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Ear and mouth

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jmnies's version from 2017-02-14 05:15

Section

Question Answer
TophiA deposit of uric acid crystals characteristic of chronic tophaceous gout.
Cutaneous CystFormerly called a sebaceous cyst, a dome-shaped lump in the dermis forms a benign closed firm sac attached to the epidermis. A dark dot (blackhead) may be visible on its surface.
Chondrodermatitis HelicisThis chronic inflammatory lesion starts as a painful, tender papule on the helix or anti helix; later stage of ulceration and crusting; biopsy
Basal cell carcinomaCancer from basal layer of epidermis, caused by UV radiation, tanning beds, arsenic exposure; Low metastatic potential; raised nodule shows the lustrous surface and telangiectatic vessels
Rheumatoid NodulesIn chronic rheumatoid arthritis, look for small lumps on the helix or anti helix; Most common cutaneous manifestation of RA
Acute otitis media with purulent effusioncommonly caused by bacterial infection from S. pneumoniae and H. influenzae. Symptoms include earache, fever, and hearing loss. The eardrum reddens, loses its landmarks, and bulges laterally, toward the examiner’s eye; conductive hearing loss
Bullous Myringitispainful hemorrhagic vesicles appear on the tympanic membrane, the ear canal, or both. Symptoms include earache, blood-tinged discharge from the ear, and conductive hearing loss,
Bullous Myringitis causescaused by mycoplasma, viral, and bacterial otitis media
Tympanosclerosisa deposition of hyaline material within the layers of the tympanic membrane that sometimes follows a severe episode of otitis media. It does not usually impair hearing and is seldom clinically significant.
Exostosesmultiple nontender benign bony growths of the EAC most commonly occur in individuals who have had repeated exposure to cold water (surfers)
Serous effusionsusually caused by viral upper respiratory infections (otitis media with serous effusion) or by sudden changes in atmospheric pressure as from flying or diving (otitic barotrauma)
Hemotympanumblood behind TM secondary to basilar skull fracture
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Teeth

Question Answer
Angular Cheilitissoftening/fissuring of the skin at angles of the mouth, followed by fissuring. nutritional deficiency or, overclosure of the mouth, seen in people with no teeth or with ill-fitting dentures. Saliva wets and macerates the infolded skin, often leading to secondary infection with Candida
Pale lipsanemia
Blue lipscyanosis
Red lipsCO poisoning
Actinic cheilitissunlight exposure and affects primarily the lower lip. Fair-skinned men who work outdoors are most often affected. may lead to carcinoma
Angioedemalocalized subcutaneous or submucosal swelling caused by leakage of intravascular fluid into interstitial tissue
Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu syndrome)Multiple small red spots on the lips strongly suggest hereditary hemorrhagic telangiectasia, an autosomal dominant endothelial disorder causing vascular fragility and arteriovascular malformations (AVMs).
Peutz-Jeghers SyndromeLook for prominent small brown pigmented spots in the dermal layer of the lips, buccal mucosa, and perioral area, autosomal dominant syndrome, these characteristic skin changes accompany numerous intestinal polyps
Chancre of Primary SyphilisThis ulcerated papule with an indurated edge usually appears after 3 to 6 weeks of incubating infection from the spirochete Treponema pallidum. These lesions may resemble a carcinoma or crusted cold sore, very infectious
Carcinoma of the LipLike actinic cheilitis, squamous cell carcinoma usually affects the lower lip. It may appear as a scaly plaque, as an ulcer with or without a crust, or as a nodular lesion
Kaposi’s Sarcoma in AIDSThe deep purple color of these lesions suggests Kaposi’s sarcoma, a low-grade vascular tumor associated with human herpesvirus 8. The lesions may be raised or flat
Fordyce Spots (Fordyce Granules)Fordyce spots are normal sebaceous glands that appear as small yellowish spots in the buccal mucosa or on the lips. Here they are seen best anterior to the tongue and lower jaw.
Koplik’s SpotsKoplik’s spots are an early sign of measles (rubeola). Search for small white specks that resemble grains of salt on a red background.
PetechiaePetechiae are small red spots caused by blood that escapes from capillaries into the tissues. Petechiae in the buccal mucosa, as shown, are often caused by accidentally biting the cheek
LeukoplakiaA thickened white patch (leukoplakia) may occur anywhere in the oral mucosa. The extensive example shown on this buccal mucosa resulted from frequent chewing of tobacco, a local irritant. This benign reactive process of the squamous epithelium may lead to cancer and should be biopsied. Another risk factor is human papillomavirus infection.
Marginal gingivitiscommon among teenagers and young adults. The gingival margins are reddened and swollen, and the interdental papillae are blunted, swollen, and red. Brushing the teeth often makes the gums bleed. Plaque is not there
Acute Necrotizing Ulcerative GingivitisThis uncommon form of gingivitis occurs suddenly in adolescents and young adults and is accompanied by fever, malaise, and enlarged lymph nodes. Ulcers develop in the interdental papillae. Then the destructive (necrotizing) process spreads along the gum margins, where a grayish pseudomembrane develops. The red, painful gums bleed easily; the breath is foul
Gingival HyperplasiaGums enlarged by hyperplasia are swollen into heaped-up masses that may even cover the teeth. The redness of inflammation may coexist, as in this example. Causes include phenytoin therapy (as in this case), puberty, pregnancy, and leukemia
Pregnancy Tumor (also termed Pregnancy Epulis or Pyogenic Granuloma)Red purple papules of granulation tissue form in the gingival interdental papillae, and sometimes on the fingers. They are red, soft, painless, and usually bleed easily
Attrition of Teeth; Recession of GumsIn many elderly people, the chewing surfaces of the teeth are worn down by repetitive use so that the yellow-brown dentin becomes exposed—a process called attrition
Erosion of TeethTeeth may be eroded by chemical action. Note here the erosion of the enamel from the lingual surfaces of the upper incisors, exposing the yellow-brown dentin. This results from recurrent regurgitation of stomach contents, as in bulimia
Hutchinson’s Teeth in Congenital SyphilisHutchinson’s teeth are smaller and more widely spaced than normal and are notched on their biting surfaces. The sides of the teeth taper toward the biting edges. The upper central incisors of the permanent (not the deciduous) teeth are most often affected. These teeth are a sign of congenital syphilis
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