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FHHD Flashcards

1
Q

What is haemachromatosis

A

Excessive iron absorption in intestine causing pathological increase in iron body stores - 2/3rds will be incorporated in Hb, the rest stored in liver mainly. Once absorbed theres no mechanism to remove it. The iron stores cause liver scarring (fibrosis) + enlarged + may lead to cirrhosis.

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2
Q

Explain Wilsons disease

A

Abnormally high levels of copper in the body due to genetic defect where theres a lack of removal of copper by the liver through bile = accumulation of copper = hepatitis = cirrhosis

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3
Q

Keratin pearls are characteristic of…

A

Squamous cell carcinoma

Keratinisation - seen as circles or kinda like roses.

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4
Q

Ground glass hepatocytes are characteristic of ..

A

Hep B induced hepatitis

They are smooth and pink

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5
Q

Mallorys hyaline is seen in…

A

Alcoholic liver

Pink patches

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6
Q

Describe mould fungi

A 
Branching filaments (hyphae)
Mass of interwoven branches are called mycelium
Reproduce by spores
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7
Q

Describe yeast fungi

A

Unicellular

Reproduce by budding

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8
Q

What are dermatophytes

A

Fungi that colonise and digest keratin in skin (stratum corneum), nails, hair. They cause tinea infections

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9
Q

What are the three genera of dermatophytes

A

Microsporum
Epidermophyton
Trichophyton

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10
Q

What is saouraud agar used to culture

A

Fungal Dermatophytes - epidermophyton and microsporum

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11
Q

What genus is candida from

A

Yeast

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12
Q

What is the alternate term used for leukoplakia

A

Chronic hyperplastic candidosis

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13
Q

Wats the alternate name for denture stomatitis + clinical features

A

Chronic atrophic candidosis
Red+ swollen+ inflamed mucosa under denture
Probs cuz denture was affecting integrity of mucous membrane underneath hence allowing prolif of fungi C.albicans

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14
Q

Which two organisms cause angular cheilitis

A

Bacteria eg staph aureus, and fungi eg C.albicans.

A weakened immune system + trauma/chapped lips/excess drool salivation/ deep creases in corners of mouth allow bacteria/fungi to spread more easily.

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15
Q

What is perleche a synonym of

A

Angular cheilitis

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16
Q

What is maceration and what is it a predisposing factor to

A

Softening/breakdown of skin due to long term exposure to moisture.

Oral candidosos

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17
Q

Use n form of chlorhexidine

A

Solution

Antibacterial and anticandidal

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18
Q

Preparation form of miconazole and use

A 
Topical oral gel/cream 
Candida species (altho have variable sensitivity) + antistaphylococcal activity
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19
Q

Treatment and prevention of candidiasis:

A

3 options - amphotericin B, nystatin, azoles eg miconazole.

Prevention- remove predisposing factor eg denture

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20
Q

Describe actinomyces

A

Rod shaped
Gram positive
Filamentous bacteria
Facultative anaerobe

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21
Q

Describe actinomycosis

A

Mainly caused by Actinomyces israelii
Chronic infection +granulomas
Tissue destruction
Swelling
Multiple discharging sinuses in chronic case
Extensive fibrosis
Mycelia formed embedded in polysaccharide matrix containing acid fast structures- often visible to naked eye - sulphur granules - light yellow in colour

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22
Q

Actinomyces treatment

A

Antibiotics eg penicillin, tetracycline

Surgical debridement reduces scarring/deformity and enhances healing and lowers recurrence incidence

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23
Q

Wat is commensal

A

Org that bevegits from another withiut cauding benefit ot harm to host

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24
Q

Carriage

A

Asympyonatically carring a pathogeniv organidn which can be trabsmittef to other ppl eg staph aureus in the nose

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25
Q

Pathogen

A

Any org capqble of causing infection

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26
Q

Oppurtnistic pathogeb

A

Cause disease if host is immunocomptomised or get to sotes where they dont normslly live

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27
Q

Virulence

A

Degree of pathegonicity

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28
Q

Fomites

A

Inanimate objectvwhich carries and transmits organisms eg a steam mop

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29
Q

Coagulase in staph aireus

A

Walling off of staph aureus from phagocytosis

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30
Q

Classic exotoxins

A

Heat destroyed
Neurralised by antitoxib
Hughly toxic
Actvat specifuc sites

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31
Q

Endemic

A

Infection Always present at constant lebel in pop or may have sessinal variation

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32
Q

Epidemic

A

Short term higher than normak level in population

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33
Q

Outbreak

A

Lovalised increase in incidence of dusease

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34
Q

Pandemic

A

Epidemic spreading between continents

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35
Q

Degree of infectivity

A

Ability to enter, muktiply, and survive inside hist

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36
Q

Active case

A

Clinically unwell
Whereas carrier looks well (asymptonatic) but are chronically infected and are unaware of their infection risk to others.

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37
Q

Cellulitis

A

Spread of infection in soft tossues - mostly caused by strep pyogenes

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38
Q

Cardinal signs of inflam

A

Red swollen painful hot

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39
Q

Asepsis

A

State of being free from living organisms

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40
Q

Antiseptic

A

Applied to open wounds/abrasions

Destroys/inhibits growth of microbe

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41
Q

Gram pos bacteria

A

More sensituve to disinfectabt

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42
Q

Disinfection used when

A 
Surfaces
Spilkages
Grossly contaminated areas
Non surgical instrument
B4 sterilisation
Dental unit wster dupplies
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43
Q

Sterilisation

A

Surgical instruments- then store them under sterile conditions

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44
Q

Prodromal stage

A

After the incubation period

Symptoms arent spevific and severe yet and can still perform usual functions

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45
Q

3 main sources of infection in dental surgety

A

Carrier
Prodromal
Suffering from infectious disease

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46
Q

3 main ways if transmissuib in dent surgery

A

Contaminated instrunents
Direcr contact with russues if skin n fluids
Droplets cintainung unfectuous agent

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47
Q

Incineration

A

Infected waste

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48
Q

Whats eh

A

Oxidation potential

Eg obligate anaerobes require low oxidation potential

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49
Q

3 facultative anaerobes

A

Staph
Strep
Ecoli

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50
Q

2 obligate aerobes

A

Neiserria

Pseudomonas

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51
Q

Anaerobiosis

A

Any form of life that is sustained in the absence of oxygen

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52
Q

Describe an abscess

A

Forms around apices of teeth with necrotic infected root canals
Mainly caused by obligate anaerobes + oral streptococci

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53
Q

Define osteomyelitis

A

Inflammation n infection of usually long bones but can affect jaw bone cavity

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54
Q

Chronic marginal gingivitis

A

No particular species of bacterua involved - its as a result of dental plaque accumulation

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55
Q

AUG

A

Grey gingival pseudomembrane which can be pulled off to reveal bleeding area underneath. Loss of interdental papilla.

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56
Q

Wat organisms linked to AUG

A

Spirochaetes eg treponema
Prevotella intermedia
Fusobacterium

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57
Q

Organisms causing periodontitis

A

Porphyromonas gingivalis
Prevotella intermedia
Aggregatibacter
Cspnocytophaga

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58
Q

Orgs causing pericoronitis

A

Prevotella intermedia

Fusobacterium nucleatum

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59
Q

Peri implantitis

A

P. Gingivalis and intermedia

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60
Q

Wat org causes actinomycosis

A

Actinomyces israelii

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61
Q

Wats sialadenitis

A

Infecrion of salivary glands

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62
Q

Orgs causing sialadenitis

A

Strep
Staph from nose n skin
Gram neg anaerobes too

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63
Q

Clostridium endospores adv

A

Allows org to survive in adverse conditions eg skin n soil

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64
Q

3 main clostridial infections

A
  • tetanus - clostridium tetani
  • botulism - clos. Botulinum
  • gas gangrene - several species eg c perfringen
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65
Q

Wats the morohology of tetanus bacilli

A

Drumstick shape due to round terminal spores

Can be gram stained to see this

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66
Q

Wat are the 2 things tetanus produces

A

Tetanospasmin (neurotoxin)

Tetanolysin (haemolysin)

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67
Q

Where are clostridia found

A

Intestine
Soil
Water
Decaying plant n animal matter

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68
Q

Tetanus - 4 features

A

Trismus
Risus sardonicus - facial muscle spasm
Opisthotonus - backward arching of head neck spine
Resp muscke spasm

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69
Q

Describe botulism

A

Ingested of toxin via processed foods n canned.
Extremely potent toxins A-G
In humans type A,B,E
Blocks ach at nerve terminals = vomiting, thirst, muscle paralysis.

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70
Q

C perfringen conditions

A

Antibiotic associated diarrhoea

Food poisoning

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71
Q

C difficile causes:

A

Antibiotic associated diarrhoea

Pseudomembranous colitis

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72
Q

Nagler reaction

A

Alpha toxin of c perfringen is a lecithinase, demonstrated in egg yolk medium - a line of incubated c perfringed added to medium- seeing opacity will indicate lecithinase activity

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73
Q

Tetanus prevention

A

Toxoid injection to give immunity

Or antitoxin for short term passive immunity (an immunoglobulin)

74
Q

Tests for staph aureus

A 
Based on enzyme production: 
- dnase
- coagulase
- catalase 
Sugar fermentation tests
- glucose
- mannitol
75
Q

Septicaemia

A

Absorption of pathogenic bacteria and their toxins from blood into tissues causing widespread destruction

76
Q

Epidermolytic toxin - splitting within plane of epidermis causes:

A

Scalded skin syndrome
Impetigo non bullous
Pemphigus neonatorun

77
Q

Describe pustular impetigo

A

Vesicles- pus filled- on an erythematous base

May also have dry crysted lesions where vesicles have burst

78
Q

Why is scalded skin s mainly in children

A

Cuz neonates lack the antitoxin to the epidermolytic toxin from staph aureus

79
Q

Wat toxin causes toxic shock syndrome

A

TSST-1

80
Q

Wat condition is linked to highly absorbsnt tampons

A

Toxic shock syndrome

The tampon creates conditions for bacteriak multiplication and toxin production

81
Q

What is the name of the toxin that breaks down wbcs, released by staph aureus

A

Panton valentine leucocidin

82
Q

Wats panten valentine leucocidin associated with - resistance

A

MRSA

83
Q

What enzyme released by staph aureus breaks down hyaluronic acid intracellular ground substance of tissues

A

Hyaluronidase - spreading factor

84
Q

Role of peptidoglycan

A

Inhibits inflam response

85
Q

Protein A (staph aureus)

A

Binds to fc region if iGg

86
Q

Wat is tested for in the slide test

A

Clumping factor - binds to fibrinogen hence looking for clumps under microscope. Plus cell surface bound coagulase which converts fibrinogen to fibrin

87
Q

Oral strep - what type of haemolysis do they do

A

Alpha - partial
Or
None

88
Q

Function of antigen |/|| and what bacterial cell wall it is found from

A

Streptococcus mutans

Immune modulation
Platelet aggregation
Tissue invasion
Biofilm formation - binds pellicle components

Also found in E.coli - the K antigen

89
Q

S. Mitis species main infections:

A

Bacterial endocarditis

Plaque isolated - pioneering species

90
Q

S. Salivarious species group

A

Plaque pioneering specie
Mainly found on tongue
S.vestibularis - produces urease and hydrogen peroxide which can contribute to local salivary peroxidase activity and competing with pathogenic bacteria

91
Q

Strep Anginosus - what infections does it cause

A

Purulent infections eg abscesses

92
Q

Define bacterial endocarditis

A

Infection of endocardium inner lining of heart by microorganisms present in the blood stream
Serious life threatening condition

93
Q

Which bacterial group id most frequently isolated from heart valve vegetations in IE

A

Oral streptococci

94
Q

Wat factors make someone predisposed to IE

A

Congenital heart defect
Prosthetic heart valve
Heart disease

All these factors cause irregular blood flow = thrombi formation

95
Q

How can oral bacteria cause IE

A

Dental manipulations may introduce the bacteria into patients blood stream from an oral infection eg periapical abscess.

96
Q

Characteristics of strep

A 
Fastidious culture requirements - complex growth media
Catalase neg 
Facultative anaerobes 
Cocci forming chains
Gram positive
97
Q

Describe Lancefield grouping

A

For beta haemolytic species of streptococci which are the most frequently isolated type of strep in the body.
Groups specific carbohydrate antigens in cell walls - useful as a specie marker.

They use nitrous acid to extract the specific antigen from the bacterial cell wall - precipitin reaction. And lancefield group antisera used to identify the antigen group.

An antigen/antiserum complex will form and be seen as a line of precipitation

98
Q

Which type of strep cannot be lance field grouped

A

Viridans strep (oral)

99
Q

Where is the M protein surface antigen found

A

S.pyogene surface

It is an antigen

100
Q

Features of M protein

A

Heat n acid stable
Antiphagocytic property
Antibody to it contributes to immunity

101
Q

Wat do o streptolysins breakdown

A

Platelets
Rbc
Cardiac tissue
Neutrophils

102
Q

Where are o and s streptolysins found

A

Beta haemolytic strep

Eg s.pyogenes

103
Q

S streptolysin

A

Breaks down rbcs
White blood cells (leucocidal)
Not inactivated by oxygen whereas o toxin is

104
Q

What are the two important beta haemolytics strep pathogens

A

S.pyogene

S.agalactiae

105
Q

What organisms is bacitracin sensitive and explain wat this means

A

Strep pyogenes

Bacitracin is a peptide that interferes with cell wall and peotidoglycan synthesis - hence will see a zone of inhibition when placed on blood agar

106
Q

Which bacteria are optochin sensitive and what can u use this to differentiate fron

A

S.pneumonia - hence will see zone of inhibition. Since pneumonia is alpha haemolytic u can use this test to differentiate it from other alpha haem strep eg viridans

107
Q

Wats conjunctiva

A

Lines the surface of the eye and eyelids

108
Q

Complications of gonorrhea

A

Salpingitis
Epididymitis
Purulent conjunctiva of newborn = blindness
Disseminated - fever, joint pain, skin lesions

109
Q

Function of neisseria gono fimbriae/pilli

A

Attachment

Resistance to phagocytosis

110
Q

Can we do serology for neisseria gonorrhea

A

Nah cuz its very heterogeneous serologically

111
Q

Treatment for gonor

A

Antibiotics - penicillin - slow release IM, also tetraycline and ceftriaxone used

112
Q

How does treponema pallidum enter body

A

Penetration of intact mucosa

Abraded skin

113
Q

Whats a chancre

A

Firm
Painless
Ulcerated nodule
Occurs in primary syphilis

114
Q

Secondary syphilis

A

Rash - macular or pustular
Condylomata lata - genital warts
Mucous patch/snail track ulcer
Lesions are highly infectious

115
Q

Describe latent syphilis

A

No clinical features- so no lesions or rash or warts or ulcers
Butt serology persists - so might still be present in blood (remember its disseminated at secondary stage)
Then from latency it may reactivate to secondary stage - relapse

116
Q

Describe a mucous patch/snail track ulcer

A

Oral ulceration that occurs in secondary syphilis whereby it has spread systemically and caused a grey shedding superficial ulcer

117
Q

What type of bacteria are present in large intestine

A

Strict anaerobes

118
Q

Wats dysentery

A

Abdominal cramps
Pus and blood in stool
Due to bacterial invasion of tissues in intestine causing necrosis

119
Q

List the gram negative bacilli present in the large intestine

A

Enterobacteriacea: E.coli, klebsiella, shigella, salmonella

120
Q

Wat are pili n wat do they do

A

Aka fimbriae
Hair like processes on surface of bacteria
Adhesion to cells
Transfer of DNA during conjugation (wen bacteria unite to transfer their dna)

121
Q

Wat do mycolic acids do in mycobacterium

A

They are present in cell wall, they cross link arabinose and galsctose to form arabinogalactan layer.
Presence of mycolic acid layer (lipid) makes mycobacterium acid fast hence cant be gram stained since this layer covers the peptidoglycan layer beneath

122
Q

Describe features of mycobacterium

A

Aerobic (they cause tb which commonly occurs in lungs which is has a lot of oxygen hence will obviously be aerobic)
Non motile
Rods - straight or curved

123
Q

What colour do acid fast bacilli appear with the ziehl neelsen stain

A

Red

Others appear green

124
Q

What culture medium is used to grow tubercle bacilli and how will they appear

A

Lowenstein Jensen slopes (LJ)
Rough buff n tough yellow colonies
However it takes up to 8 weeks for this to grow so need to use faster detection methods

125
Q

What is tb

A

A chronic granulomatous disease

126
Q

What type of hypersensitivity reaction is tb

A

Type 4- cell mediated

127
Q

Wat specimens can be examined for tb

A

Sputum
Urine
Pleural fluid
Csf

128
Q

IE effects which places

A

Heart valves
Septal defect
Mural endocardium in a left ventricular aneurysm

129
Q

Whats the treatment drugs for tb

A

Isoniazid

Rifampicin

130
Q

Causes of dentoalveolar abscess

A

Oral strep/staph and mainly other oral obligate anaerobes:

  • prevotella
  • veillonella
  • fusobacterium
131
Q

Describe herpetic stomatitis

A 
Caused by HS1 mainly but can be caused by hsv2. 
Blisters
Ulcers
Bleeding
Difficulty eating
Swallowing
Redness of all gingiva
132
Q

Give an example of short term disturbance of oral cavity n long term

A

St - short term antibiotic therapy (causing candida over growth)
Lt- loss of salivary secretion eg due to sjogrens syndrome

133
Q

What mouthwash can you use for herpetic gingivostomatitis

A 
Tetracycline 
Swallowed after 
Must complete full course 
Broad spectrum antibiotic
Do not give to ppl with renal disease - can exacerbate it, pregnancy/breastfeeding
134
Q

Which two first line antibiotics are used for dental infections

A

Metronidazole - inc activity against anaerobic bacteria - avoid alcohol
Amoxycillin - broad spectrum antibiotic- interferes with cell wall synthesis- predisposes to candidiasis

135
Q

Features of different antifungals

A

Amphotericin - lozenge- not absorbed by gut
Nystatin - also not absorbed by gut
Miconazole - cream or gel - applied to dentures- adv is tht u can keep dentures in. Drug is absorbed. Interaction warfarin.

136
Q

Wat antiviral is used for herpes infections

A

Aciclovir - needs to be used in initial infection n frequent risk dosage
Topical - herpes labialis - the application at prodromal stage
Systemic - for health care workers who are treating immunicompromised patients
Higher dose used for vzv (shingles)

137
Q

Wats the gold standard

A

A diagnostic test that is considered most accurate

Eg culture is considered the gold standard

138
Q

Identifying fungi

A

Cotton blue stain - microscopy

Growth on sabourauds agar

139
Q

Wats the purpose of oxidase

A

Enzyme that allows respiration - found in bacteria using o2 as an electron acceptor eg Neisseria - aerobes and facultative anaerobes

140
Q

Explain oxidase test

A

Dyes that act as electron acceptor , become purple when oxidised (losing electrons) eg cytochrome c becomes oxidised as electrons pass to o2

141
Q

Wats MacConkey agar used for

A

Detecting lactose fermenting (pink) orgs n non fermenting (yellow)
Eg e.coli n salmonella

142
Q

Wen is serology mainly used

A

Viral infection

Difficult to grow presumptive bacteria

143
Q

Wats tegument

A

Cytoplasm area of herpes virus which contains virally encoded proteins n enzymes for replication

144
Q

Wats nucleocapsid

A

Surrounds the genome inside herpes virus cell

145
Q

Can herpes spread via dry surfaces

A

No, cuz they have a fragile lipid envelope sensitive to acids etc, once envelope is damaged virus isnt infectious - fluids only

146
Q

Describe herpetic whitlow

A

Manual contact of an infected lesion causing infection and abscess of fingers and hands = red, swollen, painful, may form blister (fluid filled) which may burst and crust over.

147
Q

List the conditions caused by HSV

A 
Herpetic whitlow
Eczema herpeticus 
Hsv prostatitis 
Hsv encephalitis 
Hsv meningitis
148
Q

Hsv encephalitis

A

Cerebral dysfunction
Temporal lobes damaged
Blood in csf
Seizures possible

149
Q

Hsv chemotherapy:

A

Gamma globulins
Amantadine
Rifampicin
Reverse transcriptase inhibitors

150
Q

Describe nucleoside analog drugs

A

Eg aciclovir, famciclovir, valaciclovir

Only act on cells containing thymidine kinase - replicating - therefore rlly specific in their action.

151
Q

How is vzv transmitted

A

Aerosols - droplets inhaled

Skin contact

152
Q

Clinical pres of chicken pox

A

Fever
Rash on skin - vesicular /pustular/scab
Mucous membeane ulcers on hard palate with red halo

153
Q

Complications of VZV

A

Encephalitis (like hsv)
Secondary infection- bronchopneumonia (infects bronchi)
Guillain barre syndrome - body immune system attacks nerve cells = myelin damage, rapid onset muscle weakness n pain - PNS
Traverse myelitis - inflammation of spinal cord - CNS

154
Q

Describe Ramsay Hunt syndrome

A

Caused by VZV infecting a motor nerve - affects geniculate ganglion of CNV|| (facial nerve) ipsilateral facial paralysis LMN lesion - f palsy
Rash in external ear
Loss of taste in ant 2/3 tongue

155
Q

What condition would you find downey cells in

A

EBV infection - glandular fever/infectious mononucleosis

156
Q

Clinical symptoms of EBV

A 
Fever 
Enlarged lymph nodes
Pharyngitis 
Fatigue 
Pain 
Rash 
Oral ulcerations similar ANUG 
Petechiae in hard palate 
Oral hairy leukoplakia 
Gingival bleeding 
Swollen tonsils 
Enlarged liver/spleen
157
Q

What type of cells do ebv infect

A

Cells containing c3d complement receptor on surface - B lynphocytes and Oro/nasopharync epithelial cells.

158
Q

Describe burkitts lymphoma

A

Tumour of lymphatic system caused by EBV
B lymphocytes infected and proliferate into a tumour mass
Non hodgekins lymphoma
Africa and children
Mainly jaw n abdomen affected

159
Q

Complications of ebv

A

Lymphoma may spread to bone marrow = neutropenia, thrombocytopenia, anaemia
Could infect other organs- brain, liver, lungs
Breathing difficulties due to swollen tonsils

160
Q

Ebv treatment

A

Cant use acyclovir cuz it doesn’t use thymidine kinase
No drugs available
Gland F: dont prescribe amoxicillin (red rash), bed rest n antipyretics, hospitalise if liver/spleen involved

161
Q

Which condition has dane particles in fluid n right hypochondral pain

A

Hep B

162
Q

Wat 3 things can be detected in hepB

A

E antigen (HBeAg)
S antigen
Viral dna polymerase

163
Q

Treatment for hepB

A

Lamivudine- RT inhibitor

Interferon - slows growth of virus

164
Q

Which two hep viruses are non enveloped

A

A n E

165
Q

Describe replication of Hep B

A

Rna intermediate used by RT to replicate DNA from it

High mutation rate but small genome limits genetic variability

166
Q

True or F: hep c can be transmitted sexually n vertically

A

False

167
Q

How does AIDS reduce immune response

A

Infects CD4+ t cells and macrophages = reduced numbers

Acute - t cytoxic cells kill infected cells
Chronic - immune system gradually loses ability to generate new t cells

= oppurtunistic infections

168
Q

Key cause of chronic bronchitis and emphysema

A

SMOKING

169
Q

Pathological def of emphysema

A

Perm dilation of airspaces distal to terminal bronchioles

170
Q

Wat metaplasia occurs in barrets oesophagis

A

Squam cell epith to columnar

171
Q

Where does krukenberg tumour spread from

A

Gastric carcinoma

172
Q

Jaundice definition

A

Raised serum bilirubin with bilirubin deposition in tissues

173
Q

Wats asterixis n wen does it occur

A

Hand tremor when wrist is extended

174
Q

Wats phage typing

A

Used to identify strains of bacteria. Bacterua culture are plated, different phages added to dofferent areas of plate. Plaque formation indicates susceptibikity to phage.

175
Q

Which virus switches off p53 and wat is p53

A

Human papilloma virus

P53 = tumour suppressor gene - apoptosis of abnormal cells

176
Q

Polymorphisn

A

Changes in dna in population due to natural selection

177
Q

Wats sporadic cancer

A

Not due to inherited changes

178
Q

Role of retinoblastoma tumour suppressor gene

A

Important for transition from g1 to s phase (growth to replication of chromosomes)

179
Q

Myc gene

A

Enhancer sequence moved towards it = burkitts lymphoma

180
Q

Philadelphia chromosome

A

Translocation of c22 and 9 = chronic myelogenous leukemia - abnormal n increased prolif of myeloid stem cells in bone marrow

181
Q

Wat type is brca1 n 2

A

Tumour suppresspr genes - caretaker type - dna repair n regulation in response to DNA damage

ICP (6 decks)

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