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DEN 7108 Micro and Immuno Concepts Part II > Exam 4 Salivary Gland Infections > Flashcards

Exam 4 Salivary Gland Infections Flashcards

1
Q

What is sialadenitis?

A

Inflammation or infection of the salivary glands

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2
Q

What are the characteristics of sialadenitis?

A
  • Can be acute or chronic/recurrent
  • Can be infectious or non-infectious
  • Can be viral or bacterial
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3
Q

Which salivary gland is more commonly infected in sialadenitis?

A

Parotid gland (compared to submandibular)

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4
Q

Who is affected by majority of sialadenitis cases?

A

Adults

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5
Q

Which form of sialadenitis is more frequent in children?

A

Mumps

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6
Q

_____ can cause autoimmune sialadenitis

A

Sjogren’s syndrome

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7
Q

Sjogren’s syndrome autoimmune sialadenitis causes:

A

Inflammation of the salivary glands due to lymphocytic infiltrate

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8
Q

Clinical signs and symptoms of Sjogren’s syndrome autoimmune sialadenitis

A
  • Dry eyes
  • Dry mouth
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9
Q

What two things are required for Sjogren’s syndrome diagnosis?

A
  • Sjogren’s syndrome autoimmune antibodies (SSA antibodies)
  • Positive salivary gland biopsy
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10
Q

Sjogren’s syndrome may be ____ or ____ in presentation

A

Unilateral or bilateral

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11
Q

Sjogren’s syndrome is most likely to develop in:

A

Middle aged or older women

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12
Q

What does Sjogren’s syndrome increase the risk for?

A

Non-Hodgkin lymphoma

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13
Q

Sjogren’s syndrome: _____ is contraindicated

A

Anti-histamines

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14
Q

Pharmacologic (____) immunosuppression can be used for prevention of ____ and treatment of ______

A

Induced; Graft vs host disease; Autoimmune disorders

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15
Q

What are four main treatments to prevent GvHD?

A
  • Methotrexate
  • Cyclosporin
  • Tacrolimus
  • Glucocorticoids
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16
Q

Methotrexate is often used to treat ____ and ____

A

Chemotherapy and autoimmune disorders

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17
Q

Methotrexate competitively inhibits _____

A

Dihydrofolate reductase (DHFR)

tetrahydrofolate synthesis

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18
Q

Methotrexate selectively inhibits ____

A

IL-1 beta binding

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19
Q

Methotrexate interactions

A
  • Penicillin
  • Aminoglycosides
  • NSAIDs (potentially fatal interactions)
  • Nitrous oxide (induces hematologic toxicity)
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20
Q

What effect does penicillin have on methotrexate?

A

Decreases elimination of methotrexate, increases toxicity risk

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21
Q

What effect do aminoglycosides have on methotrexate?

A

Reduces absorption of methotrexate

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22
Q

Cyclosporin is mainly used to treat:

A
  • Autoimmune diseases
  • Autoimmunity and prevention of GvHD
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23
Q

Cyclosporin blocks:

A

Inflammatory cytokines (IL-2)

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24
Q

____ inhibits T-lymphocyte activity

A

Cyclosporin

25
Tacrolimus has similar properties to cyclosporin in that it inhibits ____
IL-2 production
26
True or false: Tacrolimus is a much more potent immunosuppressant
True
27
Tacrolimus is used to treat:
Autoimmune disorders and prevention of GvHD
28
____ has a wide range of interactions and contraindications
Tacrolimus
29
Tacrolimus has interactions with:
- Macrolides - Anti-fungals of azole class | compete for cytochrome P450 liver enzymes CYP3A
30
Tacrolimus is influenced by ____. CYP3A5 G/G make ____, which ____ risk of drug toxicity.
Genetics; non-functional CYP3A5 protein; increases
31
____ are steroid hormones
Glucocorticoids (prednisone)
32
Glucocorticoid mechanism: blocks some nuclear translocations, inhibits ____ and inhibits cytokines such as ____
NfKB (B and T cells); IL-2, IL-4, IL-8
33
Glucocorticoids (Prednisone) in ___ doses cause immunosuppression. This may result in ___ and ___
High; T cell or humoral immune deficiency, neutropenia
34
Viral sialadenitis is caused by ____
- HIV-associated CMV sialadenitis - Mumps
35
DOC for CMV sialadenitis
Gancyclovir
36
____ is an important opportunistic pathogen in immunocompromised patients, such as those who have ____
CMV; HIV/AIDS, transplant patients
37
CMV as an opportunistic pathogen can cause:
- Pneumonia - CMV retinitis - parotitis
38
CMV has ___ transmission and is ___ in myeloid cells (____) such as in ____
Horizontal; latent; macrophages; saliva
39
____ is used to treat life- and sight-threatening CMV infections
Gancyclovir
40
In children, ____ is the most frequent cause of acute viral sialadenitis. ____ is most commonly affected
Mumps (MuV); Parotid (epidemic parotitis)
41
Mumps most commonly occur in:
Unvaccinated kids (vaccine is highly effective)
42
In children, mumps is the most frequent cause of ____
Acute non-suppurative sialadenitis
43
Complications of mumps
- Permanent deafness - Orchitis - Oophoritis
44
Bacterial sialadenitis (acute suppurative) is most common in the ____ gland. Most common causes are _____ and presents as ___ at duct opening
Parotid; S. aureus; Suppurative (pus)
45
Sialolithiasis in submandibular gland occurs in 2/3 - 3/4 of _____
Chronic recurrent sialadenitis
46
Bacterial sialadenitis treatment
- Penicillinase-resistant antibiotics - Sialagogues (pilocarpine, gum, lemon drops)
47
Sialolithiasis ___ form in submandibular gland ___ submandibular sialoliths are radio___ ___ parotid stones are radio___
80% 90%; radiopaque 90%; radiolucent
48
Treatment of sialolithiasis may involve:
Lithotripsy or surgery
49
_____ are the most common type of salivary gland malignancy in adults
Mucoepidermoid carcinomas
50
Those with Sjogren's syndrome is high risk for _____
non-Hodgkin lymphoma (RR=20)
51
What is an MZL? E-MZL?
Marginal zone lymphoma Extra-nodal marginal zone lymphoma
52
A small fraction of E-MZL may involve _____
Salivary glands
53
E-MZL is associated with _____ (autoimmune disease)
Sjogren's syndrome
54
Primary salivary gland-EMZL mainly involves the:
Parotid gland
55
_____ may be indicated for salivary gland tumors. _____ is the most frequently reported side effect of radiotherapy for tumors involving salivary glands.
Radiotherapy; xerostomia
56
What can be used to stimulate unaffected salivary glands?
Salivary stimulants like pilocarpine
57
Many ____ drugs induce xerostomia
Chemotherapeutic
58
In those with GVHD: ____ occurs in approximately 60% chronic GVHD ____ and ____ common >50%
Xeropthalmia Xerostomia and chronic bacterial sialadenitis

DEN 7108 Micro and Immuno Concepts Part II (27 decks)

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