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5th - OD - Infections > Fungal Infections > Flashcards

Fungal Infections Flashcards

1
Q

What is the most common candida species?

A

C.albicans

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2
Q

What form do c.albicans take?

A

Polymorphic

Yeast/ pseudohypae/ hypae

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3
Q

What is pathogenic form of c/albicans?

A

Hyphal

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4
Q

How do c.albicans cause pathology?

A

Yeast –> hyphae transformation
Secreted aspartyl proteases = tissue invasion
Candidalysin = tissue damage

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5
Q

How does candidalysin cause tissue damage?

A

Pore forming toxin

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6
Q

When will yeast transform to hyphae?

A

In pH < 7

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7
Q

Mechanism of yeast to hyphae transformation?

A

Yeast bind oral keratinocytes
Under specific environmental condition yeast transform hyphae form
Hyphae form binds, allows penetration into epithelial cells
Candidalysin and SAPs = damage

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8
Q

Predisposing factors of candida species?

A 
Prosthesis
Low saliva rate 
Low pH induces high sugar diet 
Antibitoics 
Immunosuppression
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9
Q

Why do antibiotics increase candida risk?

A

Reduced bacterial competition

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10
Q

Why does immunosuppression increase candida risk?

A

Reduced cellular defence

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11
Q

What does candidalysin do?

A

Pore forming toxin that kills cells and initiate immune response

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12
Q

How are candida infections classified?

A

Acute
Chronic
Candida-associated
HIV-releated

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13
Q

Example of acute candida infections?

A

Acute pseudomembranous candidiasis = thrush

Acute atrophic candidosis

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14
Q

Examples of chronic candida infection?

A

Chronic atrophic candidosis (denture stomatitis)

Chronic hyperplasia candidosis

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15
Q

Examples of candida-associated lesions?

A

Median rhomboid glossitis

Angular chelitis

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16
Q

What is acute pseudomembranous candidosis

A

Thrush

Creamy thick plaques - easily be rubbed off leaving bleeding base

17
Q

How does acute atrophic candidosis present?

A

Red, painful lesions

Common dorsum of tongue e

18
Q

Who does acute atrophic candidosis present in?

A

Those on prolonger corticosteroids or antibiotics therapy

Bacterial flora altered - candida flourish

19
Q

Management of candida conditions?

A
  1. confirm diagnosis with swab/ oral rinse
  2. investigate and tx underlying cause
  3. tx w/ anti fungal
20
Q

What are examples of topical and systemic antifungals?

A

Topical: nystatin, miconazole
Systemic: fluconazole

21
Q

Issue w/ antifungals

A

Warfarin interaction

22
Q

How does denture stomatitis present?

A

Clear boundary where denture has been - red/ atrophic looking lesions

23
Q

How tx denture stomatitis?

A

Improve denture hygiene - leave out at night/ clear denture

Provide anti fungal

24
Q

How does median rhomboid glossitis present>

A

Erythematous area on dorsum of tongue

Epithelial proliferation - candida in epihteliuum

25
Q

What feature can often be seen w/ median rhomboid glossitis?

A

Kissing lesion - lesion on palate

26
Q

Is median rhomboid glossitis malignant?

A

No and not premalignant

27
Q

How does angular chelitis present?

A

soreness and fissures at corner of the mouth

28
Q

What can be causes of angular chelitis?

A

Loss vertical demension
Haematological deficiency
Systemic disease - Chrons

29
Q

Treatment of angular chelitis?

A

Address udnerlying cause

Topical anti fungal

30
Q

How does chronic hyper plastic candidosis present?

A

White or red patch - can’t be rubbed off

Often labial commissure or tongue

31
Q

Issue w/ chronic hyperplastic candidosis?

A

Premalignant - 25% malignant change

32
Q

Causes of CHC?

A

Usual candida RFs

Smoking

33
Q

Management of CHC?

A

Biopsy - assess degree dysplasia and risk malignant transformation
Systemic antifungal
Smoking cessation

34
Q

When excise CHC?

A

No improvement and high risk malignant transformation

5th - OD - Infections (5 decks)

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