GASTROENTEROLOGY - OSCE OTC MATERIAL OSPAP MSC APPLIED CLINICAL SKILLS LATEST UPDATE

GASTROENTEROLOGY - OSCE OTC MATERIAL OSPAP MSC APPLIED CLINICAL SKILLS LATEST UPDATE

Gastroenterology
Mouth ulcers
Symptoms/diagnosing questions
• Painful oral lesions
• Usually grey-white in colour and small in size
• Can make eating and drinking painful
• Location of ulcer (usually at side of cheeks, tongue and inside of lips)
• Is it painless (refer can indicate something more sinister)?
• Occurs in small crops (a single large ulcer indicates something sinister)
REFER
â–ª Children under 10 (possible hand foot and mouth disease)
â–ª Ulcers greater than 1cm in diameter
â–ª Ulcers in crops of five to ten or more
â–ª Duration longer than 14days
â–ª Painless ulcer
â–ª Irregular shaped ulcers
â–ª Eye involvement
Treatment
1. Corticosteroids e.g. Hydrocortisone sodium succinate pellets
2. Antibacterial agents e.g. Chlorhexidine
3. Choline salicylate- Bonjela
4. Benzydamine
5. Local anaesthetics e.g. lidocaine, benzocaine
6. Protectorants
Other differential diagnosisthat must be referred
1. Major aphthous ulcers- usually larger in diameter and slower to heal
2. Trauma- can be due to tongue biting or traumatic event
3. Oral thrush- creamy white soft patches
4. Herpes simplex- usually small and many in number and may show signs
of systemic infection such as fever
5. Medicine induced fever-some drugslike nsaids, beta-blockers, cytotoxic
agents can induce ulcer