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Case #15 (Questions 56-59) Age: 77 Sex: male Race: Caucasian Social History: Smoked 2 pk/day cigarettes for 31 years, but quit 18 years ago Medical History: Corticosteroid therapy for rheumatoid arthritis Dental History: Client wears a full upper denture and a lower partial Clinical Appearance: A diffuse, flat, white lesion covering the right ventral of the tongue and extending onto the floor of the mouth.  The lesion is asymptomatic and does not rub off. Picture15.jpg 59. If the lesion was due to using corticosteroids, what is it likely to be?

Case #12 (Questions 43-46) Age: 32 Sex: female Race: Hispanic Medical History: Client reported a history of alcohol use disorder and a previous episode of a sexually transmitted disease accompanied by regional lymphadenopathy. Chief Complaint: “For several weeks I have had a painless sore on my tongue that is not healing.” Clinical Appearance: A discrete round ulcer with rolled borders is located on the right border of the dorsal surface of the tongue. Picture12.gif 46. If a child is infected with syphilis in utero or during the birthing process, what dental anomaly might be present when the primary teeth erupt?

Case #5 (Questions 15-18) Age: 28 Sex: male Race: Caucasian Medical History: Ct. reports that he first tested positive for HIV 4 years ago.  He has not had any opportunistic infections Current Medications: no medications Chief Complaint: Ct. noticed a white lesion located on his tongue.  Clinical Appearance: It is an irregular shape located on the lateral and dorsal surfaces of the tongue.  It appears corrugated and cannot be wiped off.  Picture5.jpg 17. If this individual is progressing from stage 2 to stage 3, what level must his CD4+ T cells drop below to declare stage 3 infection?

Case #14 (Questions 51-55) Age: 35 Sex: female Race: Caucasian Medical History: Client has been under higher levels of stress due to a divorce.  She has gained 9 pounds in the past five months, but was specifically trying to avoid overeating due to stress. Chief Complaint: “I have had headaches off and on for the past three weeks.  My right ear hurts when I chew.” Clinical Appearance: Scooped out appearances on the occlusal and incisal cusp tips of the teeth. Radiographic Appearance: The right condyle appears to be flattened off in areas.  Picture14(1).jpg 54. Which health condition might explain why she is gaining weight?

Case #6 (Questions 19-22) Age: 6 Sex: male Race: Caucasian Medical History: This child has had a low-grade fever for the past three days.  The child also has painful bilateral lymphadenopathy.  This child recently recovered from the chickenpox infection.  His sister has contagious lesions present today at this appointment. Dental History: Parent states, “The child is unable to eat due to sores in his mouth and on his tongue.  His gums also hurt.”  Clinical Appearance: Multiple tiny vesicles and ulcers are accompanied by generalized painful, edematous and erythematous gingiva.  Picture6(1).jpg 22. Since the child experienced the chickenpox infection, what condition might surface from the same virus at a later date?

Case #18 (Questions 65- 66) Age: 63 Sex: male Race: Caucasian Medical History: Client was treated with radiation to the head and neck for thyroid cancer last year.  He is currently in remission. Dental History: Approximately six months after undergoing radiation treatment, he developed this lesion.  It slowly grew larger and became more painful.  Periodontal status was a case type I prior to radiation treatment. Chief Complaint: Client notices extreme pain from the lower right of his jaw.  He sees something white in his mouth, but it never seems to come off.  It bothers him to eat and brush since any stimulus to the area is not pleasant. Clinical Appearance: Lack of gingival tissue around the lingual aspect of tooth #30.  The underlying bone is exposed.  Picture18.jpg  65. What was responsible for the bony exposure seen in this individual?

Case #28 (Questions 87-88) Age: 72 Sex:  male Race: Native American Medical History: Client has a history of osteoarthritis Medication: Celebrex® Social History: heavy pipe smoker for several years Clinical Appearance: A generalized white appearance of the hard palate is seen.  Inflamed openings of the salivary ducts are surrounded by raised, keratotic nodules. Picture28.jpg  87. The appearance of the hard palate is called

Case #15 (Questions 56-59) Age: 77 Sex: male Race: Caucasian Social History: Smoked 2 pk/day cigarettes for 31 years, but quit 18 years ago Medical History: Corticosteroid therapy for rheumatoid arthritis Dental History: Client wears a full upper denture and a lower partial Clinical Appearance: A diffuse, flat, white lesion covering the right ventral of the tongue and extending onto the floor of the mouth.  The lesion is asymptomatic and does not rub off. Picture15.jpg 57. The clinical term for this white lesion of unknown etiology that does not rub off is

Case #26 (Questions 82-83) Age: 56 Sex: female Race: Caucasian Medical History: Client has a history of type 2 diabetes mellitus and hypertension; going through menopause Medication: hydrochlorothyazide and glucophage Dental History: Client complained of a “red, bleeding sore” located distal to the gingival margin of tooth #27 that has been present for several weeks. Client wears a partial denture to replace mandibular teeth. Clinical Appearance: soft, erythematous, exophytic, sessile-based lesion measuring approximately 10 X 12 mm just distal to tooth #27. Picture26.jpg  82. Since the space adjacent to this lesion is edentulous and there is recession of the facial gingival tissue on tooth #28, what might be the cause of this lesion?

Case #7 (Questions 23-25) Age: 18 Sex: male Race: Asian Medical History: Allergic to peanuts Chief Complaint: Client came to the emergency room immediately after his lunch.  He complained of a “sudden swelling of his upper lips”.  Clinical Appearance: Further questioning revealed he just ate Chinese food for lunch.  A diffuse soft swelling of the lips is noted.  It is more prominent on the upper lip.  The skin is normal in color but appears stretched by the swelling.   Picture7(1).jpg 25. What treatment will be provided for him if he begins having difficulty breathing?