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DEN 2027 - Disease Mechanisms > Candidal Infections > Flashcards

Candidal Infections Flashcards

1
Q

What is the study of fungi called?

A

Mycology

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2
Q

What type of organisms are fungi?

A

Eukaryotic microorganisms

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3
Q

Name 3 areas where fungal infections can occur

A
  1. Superficial
  2. Subcutaneous
  3. Systemic
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4
Q

Where are most fungal infections found?

A

Superficially

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5
Q

What is the most relevant fungi to dentistry?

A

Candida albicans

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6
Q

Describe the biological features of Candida albicans

A
  • Large oval shaped organism
  • Dimorphic
  • Usually endogenous in origin
  • Pathogenicity is attributed to certain virulence factors
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7
Q

What does dimorphic mean?

A

Exists in two forms (yeast and hyphal)

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8
Q

Name 4 virulence factors of Candida albicans?

A
  1. Ability to evade host defences
  2. Adherence
  3. Biofilm formation
  4. Production of tissue-damaging hydrolytic enzymes
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9
Q

Name 4 genes associated with Candida virulence

A
  1. SAP4-6 (aspartyl proteinase)
  2. ALS1-7 and ALS-9 (adhesion)
  3. HYR1 (hyphal regulation)
  4. ECE1 (extent of cell elongation)
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10
Q

How does Candida albicans stain in a Gram stain?

A

Stains as a Gram positive, large ovoid organism

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11
Q

What 2 types of patients tend to be affected by Candida albicans?

A
  1. Immunocompromised patients

2. Hospitalised with serious underlying diseases

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12
Q

What are the 4 stages of diagnosis of infection by Candida albicans?

A
  1. Clinical features
  2. Gram stain
  3. Growth of Sabouraud agar
  4. Presence of Candidal hyphae on smears
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13
Q

Why is Sabouraud agar used in the identification of Candida albicans?

A

Bacteria do not grow on this type of agar (only fungi grow)

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14
Q

Name 6 non-specific host defences against Candidal infections

A
  1. Skin and mucous membranes
  2. Secretions (saliva)
  3. Antimicrobial factors in secretions
  4. Commensal bacteria
  5. Phagocytosis
  6. Natural killer cells
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15
Q

What are 3 antimicrobial factors found in secretions which protect the body from Candidal infections?

A
  1. Histatins
  2. Lactoferrin
  3. Lysozyme
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16
Q

Why can commensal bacteria act as a defensive factor against Candidal infections?

A

Inhibit Candidal colonization

17
Q

What are the 4 types of oral Candidiasis?

A
  1. Pseudomembranous
  2. Hyperplastic
  3. Erythematous
  4. Angular cheilitis
18
Q

What 2 ways may a pseudomembranous oral Candidal infection present?

A
  1. Fine whitish deposits on an erythematous patch of mucosa
  2. More high developed small, soft, white, slightly raised plaques resembling milk curds
    (both presentations can be removed by wiping)
19
Q

Name 2 patient complaints of a pseudomembranous oral Candidal infection

A
  1. Slight tingling sensation

2. Foul taste

20
Q

How are hyperplastic oral Candidal infections presented?

A

White plaques which cannot be removed by scraping

21
Q

Where is the most common location for hyperplastic oral Candidal infections?

A

Cheek mucosa

22
Q

What is most likely a major element in the cause of hyperplastic oral Candidal infection?

A

A breach of the integrity of the oral mucosa

23
Q

What 2 locations are the most common for erythematous oral Candidal infection to occur?

A
  1. Tongue

2. Palate

24
Q

How is angular cheilitis characterised?

A

Cracks radiating from the angle of the mouth, often associated with small white plaques

25
Q

What 3 types of patients are particularly susceptible to angular cheilitis?

A
  1. Patients with reduced vertical dimension of occlusion
  2. Secondary to severe attrition
  3. Worn dentures
26
Q

What fungus may be present in angular cheilitis, other than Candida albicans?

A

Staphylococcus aureus

27
Q

What are 2 topical treatments for Candida albicans?

A
  1. Miconazole

2. Nystatin

28
Q

What is the topical treatment of Staphylococcus aureus?

A

Fusidic acid

29
Q

What are 4 local host factors associated with Candidal infections?

A
  1. Denture wearing
  2. Steroid inhaler use
  3. Reduced salivary flow
  4. Carbohydrate rich diet
30
Q

What are 4 systemic host factors associated with Candidal infections?

A
  1. Extremes of age
  2. Endocrine disorders e.g. diabetes
  3. Immunosuppression
  4. Receipt of broad-spectrum antibiotics
  5. Nutritional deficiencies
31
Q

Name 4 types of patients at risk of Candidal infections

A
  1. Patients with dentures or appliances
  2. Patients with xerostomia
  3. Patients with poor diet or abnormal nutrition
  4. Patients prescribes antibiotics or corticosteroids
32
Q

What are the 2 components of management of patients with Candidal infections?

A
  1. Identify, correct or eliminate predisposing causes

2. Provide antifungal therapy if necessary

33
Q

How may Candidal infections in HIV positive patients be treated?

A

Fluconazole

34
Q

How do polyene drugs work?

A

Bind to ergosterol in cell wall causing leakage

35
Q

How do triazole drugs work?

A

Interfere with synthesis of ergosterol in cell wall

DEN 2027 - Disease Mechanisms (20 decks)

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