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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
**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
VZV on tip of nose
Sign of **ocular involvment** REFER TO OPTHALMOLOGIST
27
**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
Infectious Mononucleosis
**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
Prodrome of EBV
Fatigue Malaise Anorexia
30
EBV Oral Lesions
Oropharyngeal tonsillar enlargement Petechiae on hard palate Necrotizing ulcerative gingivitis
31
Other manifestations caused by EBV infection (3)
Oral Hairy Leukoplakia (HIV patients) Lymphomas/lymphoproliferative disorders Nasopharyngeal carcinoma
32
Cytomegalovirus
**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
CMV --\> HSV 5 "owl eye"
34
Enteroviruses (3)
Echovirus Coxsackievirus Poliovirus Infection of one strain confers immunity to rest Fecal oral transmission
35
Coxsackievirus manifestations/infection
Herpangina Hand, foot, and mouth Acute lymphonodular pharyngitis
36
**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
Hand Foot and Mouth
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
Acute lymphonodular pharyngitis
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
Rubeola
**"Measles**" **_Paramyxovirus_** Spread via respiratory droplets Lymphoid hyperplasia ***_Nine Day measles --\> 3 days in each 3 stages_***
40
Rubeola First stage
3 C's --\> Cough, Coryza, Conjuctivitis **KOPLICK'S SPOTS** - necrosis of epithelial cells
41
**Koplick's Spots** Necrosis of epithelial cells Small **_blue-white_** macules (grains of salt on red background) Pathognomonic -- specefic characteristic of Measles
42
Second Stage of Reubeola
Erythematous rash begins \*\* Downward progression of rash \*\* Blanches on pressure
43
Third stage of Rubeola
Rash and koplick spots resolve Everything RESOLVES
44
Rubella
German Measles **TOGAVIRUS** **_THREE DAY MEASLES_** -- mild symptoms Arthritis **Forchheimers' sign** (oral manifestation)
45
Forchheimers Sign Oral manifestation of Rubella Small discrete dark red papules on the palate
46
Congential Rubell
Triad of effects: Deafness Heart Defect Cataracts
47
Mumps
**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
Epidiymorchitis
Swollen testicles in male due to MUMPS
49
HSV 6 & 7
Little known ## Footnote **Latent form in CD4 T lymphocyte**
50
HIV/AIDS
Target cell --\> **CD4 T helper cell** _Oral manifestations:_ Candidiasis Hairy leukoplakia (EBV - HSV 4) Vascular malignancy Non-Hodgkin's lymphoma Periodontal disease
51
**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
**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
Eczema Herpeticum
Patients with chronic skin conditions may develop diffuse, life-threatening infection HSV 1
54
Congenital Rubella
Deafness Cataracts Heart Disease
55
Rubella --\> Rubeolla --\>
Togavirus Paramyoxyvirus
56
HIV Periodontal Disease Presentation
Linear Erythema Gingivitis Necrotizing Ulcerative Gingivitis Necrotizing Ulcerative Periodontitis
57
Linear Erytham gingivitis
Doesn't respond to plaque control and is more erythematous than normal Treatment --\> systemic antifungals

Oral Pathology (17 decks)

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