STOMATITIS

Vesicobullous Lesions

100

These are 4 vesicobullous lesions

What are: herpes simplex, herpes zoster, herpangina, pemphigoid, pemphigus vulgaris, erythema multiforme

200

The incubation time and route of spread of herpes

What is 7 days, and direct contact of infected fluids.

300

The herpes virus lays dormant in this structure, AND this key finding on history differentiates herpes from recurrent aphthous stomatitis.

What is the trigeminal ganglion, and vesicular eruption preceding ulceration.

400

This is the most common complication of zoster AND this is the most commonly affected branch of CNV affected.

What are postherpetic neuralgia and the ophthalmic division (V1).

500

This is the causative agent for herpangina AND this is the pathognomonic cell type on histology for pemphigus vulgaris.

What are the cocksackie virus and the tzanc cell?

Ulcerative Lesions

100

These are 3 ulcerative lesions of the oral cavity.

What are recurrent aphthous stomatitis, trenchmouth (ANUG - acute necrotizing ulcerative gingivitis), SLE, DLE Will take herpes or any other vesicolbullous lesions defined as "late".

200

The difference between major and minor aphthous ulcers

What is: Minor are <1cm and heal in a week without scarring. Major are >1cm, scar, and can persist up to 6 months.

300

These are "herpetiform" ulcers

What are ulcers that occur in groups of 20-200, 1-3mm (small), and resemble herpes but lack a vesicular stage (HISTORY!).

400

This is the treatment for aphthous stomatitis

What is supportive therapy for minor ulcers, with topical or systemic steroids for major ulcers.

White Lesions

100

These are 4 white lesions of the oral cavity

What are leukoplakia, candidiasis, geographic tongue, lichen planus, white sponge nevus, leukedema

200

These are the three types/patterns of lichen planus and what they look like

What are reticular (white, raised "lacy" lines on buccal mucosa - "wickham's striae"), plaque (hyperkeratotic raised white patches), and atrophic/ulcerative (deep, painful ulcers)?

300

This is the clinical finding that differentiates simple candida infections from true leukoplakia (where hyperkaratosis is present).

What is the ability to scrape it off, leaving an erythematous base?

400

These are the three most common antifungals to prescribe for candida and the primary concern when prescribing them.

What are nystatin, clotrimazole, ketoconazole. First one is a matter of compliance (swish for 2 minutes - it burns btw - and swallow 4 times a day!). Last two can cause liver enzyme elevation in pts. with liver dz, so gotta ask about that.

500

This is the classic appearance of a white sponge nevus, it's pattern of inheritance, and two other lesions in the differential.

What is a heaped-up, hyperkaratotic, "scrotal" appearance, autosomal dominant inheritance, and candida and lichen planus (will accept squam) are the ddx.

Tongue Lesions

100

These are 3 tongue lesions

What are geographic tongue, median rhomboid glossitis, hairy tongue, oral hairy leukoplakia?

200

This is median rhomboid glossitis

What is a benign condition where the papillae are missing in a well-circumscribe area on the midline dorsum of the tongue.

300

This is what hairy tongue is and how to treat it

What is painless hypertrophy of the filiform papillae. Treat by removing presumptive cause (antibiotics, steroids, smoking) and meticulous oral hygeine, including tongue brushing.

400

This is the relevant clinical entity regarding oral hairy leukoplakia and the difference between it and hairy tongue.

What is HIV, and the difference is the location (usually lateral/bilateral patches vs midline and all over with hairy tongue), and the fact that it's white hyperkaratosis, not longer papillae.

500

These are the four kinds of papillae on the tongue and some information about each.

What are the FILIFORM (no taste, mechanical, v-shaped), FUNGIFORM (mushroom-shaped, taste, VI), VALLATE (10-14 of them, IX, sulcus terminalis) and FOLIATE papillae (back & sides, VII, IX).

Potpourri

100

These are the 5 "tastes"

What are sweet, salty, sour, bitter and UMAMI Umami - L-glutamate, in MSG, breastmilk, tomatoes, mushrooms, fish...

200

At approximately this week in an 5 or 6 week cycle of oral radiotherapy, we see signs of radiation mucositis.

What is week 2?

300

These are the serous-secreting glands adjacent to the vallate papillae.

What are VON EBNER's glands? (Vallate-Von Ebner)

400

This is the hallmark sign on histology of lichen planus

What are sawtooth rete ridges (hyperkaratosis!) with liquefaction of the basal layer.

500

These are 5 local and 5 systemic factors contributing to oral candida infections.

LOCAL: Physical irritation, Preexisting infection, Poor oral hygiene, Ill-fitting dentures, Overuse of mouthwashes, Lip licking, Smoking SYSTEMIC: Diabetes, pregnancy, AIDS, Malignancy (leukemia and lymphoma), ABx, steroids (topical or systemic),immunosuppression, Rads or chemotherapy