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Pathology > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Describe an opportunistic infection.

A
  • non-pathogenic organism
  • low virulence
  • immunocompromised host
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2
Q

Describe mutualism.

A
  • both organisms benefit
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3
Q

describe commensualism

A

one benefits & other is not helped/harmed

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4
Q

Give an example of a commensal bacteria?

A

C. albicans

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5
Q

General principles of viral infections?

A
  • intracellular parasite
  • cell type specific
  • latency
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6
Q

HHV subtypes & the common name

A

1 = HSV1 (oral herpes)
2 = HSV2 (genital herpes)
3 = VZV (chicken pox & shingles)
4 = EBV
5 = cytomegalovirus
5 = kaposi sarcoma

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7
Q

Describe primary herpetic gingivostomatitis.

A
  • generally young age
  • ALL over mouth (masticatory & moveable // keratinized & non)
  • FLU-like (systemic)
    –> fever, malaise, lymphadenopathy, headache
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8
Q

Describe recurrent herpes labialis

A

cold sores / vesicles or ulcers on lips
- 2 weeks

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9
Q

Describe recurrent intra-oral herpes

A

cold sores / ulcers on masticatory / non-moveable / keratinized tissue
(hard palate or gingiva)
-typically clusters
resolves in 2 weeks

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10
Q

Where does HSV lay dormant?

A

Trigeminal ganglion

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11
Q

What cell type does HSV have an affinity for?

A

epithelial

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12
Q

What are tzanck cells?

A

individual cells within serous fluid that have been virally altered

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13
Q

What is herpes gladiatorum?

A

when herpes labialis is in close contact with individuals & ruptures
(wrestlers)

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14
Q

What is herpes whitlow?

A

herpes on fingers (historically prevalent in dentist)

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15
Q

What is HSV autoinoculation?

A

spreading herpes among yourself such as getting it in your eyes

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16
Q

What is recurrent aphthous stomatitis?

A
  • T lymphocyte mediated cytotoxic rxn
  • focal mucosal destruction
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17
Q

Describe the evolution of an aphthous ulcer

A
  • erythematous macule
  • ulceration
  • (yellowish) fibrinous membrane
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18
Q

What are some precipitating factors for recurrent aphthous stomatitis?

A
  • stress
  • trauma
  • SLS (in toothpaste)
  • allergies
  • acidic food/juices
  • gluten
  • endocrine alterations
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19
Q

What are the clinical forms of recurrent aphthous stomatitis?

A
  • minor
  • major
  • herpetiform
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20
Q

Describe minor aphthous ulcers

A
  • shallow, yet painful
  • non-keratinized, moveable tissue
  • single or multiple
  • heal in 2 weeks
    *recurrent
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21
Q

Describe major aphthous ulcers

A
  • larger
  • deeper –> may scar
  • heal slowly (weeks to months)**
  • non-keratinized, moveable tissue
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22
Q

Describe herpetiform aphthous ulcers

A
  • clusters of small, shallow, painful ulcers
  • heal in 2 weeks
  • short remission
  • non-keratinized, moveable tissue
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23
Q

T/F both recurrent herpes & recurrent aphthae have a vesicular stage?

A

false (only herpes)

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24
Q

Primary vs recurrent infection with VZV?

A

primary - varicella (chicken pox)
recurrent - zoster (shingles)

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25
Q

How do you differentiate shingles from chicken pox?

A

clinical manifestation / presentation

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26
Q

How is VZV transmitted?

A

droplets (respiratory)

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27
Q

Where do chicken pox lesions begin? Can they scar?

A

face/trunk
NO

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28
Q

Where does vzv lay dormant?

A

dorsal root ganglion

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29
Q

Describe herpes zoster virus.

A
  • prodrome of pain & paresthesia
  • unilateral dermatomal involvement
  • can include oral cavity // pos. bone necrosis
  • lasts >2 weeks
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30
Q

T/F herpes zoster can scar?

A

true

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31
Q

What is a dreaded complication of shingles?

A

post-herpetic neuralgia

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32
Q

What is meant by a transforming viral infection? Example?

A

can become malignant / tumor forming
– EBV (HHV-4)

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33
Q

What are the 4 presentations associated with EBV?

A
  • infectious mononucleosis
  • lymphomas (Burkitt)
  • nasopharyngeal carcinoma
  • oral hairy leukoplakia
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34
Q

What is the cell specificity for EBV?

A
  • B lymphocytes
  • infects epithelial cells of oral mucosa, oropharynx, and nasopharynx
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35
Q

How common is EBV?

A

most adults are EBV+

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36
Q

Clinical features of infectious mononucleosis?
- symptoms, population, prognosis, transmission

A
  • feel like crap (flu-like)
  • young adults
  • can be debilitating EBV infection
  • self-limiting (goes away on own)
  • saliva
37
Q

What occurs on a cellular level with mononucleosis?

A
  • peripheral blood lymphocytosis (increase in LYMPHOCYTES)
  • atypical lymphocytes (Downey cells)
38
Q

Oral presentations of infectious mononucleosis?

A
  • petechiae hemorrhage
  • necrotizing ulcerative gingivitis
39
Q

Lab testing for infectious mono?

A
  • heterophile antibody
  • monospot test
40
Q

How to treat infectious mononucleosis?

A
  • treat symptoms only
  • bed rest –> prevent splenic rupture
41
Q

What virus causes oral hairy leukoplaking?

A

EBV (HHV-4)

42
Q

Describe oral hairy leukoplakia.

A
  • epithelial hyperplasia due to EBV
  • white striations on lateral tongue
  • often pt in immunodeficient state
43
Q

What population is HHV-5 most common?

A

> 60 yrs
cytomegalovirus

44
Q

T/F most CMV infections are asymptomatic?

A

true

45
Q

What are some oral symptoms of acute CMV?

A

Rare:
- xerostomia
- painful swelling
- acute sialadenitis
Immunocompromised:
- retinitis / blindness
- colitis

46
Q

What is coxsackie virus?

A
  • self-limited dx in children
  • flu-like symptoms
  • fecal oral / airborne
47
Q

What is herpangina?

A
  • coxsackie virus
  • small vesicles that rupture & ulcerate
  • posterior oral cavity & oropharynx
48
Q

What is hand, foot, & mouth dx?

A
  • coxsackie virus
  • common in daycares
  • vesicular eruptions on hands, feet, & anterior mouth
49
Q

How does measles present? alternate name?

A
  • skin rash of children
  • rubeola
50
Q

What is an oral presentation of measles?

A

Koplik spots
– grains of salt on erythematous base

51
Q

How does mumps present? alternate name?

A
  • salivary gland swelling & discomfort
  • children
  • infectious parotitis
  • 30% subclinical
  • Lab: elevated serum amylase
52
Q

Complications of mumps?

A
  • rare in young people
  • orchitis, oophoritis, mastitis, meningitis, thyroiditis, pancreatitis
    –> sterility & hearing loss
53
Q

What does the histology of tuberculosis look like?

A

granulomatous (epithelioid macrophage, giant cells, lymphocyte)
caseous necrosis

54
Q

What populations do we typically see TB?

A
  • homeless
  • malnourished
  • overcrowded
    *HIV infection
  • immigrants
55
Q

What type of infection / pathogen is TB?

A
  • intracellular
  • pulmonary infection common
  • mycobacterium tuberculosis
56
Q

What are the 2 stages of TB infection?

A
  • infection = growth of organism in pt
  • active disease = destructive & symptomatic (infectious)
57
Q

How is TB spread?

A
  • droplet nuclei (reach alveoli)
  • airborne long periods
58
Q

What is the virulent factor of TB?

A

cord factor –> blocks fusion of phagosome with lysosome

59
Q

Oral manifestations of TB?

A
  • ulceration on any tissue type
60
Q

How to treat TB?

A
  • multi-drug regimens for long period
61
Q

How to test for TB?

A

mantoux tuberculin skin test
- Type IV hypersensitivity
- T cells sensitized by prior infection recruited to area
**if produces red induration…MUST do other tests (chest xray) to confirm

62
Q

Is there a vaccine for TB?

A

yes, BCG
- live-attenuated, BUT causes positive PPD rxn
- not used in US

63
Q

What is scrofula?

A
  • TB lymphadenitis of neck
  • M. bovis from infected milk
    –>not common in US bc pasteurization
64
Q

What causes syphilis?

A
  • Treponema pallidum (bacteria)
  • STD
65
Q

What are the types of syphilis?

A
  • congenital = in utero
  • acquired = STD
66
Q

What are the clinical stages of untreated acquired syphilis?

A
  • primary (1 week - 3 mo) = chancre
  • secondary (1-12 mo) = maculopapular patch & condyloma lata
  • tertiary (1-30 yrs) = gumma & syphilitic glossitis + NS & CV system
67
Q

What stages of syphilis are infectious?

A

primary & secondary ONLY

68
Q

Lesions of congenital syphilis?

A
  • hutchinson incisors
  • mulberry molars
  • snuffles
  • saddle nose
  • rhagades: angular fissures/cracks
69
Q

What is hutchinson’s triad of congenital syphilis?

A
  • blind: interstitial keratitis
  • deaf
  • dental anomalies
70
Q

How to lab test for syphilis?

A

*cannot culture
- serological tests (treponemal & non-treponemal)

71
Q

What is a superficial fungal infection? Example.

A
  • skin, hair & nails
  • dermatophytes
72
Q

What is subcutaneous fungal infection? Example.

A
  • dermis & subcutaneous tissue
  • sporotricosis
73
Q

What is a systemic fungal infection? Example.

A
  • deep infection of internal organs
  • histoplasmosis
74
Q

What is an opportunistic fungal infection? Example.

A
  • immunocompromised host
  • candidiasis
  • mucormycosis
75
Q

What is histoplasmosis?

A
  • endemic to MS river valley
  • bird droppings –> inhaled
  • usually subclinical / flu-like
  • deep infection of lungs
    –> dystrophic calcification
76
Q

What is the most common systemic fungal infection in US?

A

histoplasmosis capsulatum
80-90% infected

77
Q

What is disseminated histoplasmosis?

A
  • elderly, debilitated, immunosuppressed, AIDS
  • spreads out of lungs
    –> adrenal & oral lesions
78
Q

What is coccidioidomycosis?

A
  • deep fungal infection of lungs
  • 40% respiratory symptoms
  • disseminated dx may occur
  • granulomatous inflammation
79
Q

What are the clinical forms of candidiasis?

A
  • pseudomembranous (thrush)
  • erythematous (atopic)
  • hyperplastic
  • angular cheilitis (perleche)
  • central papillary atrophy (median rhomboid glossitis)
80
Q

Can you wipe off candida?

A

yes, and leaves behind an erythematous region

81
Q

What can cause erythematous candidiasis?

A
  • steroid inhaler
82
Q

What patients often present with angular cheilitis?

A
  • decreased VDO / edentulous
  • droolers
83
Q

What is hyperplastic candidiasis?

A
  • does not wipe off –> call leukoplakia
  • harder to diagnose bc looks pre-malignant (must biopsy)
84
Q

Describe median rhomboid glossitis?

A
  • red patch down dorsal posterior tongue
85
Q

What is sarcoidosis?

A
  • multi-system granulomatous disorder
    –> non-caseating
  • unknown cause
  • younger adults // Af. American
  • hilar lymphadenopathy & skin/eye lesions
86
Q

How to diagnose sarcoidosis?

A

diagnosis of exclusion
– biopsy: bronchi & minor salivary gland
– radiograph, clinical, lab (ace, Ca)
– histo: non-caseating granulomas, asteroid bodies & schaumann bodies

87
Q

Oral manifestations of sarcoidosis?

A
  • uncommon to have lesions (submucosal papule)
  • bilateral parotid enlargement
  • xerostomia
  • facial nerve weakness
88
Q

How to treat sarcoidosis?

A
  • mild dx: no tx, may resolve
  • severe dx: systemic corticosteroids

Pathology (9 decks)

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