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68 Cards in this Set

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What areas are primarily affected by Impetigo?
Extremities & Face
What areas are primarily affected by Erysipelas?
Legs & Face
Who is at risk for Impetigo?
Poor hygiene, Hot & humid, Crowded living
Who is at risk for Erysipelas?
Young, old, debilitated, diabetics
What condition manifests as fragile vesicles which quickly rupture and are replaced by thick, adherent amber crusts or longer lasting flaccid bullous lesions?
Impetigo
What condition manifests as Butterfly-shaped lesion, bright red, well-circumscribed, swollen, indurated, and warm to the touch?
Erysipelas
How does treating Impetigo differ from treating Erysipelas?
Impetigo = Systemic oral antibiotics
Erysipelas = Penicillin or Erythromycin
Which condition is a Superficial infection of the skin, Impetigo or Erysipelas?
Impetigo
Which condition is an infection of the dermis, spreads through lymphatic channels?
Erysipelas
What kind of infection is Syphilis and what is the cause?
Chronic infection caused by Treponema Pallidum
What is the primary modes of transmission for Syphillis?
Venereal or Mother to Fetus
T/F
Antibiotic therapy will cure Syphillis
False
Antibiotic therapy may arrest clinical symptoms, but might not result in total care
What feature of tertiary syphilis is when the tongue appears large and irregularly shaped due to diffuse atrophy and loss of dorsal tongue papillae?
Luetic Glossitis
What are the most severe complications that may arise in Tertiary Syphilis?
Congestive Heart Failure
Dementia
Death
What is another term for the occasional papillary lesions found in secondary syphilis?
Condylomata Lata
What feature of secondary syphilis is found in person with compromised immune system that results in Fever, Headache, Myalgia, Necrotic Ulcerations of the Face and Scalp, and Oral lesions?
Lues Maligna
What lesions found in and/or around the mouth are common for Secondary Syphilis?
Diffuse, painless maculopapular cutaneous widespread rash
Mucous patches - superficial areas of irregular grayish mucosal necrosis most commonly found on tongue, lip, buccal mucosa, palate
How does Primary syphilis spread throughout the body?
Spreads through lymphatic channels
Where are the oral lesions associated with primary syphilis located?
Lip, Tongue, Palate, Gingiva, & Tonsils
Describe the clinical appearance of oral lesions due to primary syphilis
Oral lesions may be painless, clean-based ulcerations or vascular proliferations
How long can Syphilis become latent for?
May last 1-30 years
What is included in Hutchinson's triad due to Congenital Syphilis?
Hutchinson's teeth
Interstitial keratitis
Eigth nerve deafness
What are the properties of primary tuberculosis?
1. Occurs in previously unexposed people
2. Localized fibrocalcified nodule at initial site of involvement
3. Vital organisms remain dormant in nodule for years
4. Usually asymptomatic
What do oral lesions from Tuberculosis look like?
Nodular, granular, ulcerated or firm leukoplakic areas
Where do oral lesions from primary tuberculosis manifest?
Primary - Gingiva, Mucobuccal fold, Areas adjacent to teeth, and extraction sites

Secondary - Tongue, Palate, Lip
Where do oral lesions of Secondary Tuberculosis Manifest?
Primary - Gingiva, Mucobuccal fold, Areas adjacent to teeth, and extraction sites

Secondary - Tongue, Palate, Lip
What is the most common life-threatening fungal infection in AIDS patients?
Cryptococcosis
How might Cryptococcosis manifest?
1. Cryptococcal menigitis characterized by headache, fever, vomiting, stiff neck
2. Cutaneous lesions develop in 10-20% of patients with disseminated disease
3. Erythematous papules or pustules that may ulcerate
4. Deep fungal infection associated with poor immunosuppression
What is the most common pattern of HSV-1 infection?
Acute Herpetic Gingivostomatitis
What age range is most commonly affected by Acute Herpetic Gingivostomatitis?
6 months - 5 years
What are the clinical features of Acute Herpetic Gingivostomatitis?
Pinhead vesicles, collapse to form small red lesions which develop ulceration
Movable and attached oral mucosa can be affected
Gingiva enlarged, painful, extremely erythematous
How long should Acute herpetic gingivostomatits last for?
5-7 days (mild)
2 weeks (severe)
What lesions do Herpes Simplex Virus cause on the tonsils?
Pharyngotonsillitis
Primary infection in adults
Vesicles on tonsils and posterior pharynx
Vesicles rupture and form shallow ulcerations
Where is the most common site of Herpes labialis (cold sore or fever blister)?
Most common site is vermilion border and adjacent skin of lips
When do prodromal symptoms of herpes labialis occur before the lesion develops?
6-24 hours prior to lesion development
How does Herpes Labialis present clinically?
Small erythematous papules form clusters of fluid-filled vesicles
Vesicles rupture within 2 days, healing occurs within 7-10 days
What is shown here?
Recurrent Intraoral Herpes
What are the symptoms of Varicella?
Primary infection with VZV
Rash Malaise Fever
Oral lesions may precede skin lesions
What are two major complications of chickenpox?
Reye's syndrome
Encephalitis
Who is at risk for Herpes Zoster?
Immunosuppression, Radiation, Malignancies, Old Age
Pain normally present 1-4 days before development of cutaneous or oral lesions. Lesions resolve within 2-3 weeks in healthy individuals
What causes Infectious mononucleosis?
Epstein Barr Virus
What are the symptoms for Infectious Mononucleosis?
1. Fever, lymphadenopathy, pharyngitis, tonsillitis
2. Petechiae on hard or soft palate, disappear 24-48 hours
3. Necrotizing ulcerative gingivitis
4. Chronic fatigue syndrome
5. Resolves in 4-6 weeks
What is Kaposi's Sarcoma?
1. Multifocal neoplasm of vascular endothelial origin
2. Begins with lesions of skin or oral mucosa, hard palate, and gingiva
3. Plaques or Nodules
4. Progressive malignancy that may disseminate
What causes hairy leukoplakia, which presents with hyperkeratosis and epithelial hyperplasia on lateral border of tongue?
Epstein Barr Virus
What are common manifestations of HIV infection?
1. PGL persistent generalized lymphadenopathy - present for more than 3 months, involves 2+ extrainguinal sites
2. Candidiasis is the most common oral manifestation, often the presenting sign leading to diagnosis
What family do Entero viruses belong to and what diseases does it cause?
Coxsackie Virus Family
1. Herpangina
2. Hand Foot and Mouth Disease
3. Acute Lymphonodular Pharyngitis (NOT vesicles)
What fungal infection is found in insulin-dependent diabetics with poor control as well as immunosuppressed patients that may involve the nose and maxillary sinus?
Zygomycosis
1. Nasal obstruction, bloody discharge, headache, swelling, cellulitis, facial paralysis
2. Maxillary sinus involvement may present as intraoral swelling of maxillary alveolar process or palate
3. Palatal ulceration may evolve with significant tissue destruction
4. Sinus may appear opaque on radiographs
What condition occurs when Necrotizing ulcerative gingivitis extends to involve adjacent soft tissue and adjacent bone?
Noma (Necrotizing Stomatitis, Gangrenous Stomatitis, Cancrum Oris)
Explain mechanism of Cat Scratch Disease
1. Organism enters through scratch or other trauma
2. Papule or pustule develops along scratch
3. Lymph node changes in 3 weeks
4. Self limiting; usually resolves in 4 months
5. Must be considered in differential diagnosis of patients with unexplained symptomatic lymphadenopathy
What other disease could Cat Scratch Disease be mistaken for?
Red or purple skin lesions resemble Kaposi's sarcoma
Oral lesions also resemble Kaposi's sarcoma
What other disease could Cat Scratch Disease be mistaken for?
Red or purple skin lesions resemble Kaposi's sarcoma
Oral lesions also resemble Kaposi's sarcoma
What are two forms of common streptococcal disease in the mouth and how does it manifest?
Streptococcal Tonsillitis and Pharyngitis
Sore throat, dysphagia, tonsillar hyperplasia, redness of the oropharynx and tonsils, palatal petechiae, cervical lymphadenopathy and yellowish tonsillar exudate.
Where does Primary Syphilis manifest?
Chancre develops at site of inoculation after 2-3 weeks
Oral lesions may be found on:
1. Lip
2. Tongue
3. Palate
4. Gingiva
5. Tonsils
What ailment is known as the great imitator?
Syphilis
What are the symptoms of Streptococcal Tonsillitis and Pharyngitis?
1. Sore Throat
2. Dysphagia
3. Tonsillar Hyperplasia
4. Redness of the oropharynx and tonsils
5. Palatal Petechiae
6. Cervical lymphadenopathy
7. Yellowish tonsillar exudate
What condition is most common in children ages 3-12. It affects the tonsils, softpalate, pharynx becomes erythematous and edematous.The rash looks like a sunburn with goose pimples. After rash clears desquamation of the skin. Also can have white or red strawberry tongue.
Scarlet Fever
What manifestation of Scarlet Fever is during the first 2 days the dorsal surface of tongue has white coating through which only the fungiform papillae can be seen?
White Strawberry Tongue
What manifestation of Scarlet Fever is by day 4 or 5, white coating desquamates to reveal erythematous dorsal surface with hyperplastic fungiform papillae?
Red Strawberry Tongue
What are the symptoms and oral manifestations of Tuberculosis?
Productive cough, fever, malaise, anorexia, weight loss, night sweats, consumption.
Miliary tuberculosis - diffuse dissemination through vascular system
Scrofula - tuberculosis from drinking infected milk
Oral lesions involve gingiva, mucobuccal fold, areas adjacent to teeth and extraction sites while oral lesions of secondary tuberculosis present on tongue, palate or lip
How does Cervicofacial Actinomycosis occur?
Actinomyces ssp. enters through area of prior trauma, direct extension through soft tissue, may extend to surface to form fistula
Sulfur granules - discharge large yellowish flecks representing colonies of bacteria
What is the causative organism for Cat-Scratch Disease?
Bartonella Henselae
What are the manifestations and causes of Pseudomembranous Candidiasis (Thrush)?
Adherent white plaques (resembling cottage cheese) on tongue, palate, buccal mucosa.
Plaques can be removed by scraping
Burning sensation, bad taste
May present as a result of exposure to broad spectrum antibiotics (rapid development)
Longstanding form result of immunosuppression (leukemia, HIV infection)
What are some presentations of Erythematous Candidiasis?
Acute Atrophic Candidiasis (antibiotic sore mouth)
Central papillary atrophy (median rhomboid glossitits)
Chronic Multifocal Candidiasis
Angular Cheilitis (involvement of angles of mouth)
Denture stomatitis (erythema localized to denture-bearing areas removable dental prosthesis)
What is the common agent for all of these conditions?
Candidiasis
What condition is also referred to as Candidal Leukoplakia
Chronic Hyperplastic Candidiasis
What are the features of Chronic Hyperplastic Candidiasis?
White patch cannot be removed by scraping
Mucocutaneous candidiasis
Severe oral candidiasis as component of immunologic disorder
What is the most common Systemic fungal infection in U.S.?
Histoplasmosis
How does Histoplasmosis present?
Solitary, painful ulceration of tongue, palate, or buccal mucosa
Lesion has firm, rolled margins, may be clinically indistinguishable from malignancy
Most oral lesions of histoplasmosis occur with the disseminated form of the disease