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BDS3 BAMS Microbiology and Oral Pathology > diagnostics sessions > Flashcards

diagnostics sessions Flashcards

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1
Q

appropriate clinical specimen for cariogenic MO in 4-5 year olds

A

young children involved - general swab of saliva or tooth surface

minimal invasiveness

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2
Q

cariogenic MO

A

s.mutans
lactobacillus
veillonella

anaerobic cariogenic bacteria

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3
Q

would you isolat cariogenic bacteria from 4-5 year old mouth swabs from county

A

probably would not - large sample size and difficulty to differentiate diverse colonies

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4
Q

possible methods isolating cariogenic bacteria from 4-5 year old mouth swabs from county

A

antibiotic resistance zone of clearance
molecular biology - DNA probes, PCR
enzymatic activity biochemical identification tests (next generation sequencing NGS etc)

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5
Q

Do you think acquiring the knowledge on levels of carriage will impact the overall levels of caries in the Greater Glasgow & Clyde area for 4-5 year olds?

A

yes - establish baseline prevalence data
compare to other sites nationally/internationally
can be used to monitor changes over time
if significant can lead to wide range public health measures e.g. fluoridation

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6
Q

preventative measures that can be implemented to minimise cariogenic bacteria carriage

A

OHI and diet advice

public health measures - higher F toothpaste, F varnish at schools and nurseries

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7
Q

localised gingivitis with inflammation

what specimen and where from

A

subgingival plaque biofilm

paper point from gingiva crevice on site of inflammation (could take one from opposite of mouth and compare with health)

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8
Q

organisms important in localised gingivitis with inflammation

A

porphyromonas gingivalis
prevotella intermedia
actinobacillus actinomycetemecomitans

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9
Q

methods that can be used to identify culprit organisms

A

selective agars (need to know what you are looking for - assuming)
PCR
NGS
ideally grown on plates and undertake sensitivity testing

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10
Q

how to determine cause and effect

A

removal of culprit organisms leads t resolution of disease - hard

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11
Q

what tx options are available for localised gingivitis

A

OH - mechanical disruption - brushing and scaling

antisepsis - chlorohexidine potentially antibiotics if non-responsive

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12
Q

does microbial knowledge of localised gingivitis in pt influence clinical management

A

probably not - still tx the same way as no clear way of stating one bacteria is responsible

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13
Q

severe inflammation of upper palate of denture pt

caused by

A

denture associated biofilm

- candida interactions with bacteria and penetration as denture not cleaned effectively regularly

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14
Q

MO associated with denture stomatitis

A

candida (albicans, glabrata, oral bacteria - use candida as scaffold)

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15
Q

specimens to isolate denture stomatitis organisms

A

oral rinse or swab if more localised

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16
Q

why important to identify MO in denture stomatitis

A

Differing resistance to antifungal medications so need to differentiate candida albicans from glabrata (c.g is completely resistant to azoles – fluconazole (make worse – need nystatin))

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17
Q

systemic implications of indwelling prosthesis for pt

A

Yes – can progress into systemic candidiasis if enters the blood stream – morbidity risk – chronic inflammation link

possible aspiration pneumonia if sleep with it in

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18
Q

pt pain tender and swollen, pain lower right mandible, elevated temperature
IO - abscess

microbiological concerns

A

systemically unwell - pt has elevated temperature and evidence of abscess

endo infection connecting to systemic circulation possible

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19
Q

clinical specimen for abscess

A

sample of pus - needle aspirate (remove pus and relieve pressure)

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20
Q

MO suspect in abscess

A

oral anarobes

Fusobacterium nucleatum, porphyromonas endodontalis, s.aureus (gram positive cocci)

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21
Q

why necessary to ID MO in abscess

A

need oral microbiology lab to ID as MO associated with sepsis when pt showing systemic signs of infection

need to know its antibiotic sensitivity

22
Q

does the type of MO associated with abscesses have bearing on how you will take a sample

A

Obligate anaerobes are oxygen sensitive – so if you want t grow these you must be wary – need suitable transport media

23
Q

is timing of specimen collection and transport important

A

Yes as unless organism may not survive outwith the abscess lesion due to oxygen exposure (anaerobic) – need anaerobic transport media

24
Q

techniques to identify MO from abscess lesion

A

standard plate culture and possibility of microscopy

25
Q

systemic implications if abscess lesion not dealt with correctly

A

spreading odontogenic infection - possibility sepsis

labour breathing
high temperature

Med emergency -> A&E

26
Q

management of abscess

A

needle in to drain - collect pus sample and relieve pressure

need to put in transport media need for transport rapidly to test as anaerobic– what is it and what is sensitively

27
Q

abscess and clinical signs of sepsis (laboured breathing, fever)

A

taxi to hosp

risk of death

28
Q

when in clinical practice do you really need to carry out microbiology test

A

abscess

29
Q

best way to manage biofilm (future)

A

outgrow pathogenic microrganisms with good things (prebiotics, probiotics - manipulate biofilm towards health than disease)

30
Q

endo canal contains

A

spill over of bacteria from saliva

31
Q

common MO in secondary endo infection

A

Enterococcus faecalis

32
Q

how to tx secondary endo infection of Enterococcus faecalis

A

high sodium hypochlorite (toxic) and edta (EDPA inhibit microbial)

Tx with standard irrigants – hard to get complete sterility – hard to get down into dentinal tubules

33
Q

issue with standard irrigants used in endo

A

Tx with standard irrigants – hard to get complete sterility – hard to get down into dentinal tubules

When RC filled want to suppress microbial level so don’t have chance to grow

34
Q

microbiological role of RC filling

A

When RC filled want to suppress microbial level so don’t have chance to grow

35
Q

caries caused by

A

any bacteria that can metabolise sugar, starches (crisps, cereals)

36
Q

what is key factor caries development not recognised

A

retention in oral cavity

37
Q

pH for caries

A

needs to acidic

38
Q

is microbiological dx needed for caries

A

no

OH advice

39
Q

most problematic candida

A

candida albicans - hyphe penetration

but sensitive to antifungals

40
Q

candida glabrata

A

not sensitive to fluconazole

if present in mixed candida infection - tx with fluconazole - albicans killed but not glabrata (grow rapidly now)

41
Q

1st line tx for candida

A

chlorohexidine

42
Q

if pt not responding to chlorohexidine candida tx

A

refer to oral med

mixed infection – antifungal – fluconazole, then nystatin

43
Q

tea tree oil

A

broad spectrum antifungal

44
Q

nystatin act

A

kill candida albicans and glabrata

but pt poor compliance due to taste but effective

45
Q

why is candidiasis a disease of the diseased?

A

immunocompromised, genetic predisposition, low neutrophil, polypharmacy – indicator
- Die from other thing but immunocompromised have it too e.g. pneumonia

Takes over edge

46
Q

azoles are

A

fungistatic

47
Q

pseudomembranous candidosis tx

A

scrape off before agent

agents

  • capspofungin – not used in dentistry – used in systemic fungal infections
  • azole – useless – cannot diffuse through it
48
Q

azole action pseudomembranous candidiosis

A

useless – cannot diffuse through it

like how penicillin only works on actively growing cells

49
Q

if on clinic what is the best way to clean denture

A

place in plastic bag with some water into Ultrasonic bath

50
Q

key for denture stomatitis management

A

get pt to be compliant with removing denture at night and denture hygiene

Need to maintain what you have in healthy state – only when disrupt this then invasive species can penetrate – e.g. change diet, OH regime

51
Q

persisting population of MO

A

Persist irrespective of tx – hard to completely sterilise a surface

Persisted population re populate after cleaning if put media back

Need something to be slow releasing to prevent them coming back

Need to maintain what you have in healthy state – only when disrupt this then invasive species can penetrate – e.g. change diet, OH regime

BDS3 BAMS Microbiology and Oral Pathology (6 decks)

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