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Oral Pathology - My deck > Chapter 7 > Flashcards

Chapter 7 Flashcards

1
Q

What is the only natural reservoir for HHV?

A

Humans, HHV stands for human herpes virus!

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2
Q

What are the types of HHV?

A

HHV-1, HHV-2, VZV, EBV, CMV, HHV-6, HHV-7, KSHV

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3
Q

Where are lesions typically seen in HSV-1?

A

Lesions are typically above the waist, specifically, perioral lesions

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4
Q

What condition has been able to induce HHV-1 lesions experimentally?

A

UV light exposure

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5
Q

What term describes a symptomatic primary infection in younger populations?

A

Acute herpetic gingivostomatitis

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6
Q

How is HHV-2 transmitted?

A

Sexual contact

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7
Q

Are primary infections of HHV-1 and HHV-2 usually asymptomatic or symptomatic?

A

80% are usually asymptomatic

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8
Q

After initial exposure or HHV-1 and HHV-2, where is the virus transported to?

A

The virus is taken up by the sensory nerves and transported to associated sensory ganglia (latent state).

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9
Q

What is the primary site of latency for herpes?

A

Trigeminal ganglion

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10
Q

What are the terms that describe reactivation of herpes virus?

A

Secondary infection, recurrent infection or recrudescent infection

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11
Q

What is the most common site of recurrence for HHV-1?

A

Vermillion border and adjacent skin of the lips.

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12
Q

What is other names for HHV-1 when it occurs adjacent skin of the lips?

A

Herpes labialis, cold sore, fever blister

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13
Q

True or False: 40% of people in the US has a history of herpes labialis

A

True

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14
Q

Describe the prodrome of HHV-1?

A

Pain, burning, itching, tingling 6-24 hours before the lesion develops. Symptoms are most severe in the first 8 hours.

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15
Q

Describe the appearance of HHV-1/2 lesions.

A

Multiple, small, erythematous papules (fluid filled vesicles) that rupture and crust with 2 days.

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16
Q

How long does it take for HHV-1/2 to heal?

A

7-10 days

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17
Q

How many HHV-1/2 outbreaks does a majority of people experience a year?

A

2 outbreaks a year

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18
Q

How long is the HHV-1/2 virus actively replicating for?

A

2 days. Mechanical rupture of intact vesicles releases the virus and can result in spreading the lesion

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19
Q

Where do recurrent intraoral lesions usually occur?

A

Almost always on keratinized, bound mucosa (palate, attached gingiva)

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20
Q

At what age does acute herpetic gingivostomatitis usually occur?

A

Most cases occur before 5 years old

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21
Q

True or False: Both movable and attached oral mucosa can be affected by acute herpetic gingivostomatitis.

A

True, both movable and attached mucosa can be affected by acute herpetic gingivostomatitis.

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22
Q

In acute herpetic gingivostomatitis, self-inoculation of ________, _______, and _______ can occur.

A

Fingers, eyes and genitals

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23
Q

What term describes primary herpes in patients 18 years and older?

A

(Acute herpetic?) Pharyngotonsillitis

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24
Q

What are the initial symptoms of herpetic pharyngotonsillitis?

A

Sore throat, fever, headache

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25
What term describes a herpes infection of the thumb or fingers?
Herpetic whitlow
26
What term describes a herpetic infection found in contaminated abrasions of wrestlers or rugby players?
Herpetic gladiatorum or scrumpox
27
What term describes a herpes infection created by shaving?
Herpes barbae
28
What location of HSV-1 is a concern for ocular involvement?
The tip of the nose (ocular involvement of herpes is actually the leading infectious cause of blindness in the US)
29
What term describes a life threatening infection caused by extensive herpetic cutaneous vesicular eruption that arises from pre-existing skin disease?
Eczema herpticum or Kaposi's varicelliform eruption
30
What are the histopathologic features of HHV?
Multinucleation, ballooning degeneration (Acantholysis, nuclear clearing, nuclear enlargement) Tzanck cells (free floating)
31
How is HHV diagnosed?
Clinical presentation, cytologic smear, tissue biopsy, serologic testing(has to be 4-8 days after exposure)
32
How is HHV treated?
Antivirals (acyclovir)
33
What virus causes chicken pox?
Varicella-Zoster Virus aka HHV-3
34
How is VZV spread?
Through air droplets or direct contact with active lesions
35
At what age do most cases of VZV occur?
Between the ages of 5-10
36
After initial VZV infection, where does the virus establish latency?
Dorsal spinal ganglia
37
What are some predisposing factors for reactivation of VZV?
Immunosuppression, radiation, malignancies, increasing age, alcohol abuse, emotional or physical stress
38
What is the syndrome associated with VZV?
Ramsay Hunt Syndrome
39
Describe Ramsay Hunt Syndrome.
Cutaneous lesions of the external auditory canal, facial paralysis, hearing deficits, vertigo
40
What virus causes infectious mononucleosis?
Epstein Barr virus aka HHV 4
41
What are some other lesions which demonstrate EBV?
Oral hairy leukoplakia, lymphomas (African's Burkitt lymphoma), Nasopharyngeal carcinoma
42
Approximately how many adults are infected with EBV?
Up to 95% of adults
43
How is infectious mononucleosis diagnosed?
Presence of Paul Bunnel heterophil antibodies
44
What are the signs of infectious mononucleosis?
Prodrome 2 week before, fatigue, malaise, anorexia, fever, lymphadenopathy, oral lesions (petechiae on hard palate, NUG)
45
What virus can reside in salivary glands, endothelium, macrophages and lymphocytes?
Cytomegalovirus aka HHV 5
46
Approximately, what percentage of CMV infections are asymptomatic?
Almost 90%
47
What are the common symptoms of CMV infection?
Fever, joint and muscle pain, shivering, chronic mucosal ulcerations
48
In what population is CMV common?
AIDS patients
49
What are the classifications of enteroviruses?
Echoviruses, Caxsackievirus, Poliovirus
50
What are the 3 disease caused by the coxsackievirus that are important to oral health care professionals?
Herpangina, hand/foot/mouth disease, acute lymphonodular pharyngitis
51
How are enteroviruses spread?
Crowding and poor hygiene, fecal-oral route; during acute phase, it can be transmitted through saliva or respiratory droplets
52
True or False: infection with one strain of enteroviruses confers immunity
True, infection with one strain of enteroviruses confers immunity
53
What age group(s) are commonly affected by enteroviruses?
Nearly half of reported cases occur in infants younger than 1, 85% occur in patients younger than 20
54
Describe herpangina
Skin rash, 2-6 oral lesions in the posterior mouth, along with sore throat, fever and dysphagia
55
Describe the ulcerations seen in herpangina
Begin as red macules that form fragile vesicles that rapidly ulcerate; ulcerations are 3mm in diameter
56
Describe hand-foot-and-mouth disease
Skin rash and oral lesions associated with flu like symptoms
57
Describe the oral lesions seen in hand-foot-and-mouth disease
Resemble ulcerations of herpangina, but larger (up to 1 cm), and more numberous (up to 30); buccal mucosa, labial mucosa, and tongue
58
True or False: Lesions seen in hand-foot-and-mouth disease heal without crusting
True, lesions seen in hand-foot-and-mouth disease heal without crusting
59
Describe acute lymphonodular pharyngitis
Sore throat, fever, mild headache, with 1-5 yellow to dark pink nodules in the posterior mouth that represent hyperplastic lymphoid aggregates
60
How are infections caused by enteroviruses diagnosed?
Diagnosis can be made from clinical manifestations, infection is self limiting
61
What is another name for measles?
Rubeola is another name for measles
62
What virus causes measles/rubeola?
Paramyxovirus
63
When do most cases of measles arise?
In winter
64
How is measles spread?
Through respiratory droplets
65
What is the incubation period for the paramyxovirus?
10-12 days
66
How long are measles infectious?
Infectious from 2 days before symptoms and 4 days after rash appears
67
In measles, what is responsible for the rash formation?
Vasculitis
68
How long does measles last?
Nine-day measles, 3 stages with 3 days
69
What is the 1st stage of measles?
3 C's + fever | Coryza, cough, conjunctivitis
70
What term describes multiple areas of mucosal erythema with numerous, small, blue-white macules (grains of slat on a red background) and is associated with the 1st stage of measles?
Koplik's spots (pathognomic for measles)
71
What do Koplik's spots represent?
Foci of epithelial necrosis
72
What is the 2nd stage of measles?
Fever continues + maculopapular, erythematous (morbilliform) rash
73
How does the rash first begin and spread in the 2nd stage of measles?
Face first, then a downward spread from trunk to extremities
74
What is the 3rd stage of measles?
Fever ends + rash fades, replaced by brown pigmentary staining
75
What is another name for rubella?
German measles is another name for rubella
76
What virus causes rubella?
Togavirus
77
What is the greatest importance to remember about Rubella?
It has the capacity to induce birth defects (congenital rubella syndrome)
78
What is the incubation time of the togavirus?
2-3 weeks
79
When are patients with rubella contagious?
1 week before rash to 5 days after its development
80
How long does rubella last?
3 day measles
81
What is the most common complaint seen in rubella?
Arthritis, other symptoms are mild
82
What term describes small, discrete, dark-red papules on the palate in some cases of rubella?
Forchheimer's sign
83
What is congenital rubella syndrome?
Deafness, heart disease, cataracts
84
What is another name for mumps?
Epidemic parotitis
85
What is mumps?
Mumps is a disease of the exocrine glands
86
What is the best known site of involvement in cases of mumps?
Salivary glands
87
What do glands exhibit in cases of mumps?
Edema and lymphocytic infiltration
88
What is the incubation period for mumps?
2-4 weeks
89
When are patients with mumps contagious?
Contagious from 1 day before clinical appearance to 2 weeks after resolution
90
What might 25% or postpubertal males experience during mumps infection?
Epididymorchitis
91
What might 25% or first trimester women experiency during mumps infection?
Spontaneous abortions
92
How is mumps treated?
Palliative treatment
93
How effective is the MMR vaccine?
Very! 95%
94
What does HIV and AIDS stand for?
Human immunodeficiency virus, and acquired immunodeficiency syndrome
95
Where is the HIV found?
In bodily fluids
96
How is HIV spread?
Through sexual contact, parenteral exposure to blood, transmission from mother to fetus
97
What cell does HIV target?
CD4+ helper T lymphocyte
98
What are the 3 stages of HIV/AIDS?
Acute self limited viral syndrome; asymptomatic period; final symptomatic period
99
What are the 5 oral manifestations most strongly associated with HIV infection?
Candidiasis, Oral hairy leukoplakia, Kaposi's sarcoma, Non-Hodgkin's lymphoma, periodontal diseases
100
How many HIV and AIDS patients present with candidiasis?
1/3 of HIV patients and 90% of AIDS patients
101
Oral hairy leukoplakia is a sign of severe _____ ______ and ______ _____ in HIV and AIDS patients.
Severe immune depression and advanced disease
102
What is the most common EBV related lesion in AIDS patients?
Oral hairy leukoplakia
103
Describe oral hairy leukoplakia
White mucosal plaque that does not rub off, usually occurs bilaterally, on the lateral border of the tongue
104
What term describes a multifocal neoplasm of vascular endothelial cell origin?
Kaposi's sarcoma
105
What virus causes Kaposi's sarcoma?
HHV-8
106
What percentage of patients with Kaposi's sarcoma have oral lesions?
70%, in 20% of patients the oral cavity is the primary site of involvement
107
What locations are commonly affected by Kaposi's sarcoma?
Hard palate, gingiva and tongue
108
In Kaposi's sarcoma, is a biopsy required?
Yes
109
Describe a few characteristics associated with Non-Hodgkin's Lymphoma
Up to 5% of HIV infected patients, presents as a high grade/aggressive disease = widespread involvement and short survival times
110
What are the 3 atypical patterns of periodontal disease associated with HIV?
Linear gingival erythema, necrotizing ulcerative gingivitis, necrotizing ulceratice periodontitis
111
What is linear gingival erythema?
Gingivitis that doesn't respond to improved plaque control and has a greater degree of erythema
112
How is linear gingival erythema treated in HIV patients?
Systemic antifungals
113
How is NUG and NUP treated? in HIV patients
Debridement, antimicrobials, immediate follow up and long term maintenance

Oral Pathology - My deck (22 decks)

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