bact viral fungal Flashcards

1
Q

what cause necrotizing gingivitis

A

-ve bacteria spirochaetes
Other factors – stress, smoking, fatigue, poor oral hygiene, decreased host resistance/immune response

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2
Q

clinical feature of necrotizing gingivitis

A

painful necrosis and crater-like, punched out ulceration of the interdental papillae

sudden onset

Ulcers covered by greyish pseudomembrane demarcated from surrounding mucosa by linear erythema

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3
Q

what is thought to arise subsequent to necrotizing gingivitis

A

cancrum oriswha

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4
Q

what cause cancrum oris

A

malnourished
other systemic infection (measles)
begins as necrosis of gingivae but spreads to adjacent soft tissues and bone resulting in severe, gangrenous necrosis of oral tissues

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5
Q

what is actinomyces infection (actinomycosis) characterized by?

A

multiple foci of chronic suppuration
firm swellings commonly in the submandibular region with variable pain symptoms

abscesses which leads to marked fibrosis of surrounding tissues

abscess is characterized by many small yellow granules aka ‘sulphur granules’ - represent microbial colonies

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6
Q

what is responsible for syphilis

A

bacteria infection - spirochaete Treponema pallidum

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7
Q

explain syphilis, what types and how is it acquired briefly

A

congenital - vertical transmission
lethal during development of baby

Acquired - STD
primary
secondary
tertiary

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8
Q

clinical findings in congenital syphillis

A

Notched permanent incisors
(Hutchinson’s incisors)
Hypoplastic first molars
(Mulberry molars)

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9
Q

life cycle of tremponema pallidum

A

exposure to treponema pallidum -> primary disease (1-2 weeks manifestation chancre) -> heal -> secondary disease (2-8 weeks )systemic rashes, condyloma latum, mucous patch) -> latent -> tertiary disease (8-30 years)

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10
Q

what is primary syphilis

A

happens 1-3 weeks after exposure to T.pallidum
manifested by chancre, which is a
lesion at primary site.
painless, ulcerated and localised.
heals after 2-8 weeks, some scarring seen.
lesion is highly infectious.
pt with primary syphillis may have -ve serology

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11
Q

What is secondary syphilis

A

happens 2-12 weeks after primary disease
manifested by systemic rashes, mucuous batch and the labial mucosa, and condyloma latum on oral and genital regions

shows positive serology at this stage

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12
Q

what is tertiary syphilis

A

Latent stage lasting 3-10 years
Positive serology
Slow, persistent reactions (inflammatory, destructive lesions)
clinical manifestation - gumma, which happens anywhere
orally, you may see palatal perforation and syphilitic glossitis

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13
Q

how does someone get TB

A

infection of Mycobacterium tuberculosis
Airborne infection
Re-emergence of TB
Development of multidrug resistant TB
Immunocompromised patients

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14
Q

progression of TB

A

stage 1
- initial infection of m.tb
stage 2
- site of infection is ghon focus.
- can heal (scarring) or progress to latent)
stage 3
- antibody mediated immune response is ineffective in curbing mtb.
- formation of tubercle/granuloma, which is surrounded by activated macrophage
- caseous necrosis happens here
- individual is tuberculin positive here.
- this characterized by latent stage
stage 4
- growth of tubercle
- can invade artery -> hematogenous spread of mtb (aka miliary tb)
- disease comes and go - tissue destruction controlled by healing and fibrosis
stage 5
- Caseous centers of
tubercles liquify
- Rapid extracellular growth of M.TB
-Antigen load causes walls of nearby
bronchi to become necrotic and rupture
-rapid spread through lungs

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15
Q

2 forms of leprosy

A

tuberculoid form
lepromatous form

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16
Q

clinical manifestation of leprosy

A

Skin Lesions: Hypopigmented or erythematous macules, papules, or nodules that may be numb to touch due to nerve involvement.
Nerve Damage: Thickened nerves, loss of sensation, muscle weakness, and paralysis, particularly in the hands and feet.

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17
Q

state the types of candida infections

A

acute
- atrophic
- pseudomembranous (oral thrush)
chronic
- atrophic
- hyperplastic

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18
Q

management of fungal infections in general

A

2% miconazole (gel) applied topically, then swallowed. 4 times a day, after meal, up to 2 weeks. use for one more week after infection goes away

19
Q

symptoms of acute atrophic candidiasis

A

Generalised or focal areas of red/inflamed oral mucosa
pain

20
Q

possible causes of acute atrophic candidosis

A

denture use
antibiotic use

21
Q

Acute pseudomembranous candidosis features

A

areas of generalised or focal inflammation

presence of soft, white/yellow plaques that can be lifted off the mucosa.

These plaques represent inflammatory exudate, dead cells and fungal colonies

22
Q

how is diagnosis of acute pseudomembranous candidosis made?

A

oral features and cytology smear

23
Q

management of acute pseudomembranous candidosis

A

For a simple case e.g. following antibiotic therapy:
- topical antifungal agents and oral hygiene instruction

For a complex case e.g. immunosuppressed patient:

  • medical consultation and topical/systemic antifungal agents
24
Q

what about Chronic Hyperplastic Candidosis

A

Correct diagnosis important because lesion can resemble other pathology including lichen planus and early squamous cell carcinoma

biopsy as cytology smear not always reliable

25
Q

how to do exfoliative cytology, what equipment needed?

A

Examination of cells scraped from the surface of the lesion

equipment’
-Glass slide
-Fixative (usually 70% alcohol)
-Plastic

26
Q

manifestation of HPV

A

squamous papilloma
condylomata accuminatum
focal epithelial hyperplasia
oropharyngeal carcinoma

27
Q

what is squamous papilloma

A

associated with HPV 6 and 11
located at Vermillion and intraoral mucosa
Exophytic lesions, “cauliflower” appearance
Asymptomatic
Usually solitary lesions

28
Q

dd of squamous papilloma

A

Verruciform
xanthoma (based on location)
Papillary hyperplasia (associated
with ill fitting denture)
condyloma accuminatum

29
Q

what is condyloma accuminatum

A

HPV types 6 and 11
more seen in HIV
Broad based pink nodules that grow and coalesce

30
Q

what is focal epithelial hyperplasia

A

Association with HPV types 13 and 32
Numerous nodular soft tissue lesions extending over mucosal surfaces - (looks like alot of thickening on the lips)

31
Q

oropharyngeal carcinoma

A

HPV 16 and 18
tonsilar area
a basaloid subtype of oscc

32
Q

primary hsv symptoms

A

Widespread vesicular eruption involving skin, vermillion and mucosa
Primary gingivostomatitis
Fever, arthralgia, malaise, headache, cervical, lymphadenopathy

33
Q

recurrent herpes sign

A

Vesicular eruption affecting perioral skin, lips, gingivae and palate
Herpes labialis

34
Q

dd of hsv

A

primary
- necrotising gingivitis
- streptococcal pharyngitis
secondary
- apthous ulcer

35
Q

what about varicella zoster

A

there is primary and secondary varicella disease
primary
- chicken pox
- transmission by inhalation of droplets, direct contact
- can reside in sensory ganglia
secondary
- shingles
- happens when immunocompromised

36
Q

coxsackie virus causes?

A

Hand-foot-and-mouth disease and Herpangina

36
Q

how does chicken pox look like

A

Itchy skin rash -> a vesicular eruption
Successive “crops” develop
Oral mucosal involvement
Bacterial infection of skin lesions

36
Q

oral manifestation of HIV

A

kaposi sarcoma
hairy leukoplakia
NG/NP
non-hodgkin lymphoma

36
Q

what about Ebstein barr virus

A

manifestation
Oral Hairy Leukoplakia at Lateral border of the tongue
Associated with HIV infection

36
Q

shingles - varicella zoster that happens in adults

A

Vesicular rash corresponding to affected sensory dermatome
Facial and auditory nerve involvement results in Ramsay-Hunt syndrome

37
Q

what about human herpes virus 8

A

associated with Kaposi’s sarcoma
lesion involving:
Skin, oral cavity, viscera
Aggressive, clinical course, poor prognosis

37
Q

Hand-foot-and-mouth disease features and management

A

Mild to moderate mouth ulceration and vesicular rash on extremities
Self limiting infection
Resolves 1-2 weeks
management
- Symptomatic treatment
- hydration

38
Q

features of measles

A

Transmission by airborne droplets
Koplik’s spots →
Small erythematous macules with necrotic white centres