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BDS3 Microbiology and Oral Pathology > Candidosis > Flashcards

Candidosis Flashcards

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1
Q

does candida act in isolation

A

no they will usually be found with bacteria

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2
Q

what bacteria can candida interact with

A

strep mutans
endrococcus localus
p. gingivalis
staph aureus

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3
Q

are candida bigger than bacteria

A

yes - they provide sites of attachment for bacteria and can take up lots of space

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4
Q

what are the physical scaffolds candida create for bacteria called

A

mycofilms

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5
Q

why might candida infection occur

A

usually due to immunosuppression

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6
Q

what are some examples of candidal infection

A

periodontitis
dental implants
denture stomatitis
UTI
chronic wounds
endocarditis

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7
Q

what are the 4 main types of candidosis

A

pseudomembranous
erythematous
hyperplastic
angular cheilitis

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8
Q

what is pseudomembranous candidosis

A

thrush

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9
Q

what is erythematous candidosis

A

atrophic - HIV related
denture replated

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10
Q

what is hyperplastic candidosis

A

candidal leukoplakia - associated with early stage malignancy

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11
Q

what can happen to pseudomembranous candidosis

A

can be scraped away - more common before antiretroviral therapy for HIV patients

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12
Q

where does chronic hyperplastic candida grow

A

inside the tissue rather than on them - hyphe grow into tissue and cannot be scraped off

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13
Q

what should you do when hyperplastic candida is spotted

A

take a biopsy to check for pre-malignancy

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14
Q

what is angular cheilitis

A

candida at the corners of the mouth

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15
Q

what topical antifungal is prescribed for treatment of angular cheilitis

A

myconazole

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16
Q

how can denture stomatitis occur

A

lots of nooks and cracks in the denture surface, the PMMA contacting the mucosa can irritate it
coaggregation and biofilm formation

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17
Q

what are the types of denture stomatitis

A

Newton’s type 1 - localised inflammation
Newton’s type 2 - diffuse inflammation
Newton’s type 3 - granular inflammation

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18
Q

what are signs and symptoms of denture induced stomatitis

A

inflamed mucosa
burning sensation
discomfort
bad taste

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19
Q

what is one of the biggest potential problems of not treating denture stomatitis

A

they can inhale the microorganisms - aspiration pneumonia

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20
Q

describe how denture stomatitis occurs

A

plaque forms on the denture surface, this releases toxins which irritate the mucosa and cause inflammation and thinning

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21
Q

what are the two main types of candida species

A

candida albicans
candida glabrata

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22
Q

what is candida albicans sensitive to

A

fluconazole and myconazole

23
Q

is candida glabrata sensitive to fluconazole or metronidazole

A

no

24
Q

what can be quite hard about treatment of candida

A

toxicity of some antifungal agents
emergence of resistance

25
Q

why are we seeing more candida glabrata emerging

A

use of fluconazole allows depression of other microbes and allows it to grow

26
Q

why is candida albicans so important

A

starts as a yeast but feed it sugar and if it gets stressed it becomes hyphe which can adhere to tissues and also invade into the tissue and bloodstream

27
Q

does glabrata form hyphe

A

no

28
Q

how does systemic candidiasis occur

A

organism gets on a disruption to the skin its stressed in the environment and forms hyphe, it then creates biofilms, the biofilms then enter the bloodstream and then can infect other tissues

29
Q

what are hydrolytic enzymes

A

enzymes that catalyse the hydrolysis of a substrate through addition of water
they are present in biofilms

30
Q

what does phospholipase contribute to infection

A

host cell penetration

31
Q

what does haemolysin contribute to infection

A

facilitates hyphal invasion

32
Q

what does proteinase contribute to infection

A

adhesion to epithelial cells

33
Q

how is chronic candida in the mouth associated with head and neck cancer

A

alcohol produced by candida - acetaldehyde is a carcinogen which can damage DNA and cause cancer

34
Q

what ways in which can you test if a patient has candidiasis

A

smear (scrape it off)
oral rinse
swab
foam pad
biopsy

35
Q

what would the rinse, swab and foam pad tests be put on

A

agar plate with sabouraud agar

36
Q

how do you treat candida glabrata

A

nystatin

37
Q

in what 3 ways do antifungals work

A

azoles - work on ergosterol via synthesis pathways
polyenes - bind directly with ergosterols and cause leakage and cause death
echinocandins - act of beta 1,3 glucan synthase - destabilises cell wall can causes cell death

38
Q

what is an antibacterial and anticandidal topical solution you should go to first

A

chlorhexidine

39
Q

what is the dual-resistance mechanism

A

staph aureus can coat itself in candida polymers and become resistant to vancomycin

40
Q

if a patient is not immunocompromised and has good oral hygiene what should the treatment be

A

any topical or systemic antifungal

41
Q

if the patient is not immunocompromised and has poor oral hygiene, what should the treatment be

A

improve oral hygiene and prescribe chlorhexidine rinse

42
Q

if the patient is immunocompromised what should the treatment for candida be

A

systemic antifungal and topical antifungals and a chlorhexidine rinse

43
Q

if the patient is suffering from candida infection but is not immunocompromised and has a dry mouth what should the treatment be

A

topical antifungal - avoid systemic antifungals

44
Q

if the patient is suffering from candida infection but is not immunocompromised and does NOT have a dry mouth what should the treatment be

A

any topical or systemic antifungal

45
Q

if the patient is suffering from candida and has large erosive lesions but is not immunocompromised what should treatment be

A

systemic antifungal and topical antifungal and a chlorhexidine mouthwash

46
Q

if a patient presents who is not immunocompromised and does not have any large erosive lesions but is suffering from candida what should the treatment be

A

any topical or systemic antifungal

47
Q

what are three examples of hydrolytic enzymes

A

phospholipases
haemolysin
proteinases

48
Q

what is the function of phospholipases

A

host cell penetration

49
Q

what is the function of haemolysin

A

facilitates hyphal invasion

50
Q

what is the function of proteinases

A

adhesion to epithelial cells

51
Q

what are examples of azole drugs that work on ergosterol synthesis of the fungal cell wall

A

fluconazole
voriconazole

52
Q

what is an example of polyenes that bind directly with ergosterol and cause leakage and death

A

nystatin

53
Q

what is an example of echinocandins that act on the beta 1,3 glucan synthase and destabilise the cell wall

A

capsofungin
micafungin

BDS3 Microbiology and Oral Pathology (6 decks)

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