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Oral Pathology > Chapter 7 > Flashcards

Chapter 7 Flashcards

1
Q

HSV 1 –>

HSV 2 –>

HSV 3 –>

HSV 4 –>

HSV 5 –>

HSV 6 –>

HSV 7 –>

HSV 8 –>

A

Oral HSV

STD HSV

VZV

EBV

CMV

?

?

Kaposi’s Sarcoma

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2
Q

HSV 1

A

Saliva or active perioral lesions

Age affects clinical presentation of symptomatic primary infections

Most commong site of latency –> Trigeminal Ganglion

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3
Q
A

HSV 1

Recurrent (secondary, reactivated) herpes

HERPES LABIALIS

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4
Q

Prodrome for HSV 1

A

Stage of intiail presentation of HSV expression

Pain, Itching, Tingling

6-24 hrs before lesion develops

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5
Q
A

Primary Herpes Gingivostomatitis (HSV 1)

Primary HSV 1 infection before age 5

Moveable and attached oral mucosa –> YELLOW LESION WITH A RED HALO

Self inoculation – Leading infectious cause of BLINDNESS

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6
Q

Primary Herpes Pharyngotonsillitis

A

Primary HSV 1 or HSV 2 infection

Sore throat

Fever -indicative of viral infection

Headache

18+ years old

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7
Q

Reactivation of Herpes Simplex

A

Most common site –> Vermillion border, adjacent to skin of lip

HERPES LABIALIS (HSV 1)

Appearance –> Small erythematous papules

* Fluid filled vesicles

* Vesicles rupture and crust within 2 days

* Heals without scarring in 7 - 10 days

Symptoms are most sever in the first 8 hours

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8
Q

Herpes Labialis

A

Reactivation of HSV 1

“Cold Sore”

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9
Q
A

Intraoral reccurent HSV

Keratinized bound mucosa (palate, attached gingiva)

Vessicles rapidly collapse

Form a cluster of erythematous macules that coalece

Damaged epithelium is lost

Central yellowish area of ulceration

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10
Q

Common reasons for HSV reactivion

A

STRESS

pregnancy

allergies

trauma

illness,

UV LIGHT

immunocompromised

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11
Q
A

Herpetic Whitlow

HSV 1 infection of thumb and fingers

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12
Q
A

Herpes Gladiatorum

Scrumpox

Herpetic infection found in wrestlers HSV1

Contaminated abrasions

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13
Q
A

Herpes Barbae

HSV1 infection spread to bearded regions during shaving

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14
Q
A

HSV Histology

Multinucleation

Ballooning Degeneration

Tzanck Cells

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15
Q

HSV Histology –> Ballooning Degeneration

A

Acantholysis (separation of keratinocytes)

Nuclear clearing

Nuclear enlargement

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16
Q
A

Tzanck Cells

Free floating (clump of cells) epithelial cells

Cells detached

Caused by acantholysis

Pemphigous vulgaris

HSV

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17
Q

Two infections that involve Tzanck Cells

A

HSV

Pemphigous vulgaris (detached desmosomes)

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18
Q

How to diagnosis HSV

A

Clinical presentation

Cytologic smear (tzanck smear)

Tissue biopsy

Serologic testing (4-8 days after intial exposure)

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19
Q

Latent in TRIGEMINAL ganglion

A

HSV 1

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20
Q

Latent in DORSAL SPINAL GANGLION

A

VZV - “chicken pox”

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21
Q

HSV treatment

A

Acyclovir (systemic or topical cream)

Early introduction of antiviral – accelerated clinical resolution

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22
Q

Leading cause of infectious blindness

A

HSV1

Primary herpes gingivostomatitis

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23
Q

Varicella Zoster Virus

A

HSV 3

Primary infection –> Chicken Pox

Recurrent infection –> Herpes zoster (shingles)

Spread through AIR DROPLETS

Most individuals infect by 15 if not vacinnated

Latency –> DORSAL ROOT GANGLION

24
Q
A

Chicken Pox

Primary infection of Varicella Zoster

25
Q
A

Herpes Zoster – SHINGLES

Reccurant infection of Varicella Zoster

Limited to dermatome of infected dorsal root ganglion

Single occurance - reactivation

ORAL LESIONS – Movable or ound tissue, unilateral

White opaque vesicles that rupture and form shallow ulcerations

May cause permanent blindness

26
Q

VZV on tip of nose

A

Sign of ocular involvment

REFER TO OPTHALMOLOGIST

27
Q
A

Ramsay Hunt Syndrome

VZV infection

Cutaneous lesions of external auditory canal

Involvment of ipsilateral face and auditory nerves

Facial Paralysis (CN VII - facial nerve)

Hearing defects (CN VIII)

Vertigo

28
Q

Infectious Mononucleosis

A

EBV – Epstein Barr Virus

HSV 4

Diagnosis Test –> Paul-Bunnel Heterophil Antibodies

Treatment:

Most cases resolve in 4 -6 weeks

No steriods of ABX

NSAIDS can be given

No antivirals (not clinically beneficial)

29
Q

Prodrome of EBV

A

Fatigue

Malaise

Anorexia

30
Q

EBV Oral Lesions

A

Oropharyngeal tonsillar enlargement

Petechiae on hard palate

Necrotizing ulcerative gingivitis

31
Q

Other manifestations caused by EBV infection (3)

A

Oral Hairy Leukoplakia (HIV patients)

Lymphomas/lymphoproliferative disorders

Nasopharyngeal carcinoma

32
Q

Cytomegalovirus

A

HSV 5

Resides in:

  • Salivary Gland cells
  • Endothelium
  • Macrophages
  • Lymphocytes

90% asymptomatic –> fever, joint and muscle pain

Common in AIDS patients

CHRONIC mucosal ulcerations

33
Q
A

CMV –> HSV 5

“owl eye”

34
Q

Enteroviruses (3)

A

Echovirus

Coxsackievirus

Poliovirus

Infection of one strain confers immunity to rest

Fecal oral transmission

35
Q

Coxsackievirus manifestations/infection

A

Herpangina

Hand, foot, and mouth

Acute lymphonodular pharyngitis

36
Q
A

Herpangina – COXSACKIE VIRUS (enterovirus)

Oral lesions in POSTERIOR MOUTH (Soft palate, tonsillar pillars)

Red macules –> fragile vessicles rupture –> ulcerations

Resovle in 10 days

Dysphagia, sore throat, Fever (viral infection)

37
Q

Hand Foot and Mouth

A

Coxsackievirus (enterovirus)

Skin rash on hands and feet (ventrual surfaces, palms)

Rash in mouth

Oral lesions – ARISE FIRST with no prodrome

Resemble herpangina but larger and ore numerous

Buccal mucosa, labial mucosa, tongue (most common)

38
Q

Acute lymphonodular pharyngitis

A

Sore throat

Fever

Mild headache

1-5 yellow to dark pink nodules on soft palate or tonsillar pillars

Represents hyperplastic lymphoid aggregates

Resolves in 10 days

Coxsackie virus (enterovirus)

39
Q

Rubeola

A

“Measles”

Paramyxovirus

Spread via respiratory droplets

Lymphoid hyperplasia

Nine Day measles –> 3 days in each 3 stages

40
Q

Rubeola First stage

A

3 C’s –> Cough, Coryza, Conjuctivitis

KOPLICK’S SPOTS - necrosis of epithelial cells

41
Q
A

Koplick’s Spots

Necrosis of epithelial cells

Small blue-white macules (grains of salt on red background)

Pathognomonic – specefic characteristic of Measles

42
Q

Second Stage of Reubeola

A

Erythematous rash begins

** Downward progression of rash **

Blanches on pressure

43
Q

Third stage of Rubeola

A

Rash and koplick spots resolve

Everything RESOLVES

44
Q

Rubella

A

German Measles

TOGAVIRUS

THREE DAY MEASLES – mild symptoms

Arthritis

Forchheimers’ sign (oral manifestation)

45
Q
A

Forchheimers Sign

Oral manifestation of Rubella

Small discrete dark red papules on the palate

46
Q

Congential Rubell

A

Triad of effects:

Deafness

Heart Defect

Cataracts

47
Q

Mumps

A

Epidemic Parotitis

Diseas of exocrine glands – SALIVARY glands is the best known site

Glandular edema and lymphatic infiltration

Salivary gland changes: Discomfort and swelling, saliva stimulation increase in pain

Epidiymorchitis – swollen testicles in males

48
Q

Epidiymorchitis

A

Swollen testicles in male due to MUMPS

49
Q

HSV 6 & 7

A

Little known

Latent form in CD4 T lymphocyte

50
Q

HIV/AIDS

A

Target cell –> CD4 T helper cell

Oral manifestations:

Candidiasis

Hairy leukoplakia (EBV - HSV 4)

Vascular malignancy

Non-Hodgkin’s lymphoma

Periodontal disease

51
Q
A

Hairy Leukoplakia (EBV ~ HSV 4)

Most commonin HIV immunosuppressed patients

White mucosal plaque that DOES NOT RUB OFF

**Lateral border of the tongue**

No treatment is necessary

52
Q
A

Kaposi’s Sarcoma – HSV 8

Multifocal neoplasm of vascular endothelial cell origin

Oral Lesions: Large red, blue, purple overgrowth lesions

Most commonly found hard palate, gingiva, tongue

** BIOPSY IS REQUIRED**

HIV patient’s

53
Q

Eczema Herpeticum

A

Patients with chronic skin conditions may develop diffuse, life-threatening infection

HSV 1

54
Q

Congenital Rubella

A

Deafness

Cataracts

Heart Disease

55
Q

Rubella –>

Rubeolla –>

A

Togavirus

Paramyoxyvirus

56
Q

HIV Periodontal Disease Presentation

A

Linear Erythema Gingivitis

Necrotizing Ulcerative Gingivitis

Necrotizing Ulcerative Periodontitis

57
Q

Linear Erytham gingivitis

A

Doesn’t respond to plaque control and is more erythematous than normal

Treatment –> systemic antifungals

Oral Pathology (17 decks)

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