Infectious Disease

Question 1

Describe Hepatitis A…

Answer 1

• Fecal/Oral
• International travel
• 85% clinical recovery in 3 months
• Vaccine avilable

Question 2

Describe Hepatitis E…

Answer 2

• Fecally contaminated water
• Asia, Africa, Middle East
• No chronic development

Question 3

What is the most common cause of acute viral hepatitis?

Answer 3

• Hepatitis B
• Acute 70% subclinical

Question 4

What can happen to the liver with Chronic Hepatitis B?

Answer 4

• Necorinflammatory disease of liver with persistent HBV infection
• Carrier - HBV infection without necroinflammation

Question 5

For Hepatitis B, what % get HBV Perinatally?

Answer 5

90%

Question 6

What % of HBV patient get cirrohsis at 5 years?

Answer 6

20%

Question 7

Describe Hepatitis C…

Answer 7

Acute

• Almost always subclinical

Chronic

• 60-80% of patients
• Most common cause of chronic liver disease
• # 1 indication for liver transplant

Question 8

What is the most common cause of liver disease?

Answer 8

Hepatitis C

Question 9

What is the #1 indication for liver transplant?

Answer 9

Hepatitis C

Question 10

Describe Hepatitis D…

Answer 10

• Co-exist wth HBV

Question 11

Describe Hepatitis F…

Answer 11

Hypothetical

Question 12

Describe Hepatitis G & GBV-C…

Answer 12

• Evidence suggests that it does not cause hepatitis in humans

Question 13

What is HIV?

Answer 13

• Progressive disease
• Immune dysregulation, dysfunction, and deficiency
• May be asymptomatic

Question 14

What are some clinical indicators of HIV?

Answer 14

• Candidiasis
• Cervical Cancer
• Coccidiomysosis (infection caused by fungus)
• Histoplasmosis (infection caused by fungus)
• HIV associated dementia

Question 15

Regarding AIDS diagnosis, what does the CD4+ count have to be at?

Answer 15

< 200 cells/mm3

In the absence of clinical symptoms…

Question 16

What does HAART stand for?

Answer 16

High Active Antiretroviral Therapy

Question 17

What are 4 drugs classes of HIV meds?

Answer 17

• Fusion Inhibitors
• Nucleoside Reverse Transcriptase Inhibitors
• Non-Nucleoside Reverse Transcriptase Inhibitors
• Protease Inhibitors

Question 18

What are some HAART Regimens for HIV?

Answer 18

• NNRTI Based
• 1 NNRTI + NRTI’s (non-nucleoside reverse transcriptase inhibitor + nucleoside reverse transcriptase inhibitor)
• Protease Inhibitor Based
• 1 or 2 PIs + 2 NRTI’s
• Triple NRTI based
• 3 NRTI’s

Question 19

What are 2 lab values to keep an eye on regarding HIV patients?

Answer 19

• CD4 + T-lymphocyte count
• Plasma HIV load/titer (viremia)

Question 20

How do you dentally manage an HIV patient?

Answer 20

• Tolerate full spectrum dental care
• Optimize oral hygiene and function
• Monitor for and mange HIV-associated oral lesions
• Drug-induced side effects: Xerostomia, coagulopathy, bone marrow suppression, hepatotoxicity
• Recall
• No automatic need for ABX prophylaxis
• Cannot refuse care

Question 21

What are some drug induced side effects of HIV meds?

Answer 21

• Xerostomia
• Coagulopathy
• Bone Marrow Suppression
• Hepatotoxicity

Question 22

What are some oral lesions that can manifest in HIV patients?

Answer 22

• Candidiasis
• Oral hairy leukoplakia
• Kaposi’s sarcoma
• Non-Hodgkin lymphoma
• HIV gingivitis/periodontitis
• Viral lesions (HSV,HPV)
• Major apthous ulcers