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Dr. Murrahs class > Chapter 5: Bacterial Infections > Flashcards

Chapter 5: Bacterial Infections Flashcards

1
Q
A

impetigo

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2
Q
A

impetigo

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3
Q

what bacteria is impetigo caused by?

A

streptococcus pyogenes and/or staphylococcus aureus

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4
Q

what are the two forms of impetigo?

A

nonbullous and bullous

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5
Q

cases of impetigo usually arise in ___ skin

A

damaged

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6
Q

there is an increase prevalence of impetigo in what 3 populations?

A

HIV, type 2 DM, and dialysis

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7
Q

which type of impetigo is more prevalent?

A

nonbullous

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8
Q

nonbullous impetigo most frequently occurs where on the body?

A

legs

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9
Q

nonbullous impetigo facial lesions are usually located where on the face?

A

around the nose and mouth

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10
Q

nonbullous impetigo is seen in what age patient mostly?

A

school-aged children

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11
Q

is impetigo contageous?

A

yes

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12
Q

in nonbullous impetigo, ___ is common, and itching causes spreading of the infection

A

pruritis

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13
Q

what is the treatment for nonbullous impetigo?

A

topical antibiotics

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14
Q

bullous impetigo is seen more commonly in what aged patient?

A

infants

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15
Q

untreated severe cases of bullous impetigo can lead to what 3 illnesses?

A

meningitis, pneumonia, and glomerulonephritis

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16
Q

superficial vesicles of bullous impetigo rapidly enlarge to form what?

A

larger, flaccid bullae, which usually rupture and evelop a thin brown crust (“lacquer”)

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17
Q

what is the treatment of bullous impetigo?

A

systemic oral antibiotics

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18
Q
A

tonsillitis

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19
Q

another name for tonsillitis/pharyngitis is ___

A

strep throat

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20
Q

what is tonsillitis/pharyngitis caused by?

A

group A beta-hemolytic streptococci, influenza, and epstein-barr virus

majority is caused by virus

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21
Q

the following are signs/symptoms of what infection?

sore throat, dysphagia, tonsillar hyperplasia, fever, headache, and other constitutional symptoms

A

tonsillitis and pharyngitis

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22
Q

how is streptococcal pharyngitis and tonsillitis diagnosed?

A

throat culture

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23
Q

what is the treatment for streptococcal pharyngitis and tonsillitis?

A

penicillin

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24
Q

what are the four sequelae to streptococcal pharyngitis and tonsillitis?

A
  • scarlet fever
  • rheumatic fever
  • rheumatic heart disease
  • acute glomerulonephritis
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25
Q
A

scarlet fever

represents the first two days - white strawberry tongue

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26
Q
A

scarlet fever

represents 4-5 days into infection - red strawberry tongue

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27
Q

___ is the result of disseminated group A beta-hemolytic streptococcal infection, with oral features including a white coating on the tongue with only fungiform papilla visible in the first two days, and an erythematous dorsal surface with hyperplastic fungiform papilla during days 4 and 5 of the infection

A

scarlet fever

first 2 days - white strawberry tongue

days 4-5 - red strawberry tongue

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28
Q

what are the dermatologic features of scarlet fever?

A

skin erythema (1 week) and desquamation (3-8 weeks)

pastia’s lines - rash in areas of pressure and skin folds presenting as transverse red streaks

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29
Q
A

scarlet fever

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30
Q
A

pastia’s lines

scarlet fever

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31
Q

what are the 5 possible complications of scarlet fever?

A
  • abscess
  • pneumonia
  • acute rheumatic fever
  • glomerulonephritis
  • hepatitis
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32
Q

what is the treatment for scarlet fever?

A

oral penicillin or erythromycin

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33
Q
A

tonsilloliths

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34
Q

tonsillar concretions occur when ___ tonsillar crypts are filled with ___ and ___. secondarily, they become colonized with what bacteria?

A
  • pharyngeal
  • desquamated keratin and foreign material
  • actinomyces spp.
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35
Q

what is the difference between a tonsillar concretion and tonsillolith?

A
  • when the contents of invaginations become compacted, it’s foul-smelling and termed a tonsillar concretion
  • if it undergoes dystrophic calcification, it’s termed a tonsillolith
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36
Q

what are the symptoms of tonsillar concretions/ tonsilloliths?

A

other than the foul smell of tonsillar concretions, they are asymptomatic

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37
Q

tonsillar concretions and tonsilloliths can promote recurrent ___

A

tonsillar infections

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38
Q

how are tonsilloliths discovered?

A

on panoramic radiograph as radio-opaque objects superimposed on the midportion of the mandibular ramus

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39
Q

what are the at home treatments for tonsillar concretions / tonsilloliths?

A
  • gargle warm salt water
  • use pulsating jets of water
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40
Q

what are the in-office treatments for tonsillar concretions / tonsilloliths?

A
  • enucleation
  • local excision
  • tonsillectomy is definitive
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41
Q

what is the bacteria responsible for diphtheria?

A

cornebacterium diphtheriae

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42
Q

___ are the sole reservoir for diphtheria

A

humans

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43
Q

what tissues does diphtheria affect first?

A

mucosal tissues

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44
Q

what are the implications of diphtheria?

A

lethal exotoxin produced by the bacteria causes tissue necrosis and cardiac complications

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45
Q

syphilis is caused by ___

A

treponema pallidum

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46
Q

how is syphilis contracted?

A

primarily through sexual contact and from mother to fetus

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47
Q

syphilis is 6x more common in what populations?

A

men and african americans

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48
Q

how is primary syphilis characterized?

A

characterized by the chancre that develops at the site of inoculation (3-90 days after inoculation)

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49
Q

what are the most common sites of inoculation of syphilis?

A

anus and external genitalia

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50
Q

or lesions account for __% of syphilis inoculation sites. describe the lesions.

A
  • 2%
  • most commonly seen on the lip
  • primary syphilis is a painless ulceration
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51
Q

another term for secondary syphilis is ___

A

disseminated syphilis

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52
Q

secondary syphilis occurs ___ weeks after initial infection

A

4-10 weeks

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53
Q

what are the systemic symptoms of secondary syphilis?

A
  • painless lymphadenopathy
  • ALWAYS: diffuse, painless, maculopapular, cutaneous, widespread rash
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54
Q
A

diphtheria

55
Q
A

primary syphilis chancres

56
Q
A

primary syphilis chancre

57
Q
A

secondary syphilis

58
Q
A

secondary syphilis

59
Q
A

tertiary syphilis

gumma

60
Q

after secondary syphilis, patients enter ___ syphilis and are free of ___ for ___ years

A
  • latent
  • lesions/symptoms
  • 1-30 years
61
Q

___% of patients will progress from latent syphilis to tertiary syphilis

A

30%

62
Q

what are the possible cardiac complications of tertiary syphilis?

A
  • aneurysm of the ascending aorta
  • congestive heart failure
  • CNS involvement
  • paralysis
  • psychosis
  • death
63
Q

describe the lesions seen in tertiary syphilis

A
  • ocular lesions
  • tongue lesions (syphilitic glossitis)
  • intraoral lesions usually affect the palate or tongue
  • gumma - characteristic; scattered foci of granulomatous inflammation
64
Q

what is hutchison’s triad, and what is it associated with?

A
  • hutchison’s incisors
  • ocular interstitial keratitis
  • 8th nerve deafness
  • occurs in congenital syphilis (however, not all people with congenital syphilis will have all of the features of hutchison’s triad)
65
Q

describe hutchison’s incisors

A
  • greatest mesiodistal width in the middle 1/3 of the crown
  • incisal 1/3 tapers to the incisal edge - resembles a flat head screwdriver
  • incisal edge has a central hypoplastic notch
66
Q

what are the dental characteristics of congenital syphilis?

A

hutchison’s incisors and mulberry molars

67
Q

what are the ocular characteristics of congenital syphilis?

A

ocular keratitis, which results in blindness

68
Q

what bacteria is responsible for gonorrhea?

A

neisseria gonnorhoeae

69
Q

___ is the most common reportable infectious disease in the US

A

gonorrhea

70
Q

how is gonorrhea contracted?

A

sexual contact

71
Q

what are the signs and symptoms of gonorrhea?

A

purulent discharge and dysuria

72
Q

what bacteria is responsible for tuberculosis?

A

mycobacterium tuberculosis

acid fast bacillus

73
Q

most patients that contract tuberculosis have an ___

A

immunodeficiency

74
Q

how does tuberculosis spread?

A

through airborne droplets

75
Q

tuberculosis of the skin is called ___

A

lupus vulgaris

76
Q

___ is a form of myobacterial infection caused by drinking contaminated milk from an infected cow, and presents as an enlarged cervical lymph node

A

scrofula

77
Q

intraorally, how does tuberculosis present?

A

tongue and palate as a painless, chronic ulceration

78
Q

describe the histology of tuberculosis

A

granulomas with central areas of necrosis (caseating granulomatous inflammation)

79
Q

what is the treatment for tuberculosis?

A

8-wk course of isoniazid, rifampin, and pyrazinamide, then 16-wk course isoniazid and rifampin

80
Q
A

congenital syphilis

hutchison’s incisors

81
Q
A

congenital syphilis

mulberry molars

82
Q
A

gonorrhea

83
Q
A

tuberculosis

84
Q
A

tuberculosis

85
Q
A

tuberculosis, as indicated by a scrofula

86
Q

leprosy is a chronic infectious disease produced by what bacteria?

A

mycobacterium leprae

87
Q

is leprosy infectious?

A

it has a low infectivity (exposure rarely results in disease)

88
Q

82% of all leprosy cases are found in what 5 places? what are the two endemic areas?

A
  • brazil, india, indonesia, myanmar, and nigeria
  • endemic areas are louisiana and texas
89
Q

___ is a host for leprosy

A

9-banded armadillo

90
Q

what are the two main categories of leprosy, and what is the significance?

A
  • tuberculoid leprosy (paucibacillary)
  • lepromatous leprosy (multibacillary)
  • treatment will be different depending on the category
91
Q
A

lepromatous leprosy

92
Q
A

lepromatous leprosy

93
Q

which type of leprosy is this?

A

tuberculoid leprosy

94
Q

which type of leprosy is this?

A

lepromatous leprosy

95
Q

which type of leprosy is this?

A

lepromatous leprosy

96
Q

describe paucibacillary leprosy

A
  • tuberculoid pattern
  • small number of skin lesions
  • rare oral lesions
97
Q

describe multibacillary leprosy

A
  • lepromatous pattern
  • loss of hair
  • facial skin enlargements = leonine facies
  • collapse of bridge of the nose = pathognomonic
98
Q
A

lepromatous leprosy (multibacillary leprosy)

99
Q

___ is a rapidly progressive, polymicrobial, opportunistic infection that is most frequently preceded by measles

A

noma

100
Q

what are the two types of bacteria responsible for noma?

A

fusobacterium necrophorum and prevotella intermedia

101
Q

noma frequently begins as ___

A

NUG

102
Q

noma most frequently develops in ___ in children of what age?

A
  • africa
  • ages 1-7
  • nutrition from breastfeeding = carbs and unsafe water
103
Q

in noma, how do the zones of necrosis present?

A
  • develop in gingiva or soft tissue
  • necrosis spreads, but does not follow tissue planes and spreads through anatomic barriers (like muscle)
  • necrotic areas are well-defined and unilateral
104
Q

what is the treatment for noma?

A
  • antibiotics and correct nutrition
  • conservative debridement of gross necrotic areas
  • aggressive removal is contraindicated (it compounds reconstruction problems - reconstruction is delayed 1 year to ensure complete recovery)
  • leave necrotic bone to hold facial form; remove if it sequestrates
105
Q

what are the mortality rates of noma?

A
  • 95% mortality if untreated
  • 10% mortality if treated in the US
106
Q
A

necrotizing ulcerative mucositis, which is characteristic of noma

107
Q
A

noma

108
Q
A

actinomycosis

109
Q

actinomycosis is a bacterial infection caused by what bacteria?

A

actinomyces israelii

110
Q

where can actinomyces israelii colonization occur in healthy patients?

A

tonsillar crypts, plaque, and/or carious dentin

111
Q

55% of cases of actinomycosis are diagnosed in the ___ region

A

cervicofacial

112
Q

what is the treatment for actinomycosis?

A

long-term high dose antibiotics

113
Q

what bacterial infection can result in a suppurative reaction of the infection that may discharge a yellow material? what does the yellow material represent?

A
  • actinomycosis
  • represents colonies of bacteria (actinomyces israelii), termed sulfur granules
114
Q

what bacteria causes cat-scratch disease?

A

bartonella henselae

115
Q

cat-scratch disease is the most common cause of ___ in children

A

chronic regional lymphadenopathy

116
Q

cat-scratch disease begins in the ___, and classically spreads to ___

A
  • skin
  • adjacent lymph nodes
117
Q

cat-scratch disease arises after contact with what?

A
  • a domestic cat or kitten
    • scratches, licks, bites
118
Q

80% of cat scratch disease cases occur in patients younger than ___

A

20

119
Q

what can happen in cases of cat-scratch fever where primary lesions are adjacent to the eye?

A

can result in a conjunctival granuloma with preauricular lymphadenopathy (= oculoglandular syndrome of parinaud)

120
Q

how is cat-scratch fever diagnosed?

A

serologic tests

121
Q

what is the treatment for cat-scratch fever?

A
  • it is a self-limiting condition
  • palliative treatment only unless severely involved, then antibiotics are appropriate
  • resolves in 4 months
122
Q
A

cat scratch disease

123
Q
A

cat scratch disease

124
Q

___ is one of the most common health complaints in the US

A

sinusitis

125
Q

sinusitis is usually caused by a blockage of the ___

A

ostiomeatal complex (therefore disruptive normal drainage)

126
Q

what are the most common predisposing factors of sinusitis?

A
  • allergic rhinitis
  • upper respiratory tract viral infection
127
Q

if not corrected, acute sinusitis can become ___

A
  • chronic
    • defined as recurring episodes of acute sinusitis/symptomatic sinus disease lasting longer than 3 months
128
Q

in chronic sinusitis, calcification can occur, which is termed a ___

A

antrolith

129
Q

describe pain of maxillary sinusitis

A
  • increased pain when head is upright
  • decreased pain when patient is supine
    • a sinus infection should be strongly considered when patients complain of pain from several teeth
130
Q

___ helps diagnose chronic sinusitis

A

radiographic imaging

sinus is cloudy with increased density

131
Q

what is the treatment for acute sinusitis?

A

no treatment; disease is self-limiting

132
Q

what is the treatment of chronic sinusitis?

A
  • if unresponsive, surgical correction to enlarge the ostial openings
  • surgery should try to be avoided in children
    • decreased distance between orbit and brain
133
Q
A

sinusitis

cloudy right maxillary antrum

Dr. Murrahs class (17 decks)

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