CC Sept 2015 Aphthous ulcers

echoecho's version from 2016-05-26 03:42


Question Answer
Aphthous ulcers are commonly referred to as what? canker sores
Aphthous ulcers are a common problem in what age group?young adults
The prevalence of aphthous ulcers is around ____%, making it the most common disease of the oral mucosa?20
It is more common in developed or underdeveloped countries? More common in lower or higher socioeconomic groups?1) developed 2) higher
Peak age of onset is ____ to _____ years, with which gender affected more?10-19; both genders are equally affected
Aphthous ulcers are more common in what ethnic group?whites
What % of people with aphthous ulcers develop them before the age of 30 y.o.? 80
Compare minor aphthae with major aphthae and herpetiform aphthae?minor aphthae are small and shallow, major aphthae are larger with deeper ulceration adn herpetiform aphthae are more numerous and vesicular
Where may aphthous ulcers be located in the mouth?labial or buccal mucosa, the soft palate or the floor of the mouth
These ulcers are rarely associated with what symptoms?fever, adenopathy, other systemic symptoms
The coomon course of these ulcers is ___ to ___days?10; 14
Although the course of major lesions may be _____?longer
Herpetiform ulcers usually have a course of _________ to _________ days?7; 10
What is the etiology of aphthous ulcers?uncertain but may be due to a combination of stress, physical or chemical trauma, food sensitivity or infection
What ingredient in toothpaste has been implicated in aphthous ulcers?sodium lauryl sulfate
Can family hx of apthous ulcers be an additional risk factor?yes
What etiology is the current prevailing hypothesis?autoimmune
Is smoking a risk fx?no; and it actually provides a protective effect against recurrent aphthae.
Major aphthae can have an association with what infection?HIV
Recurrent ulcers are associated with what diseases?celiac; inflammatory bowel disease
Treatment?usually supportive (as s/s are time-limited and generally require no specific therapy)
What dietary changes often allow patients to tolerate symptoms?avoiding acidic or spicy foods
What helps to prevent secondary ulcer infection/good oral hygiene
What are the main goals of treatment?relieving pain and speeding healing
*** Agents that provide effective pain relief include what?1) 2% viscous lidocaine 2) benzocaine preparations 3) a combination of OTC magnesium hydroxide antacid and diphenhydramine hydrochloride
What may be required for pain that is refractory to local agents?systemic analgesics
Healing times may also be improved with alternative agents (although effectiveness is largely unproven), list these? 1) zinc gluconate lozenges 2) aloe vera 3) Rosa damascena 4) vitamin C 5) vitamin B 6) lysine 7) sage 8) chamomile mouthwash 9) Echinacea
***One systematic review found there was no single systemic therapy that was effective, although this was probably related to the ____ quality of the studies rather than the true effect of the individual interventions?poor
Numerous _____ therapies show some efficacy in treating these ulcers?topicl
Most agents help to ____ pain and duration of lesions; none decrease _____ of outbreaks?decrease; frequency
What therapy is the first-line treatment for aphthous ulcers or stomatitis that do not respond to conservative treatment?topical
Anti-inflammatory effects can be achieved with topical ____?steroids
List a paste and an elixir that are commonly used and have been shown to speed healing with recurrent minor aphthous ulcers?triamcinolong pase (Kenalog in Orabase); dexamethasone elixir
What treatment are reserved for severe disease?systemic or intralesional steroids
What 2 immune modulators may improve healing times of severe apthous ulcers?1) oral thalidomide 2) topical amlexanox (Aphthalsol)
Studies on thalidomide are primarily in what type of patients? Women of reproductive age should not use thalidomide unless what is ruled out?HIV; pregnancy
If used, antibiotics are administered how?topically
What are the two most common antibiotics used and have been shown to decrease pain and duration of ulcerations? These agents should not be used in what group of patients?1) Tetracycline 2) Minocycline 3) children or pregnant women
Describe how the above antibiotics are administered?1) 250 mg tetracycline capsule can be dissolved in 180 mL of water and used (swish and swallow or swish and spit) QID 2) 100 mg minocycline dissolved in 180 mL of water is administered BID in the same way as the TCN is
Is surgical excision of apthous ulcers appropriate and effective?no
What can be used as a chemical cautery method?silver nitrate sticks
*** SUMMARY = The etiology of aphthous ulcers is uncertain but may be due to a combination of what?stress, physical or chemical trauma, food sensitivity or infection
*** SUMMARY = Major aphthae can be associated with what infection?HIV
*** SUMMARY = Recurrent ulcers are associated with what 2 diseases?1) celiac disease 2) inflammatory bowel disease
*** SUMMARY = True or false, various topical treatments may be helpful?true