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Chapter 80: Oral Infections Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A patient reports painful oral lesions 3 days after feeling pain and tingling in the mouth. The provider notes vesicles and ulcerative lesions on the buccal mucosa. What is the most likely cause of these symptoms?

a. Bacterial infection b. Candida albicans c. Herpes simplex virus (HSV) d. Human papilloma virus (HPV)

ANS: C a. Culture and sensitivity b. Microscopic exam of oral scrapings c. Physical examination d. Tzanck smear

HSV infections generally start with a prodrome of tingling, pain, and burning followed by vesicular and ulcerative lesions. Bacterial infection presents with inflammation of the gingiva, bleeding, and ulceration with or without purulent discharge. Candida albicans appear as white, cottage cheese-like lesions that may be removed, but may cause bleeding when removed. HPV manifests as white, verrucous lesions individually or in clusters.

2. A patient diagnosed with gingival inflammation presents with several areas of ulceration and a small amount of purulent discharge. What is required to diagnose this condition?

ANS: C

NURSINGTB.COM a. Nystatin oral suspension b. Oral acyclovir c. Oral hygiene measures d. Surgical excision

This patient has symptoms consistent with gingivitis, which may be diagnosed by physical examination alone. Cultures are not necessary unless systemic disease is present. A microscopic exam of oral scrapings to look for hyphae may be performed to diagnose candida infections. A Tzanck smear is performed to confirm a diagnosis of herpes simplex.

3. A patient reports painful oral lesions and the provider notes several white, verrucous lesions in clusters throughout the mouth. What is the recommended treatment for this patient?

ANS: D

White, verrucous lesions in clusters are diagnostic for human papilloma virus (HPV) infection which is treated with surgical excision. Nystatin suspension is given for candida infection. Oral acyclovir is used for herpes simplex virus (HSV) infection. Oral hygiene measures are used for gingivitis.

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