Diseases of the Oral Cavity and Salivary Glands Practice Questions

Q: A 45-year-old patient complained of pain on one side of the neck. She is afraid of eating food as it worsens the pain. An ultrasound of the salivary glands is shown below. What is the most likely diagnosis?

Sialolithiasis. ***Sialolithiasis*** - The ultrasound image shows an **echogenic focus** with clear **posterior acoustic shadowing** within the salivary gland, which is characteristic of a salivary gland stone. - The patient's symptoms of **pain on one side of the neck** and **worsening pain with eating** (likely due to salivary stimulation) are classic for **sialolithiasis**, as the stone obstructs salivary flow. *Salivary gland foreign body* - While a foreign body could present with similar pain, it would typically appear as a distinct object on ultrasound, but its echogenicity and shading characteristics might differ depending on the material. - The history of a foreign body ingestion or insertion would be crucial, which is not mentioned here. *Cervical lymphadenopathy* - **Lymph nodes** on ultrasound typically appear as oval-shaped structures with a **hypoechoic cortex** and an **echogenic hilum**; they do not usually show significant acoustic shadowing unless calcified. - While cervical lymphadenopathy can cause neck pain, it is not typically exacerbated by eating in the same way an obstructed salivary gland would be. *Osteoma of the floor of the mouth* - An **osteoma** is a **benign bone tumor** that would present as a very **dense, highly echogenic mass** with severe posterior acoustic shadowing on ultrasound, originating from bony structures. - While an osteoma could cause pain, its location (floor of the mouth) and nature would not typically explain pain worsening specifically with eating due to salivary gland obstruction.

Q: Not typically associated with Ludwig's angina is

Aphthous ulcer in pharynx. ***Aphthous ulcer in pharynx*** - **Aphthous ulcers** are discrete, painful oral lesions typically associated with trauma, stress, or certain systemic conditions, and are **not a feature** of the infection and inflammation seen in Ludwig's angina [1]. - Ludwig's angina is a severe **bacterial infection** of the submandibular, sublingual, and submental spaces, characterized by aggressive cellulitis rather than ulcerative lesions. *It is caused by anaerobic organisms* - **Mixed flora**, including **anaerobic bacteria** (e.g., Peptostreptococcus, Bacteroides, Fusobacterium), are commonly implicated in Ludwig's angina, often originating from odontogenic infections [2]. - The presence of anaerobes contributes to the rapid progression and extensive tissue destruction characteristic of this severe infection [2]. *Cellulitis in the floor of mouth* - Ludwig's angina is specifically defined as a **rapidly spreading cellulitis** that involves the **submandibular, sublingual, and submental spaces** of the floor of the mouth. - This cellulitis is non-suppurative but causes significant edema and induration, which can displace the tongue superiorly and posteriorly. *Glottal edema, may require tracheostomy* - The extensive edema in the floor of the mouth can extend rapidly to the **larynx**, leading to **glottal edema** and **airway obstruction**. - Due to the critical risk of airway compromise, an emergency **tracheostomy** or **cricothyrotomy** may be necessary to secure the airway in advanced cases.

Question 1

A 45-year-old patient complained of pain on one side of the neck. She is afraid of eating food as it worsens the pain. An ultrasound of the salivary glands is shown below. What is the most likely diagnosis?

Accepted Answer

Sialolithiasis

Answer

Salivary gland foreign body

Answer

Cervical lymphadenopathy

Answer

Osteoma of the floor of the mouth

Question 2

Not typically associated with Ludwig's angina is

Accepted Answer

Aphthous ulcer in pharynx

Answer

It is caused by anaerobic organisms

Answer

Cellulitis in the floor of mouth

Answer

Glottal edema, may require tracheostomy

Question 3

What does sialosis refer to?

Accepted Answer

Non-inflammatory parotid enlargement due to metabolic conditions

Answer

Inflammatory parotid enlargement due to infection

Answer

Autoimmune parotid gland dysfunction

Answer

Ductal obstruction leading to salivary retention

Diseases of the Oral Cavity and Salivary Glands — MCQs

Diseases of the Oral Cavity and Salivary Glands — MCQs

On this page

Practice by Chapter

Want unlimited practice?