Chapter 78: Diseases of the Salivary Glands

Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A patient reports painful swelling in the mouth with increased pain at mealtimes. The provider notes a mass in the salivary gland region. What is the likely cause of these symptoms?

a. Basal cell adenoma b. Sialolithiasis c. Sjögren syndrome d. Warthin’s tumor

ANS: B a. Computed tomography b. Fine-needle aspiration c. Magnetic resonance imaging d. Plain film radiography

Sialolithiasis is a noninfectious salivary gland disorder characterized by pain at mealtimes caused by blockage of the salivary duct by stones. Basal cell adenoma is a noninfectious cause of salivary gland inflammation that is generally painless. Sjögren syndrome manifests with xerostomia and abnormal taste. Warthin’s tumor causes a painless, unilateral mass.

2. A patient has a chronic swelling of the parotid gland that is unresponsive to antibiotics and which has not increased in size. Which diagnostic test is indicated?

ANS: B

Chronic lesions may represent tuberculosis or malignancies, so fine-needle aspiration is indicated to rule out these diseases. Radiological studies are used to identify the extent of disease but are usually not diagnostic.

NURSINGTB.COM a. Intravenous (IV) penicillin b. Oral clindamycin (PNC) c. Oral erythromycin d. Topical antibiotics

3. A patient has parotitis and cultures are positive for actinomycosis. What is the initial treatment for this condition?

ANS: A

IV penicillin followed by the oral form (Penicillin V) for several months is indicated for actinomycosis; specialist consultation is indicated for patients with penicillin allergy. Clindamycin and erythromycin are used for PCN allergy. Topical antibiotics are not effective.