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Questions and Answers
What is one common local cause of ulceration mentioned?
What is one common local cause of ulceration mentioned?
Which area is typically affected by thermal trauma?
Which area is typically affected by thermal trauma?
Which of the following is a possible chemical cause of ulceration?
Which of the following is a possible chemical cause of ulceration?
Which type of trauma is not listed as a cause of ulceration?
Which type of trauma is not listed as a cause of ulceration?
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Which chemical substance is indicated as a contributor to ulceration?
Which chemical substance is indicated as a contributor to ulceration?
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What is the outcome once the source of trauma causing an ulcer has been identified and resolved?
What is the outcome once the source of trauma causing an ulcer has been identified and resolved?
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Which of the following types of recurrent lesions is mentioned in relation to oral ulcers?
Which of the following types of recurrent lesions is mentioned in relation to oral ulcers?
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What are the classifications of Recurrent Aphthous Stomatitis mentioned?
What are the classifications of Recurrent Aphthous Stomatitis mentioned?
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Which therapeutic approach is typically unnecessary once the trauma causing an ulcer is addressed?
Which therapeutic approach is typically unnecessary once the trauma causing an ulcer is addressed?
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What is the relationship between trauma resolution and ulcer healing?
What is the relationship between trauma resolution and ulcer healing?
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Which laboratory tests are essential for diagnosing anemia?
Which laboratory tests are essential for diagnosing anemia?
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Aphthous like ulceration can be associated with which of the following conditions?
Aphthous like ulceration can be associated with which of the following conditions?
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Which immune deficiency conditions may lead to aphthous like ulceration?
Which immune deficiency conditions may lead to aphthous like ulceration?
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What skin condition might be suggested by the presence of white striation?
What skin condition might be suggested by the presence of white striation?
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Which of the following conditions is primarily characterized by skin lesions?
Which of the following conditions is primarily characterized by skin lesions?
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What does a low WBC count suggest in the context of immune deficiencies?
What does a low WBC count suggest in the context of immune deficiencies?
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Which of the following reflects a possible condition that can manifest with mucosal changes?
Which of the following reflects a possible condition that can manifest with mucosal changes?
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Which gastrointestinal condition could potentially manifest as aphthous like ulceration?
Which gastrointestinal condition could potentially manifest as aphthous like ulceration?
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Which disease is associated with both skin lesions and mucosal involvement?
Which disease is associated with both skin lesions and mucosal involvement?
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What is a key characteristic of pemphigus vulgaris?
What is a key characteristic of pemphigus vulgaris?
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What do the diseases referred to in the content primarily cause?
What do the diseases referred to in the content primarily cause?
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How is the fever described in relation to these diseases?
How is the fever described in relation to these diseases?
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Which statement best describes the origin of the fevers mentioned in the content?
Which statement best describes the origin of the fevers mentioned in the content?
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Which of the following is NOT a characteristic of the diseases described in the content?
Which of the following is NOT a characteristic of the diseases described in the content?
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What is a notable characteristic of the fevers caused by these diseases?
What is a notable characteristic of the fevers caused by these diseases?
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Which of the following drugs is used in chemotherapy and is known to cause cytotoxic effects?
Which of the following drugs is used in chemotherapy and is known to cause cytotoxic effects?
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Which medication is mentioned as an agent to treat angina that may lead to oral ulceration?
Which medication is mentioned as an agent to treat angina that may lead to oral ulceration?
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Which of the following drugs is classified as a non-steroidal anti-inflammatory drug (NSAID)?
Which of the following drugs is classified as a non-steroidal anti-inflammatory drug (NSAID)?
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What common condition can be treated with Nicorandil, aside from its potential to cause oral ulceration?
What common condition can be treated with Nicorandil, aside from its potential to cause oral ulceration?
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Which of the following is NOT a potential side effect of methotrexate?
Which of the following is NOT a potential side effect of methotrexate?
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Study Notes
Oral Medicine - 2
- Oral mucosal ulcers are common, potentially reflecting a local or systemic cause.
- A thorough clinical exam and history are crucial for diagnosis.
- Complete loss of epithelium exposes underlying connective tissue (ulcer).
- Partial loss of epithelium results in an erosion.
- Common oral lesions include ulcers.
- Ulcers can be a manifestation of numerous factors (local or systemic).
- Clinical features aid diagnosis: number of lesions, location, and duration.
- A single ulcer might indicate trauma, while multiple ulcers suggest recurring issues (e.g., stomatitis, herpes).
- Location is significant (e.g., non-keratinized mucosa likely aphthous ulcer).
- 2-3+ weeks of ulceration may point to more severe causes.
- Trauma-related ulcers can be thermal (e.g., maxillary/palatal gingiva), chemical (e.g., bleaching agents), or mechanical (e.g., dentures, parafunctional habits).
Clinical Features of Oral Ulcers
- Number of lesions (single vs. multiple).
- Location (keratinized vs. non-keratinized tissue).
- Duration (> 2-3 weeks could indicate a more serious cause)
Local Causes
- Trauma: thermal (e.g., hot foods), chemical (e.g., aspirin), and mechanical (e.g., ill-fitting dentures).
- Parafunctional habits: overuse of teeth.
- Poor denture fit.
Recurrent Aphthous Stomatitis (RAS)
- Common oral condition.
- Typically starts in childhood or adolescence.
- Minor, major, or herpetiform types.
- Minor RAS is the most common type, characterized by small, round ulcers, <5mm, with a yellowish base and erythematous halo. Heals in 7-10 days. No scar.
- Major RAS is larger, >1 cm, occurs less frequently.
- Herpetiform ulcers are smaller (<5mm), multiple (frequently >10), and may coalesce.
Systemic Diseases
- Some systemic diseases can manifest as oral ulcers (e.g., Behcet syndrome, HIV, etc)
- Hematologic deficiencies, immunodeficiencies and other systemic diseases can cause ulceration as a symptom.
- Some types of leukemia frequently include gum tissue enlargement, open sores in the mouth, and bleeding.
Infections
- Viral infections (e.g., Herpes simplex virus, Coxsackievirus).
- Bacterial infections (e.g., ANUG, syphilis, tuberculosis).
Drug-Induced Ulceration
- Medications can cause oral ulcerations (e.g., cytotoxic drugs, NSAIDs).
Lichen Planus
- An immunologically mediated mucocutaneous disorder.
- Often appears as reticular, plaque-like, or erythematous lesions or patterns in the mouth.
- Commonly affects the buccal mucosa, tongue, and gingiva.
Oral Lichen Planus
- Affects buccal mucosa, tongue, and gingiva.
- Possible malignant change, less than 1-3%.
Pemphigus and Pemphigoid
- Similar autoimmune disorders, but differ in blistering locations.
- Pemphigus presents with intraepithelial blistering (intraepithelial separation from skin or mucous)
- Pemphigoid is subepithelial blistering (usually affects the skin and mucosal surfaces.
Erythema Multiform
- Characterized by painful oral ulcers.
- Can be triggered by infections or medications like NSAIDS.
Malignant Neoplasms
- Oral cancers and lymphomas can present as persistent non-healing ulcers with irregular borders.
Other
- Other potential causes for oral ulceration include lupus erythematosus, chronic inflammatory diseases, etc.
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Description
This quiz focuses on the clinical features and causes of oral mucosal ulcers. It covers diagnosis methods, including the importance of lesion number, location, and duration. Understanding trauma-related ulcers and their manifestations is crucial for identifying potential systemic issues.