how to take ulcer history for FCPS ,MCPS,MDS,MOMS STUDENTS?

1. Ulcer history
q.1) how long you had the ulcer?
q.2) how many are there?
q.3) where is the ulcerlocated?
q.4) is it painful?
q.5) do u know of anything that may have caused the ulcer?
q.6) have u everhad ulcersbefore?
q.7) if yesthen how many? How often?howlong do theylast?
q.8) are there any associatedproblems?Pain ,bleeding,halitosis?
Q.9) is it gettingbigger,smalleror staying the same size?
q.10) do u get itchingor tinglingbefore the ulcersappear?(viral aetiology)
q.11) do the ulcers start as blisters?
q.12) do u get ulcersat otherbody sites?
SOCIAL HISTORY:
Do u smoke?If so,howmany cigarettes/dayand for how long?
Do u drink alcohol?
Do u chewtobacco? If so how much and how often?
Do u chewbetel nuts? IF SO HOW OFTEN?
Past medical history:medications,seriousskin,GITand hematological illnesses.
Patient as a whole examination:extraoral (lympgnodes,swellings,asymmetry)
Examinationof ulcer:
INSPECTION:
Upper lip+ lowerlip
SITE: GIVEA CLUE TO THE CAUSE. e.g adjacentto sharptooth edge---- trauma,interdental papilla---
anug.
Posteriorpartof mouth:coxsackie virus,e.g Herpangina.

2. Recordin notes.Drawdiagramtake photo.
Numberof ulcers:multiple ulcerssuggestviral infections:e.gcoxsackie,herpesorrecurrentapthae.
Size:measure inmm
Shape: roundor cresentric(e.gtraumaticulcers),ireegular(cmv) andcoalescing( herpes) ,angularor
stellate( TB),Punchedout(tertiarysyphilis),malignant(irregularorunevenshape)
Floor: note the color,the presence of slough, scab,fungatinggranulationorbleeding.
EDGE: RAISED , ROLLED, EVERTED (MALIGNANTULCERS) , undermined/overhanging(tuberculous
ulcers) .Punchedout( tertiarysyphilis),rolledandpearly(rodentulcer) .