Exam 4-AIDS Flashcards
AIDS is NOT associated with a ________ induced immune deficiency…
medically induced (like an organ transplant)
What are the 5 groups that are most susceptible to AIDS ?
1.MSM (men sex w. men) 2.IVDA 3.Hemophilia-pre1985 4.Blood transfusion recipients 5.People in contact with already infected individuals
What is the acronym given to the type of medical treatment for AIDS patients? Thanks to this, only ___% of AIDS patients will progress to oral manifestations..
HART-Highly Active Retroviral Therapy…40%
Which two aspects of the immune system are affected in AIDS?
1.Defense AND 2.Surveillance
Why is AIDS a SYNDROME?
it has MULTIPLE clinical features
AIDS can resemble other immune problems, but overall can be described as more ______ manifestations
“FLORID”-complex, exacerbated
What are the three most common herpes virus infections possible in AIDS?
1.Herpes Simplex 2.Vericella-Zoster 3.Epstein-Barr
What are the 2 most common forms of oral HPV manifestations in AIDS patients?
1.Papillomas 2.Condyloma Acuminata
Herpes simplex in AIDS: that PRE-LESIONAL feeling called ______ does NOT typically occur in AIDS patients
AURA
Herpes simplex: What are the 3 most common locations?
1.Skin of the lips 2.hard palate 3.Gingiva (KERATINIZED tissue!!)
Herpes simplex: what drug can you treat with in extreme circumstances?
acyclovir
What are two distinguishing characteristics of Vericella Zoster infections in AIDS patients that separate it from a typical infection? What is the name of the drug that can help these patients?
- EXTREME PAIN (like hospitalization) 2. UNILATERAL….Silvadene (burn cream)
ON EXAM What is the etiologic factor in Oral Hairy Leukoplakia in AIDS patients??
Epstein Barr Virus (HHV-4)
What are two distinguishing characteristics between HPV associated Papillomas and Condyloma Acuminata?
1.Pap=normal color/pink CA=WHITE 2. Pap=pedunculated CA=Sessile/Broad based
Oral hairy leukoplakia can be a ________ for progression to full blown AIDS…
Predictor
What is a possible CO-FACTOR to Epstein Barr (HHV4) that is causing oral hairy leukoplakia?
HPV
Where is the most common location for oral hairy leukoplakia? What is a secondary distinguishing feature regarding location?
LATERAL border of the tongue, BILATERAL
Are oral hairy leukoplakia’s symptomatic or asymptomatic?
asymptomatic
Oral hairy leukoplakia lesions may show ______ and _____ pattern
waxing and waning
Oral Hairy Leukoplakia: NON-_______ plaques in a ______/_____ pattern…“________” surface most often; occasionally smooth
wipeable….vertical/linear….”Shaggy”
What color is Oral Hairy leukoplakia?
white
What is the ideal treatment for oral hairy leukoplakia?
the lesion regressing with control of the AIDS in general
What are the names for the 4 possible outcomes of BACTERIAL infections in an AIDS patient?
1.Linear Gingival Erythema (HIV assoc gingivitis) 2.Necrotizing Ulcerative Gingivitis 3.Necrotizing Ulcerative Periodontitis 4.Necrotizing Ulcerative Stomatitis
RANDOM: not sure if hell ask but why not…What are the three bacteria that can cause gingivitis/periodontits in AIDS patients (rarely seen)?
- Myco-Bacterium Avium 2.Klebsiella Pneumo 3.Enter-o-bacter Clo-ac-ae
HIV associated periodontal disease is DUE TO ________!!!!
IMMUNE DEFICIENCY!!!!
So I already asked for the less common, random bugs that can cause gingivitis/perio in AIDS, BUT what are the 3 MOST common bug species???
1.Ei-Ken-ella 2.WO-lin-ella 3.Bacter-oi-des
HIV associated periodontal disease: _________ males predominantly
Homosexual
HIV associated periodontal disease: Resembles rapidly progressive ____
ANUG
HIV associated periodontal disease: Does not respond to conventional _________
periodontal therapy
HIV associated periodontal disease: Occurs even with good ______ control
plaque
HIV associated periodontal disease: with the typical SRPs, WHAT seems to do GREAT???
Chlorhexidine gluconate (Peridex) rinses
What was previously called HIV associated gingivitis?
Linear Gingival Erythema
Linear Gingival Erythema: Spontaneous bleeding, sometimes ______
NOCTURNAL (blood on pillow)
Linear Gingival Erythema: ______ tissue necrosis
Soft
Linear Gingival Erythema: What is a CLASSIC distinguishing feature between this and typical gingivitis in non-AIDS patients?
LGE is PAINFUL!! (if patient has painful gingivitis, consider this as Dx)
HIV associated periodontitis: What is the transitional stage between Linear Gingival Erythema and more severe forms of involvement?
Necrotizing Ulcerative Gingivitis
HIV associated periodontitis: Which form usually affects only FOCAL areas in contrast to the more diffuse involvement of more severe forms?
Necrotizing Ulcerative Gingivitis
HIV associated periodontitis: Necrotizing Ulcerative Gingivitis: May be limited to ________ areas
interdental papilla
HIV associated periodontitis: Necrotizing Ulcerative Gingivitis- Some early _____ destruction is often present as well
bone
HIV associated periodontitis: Which type presents as severe loss of periodontal attachment?
Necrotizing Ulcerative Periodontitis
HIV associated periodontitis: Necrotizing Ulcerative Periodontitis will actually have minimal ______ formation..
pocket (the gingiva recedes WITH the bone)
HIV associated periodontitis: Necrotizing Ulcerative Periodontitis shows interproximal _______
cratering
Which HIV associated periodontitis state displays SEQUESTRATION of bone where the patient will have random pieces of bone pop out of the sulcus??
Necrotizing Ulcerative Periodontits
Which HIV associated periodontitis state is associated with severe pain that is “deep” or “bone” pain?
Necrotizing Ulcerative Periodontits
HIV associated periodontitis: Necrotizing Ulcerative Periodontitis with SPREAD to involve soft tissue and bone outside the alveolar ridge areas is called WHAT???
Necrotizing Ulcerative Stomatitis
What is the MOST severe form of HIV associated periodontitis?
Necrotizing Ulcerative Stomatitis
What are the three main types of Fungal infections in AIDS patients?
- Candidiasis 2. Histoplasmosis 3.Cryptococcus
What is the most common clinical presentation of candidiasis in AIDS patients?
PseudoMembraneous
A fungal infection can usually be seen in as many as ___ or ___% of AIDS/pre-AIDS patients…
75-90%
Pseudomembranous Candidiasis is typically creamy white or yellow plaques that resemble ______…MMMMMM!!!YUMM!
milk curd
Pseudomembranous Candidiasis-Usually have an ________ background
erythematous
Pseudomembranous Candidiasis: is it always wipeable?
YES! but sometimes you must try pretty hard
What are the 4 most affected areas in Pseudomembranous Candidiasis?
1.Palate 2.Buccal Mucosa 3.Labial Mucosa 4.Dorsum of Tongue
What is the fungal infection that affects people mostly in the Ohio and Mississippi river valley regions?
HistoPlasmosis
What are the two aggressive treatments for Fungal infections in AIDS?
1.Amphoteracin B 2.Azole derived meds
What is by far the most common neoplasm associated with AIDS?
Kaposi’s Sarcoma
What is the etiology of Kaposi’s Sarcoma?
HHV VIII
Kaposi’s Sarcoma: Diffuse, uncontrolled _________ in an immune deficient host
angiogenesis
KS is the initial manifestation of AIDS in ___% of patients
30%
What are the two most common features of patients with Kaposi’s Sarcoma?
White and Homosexual
_____% of all with KS will have ORAL lesions
54%
What are the two typical colors of Kaposi’s Sarcoma?
Purple and Red
Kaposi’s Sarcoma lesions typically appear as ______ to slightly raised to nodular, and may show _______ in nodular phase
Macular… ulceration
What are the two sites of preference for oral lesions of Kaposi’s Sarcoma?
keratinized mucosa-hard palate and gingiva
What are the two possible treatments of a Kaposi’s Sarcoma lesion?
surgical excision or laser removal