Candidiosis

Question 1

Name four classifications of Oral Candidosis that are confined to the mouth and commissure. (4)

Answer 1

• Pseudomembranous - Thrush
• Erythematous - atrophic(HIV)/Denture related
• hyperplastic - Candidal leukoplakia
• angular cheilitis

Question 2

Describe features of pseudomembranous candidosis (3)

Answer 2

• presents as what plaques on the hard palate and other soft tissues
• White plaques are easily scraped away
• Soft tissues look inflamed

Question 3

describe features of chronic hyperplastic candidal leukoplakia (4)

Answer 3

• grows into the tissue
• cant be scraped off
• biopsy required to diagnose
• antifungal agents needed to treat

Question 4

describe features of angular chelitis (2)

Answer 4

• commonly found at corner of mouth

* topical antifungal treatment required

Question 5

describe features of erythematous candidosis (4)

Answer 5

• denture induced stomatitis
• tends to match shape of denture connector
• exists on denture surface
• treated by oral hygiene

Question 6

Would fluconazole be effective against C. Albicans & C. Glabrata? (1)

Answer 6

It would be effective against C. Albicans but not C. Glabrata

Question 7

Describe Candida morphogenisis (4)

Answer 7

Can start as a yeast cell, but under stress can grow a hyphae which assists in adhesion and can even burrow into tissue, leading to vascular invasion.

Question 8

What methods can be used to diagnose candida? (3)

Answer 8

• Microscopy following a smear
• Culture following oral rinse/swab/foam pad
• Histology following a biopsy

Question 9

what type of agar plate would you use to culture candida? (1)

Answer 9

Sabourauds Agar

Question 10

how do Azoles work? (2)

Answer 10

They inhibit the synthesis of ergosterol which is a key component of the fungals cell membrane

Question 11

how do polyenes (such as nystatin) work? (2)

Answer 11

They bind directly to ergosterol and create pores in the fungal membrane that lead to leakage and cell lysis

Question 12

how do echinocandins work?

Answer 12

bind to beta1, 3 glucan synthase which directly affects the fungal cell wall leading to cell death.

Question 13

Why are S. Aureus and C. Albicans problematic when they work together? (3)

Answer 13

• They can become dual resistant
• Candida polymers bind to S.Aureus making it resistant to Vancomycin
• Candida becomes miconazole resistant in return

Question 14

What’s the best candida treatment for a patient who is immunocompetent and has good oral hygiene? (1)

Answer 14

*Any topical or systemic antifungal

Question 15

What’s the best candida treatment for a patient who is immunocompetent and has bad oral hygiene? (2)

Answer 15

• Improve oral hygiene

* Chlorhexidine Rinse

Question 16

What’s the best candida treatment for a patient who is immunocompetent and has dry mouth? (2)

Answer 16

• topical antifungal

* avoid systemic antifungals

Question 17

What’s the best candida treatment for a patient who is immunocompetent and has large erosive legions? (2)

Answer 17

• systemic antifungals

* topical antifungal/ or chlorhexidine rinse

Question 18

What’s the best candida treatment for a patient who is immunocompromised? (2)

Answer 18

• systemic antifungals

* topical antifungal/ or chlorhexidine rinse