Infectious Diseases Flashcards
Organism that is capable of causing disease
Pathogen
______ virulence of a pathogen -causes disease in a healthy population
High
______ virulence of a pathogen causes disease only in susceptible populations
Low
________ pathogen
•Non-pathogenic organism
•Low virulence
•Immunocompromised host
Opportunistic
- Interaction between two organisms
* Both organism benefits
Mutualistic
- Interaction between two organisms
- One organism benefits
- Other is neither harmed nor helped
- C. albicans
Commensalism
How do _______ injure cells and cause tissue damage?•Bind to or enter host cells
•Release endotoxins or exotoxins
•Release enzymes that degrade tissue components
•Damage blood vessels and cause ischemic injury
•Induce host inflammatory and immune responses
pathogens
- Intracellular parasites
- Cell type specific
- Viral latency
Viruses
A ______ is a nucleic acid looking for a home
virus
What are the 5 steps of viral infection and replication?
- Attach
- Penetrate
- Reproduce
- Assemble
- Release
- Humans are the natural reservoir
- Latency
- Reactivation
Human Herpes Virus (HHV)
Herpes Simplex Virus Type 1
•HHV-1
Herpes Simplex Virus Type 2
•HHV-2
Varicella Zoster Virus
•HHV-3
Epstein Barr Virus
•HHV-4
Cytomegalovirus
•HHV-5
Kaposi Sarcoma associated virus
•HHV-8
Transmission of _______
•Contact with affected individual shedding virus
•Symptomatic active lesions
•Asymptomatic viral shredding
HSV
____ herpes virus are usually above the belt that are mostly oral infections
HHV-1
_____ herpes virus are usually below belt that are mostly genital infections
HHV-2
______ Infection With Herpes Simplex Virus
•Initial exposure to virus in an individual without immunity
•Generally occurs at young age after physical contact with infected individual
•Mostly subclinical disease–80% of US population has antibodies to HSV
Primary
- Flu-like illness with fever, malaise, arthralgia, headache
* Cervical lymphadenopathy
Primary Herpetic Gingivostomatitis
Where are the only 2 places recurrent intra-oral herpes can occur?
Hard palate
Attached gingiva
Does primary herpetic gingivostomatitis occur on attached or unattached mucosa?
Both
•Focal mucosal destruction
•T lymphocyte mediated cytotoxic reaction
-Not an infectious disease
Recurrent Aphthous Stomatitis
The following are participating factors for \_\_\_\_\_\_\_\_\_: •Sodium lauryl sulfate (SLS) •Stress •Trauma •Allergies •Acidic foods / juices •Gluten •Endocrine alterations
Recurrent Aphthous Stomatitis
Does aphthous stomatitis occur on movable or immovable tissue?
Movable
What are the 3 forms of recurrent aphthous stomatitis?
Minor
Major
Herpetiform
\_\_\_\_ aphthae •Recurrent disease •Shallow, painful ulcerations on non-keratinized mucosa •Solitary or multiple lesions •Heal in two weeks
Minor Aphthae
\_\_\_\_ aphthae •Recurrent disease •Larger (> 0.5cm) •Deeper -may heal with scarring •Heal slowly -weeks to months
Major Aphthae
____ aphthae
•Crops of small, shallow, painful ulcers
•Heal in two weeks
•Short remissions
Herpetiform Aphthae
- Transmission by inspiration of infected droplets
- Clinical disease in most individuals
- Constitutional symptoms
- Skin lesions begin on face/trunk
- Vesicles in repeated waves
- Heal without scarring
Varicella (Chicken Pox)
What ganglion does Herpes Simplex like to stay in?
Trigeminal
•Prodrome of pain, paresthesia
•Unilateral dermatomal involvement
-Unilateral and painful
Varicella (Shingles)
DOes recurrent herpes have a short or long duration?
Short duration
Does varicella zoster have a short or long duration?
Long duration
Transformative virus that can cause tumors
•Most adults EBV+
•Latency
•Tropism for B lymphocytes
•Infects epithelial cells of oral mucosa, oropharynx and nasopharynx
•Herpesvirus(HHV-4)
What are the 4 disease associated with HHV-4?
- Infectious Mononucleosis
- Lymphomas–NHL and HLe.g. Burkitt lymphoma(NHL)
- Nasopharyngeal Carcinoma
- Oral Hairy Leukoplakia
- Debilitating EBV infection
- Self-limiting
- Young adults
- Salivary transmission
- Fatigue
- Malaise
- Lymphadenopathy
- Fever
- Sore throat
- Peripheral blood lymphocytosis
- Lymphocytes, not monocytes
- Atypical lymphocytes (Downey Cells)
Infectious Mononucleosis
•Epithelial hyperplasia associated with EBV infection•Lateral border of tongue –common location •May occur in any immunodeficiency state
-Bilateral; vertical white striations
Oral hairy Leukoplakia
Are oral hairy leukoplakia and hairy tongue the same thing?
NO
(HHV –5 ) •Most of population affect by age 60 •Most CMV infections are asymptomatic •Initial infection •Latency •Reactivation
Cytomegalovirus•CMV
- Similar to infectious mononucleosis (EBV)
- Heterophile antibody negative
- Rarely acute sialadenitis with painful swelling and xerostomia
CMV
Is infectious mononucleosis heterophile antibody positive or negative
Positive
•Self-limited disease that occurs in epidemics of flu-like symptoms in young children
•Transmitted by fecal-oral and airborne routes
-Herpangina
-HFM disease
Coxsackie Virus
- Constitutional symptoms
- Begins as small vesicles that rupture and ulcerate
- Posterior oral cavity and oropharynx
Herpangina
•Vesicular eruption of hands, feet and anterior mouth
HFM disease
•Childhood infection •Communicable disease •Skin rash •Measles, Mumps, Rubella vaccine (MMR) Immunization -Koplik's spots in oral
Measles (Ruebella)
•“Grains of salt” on an erythematous base
•Foci of epithelial necrosis
-oral manifestation of Measles
Koplik’s spots
- Childhood infection
- Communicable disease
- 30% subclinical infection
- Prodromal constitutional symptoms
- Salivary gland swelling and discomfort
- Elevated serum amylase–Released from granules during lysis of acinar cells
- Specific serologic tests
- Complications rare in the young and more common in older individuals
- Orchitis, oophoritis, mastitis, meningitis, thyroiditis, pancreatitis
- Sterility, hearing loss
Mumps
- Pulmonary infection most common
- Intracellular pathogen
- Granulomatous disease
Tuberculosis
What 3 cells are in granulomatous inflammation?
Activated macrophages (histiocytes)
Multinucleated giant cells
Lymphocytes
- Infection -growth of the organism in a patient
- Active disease -destructive, symptomatic disease
- Droplet nuclei (1 -5 microns)
- Stay airborne for long periods of time
- Reach the pulmonary alveoli
Tuberculosis
- Previously unexposed (unsensitized) person
- Gohn complex (parenchymal lung lesion and hilar nodal lesion)
- Cell-mediated immunity controls infection
- Fibrosis and calcification
- Viable organisms dormant in lesions (latent disease)
- May reactivate if immune defenses lowered
Primary Pulmonary Tuberculosis
- Reactivation of dormant primary lesions in a previously sensitized host
- Cavitation leads to erosion into airway and production of contaminated sputum
Secondary Pulmonary Tuberculosis
What type of necrosis is seen in TB?
Caseous necrosis
MT produces _______ that blocks fusion of phagosome with lysosome
TB Cord factor
What type of hypersensitivity rxn is Mantoux TB skin test?
Type 4 delayed
- Tuberculous lymphadenitis of neck
- Mycobacterium bovis infection from infected milk
- Pasteurization of milk
- Tuberculosis control for cattle
Scrofula
•Treponema pallidum•Sexually-transmitted systemic disease•Sequential clinical stages•Years of latency
Syphilllis
What are the 2 forms of syphilllis?
Acquired
Congenital
What is the lesion of primary syphilis?
Chancre (Hard)
What are the 3 lesions of secondary syphilis?
Skin rash
Mucous patch
Condyloma lata
Which phase of acquired syphilis is the most destructive?
Tertiary
What is the lesion of tertiary?
Gumma
Which form of acquired syphilis is not infectious?
Tertiary
What are the 2 dental manifestations of congenital syphilis?
Hutchinson’s incisors
Mulberry molars
The following are lesions of \_\_\_\_\_\_\_\_: •Snuffles •Saddle nose •Rhagades •Hutchinson’s incisors •Mulberry molars
Congenital syphilis
What are the 3 congenital symptoms of the Hutchinson’s triad?
- Blind -interstitial keratitis
- Deaf
- Dental anomalies
•Endemic to Mississippi River Valley •Transmission by inhalation of spores–Bird droppings, dust particles •Sub-clinical infection usual •Flu-like syndrome Mississippi Valley Fever •Inhalation of spores •Phagocytosis •Specific immunity •Killing of organism •Dystrophic calcification
Histoplasmosis
- Deep fungal infection of the lungs
- 40% develop respiratory symptoms
- Disseminated disease may occur
Coccidiomycosis
•Multi-system granulomatous disorder •Unknown cause •Young adults •African-Americans-10:1 •Common findings –Hilar lymphadenopathy –Skin and eye lesions NOT AN INFECTION
Sarcoidosis
Is sarcoidosis caseating or non-caseating?
Non-caseating
Salivary Gland involvement in _________:
•Parotid enlargement
•Xerostomia
•Facial nerve weakness
Sarcoidosis
