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Oral lesions, infex
CMI - Fall 2011
Question | Answer |
---|---|
Sjogren's syndrome involves the triad of what? | Swelling of Parotid or Submandibular glands w/ xerostomia and xerophthalmia |
What is another word for dry mouth? dry eyes? which syndrome are these usually seen in? | Xerostomia, Xerophthalmia, Sjogren's syndrome |
Besides the primary triad of Sjogren's syndrome, what other things may be seen? | Dry skin, vaginal dryness, change in taste |
Primary Sjogren's syndrome? | Occurring alone-no other autoimmune d/o's |
Secondary Sjogren's syndrome? | Occurring in conjunction w/another connec tissue dz, such as Rheu Arth, SLE, Polymyositis |
Gender difference of Sjogren's synd? | 9f:1M (& usually over age 40) |
What is the 1st and 2nd MC rheumatologic d/o's? | 1st=SLE, 2nd=Sjogren's Synd |
What are some lab results that will be seen in Sjogren's synd? | ^ESR, ^Gamma Globulin, Presence of anti-SS-A abs and anti-SS-B autoabs |
What is the gold std for Sjogren's synd dx and what will it show? | Inside lower-Lip bx; Will show lymphocytic infiltration and ductal hyperplasia |
What is a specific test that can be done to test for Sjogrens? | Schirmer's Test: Place a pc of filter paper at the lower conjunctival sac and less than 5mm of wetness in 5 minutes is + for sjogrens |
What is the genl tx for Sjogrens? | Steroids for inflamm and symptomatic tx for eyes and mouth |
What is parotitis? | Painful swelling of one parotid gland with erythema over the gland |
Who is parotitis seen in? | Elderly (>60-70) |
What will the PE of parotitis look like? | Pt looks ill; very painful reddened duct with pus draining from it |
A culture of the pus from someone with parotitis will usually show what growing? | Staph Aureus |
Tx for parotitis? | Rehydration, IV ABX, good oral hygiene, if skin overlying gland becomes thin and shiny--gland may need to be surgically decompressed **MUST always admit a pt w/parotitis w/in 24 hrs to begin IV abx |
What is the name of the fungal ingfection of the mucous membs of the mouth and tongue? | THrush |
Who is thrush usually seen in? | Very young, elderly -RFs: dentures, poor oral hygiene, pre-existing infec, use of inhaled ster, nutritional deficits, DM, steroids, tumors, chemo, AIDS, abx, pregnancy |
WHat is a topical/PO option that can be used for thrush? | Nystatin |
For thrush, it is best to rinse and spit--what can be done for infants? | USe a long q-tip to "paint" the meds on the tongue (bc cant swish and spit) |
Inflamm of the tongue is called? | Glossitis |
What are some causes of glossitis? | Anemia, Vit B defic, Irrit, Infex, Poorly fitting dentures, rough teeth, trauma, burns, chewing tobacco, alcohol |
Tx for glossitis? | Remove irritant, good hygiene, nutrition consult, topical lidocaine (to help w/ eating, sleeping) |
What is the name of the viral infection of the mouth charac by crops of small vesicles, ulcers, inflammation? | Herpetic stomatitis |
WHo is herpetic stomatitis usually seen in? | Young - 9mo to 5yo |
Etiology of herpetic stomatitis? | HSV type 1 > type 2 |
Antiviral meds can be given in herpetic stomatitis...but why may it not be worth it? | May decrs sxs by 1 day, but usually have to take the med 5x/day |
When should you tell a pt to expect herpetic stomatitis to resolve? | W/in 1-2 wks |
What is another name for canker sores? | Aphthous stomatitis |
Canker sores are more common in who? | Kids 10-19 and F>M |
Etiology of aphthous stomatitis? | UNKNOWN--may be herpes virus? but not always? |
Would you be more likely to see a fever in a pt with herpetic stomatitis or aphthous stomatitis? | Herpetic stomatitis (aphthous is usually afebrile) |
When should pts expect canker sores to resolve? | 1-2 wks |
What is the name for an infection of the mouth, face, jaw, or throat that begins as a tooth infection or cavity? | Dental abscess |
What is an easy way to check likelihood of a dental abscess? | Pain with tapping on tooth w/tongue blade |
What is trismus? | Inability to open mouth (d/t pain) |
If a dental abscess has ruptured, what should you do? | Have pt gargle salt water to remove drainage |
Marcaine vs Lidocaine? | M = lasts longer |
Tx for dental abscess? | Pain management, abx, dental block |