Question 1

A patient reports painful swelling in the mouth with increased pain at mealtimes. The provider notes a mass in the salivary gland region. What is the likely cause of these symptoms?&#10;A) Basal cell adenoma&#10;B) Sialolithiasis&#10;C) Sj&#246;gren syndrome&#10;D) Warthin's tumor

Accepted Answer

The symptoms and findings described suggest the presence of a salivary gland stone, also known as sialolithiasis. The stone can cause obstruction of salivary gland ducts leading to painful swelling, particularly during meals when saliva production is stimulated. Basal cell adenoma, Sjögren syndrome, and Warthin's tumor can also affect the salivary glands but would typically present with different symptoms or characteristics on examination.

Question 2

A patient has a chronic swelling of the parotid gland that is unresponsive to antibiotics and which has not increased in size. Which diagnostic test is indicated?&#10;A) Computed tomography&#10;B) Fine-needle aspiration&#10;C) Magnetic resonance imaging&#10;D) Plain film radiography

Accepted Answer

A chronic swelling of the parotid gland that is unresponsive to antibiotics may indicate a possible neoplasm or malignancy. Fine-needle aspiration, which involves removing a small sample of cells from the gland for examination, is the most appropriate diagnostic test to confirm or rule out cancer. Computed tomography and magnetic resonance imaging may provide additional information, but are not necessary as a first-line diagnostic test. Plain film radiography is not useful in diagnosing soft tissue masses.

Question 3

A patient has parotitis and cultures are positive for actinomycosis. What is the initial treatment for this condition?&#10;A) Intravenous (IV) penicillin&#10;B) Oral clindamycin (PNC)&#10;C) Oral erythromycin&#10;D) Topical antibiotics

Accepted Answer

The initial treatment for actinomycosis, including when it presents as parotitis, is intravenous penicillin. Actinomycosis is a bacterial infection caused by Actinomyces species, which are sensitive to penicillin.

Deck 78: Diseases of the Salivary Glands