candida

Question 1

How much bigger is the bio-film of yeast and what does it provide

Answer 1

approx. 25-50x the biovolume of bacteria as Fungi occupy high physical volume in colonisation and infection

Provide physical scaffold for bacteria – ‘Mycofilms’

Create protective environment

Question 2

What are the risk factors for developing candidasis

Answer 2

Immuno-compromised patients

Immunosuppressive drugs

Advanced HIV infection

Intra-abdominal surgery

Central venous catheter

Parenteral nutrition

Broad-spectrum antibiotics

Dialysis

Colonization at a sterile siteDiabetes

Burn unit patient

Trauma patient

Long-term corticosteroid use

Question 3

What are the different infection types of candidal disease

Answer 3

periodontitis

Dental implants

Denture stomatitis

CF lung infections

Ventillator associated pneumonia

UTI’S

Infectious kidney stones

Sutures

chronic wounds

many more

Question 4

What are the classifications of oral candidosis

Answer 4

Psuedomembranous
-Thrush

Erythematous
-Atrophic
-Denture related

Hyper-plastic
- Candidal leukoplakia

Angular cheilitis

Question 5

how does denture induced stomatitis occure

Answer 5

The fungi Adhere and colonise acrylic surfaces leading to

-Co-aggregation, biofilm formation

Question 6

What are the S&S of denture induced stomatitis

Answer 6

Inflamed mucosa – particularly under upper denture

Burning sensation

Discomfort

Bad taste

Question 7

What are the candida species

Answer 7

Candida albicans

Candida glabrata
(These are the worst ones)

Candida parapsilosis

Candida tropicalis

There is over 150 species

Question 8

What is a difference between Candida albicans and Candida glabrata

Answer 8

Albicans is sensitive to fluconazole and itraconazole whereas Glabarta is not

Albicans has Hypha

Question 9

What is the prevalence of Albicans

Answer 9

Present in 71% of healthy individuals

-Oral carriage varies (35-55%)

Question 10

What is the mortality rate of Albicans

Answer 10

35% mortality rate

Question 11

What is a hydrolytic enzyme

Answer 11

An enzyme that catalyzes the hydrolysis of a substrate through the addition of water

Question 12

What can chronic candida lead to

Answer 12

Head and neck cancer

Question 13

how could you diagnose oral candidosis

Answer 13

smear for microscopy

Oral rinse

Oral swab

Foam pad

Biopsy to histology

Question 14

Name azole antifungal therapies and how do they work

Answer 14

Fluconazole
Voriconazole
Posaconazole

They affect the ergoserol and inhibit to be synthesised

the are fungicstatic

Question 15

Name Polyenes antifungal treatment and how do they work

Answer 15

Nystatin
Amphotericin B
Liposomal AmB

They bind to ergosterol in the cell membrane directly and lead to cell death

They are fungicidal

Question 16

Name Echinocandins antifungal treatment and how do they work

Answer 16

Caspofungin
Micafungin
Anidulafungin

They act on the beta 1,3 glucan synthase which results in destabilising of the cell wall and then cell death

Question 17

What are azoles ineffective against

Answer 17

Biofilms

Question 18

If patient has candida is immunocompetent and has poor OH what would the treatment do

Answer 18

Improve OH and use chlorhexidine mouthwash

Question 19

If patient has candida is immunocompetent and has good OH with no dry mouth or no large erosive lesions what would the treatment do

Answer 19

Any topical or systemic antifungal

Question 20

If patient has candida is immunocompetent and has dry mouth what would the treatment be

Answer 20

Topical antifungal, avoid systemic

Question 21

If patient has candida is immunocompetent and has large erosive lesions what would the treatment do

Answer 21

Systemic antifungals + topical antifungals/ chlorhexidine rinse

Question 22

What microorganism is related to endodontics

Answer 22

Enterococcus faecalis

Question 23

How to treat C. Glabrata

Answer 23

Caspofungin

Question 24

• Are there systemic implications of an indwelling prosthesis for the patient

Answer 24

Possibility of aspiration pneumonia