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Oral Diagnosis and Medicine Competency Case

Oral Diagnosis and Medicine Competency Case. Seth Rush Team 2 UMKC SOD 2012 Chart #: 546-6-24. Patient History. 78 year old Caucasian female Pt. came if for routine dental care Pt. has a history of: broken jaw, broken ankle rectal abscess degenerative arthritis w/ pain back

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Oral Diagnosis and Medicine Competency Case

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  1. Oral Diagnosis and Medicine Competency Case • Seth Rush • Team 2 • UMKC SOD 2012 • Chart #: 546-6-24

  2. Patient History • 78 year old Caucasian female • Pt. came if for routine dental care • Pt. has a history of: • broken jaw, broken ankle • rectal abscess • degenerative arthritis w/ pain back • Heart valve problem (pt. does not recall exact details) • Hypothyroidsism • Frequent kidney stones • Urinary tract infection 1 year ago

  3. Medications • Crestor (for cholesterol) • Lexapro (for anxiety/depression) • Synthroid (for hypothyroidism)

  4. Lesion Description • Multiple bullae/vesicles on the on the right buccal mucosa • The lesions have well-defined borders and are asymmetric • The lesions involve the oral epithelium • The lesions have an erythmatous border

  5. Patient Dialouge • When did you first notice the lesions? • About 2 days prior to the appointment • Do the lesions cause any discomfort? • Yes, very severe pain • Have the lesions changed in size/location? • Not to the patient’s knowledge • Have you ever had any lesison like this before? • No, this is the first time • Do you have any other lesions anywhere else on your body? • No, only these lesions • Have you seen a doctor/dentist about these lesions? • Yes, my doctor said these were cold sores and gave me a topical steroid

  6. Differential Diagnosis • Mucous Membrane Pemphigous • Erythema Multiforme • Pemphigus Vulgaris • Linear IgA diseases • Aplastic anemia • Uncontrolled Diabetes

  7. Treatment • A biopsy was note performed, because the patient was referred to AEGD • The lesions should be biopsied to determine a definitive diagnosis • Topical corticosteroids • Systemic corticosteroids • Immunosuppresive drugs

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