Q: The patient’s tongue is affected by:
(A). Hairy tongue
(B). Erythema migrans
(C). Median rhomboid glossitis
(D). Hairy leukoplakia
The most important clue in this image is the redness in the middle of the tongue. Now let’s review the definitions of each condition.
o Median rhomboid glossitis: Condition with a flat or slightly raised erythematous area in the midline of the dorsal surface of the tongue in a rhomboid (diamond) shape.
o Erythema migrans or benign migratory glossitis: Condition with erythematous patches surrounded by a white or yellow border on the dorsal and lateral borders of the tongue.
o Hairy tongue: Condition with dark staining of the accumulated keratin on the filiform papillae.
o Hairy leukoplakia: Lesions caused by the Epstein-Barr virus (EBV) that appear as white patches that resemble folds or ridges on the sides of the tongue.
Answer: (C). Median rhomboid glossitis
Median rhomboid glossitis vs erythema migrans
I am pretty sure that you already know this, but let’s break down the name of the condition. Median (middle), rhomboid (let’s call it diamond shape), and glossitis (swollen tongue). As simple as this is, I have seen some students misinterpret this condition to erythema migrans. From StudentRDH boards review for the national boards, in the chapter of Oral pathology. Geographic tongue (aka erythema migrans):
o Erythematous patches surrounded by a white or yellow border on the dorsal and lateral borders of the tongue. Also called erythema migrans or benign migratory glossitis. The cause of the condition is unknown. No specific treatment is indicated.
o Patches can disappear and reappear in a different location.
o Filiform papillae are lost on the affected areas and the condition can cause a burning sensation.
The most important clue when detecting erythema migrans (= benign migratory glossitis) is the “white or yellow” borders that surround the redness.
Wake Up Memory Technique (WMT) for the dental hygiene boards
When you look at pictures in your case studies, during your national boards, look for every piece of a clue that you can find:
- Color (red, white, yellow etc.)
- Location (hard palate, lip etc.)
- Inside (clear, yellow pus etc.)
- Size (tiny, small, large etc.)
- Texture (round, cauliflower-like, cottage cheese-like etc.)
Remember the acronym for this: C-LIST (sorry, not an A-LISTer like Kim K). Only when you have gathered all the information, proceed to the question. I have seen many, many students make the mistake of jumping to the conclusion too fast. Try this right now with this picture:
I will not give you the answers, but simply follow the C-LIST for the dental hygiene boards.
Was this helpful? In those StudentRDH vitamins series, I try to bring the experience I had mentoring test-takers. If you have anything that confuses you (like hell), email me at Clairej@StudentRDH.com and let’s turn that into a mini-review!
Related post: Multiple choice questions, 3 tips to be better
(Disclaimer: StudentRDH is NOT affiliated with the NBDHE, NDHCE, CSCE, CDCA, WREB.)