
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46
Q

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

A

True

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47
Q

Swabs are diagnostic in Necrotizing (Ulcerative) Gingivitis

A

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

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48
Q

chronic ulcerative stomatitis affects young men

A

False

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

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49
Q

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

A

True

Detect on mucosal biopsy IMF or ELISA blood

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50
Q

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

A

True

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51
Q

Labial melanotic macules occur in 20% of the normal population

A

False

up to 3% of normal people

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52
Q

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

A

True

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53
Q

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

A

True

Blue naevi account for one third

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54
Q

Amalgam is the only cause of oral lichenoid contact dermatitis

A 
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
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55
Q

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

A

True

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56
Q

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

A

True

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

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57
Q

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

A

True

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58
Q

simple oral ulcers are more comon in young women

A

False

more common in men in teens and 20s

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59
Q

Simple ulcers are more common than complex ulcers

A

True

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60
Q

simple ulcers are divided into 3 types;
Minor
Major
Herpetiform

A

True

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61
Q

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

A

False

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

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62
Q

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

A

True

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

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63
Q

Herpetiform simple ulcers are caused by HSV

A 
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
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64
Q

Simple ulcers are found on the dorsal tongue

A

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)

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65
Q

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

A

False
get better in pregnancy
worse with other 2

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66
Q

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

A

True

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67
Q

Complex apthous ulcers are usually large

A

False
usualy small like simple minor ulcers
MUST investigate for associations

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68
Q

75% of Behcets pts get oral ulcerations

A

false
99% do
Multiple lesions,

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69
Q

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

A

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

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70
Q

Aspirin can cause irritant contact stomatitis

A

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

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71
Q

Fibroepithelial polyps are the most common oral cavity tumour

A

True

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72
Q

Fibroepithelial polyps occur in children

A

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

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73
Q

A pregnancy epulis is a Fibroepithelial polyp

A

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

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74
Q

Fibroepithelial polyp often occur along the biteline of the buccal mucosa

A

True

Also on labial mucosa/tongue/gingivae

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75
Q

A fibroepithelial polyp is the same as an oral fibroma

A

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

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76
Q

Intraoral Fibroepithelial polyps are often symptomatic

A

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

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77
Q

Morsicatio Buccarum means chronic cheek chewing

A

True

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78
Q

Traumatic ulcers in the mouth can mimic oral SCC

A

True

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79
Q

Xerostomia is uncomfortable but doesnt have serious consequences

A

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

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80
Q

Nothing can be done for Xerostomia

A

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

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81
Q

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

A

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

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82
Q

A Ranula is a mucocele located on the floor of mouth

A

True

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83
Q

Mucoceles are most common on the upper labial mucosa

A

False

lower labial mucosa

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84
Q

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

A

True

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

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85
Q

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

A

True

mucoepidermoid carcinoma often presents there

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86
Q

Mucocoeles resolve spontaneously

A

True

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

87
Q

A mucoecele is a salivary gland tumour

A

False

Different things

88
Q

Salivary gland tumour mainly arise from minor salivary glands

A

False

Minor glands only 15% of all salivary gland tumours

89
Q

The most common benign alivary gland tumour is a pleomorphic adenoma

A

True

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

90
Q

The most common malignnat salivary gland tumour is adenocarcinoma

A

False

Mucoepidermoid carcinomaBut benign tumours are more common than malignant

91
Q

Leukoplakia is most common premalignant condition of oral cavity

A

True

must bx to assess for degree of dysplasia and SCC

92
Q

Leukoplakia is assoc w/ alcohol consumption

A

True

Also Tobacco esp smoking and sanguinaria (bloodroot)

93
Q

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

A

False

All true but more common in men

94
Q

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

A

True

95
Q

leukoedema is the same as leukoplakia

A

False

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

96
Q

Erythroplakia is a rare harmless red plaque of the buccal mucosa

A

False

Rare red plaque which is more dysplastic when biopsied than leukoplakia

97
Q

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

A

True

98
Q

Erythroplakia occurs at a younger age than leukoplakia

A

False
older age group
M=F

99
Q

Erythroleukpplakia is an intraoral plaque with both white and red areas

A

True

often highly dysplastic/SCC

100
Q

Mildly dysplastic leukoplakia can be monitored

A

True

But mod/severe dysplastic need treatment

101
Q

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

A

True

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

102
Q

Oral Hairy Leukoplakia is due to EBV

A

True

103
Q

Oral Hairy Leukoplakia is seen in immunocompetent individuals mainly

A

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

104
Q

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

A

False

affects this area because keratinocytes here have EBV receptors.

105
Q

50% of cases of Oral hairy leukoplakia alos have candida

A

True

106
Q

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

A 
False
hyperparakeratosis
hyperplasia
ballooning of prickle cells
Only sparse inflammatory infiltrate
107
Q

Oral leukoplakia is caused by HPV

A

False

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

108
Q

Proliferative Verrucous Leukoplakia is a rapidly progressive variant of oral leukoplakia

A

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
Q

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

A

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

110
Q

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

A

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

111
Q

90% of mouth/oropharynx cancers are SCC

A

True

112
Q

SCCs commonly occur on the upper lip vermillion

A

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

113
Q

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

A

True

114
Q

Diet rich in fruit/veg is protective against oral SCC

A

True

115
Q

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

A

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

116
Q

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

A

True

Beware and bx anything lasting >3wks!

117
Q

EGFR inhibitors increasingly used for head and neck SCC

A

True

often with surgery and/or XRT

118
Q

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

A

True

119
Q

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

A

False

90% in first 2 years

120
Q

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

A

True

121
Q

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

A 
False
5yr survival rates 
III/IV = 30%
5yr survival rates
 I/II disease = 80%
122
Q

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

A

True

123
Q

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

A

True

124
Q

Oral verrucous carcinoma is low grade and slow growing

A

True

125
Q

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

A

Falser

arely ulcerates

126
Q

The diagnosis of verrucous carcinoma is easily made on histopathology?

A

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
Q

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

A

True

128
Q

Vaerrucous carcinoma can be terated with XRT

A

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

129
Q

Oral kaposis sarcoma most often affects the palate

A

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

130
Q

Oral akposi sarcoma will often regress with HAART

A

True

131
Q

Oral kaposi sarcoma can be terated with XRT

A

True

Also laser and intralesional vinblastine

132
Q

Oral melanoma accounts for

A

True

133
Q

oral melanoma affects women more than men

A

False

M>F

134
Q

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

A

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

135
Q

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

A

True

But hard palate most common site

136
Q

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

A

True

137
Q

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

A

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

138
Q

Hodgkins disease can arise in the oral cavity

A

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
Q

A fixed drug eruption can present as recurrent oral apthae

A

True

140
Q

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

A

False

Enlargement during 1st year of drug administration

141
Q

Drug-induced gingival hyperplasia is most frequently associated with ciclosporin

A 
False
Phenytoin most often
phenytoin (50%), 
nifedipine (25%), 
CsA (25%)
142
Q

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

A

True

143
Q

Poor oral hygeine incerases susceptibilty to Drug Related Gingival Hyperplasia

A

True

144
Q

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

A

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

145
Q

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

A

True

146
Q

Mucositis usually occurs in the first week of radiotherapy

A

False

3rd week

147
Q

Mucositis occurs in pts who receive chometherapy induicng neutropenia

A

True

Ulcers occur 4-7 days after administration of chemo

148
Q

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

A

True

149
Q

Venous lakes can only be treated with lasers

A 
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
Q

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

A

True

although not all cases have all 3 features

151
Q

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

A

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

152
Q

What is orofacial granulomatosis?

A

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

153
Q

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

A

False

Upper lip more common

154
Q

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

A

False

assymetrical

155
Q

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

A

True

156
Q

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

A

False

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

157
Q

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

A

True

158
Q

Granulomatous cheilitis usually has florid granulomas on histo

A

False
often sparse
Non caseating, non infectious type

159
Q

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

A

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

160
Q

granuloamtous cheilits affects younga dults mainly and M=F

A

True

161
Q

Oral involvement is common in Crohns disease

A

False

Uncommon - 5-15%

162
Q

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

A 
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
Q

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

A

True

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

164
Q

Strawberry gums may be seen in Wegener’s granulomatosis

A

True
petechial haemorrhage superimposed on friable micropapular surface
Pathognomonic

165
Q

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

A

True

166
Q

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

A

False

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

167
Q

Gingival pain and bleeding are uncommon in oral Wegener’s

A

False

these are common complaints

168
Q

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

A

False

20%

169
Q

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

A

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

170
Q

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

A

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

171
Q

Pyostomatitis Vegetans commonly affects the dorsum of the tongue

A

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

172
Q

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

A

True

173
Q

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

A

True

174
Q

Pyostomatitis Vegetans affects man and women equally

A

false

Men more oftenage range 20-60 usually

175
Q

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

A 
True
herpetiform simple apthae
HSV
oral pemphigus vulgaris/vegetans
candida
secondary syphylis (also snail track lesions)
176
Q

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

A

True

177
Q

Oral LP can cause loss of filiform papillae on the tongue

A

True

178
Q

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

A

True

need close follow up

179
Q

Histopath of oral LP is identical to skin LP

A

False

similar but saw-tooth rete ridges are rare

180
Q

Typical LS occurs in the oral mucosa

A

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
Q

Oral lesions are common in IgA pemphigus

A

True

all types

182
Q

Oral lesions ocur in 50% of SLE pts

A

True

183
Q

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

A

True

can also get oral petechiae

184
Q

DLE lesions can occur on oral mucosa

A

True

185
Q

Oral HSV is unusual in SLE pts

A

False

common

186
Q

Angular stomatitis is a common feature of chronic mucocutaneous candidiasis

A

True

187
Q

Primary herpetic stomatitis usually due to HSV1

A

True

188
Q

10% of cases of HSV stomattis become chronic

A

False

One third do

189
Q

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

A

True

Primary disease causes herpes stomatitis or rarely herpetic geometric glossitis

190
Q

Incubation period for oral primary HSV is 3-7 days

A

True

191
Q

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

A

False

appearance is correct but very painful

192
Q

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

A

False

Other way around

193
Q

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

A

True

a few lesions may cross the midline

194
Q

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

A

False

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

195
Q

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

A

True

196
Q

Herpangina is caused by HSV2

A 
False
coxsackie viruses (mainly A can be B)
197
Q

Hand, foot and mouth disease is caused by coxsackie A

A

True

coxsackie A, sometimes B and enteroviruses

198
Q

Hand, foot and mouth disease is worse in childhood

A

False

Adults become sicker but self limiting usually

199
Q

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

A

False

very rare

200
Q

CMV can cause persistant oral ulceration in HIV pts

A

True

201
Q

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

A

Truecan cause laryngeal obstruction

202
Q

All types of syphylis can affect the oral region

A

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
Q

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

A

False

Gumma is the characteristic lesion but premalignant leukoplakia is most common

204
Q

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

A

False

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

205
Q

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

A

False

30%

206
Q

Oral hairy leukoplakia has fine white hairs growing out of it

A

False

No hairs just a white corrugated appearance

207
Q

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

A

True

208
Q

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

A 
False
80% of apthus ulcers
Types of simple apthus ulcers are
Minor
Major
Herpetiform
209
Q

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

A

True

210
Q

Simple apthous ulcers are cremy white with an erythematous halo

A

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

211
Q

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

A

True

212
Q

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

A

True

213
Q

Depression and anxiety are common causes of burning mouth syndrome

A

True

30-70%

Medical dermatology Dan (41 decks)

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