Bacterial Infection - Microbiology

Question 1

Symptoms of periodontal abscess?

Answer 1

Pain
Swelling
Possible: lymphadenopathy, fever
Facial cellulits rare

Question 2

What expect to see of adjacent teeth in periodontal abscess?

Answer 2

Vital teeth

Pre-existing periodontal pockets

Question 3

Causes of periodontal abscess?

Answer 3

Pre-existing pockets becone occluded
Foreign bodies
Trauma periodontium
Secondary infection lateral periodontal cyst

Question 4

What see radiographically periodontal abscess?

Answer 4

Radiolucency on lateral aspect of root

Question 5

Treatment of periodontal abscess?

Answer 5

Drain and debride

Question 6

What is streptococcal gingivitis?

Answer 6

Severe of inflammation w/ marked pain causes by s. pyogenes

Question 7

What may see before streptococcal gingivits?

Answer 7

Tonsilitis

Question 8

What pt common see streptococcal gingivits in?

Answer 8

Compromised - immuno-compromised etc

Question 9

Complications of streptococcal gingivitis?

Answer 9

Fascitiis
Tissue destruction
Nephritis

Question 10

How tx streptococcal gingivits?

Answer 10

Prompt tx w/ penicillin

Question 11

RF for acute ulcerative gingivitis?

Answer 11

Poor OH, smoking, stress

Question 12

What see is acute ulcerative gingivits?

Answer 12

Ulceration
Invasion of tissue
Destruction interdental papilla

Question 13

What symptoms may pt w/ acute ulcerative gingivitis complain of?

Answer 13

Halitosis
Malaise
Lymphadenopathy

Question 14

What micro-orgnaisms see in gram stain of acute ulcerative gingivitis?

Answer 14

Treponema - spiral
Fusobacterium - gram -ve
Prevotella - black-pigment anaerobe

Question 15

What is Noma?

Answer 15

Cancrrum Oris - debilitating infection affecting children 2-6

Question 16

What is cancrrum oris often preceeded by?

Answer 16

ANUG

Infection - viral (measels)/ bacterial (tuberculosis)

Question 17

Bacterial involvement in Cancrrum oris?

Answer 17

F. necrophorum
P. intermedia
T. vincetti
T. denticola

Question 18

What see oral signs of tuberculosis?

Answer 18

Rare to see any signs - may see ulceration on tongue

Delayed healing after XLA - secondary osteomyelitis

Question 19

What investigations are required if suspect TB?

Answer 19

Biopsy - ZN stain
Cultures
Serology

Question 20

Why use ZN stain?

Answer 20

Zhiel Neelson stain specific to mycobacterium tuberculosios

Question 21

What seen ZN stain?

Answer 21

Magenta organise w/ blue background

Question 22

What other conditions present similar TB on H&E stain?

Answer 22

TB/ oro-facial granulomatitis/ sarcoidosis and chrons

Granulamtous inflamamtion

Question 23

What see histology of TB?

Answer 23

Epitheliod granulomas
Histocytes fuse to form multi-nucleated giant cells
Caesation of granulomas

Question 24

Why do granulomas form?

Answer 24

Due to slow growing organisms

Form when immune system attempt to wall off substances

Question 25

What see in primary lesions of syphillis?

Answer 25

Chancre on lip/tongue Ulcer, local oedmea Lymphadenopathy

Question 26

What would smear of primary syphilis show?

Answer 26

Spirochaetes

Question 27

What see in secondary syphilis?

Answer 27

Snail track ulceration Skin rash - palm/soles of feet Lympahdenopathy

Question 28

What see tertiary syphilis?

Answer 28

Gumma on palate/ tongue or tonsil | Leukoplakia on dorsum tongue

Question 29

What is gumma?

Answer 29

Firm necrotic centre surrounded by inflamed tissue

Question 30

What see in congenital syphilis?

Answer 30

Mulberry molars | Hutchinson incisor -crescent moon shaped

Question 31

What symptoms would expect to see in Gonorrhoea?

Answer 31

Pain and lymphadenopathy | Variable appearance: ulceration oedema of mucosa

Question 32

What see on stain of gonorrhoea?

Answer 32

See neisseria gonorrhoea | Polymorphonuclear leucocytes

Question 33

When does actinomycosis present?

Answer 33

External presentation as large bulge under mandible

Question 34

Causative agents of actinomycosis?

Answer 34

Actinomyces israeli A. oris A. naeslundii

Question 35

When can actinomycosis by secondary to?

Answer 35

Trauma e.g broken mandible

Question 36

Tx of actinomycosis?

Answer 36

Surgical drain and debride | 6-8 weeks ab

Question 37

What see histology actinomycosis?

Answer 37

Gram +ve organism Highly branched and filamentous Loculus of pus w/ fibrous septa Walled-off = slow growing

Question 38

What is acute bacterial sialedentitis?

Answer 38

Ascending infection - mainly affect the parotid

Question 39

Common cause of acute bacterial sialadenitis?

Answer 39

Failure of scretion - sjogrens, gland pathology, drugs

Question 40

How does acute bacterial sialadenitis present?

Answer 40

Unilateral, firm, red swelling | Pain, trismus

Question 41

What may see if milk duct in acute bacterial sialadenitis?

Answer 41

Pus

Question 42

Microbial cause of bacterial sialadneitis?

Answer 42

Oral streptoccoi | Oral anaerobes

Question 43

How tx bacterial sialadentitis?

Answer 43

Ab: Amoxicillin/ Flucloxacillin | Follwing resolution: sialography

Question 44

What can cause predisposition to angular chelitis?

Answer 44

Haematological deficient: Fe, B12

Question 45

What causes angular chelitis?

Answer 45

Fungal disease - candida spp, staph aureus - alone/ mixed

Question 46

How tx angular chelitis?

Answer 46

Miconazole/ nystatin | Fusidic acid

Question 47

When is fusidic acid used for angular chelitis?

Answer 47

When have mixed infection w/ staph aureus

Question 48

What is staph aureus not sensitive to?

Answer 48

Nystain

Question 49

What will tx staph aureus in angular chelitis?

Answer 49

Miconazole | Fusidic acid