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Oral Pathology, Stephen > Ch 5 Bacterial infections > Flashcards

Ch 5 Bacterial infections Flashcards

1
Q

Superficial skin infection caused by Strep pyogenes and Staph aureus

A

Impetigo (Bullous and Non-bullous forms)

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2
Q

Which age group is most commonly affected by Bullous impetigo

A

infants and newborns

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3
Q

Bullous impetigo usually caused by which bacteria: Strep pyogenes or Staph aureus

A

Staph aureus

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4
Q

What is protective against impetigo transmission

A

Intacts skin and good hygeine

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5
Q

How will bullous impetigo normally progress

A

fragile vesicles that rupture and form thin brown crusts

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6
Q

treatment options for bullous impetigo

A

1 week systemic antibiotics: cephalexin, fluclaxacillin, amoxicillin-cluvanic aci

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7
Q

Treatment of non-bullous impetigo

A

topical mupirocin

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8
Q

Found when tonsillar crypts fill w/ desquamated keratin and foreign material, then become secondarily colonized w/ bacteria, usually Actinomyeces, which become a form of foul-smelling material

A

Tonsilar concretions

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9
Q

Tonsillar concretions that undergo dystrophic calcification form

A

Tonsilloliths

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10
Q

Treatment of tonsilloliths

A

Suctions, local excision, or removal of tonsils are recurrence is common

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11
Q

What is the bacteria that causes Syphillis

A

Treponema pallidum

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12
Q

2 main modes of syphilis transmission and why

A

Sexual contact Mother to child

Treponema pallidum is very vulnerable to drying

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13
Q

What is a rare way to get syphilis currently due to better screening procedures

A

blood transmission/exposure to infected blood

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14
Q

Is Syphillis curable, and if so how

A

Curable via IM antibiotic benzathine penicillin

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15
Q

4 types/stages of syphilis

A

Primary Secondary
Tertiary
Congenital

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16
Q

Which stages of syphilis are most infectious

A

Primary and Secondary

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17
Q

When must syphilis be treated to avoid transmission during pregnancy

A

within 5-6 months of getting pregnant

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18
Q

What characterizes primary syphilis

A

Chancre

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19
Q

Where does a chancre first appear and in what time period

A

At point of initial exposure w/in 3-90 days after exposure and lasting 4-6 weeks

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20
Q

Most common site for oral syphilitic chancre and its characteristic

A

lip most common, painless, clean based ulceration with regional lymphadenopathy

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21
Q

What can a syphilitic chancre on the lip be mistaken for

A

Cancer

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22
Q

When does Secondary Syphillis start

A

4-10 weeks after initial infection

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23
Q

What are the clinical symptoms of Secondary syphilis

A

Flu like symptoms, symmetrical, reddish pink maculopapular non-itchy skin rash

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24
Q

The zones of intense exocytosis and spongiosis of the oral mucosa with zones of sensitive whitish mucosa during secondary syphilis are called

A

mucous patches

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25
Q

What are condyloma lata

A

rash becomes flat broad whitish papules in moist areas of body

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26
Q

What is the difference in chancres in primary versus secondary syphilis

A

Secondary has multiple lesions

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27
Q

When will secondary syphilis resolve

A

w/in 3-12 weeks, but can relapse into secondary during the next year

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28
Q

The period after secondary syphilis that a person is free of lesions and symptoms

A

latent syphilis

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29
Q

When is a patient with latent syphilis more contagious, early or late

A

early

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30
Q

How treat a patient with early latent syphilis

A

single IM injection of long acting penicillin

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31
Q

How treat a patient with late latent syphilis

A

3 weekly injections

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32
Q

When will tertiary syphilis show up

A

1-10 years after initial infection

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33
Q

Which stage of syphilis is the most serious

A

Tertiary

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34
Q

What systems will tertiary syphilis affect

A

Cardiovascular, CNS, sight

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35
Q

What is the character of the inflammation associated with tertiary syphilis

A

granulomatous that is focal

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36
Q

The active site of granulomatous inflammation that is indurated, nodular, or ulcerated in tertiary syphilis

A

gumma

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37
Q

Gummas of tertiary syphilis are most common where orally

A

palate and tongue, palate commonly perforates into sinus

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38
Q

Diffuse atrophy and loss of the dorsal tongue papillae produce what condition in tertiary syphilis

A

Leutic glossitis, was thought previously to be cancerous, but is not

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39
Q

What is Argyll-Robertson pupil-diagnostic sign for the neurological diagnosis of tertiary syphilis

A

thin and irregular pupils constrict for focusing but not in response to light

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40
Q

Shuffling gate of tertiary syphilis due to neurological involvement called

A

Tubes dorsalis (locomotive ataxia)

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41
Q

3 things tertiary syphilis can cause cardiovascularly

A

syphilitic aneurysm Aortic aneurysm

Aortic regurgitation

42
Q

This syphilis present in utero and at birth when child is born to mother with primary or secondary syphilis

A

Congenital syphilis

43
Q

What stage will a baby that survives birth with congenital syphilis go directly to

A

Secondary

44
Q

3 pathognomonic diagnostic features of Hutchinson’s triad for Congenital syphilis

A

Hutchinson’s teeth

Ocular interstitial keratitis 8th Nerve deafness

45
Q

5 physical characteristics of person living with congenital syphilis (look likewhat cartoon character)

A

Frontal Bossing Short maxilla
High Arched palate Saddle Nose Rhagades
[looks a bit like Mr. Magoo]

46
Q

What are rhagades

A

furrows around mouth giving appearance of premature aging

47
Q

What other names for Hutchinson’s teeth as part of the triad for congenital syphilis

A

Hutchinson’s incisors

Mulberry molar, Fournier’s molars, Moon’s molars

48
Q

Hutchinson’s incisors resemble what

A

Flat head screwdriver with a central hypoplastic notch

49
Q

When will interstitial keratitis in congenital syphilis appear and how will it look

A

between 5 and 25, opacified corneal surface with resultant loss of vision

50
Q

Can there be false positives for syphilis by using spiral shaped bacteria in oral smears

A

yes, because there are other treponemes in the mouth

51
Q

2 specific tests for syphilis

A

Treponema pallidum hemagglutination test (TPHA) Fluorescent Treponemal Antibodgy Absorption (FTA-ABS)

52
Q

What is the only good thing that came out of the Tuskegee Syphillis study

A

National Research Act requiring government to review and approve all studies on human subjects

53
Q

Most common reportable bacterial infection in the United States

A

Gonorrhea

54
Q

Bacteria that causes Gonorrhea

A

Neisseria gonorrhea

55
Q

What is protective against gonorrhea inoculation without sexual contact

A

intact stratified squamous epithelium

56
Q

Most important female complication of gonorrhea

A

Pelvic inflammatory disease (PID)

57
Q

Neisseria gonorrhea Gram stain and shape

A

Gram negative diplococcic

58
Q

If you have gonorrhea what other STD are you treated for concurrently

A

Chlamydia

59
Q

Antibiotics used to treat gonorrhea and Chlamydia

A

Ceftriaxone and doxycycline

60
Q

Most common site of oropharyngeal gonorrhea and its symptoms

A

pharynx, tonsils, uvula. Asymptomatic or mild- moderate sore throat and diffuse oropharyngeal erythmea

61
Q

Oral gonorrhea can mimic what other pathology, but what is absent in oral gonorrhea

A

Necrotizing Ulcerative Gingivitis but without the fetor oris

62
Q

What is the gonorrhea transmitted to newborn’s eyes from an infected mother

A

Gonococcal Opthalmia Neonatum

63
Q

3 drugs used for prophylaxis against gonococcla ophthalmia neonatorum

A

Opthalmic erythromycin Tetracycline

Silver nitrate

64
Q

What is the clinical symptom for men with gonorrhea infection

A

pain on urination with urethral discharge

65
Q

Chronic infectious disease caused by Mycobacterium tuberculosis

A

Tuberculosis (TB)

66
Q

What is key for testing tuberculosis

A

distinguish infection from active disease

67
Q

2 types of tuberculosis

A

Primary and Secondary

68
Q

Tuberculosis that occurs in previously unexposed people and almost always involves the lungs, commonly the result of direct person-to-person spread through airborne droplets from someone with active disease

A

Primary tuberculosis

69
Q

Can you get oral Tuberculosis only

A

No, it is always secondary to pulmonary and is rare

70
Q

Primary Tb infection results in what and where

A

localized fibrocalcified nodule at the initial site of involvement

71
Q

What is key to getting tuberculosis

A

long term exposure to large number of respiratory droplets from a person with active tuberculosis

72
Q

What is the test for the tuberculosis exposure

A

Purified protein derivative (PPD)

73
Q

Secondary tuberculosis normally occurs how and in what type of patient

A

active disease later in life from a reactivation in a person previously infected and associated with compromised immunity

74
Q

Synonymn for secondary tuberculosis describing its diffuse granulomas

A

Miliary Tuberculosis

75
Q

4 synonymns for Tuberculosis

A

Consumption Lupus vulgaris
Miliary
Scrofula

76
Q

Skin involvement of tuberculosis. A diffuse unremitting skin infection

A

Lupus vulgaris

77
Q

Oral lesions associated with tuberculosis have what character

A

hronic, painless ulcer

78
Q

This tuberculosis infection characterized by enlargement of the oropharyngeal lymphoid tissues and cervical lymph nodes and transmitted by drinking contaminated milk

A

Scrofula

79
Q

4 ways to diagnose Tuberculosis

A

Mantous or PPD skintest Chest X-ray
Culture of sputum for Gram Neg diplococcic
Mycobacterial stains

80
Q

What is the cause of the formation of granulomas, called tubercles, which are a classic histologic presentation of Tb

A

Cell-mediated hypersensitivity reaction

81
Q

Gangrenous disease leading to tissue destruction of face

A

noma

82
Q

What causes Noma

A

pportunistic infection caused by components of normal oral flora that become pathologic during periods of compromised immunity

83
Q

Predisposing factors for Noma

A 
Malnutrition
Dehydration
Poor oral hygiene
Poor sanitation
Recent illness (e.g. Tuberculosis, measles) Malignancy
Immunodeficiency (e.g. AIDS)
84
Q

What illness normally precedes Noma

A

Measels

85
Q

What age group does Noma mostly affect

A

children 2-6 years old

86
Q

How treat Noma

A

Antibiotics (penicillin or metronidazole) along with wound care, OHI, better nutrition and hydration. Prevent w/ vaccinations from childhood illness. Repair with plastic sugery

87
Q

Actinomycosis is

A

infection of filamentous, branching, Gram positive anaerobic bacteria. Not fungal

88
Q

Causitive bacteria of actinomycosis

A

Actinomyces israelii

89
Q

Where is actinomycosis likely to sequester

A

deep, e.g. fractures, gunshot wounds

90
Q

3 clinical features of actinomycosis infection

A

acute deep supurative abscess multiple draining sinus tracts

sulfur granules

91
Q

What area is common on the head and neck for actinomycosis infection

A

Area over the angle of the mandible

92
Q

2 main treatments for actinomycosis infection

A

prolonged high doses antibiotics Abscess drain and excise sinus tract

93
Q

Infectious disorder that begins in the skin but classically spreads to the adjacent lymph nodes

A

Cat scratch disease

94
Q

Most common cause of regional lymphadenopathy in children

A

Cat Scratch disease

95
Q

What is the bacterial cause of Cat Scratch disease

A

Bartonelle henselae, a gram negative rod

96
Q

Clinical features of Cat Scratch disease

A

tender regional lymphadenopathy

Sterile supportive papules at scratch site w/in 3-14 days

97
Q

How long can regional lymphadenopathy remain in Cat Scratch disease

A

3 weeks post scratch lasting for several months

98
Q

What can make Cat Scratch disease hard to diagnose

A

Primary site of inoculation has healed before patient presents with lymphadenopathy

99
Q

Cat Scratch disease treatment

A

self limiting with or without treatment in 1-2 months. Can give analgesics for pain, aspirate nodule, local heat

100
Q

One of most common health complaints in US

A

Sinusitis

101
Q

What are the bilateral sinuses of the adult

A

Frontal, Sphenoid, Ethmoid, Mastoid

102
Q

What is the key to sinus disease

A

the osteomeatal complex with its narrow openings as primary site for inspired air foreign matter

Oral Pathology, Stephen (13 decks)

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