Need a Diff Dx for "Oral Ulcers"

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Willamette

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It seems to come up a bunch, and I realize that I don't have any disease processes in mind when one of these symptoms is presented. Anyone have a list of most commons for 'em?

Willamette
 
Apthous ulcers
HSV-1 (could be 2 as well)
Crohn's dz
Leishmaniasis (mucocutaneous dz)
Syphilis (painless)
Chanchroid (painful)
Squamous cell carcinoma (can present w/ ulcer that doesn't heal on mucosa, lip, tongue, etc)

off the top of my head...

ADD vit C deficiency for bleeding gums.. 🙂
 
babinski bob said:
Apthous ulcers
HSV-1 (could be 2 as well)
Crohn's dz
Leishmaniasis (mucocutaneous dz)
Syphilis (painless)
Chanchroid (painful)
Squamous cell carcinoma (can present w/ ulcer that doesn't heal on mucosa, lip, tongue, etc)

off the top of my head...


Thanks Bob! Now that I re-read my orig. post, I should have said "oral ulcers & BLEEDING GUMS..." In reality, it's the bleeding gums that feel like they're ringing a bell...only nobody's home...

Willamette
 
Bleeding_Gum_Murphy_300.gif


Does it ring a bell now? You know this guy needs some citrus.
 
csmith1 said:
Bleeding_Gum_Murphy_300.gif


Does it ring a bell now? You know this guy needs some citrus.


:laugh: :laugh: :laugh: :laugh: ...That's fantastic! But it's something besides 7 "Cs" scourge...The pic is a kick in the ol' pantaloons though!

Willamette
 
don't forget Behcets's Disease aka Cutaneomucouveal syndrome. More common in men and it is a triad of synptoms. It was on my step 1.
 
marchiafava said:
don't forget Behcets's Disease aka Cutaneomucouveal syndrome. More common in men and it is a triad of synptoms. It was on my step 1.

HUH? I looked in Robbins but didn't find it anywhere.... Spelling??? Never heard of it... What is it anyway?
 
that's a new one...not in the BRS index...but is on Google. I'm just recommending getting through med school and step 1 with Google to anyone that asks.

from http://www.behcets.com/home.ivnu

What is Behcet's Disease?

Also known as BD, Silk Road, and Silk Route disease - Behcet's Disease currently affects an estimated 15,000 to 20,000 Americans with many more going undiagnosed.

Behcet's disease is a rare, chronic, lifelong disorder that involves inflammation of blood vessels throughout the body. Symptoms of Behcet's disease include recurrent oral ulcers (resembling canker sores), recurrent genital ulcers, and eye inflammation. The disorder may also cause various types of skin lesions, arthritis, bowel inflammation, and meningitis (inflammation of the membranes of the brain and spinal cord). Behcet's disease generally begins when patients are in their 20s or 30s, although all age groups may be affected. Behcet's is a multisystem disease; it may involve all organs and affect the central nervous system, causing memory loss and impaired speech, balance, and movement. The effects of the disease may include blindness, stroke, swelling of the spinal cord, and intestinal complications.

Behcet's disease is a disorder which proceeds over a long period of time in a series of remissions (lack of disease activity) and exacerbations (periods of active disease).
 
Are you kidding me, THAT was on your exam????????? That's just a tad bit frightening!! :scared: :scared: :scared: :scared: :scared: :scared:
 
marchiafava said:
don't forget Behcets's Disease aka Cutaneomucouveal syndrome. More common in men and it is a triad of synptoms. It was on my step 1.

I've had two patients with it, both female.

Isn't it rare??
 
If you have never even seen it or heard of it, you aren't doing enough questions! If you want to do really well(not just pass), you will need to bring your game up to a whole new level! I'm afraid to assume what else you have never even seen???!!

Here is another question(a path question):

What are the three non-palasading granulomas?? You have to have seen this.
 
marchiafava said:
If you have never even seen it or heard of it, you aren't doing enough questions! If you want to do really well(not just pass), you will need to bring your game up to a whole new level! I'm afraid to assume what else you have never even seen???!!

Here is another question(a path question):

What are the three non-palasading granulomas?? You have to have seen this.

Do tell, where are you seeing these types of questions? I have done TONS of questions and haven't come across it.
 
Do you have an answer to my question idiot, oh sorry Idiopathic. Or do you usually cover up your inadequacies by correcting the spelling of others. If you can't even give me 1 of the 3 "pallisading" granulomas Idiopathic, good luck on the boards, monkeyboy.
 
enlighten us oh wise one. Or does your intelligence only go towards making unoriginal fun of someones chosen screen name?
 
Actually...you BOTH spelled it wrong: P-a-l-i-s-a-d-i-n-g

Besides, rheumatoid nodules, scleromyxedema, epitheliod sarcomas, and urate crystals are FOUR examples of things that can give you palisading granulomas (there are many others). I find it highly unlikely that this information is "HIGH YIELD" for Step 1.

Willamette

P.S. Lest any of you think that Willamette too has become a "Smarty-Pants,"
I'll just put that one to rest by having you know that I just got dunked to the tune of 66% on a random round of 50 on Qbank! Good luck everyone!
 
marchiafava said:
Do you have an answer to my question idiot, oh sorry Idiopathic. Or do you usually cover up your inadequacies by correcting the spelling of others. If you can't even give me 1 of the 3 "pallisading" granulomas Idiopathic, good luck on the boards, monkeyboy.

Marchiafava, I really hope you do well on the boards, because your personality is NEVER gonna get you a residency! :laugh: :laugh:
 
FoxyDoc said:
Marchiafava, I really hope you do well on the boards, because your personality is NEVER gonna get you a residency! :laugh: :laugh:

I definitely second that... 👍
 
DrMom said:
I place bets on Idiopathic kicking your @ss on the USMLE.
Im pretty sure Im not the only one who'd second that.!!!!!!!!!
Also March- Im telling you objectively- In the eyes of perceptive patients(and the large majority of patients are VERY perceptive) you'd be considered an uncaring and a noncompassionate practioner (should you get that far?)[They'd literally run to see the Physician Assistant before they see the "non people person" by the way this happens fairly often]
 
You people are funny. All it takes is a little nudge and you get all these people who love to bitch and give their important opinions. Two things: #1- I won the bet with my buddy thanks to you guys. I bet him that I could get more than 5 people in less than a day to turn against me on StudentDoctor. It's too easy and I have to thank you all. #2- I'm a fourth year and I already took Step 1!!!!!! But maybe you can hope that I don't do well on Step 2??!!!
I got a 235+ on step 1 and 98% on COMLEX. You people!! HAHAHA! Thanks again for winning me a good chunk of change.

P.S. People are at their weakest when they are angry.
 
marchiafava said:
You people are funny. All it takes is a little nudge and you get all these people who love to bitch and give their important opinions. Two things: #1- I won the bet with my buddy thanks to you guys. I bet him that I could get more than 5 people in less than a day to turn against me on StudentDoctor. It's too easy and I have to thank you all. #2- I'm a fourth year and I already took Step 1!!!!!! But maybe you can hope that I don't do well on Step 2??!!!
I got a 235+ on step 1 and 98% on COMLEX. You people!! HAHAHA! Thanks again for winning me a good chunk of change.

P.S. People are at their weakest when they are angry.


What makes you think I was angry?

Willamette
 
man, fourth year must really be the promised land if you have this much free time.
 
or really really boring... I bet you can have some fun with the folks trying to match into a decent residency next year while youre already nice and matched....ooo you should see how THEY react...it should be fun dont you think?
hahaha
 
Coxsackie A (i'll remember this one forever thanx to great but not very clean mnemonic) has herpes-like ulcers that present in the mouth, along with rash on hands/feet.

And herpes itself--did anyone mention it? my memory is dimming...but i believe type II can also cause ulcers IN the mouth and type I is generally vesicles/ulcers ON the lips/around the mouth.
 
annushka said:
Coxsackie A (i'll remember this one forever thanx to great but not very clean mnemonic) has herpes-like ulcers that present in the mouth, along with rash on hands/feet.

And herpes itself--did anyone mention it? my memory is dimming...but i believe type II can also cause ulcers IN the mouth and type I is generally vesicles/ulcers ON the lips/around the mouth.


Thanks! Yep the "Big Three: Palm & Sole Rashes"

1) Rocky Mt. Spotted Fever
2) Syphilis
3) Coxsakie A


Oh yeah, if you're taking QBank...there's probably like 100 other "rare" causes of palm&sole rashes, but you can only get them on Tuesdays from the left-handed siamese cousin of some pill-pusher named Frank. Frank works outta the back of a '64 Dodge, and...oh well, I'll quit before this turns into a Tom Waits song, you get the picture....

Willamette
 
Willamette said:
Thanks! Yep the "Big Three: Palm & Sole Rashes"

1) Rocky Mt. Spotted Fever
2) Syphilis
3) Coxsakie A


Oh yeah, if you're taking QBank...there's probably like 100 other "rare" causes of palm&sole rashes, but you can only get them on Tuesdays from the left-handed siamese cousin of some pill-pusher named Frank. Frank works outta the back of a '64 Dodge, and...oh well, I'll quit before this turns into a Tom Waits song, you get the picture....

Willamette

I'll add another biggie...

4) Disseminated Meningococcemia (N. meningitidis)
 
babinski bob said:
I'll add another biggie...

4) Disseminated Meningococcemia (N. meningitidis)


Oh yeah, that one you get from Frank's neice... 🙂 .

Thanks for the addition Bob!

Willamette
 
marchiafava said:
Do you have an answer to my question idiot, oh sorry Idiopathic. Or do you usually cover up your inadequacies by correcting the spelling of others. If you can't even give me 1 of the 3 "pallisading" granulomas Idiopathic, good luck on the boards, monkeyboy.

Thats Student Doctor Monkeyboy to you 😉
 
marchiafava said:
I got a 235+ on step 1 and 98% on COMLEX. You people!! HAHAHA! Thanks again for winning me a good chunk of change.

Is that a 237? What exactly is a 235+? And honestly, it isnt really that good. 25% of test takers scored better than you if you got a 235. It isnt exactly something you should be throwing around like its a 43 MCAT or something (which I am also sure you got...or rather, 'a 38+' 🙄 )

Hope everything works out for you there, champ.
 
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