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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
Q

Tacrolimus has similar properties to cyclosporin in that it inhibits ____

A

IL-2 production

26
Q

True or false: Tacrolimus is a much more potent immunosuppressant

A

True

27
Q

Tacrolimus is used to treat:

A

Autoimmune disorders and prevention of GvHD

28
Q

____ has a wide range of interactions and contraindications

A

Tacrolimus

29
Q

Tacrolimus has interactions with:

A
  • Macrolides
  • Anti-fungals of azole class

compete for cytochrome P450 liver enzymes CYP3A

30
Q

Tacrolimus is influenced by ____. CYP3A5 G/G make ____, which ____ risk of drug toxicity.

A

Genetics; non-functional CYP3A5 protein; increases

31
Q

____ are steroid hormones

A

Glucocorticoids (prednisone)

32
Q

Glucocorticoid mechanism: blocks some nuclear translocations, inhibits ____ and inhibits cytokines such as ____

A

NfKB (B and T cells); IL-2, IL-4, IL-8

33
Q

Glucocorticoids (Prednisone) in ___ doses cause immunosuppression. This may result in ___ and ___

A

High; T cell or humoral immune deficiency, neutropenia

34
Q

Viral sialadenitis is caused by ____

A
  • HIV-associated CMV sialadenitis
  • Mumps
35
Q

DOC for CMV sialadenitis

A

Gancyclovir

36
Q

____ is an important opportunistic pathogen in immunocompromised patients, such as those who have ____

A

CMV; HIV/AIDS, transplant patients

37
Q

CMV as an opportunistic pathogen can cause:

A
  • Pneumonia
  • CMV retinitis
  • parotitis
38
Q

CMV has ___ transmission and is ___ in myeloid cells (____) such as in ____

A

Horizontal; latent; macrophages; saliva

39
Q

____ is used to treat life- and sight-threatening CMV infections

A

Gancyclovir

40
Q

In children, ____ is the most frequent cause of acute viral sialadenitis. ____ is most commonly affected

A

Mumps (MuV); Parotid (epidemic parotitis)

41
Q

Mumps most commonly occur in:

A

Unvaccinated kids (vaccine is highly effective)

42
Q

In children, mumps is the most frequent cause of ____

A

Acute non-suppurative sialadenitis

43
Q

Complications of mumps

A
  • Permanent deafness
  • Orchitis
  • Oophoritis
44
Q

Bacterial sialadenitis (acute suppurative) is most common in the ____ gland. Most common causes are _____ and presents as ___ at duct opening

A

Parotid; S. aureus; Suppurative (pus)

45
Q

Sialolithiasis in submandibular gland occurs in 2/3 - 3/4 of _____

A

Chronic recurrent sialadenitis

46
Q

Bacterial sialadenitis treatment

A
  • Penicillinase-resistant antibiotics
  • Sialagogues (pilocarpine, gum, lemon drops)
47
Q

Sialolithiasis
___ form in submandibular gland
___ submandibular sialoliths are radio___
___ parotid stones are radio___

A

80%
90%; radiopaque
90%; radiolucent

48
Q

Treatment of sialolithiasis may involve:

A

Lithotripsy or surgery

49
Q

_____ are the most common type of salivary gland malignancy in adults

A

Mucoepidermoid carcinomas

50
Q

Those with Sjogren’s syndrome is high risk for _____

A

non-Hodgkin lymphoma (RR=20)

51
Q

What is an MZL? E-MZL?

A

Marginal zone lymphoma
Extra-nodal marginal zone lymphoma

52
Q

A small fraction of E-MZL may involve _____

A

Salivary glands

53
Q

E-MZL is associated with _____ (autoimmune disease)

A

Sjogren’s syndrome

54
Q

Primary salivary gland-EMZL mainly involves the:

A

Parotid gland

55
Q

_____ may be indicated for salivary gland tumors. _____ is the most frequently reported side effect of radiotherapy for tumors involving salivary glands.

A

Radiotherapy; xerostomia

56
Q

What can be used to stimulate unaffected salivary glands?

A

Salivary stimulants like pilocarpine

57
Q

Many ____ drugs induce xerostomia

A

Chemotherapeutic

58
Q

In those with GVHD:
____ occurs in approximately 60% chronic GVHD
____ and ____ common >50%

A

Xeropthalmia
Xerostomia and chronic bacterial sialadenitis

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

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