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Human Disease > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

What does the severity of infection depend on

A
  • Pathogenicity and virulence of infecting agent
  • Host resistance
  • Environmental factors
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2
Q

Definition of infection

A

-Process of tissue invasion by microorganisms characterized by multiplication of these microorganisms in the body of the host to produce disease

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3
Q

Definition of cross infection

A

-Transmission of infection between patients as well as patients and health care professionals

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4
Q

Classification of infections

A

-Community acquired infections
Present at the time of admission or a visit to a hospital or incubating at that time

-Health-Care Associated Infections/ Nosocomial Infections/ Hospital-Acquired Infections:
Induced from a source outside the patient’s body (exogenous) or from within the patient’s own body (autogenous) after a visit or admission to a hospital or health care centre

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5
Q

Examples of microorganisms that cause disease

A
  • Viral Infection
  • Bacterial Infection
  • Parasitic Infection
  • Fungal Infection
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6
Q

Steps in diagnosing an infectious disease

A 
-Taking a history
Foreign Travel
Immigrants
Occupation
Domestic Pets
Sexual Activity 
Drug Addiction 
Tattooing 
Injections 
Transfusions 
-Clinical Examination 
Oral Ulceration 
Rashes
Lymphadenopathy 
Hetaposplenomegaly
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7
Q

Investigations for general infectious diseases and explanation of each

A

-Baseline:
Full Blood Count- looking for abnormally high/low blood cells
Blood film- thin layer of blood smeared on a microscope slide, analysing for various blood cells
C-reactive protein, blood test marker for inflammation in the body
Erythrocyte Sedimentation Rate- how long it takes for the RBC to fall, the quicker it takes, the higher levels of inflammation

-Microbiological examination of body fluids

-Immunodiagnosis
Serology: specific IgG, IgM, IgA
Antigen Detection

-Tissue Diagnosis
Aspiration/Biopsy

-Imaging Procedures

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8
Q

Mum brings 5yo child because they have been complaining of a sore mouth

Been generally unwell for a few days with a fever

Examination reveals multiple yellow-crested ulcers on the lips
Well-circumscribed ulcers on the hard palate

What is the likely diagnosis

A

Multiple well-circumscribed lesions suggest it is not malignant

Most likely to be acute herpetic gingivostomatitis (Herpes)

Based on age and presentation

First exposure to Herpes is always as a kid

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9
Q

Definition, Pathogen, Types, Incubation Period of Herpes Simplex

A
  • Herpes Simplex is a viral infection caused by Herpes Simplex Virus
  • Incubation period is 2-12 days
  • Type 1 spread by infected saliva in the mouth and upper body
  • Type 2 spread by sexual contact
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10
Q

Clinical Features of Herpes Simplex 1 and 2

A

General Features:

  • Sore throat
  • Fever (pyrexia)
  • Lymphadenopathy
  • Recurrence

Oral Features:

  • Vesicles present on pharynx, buccal mucosa, gingiva, tongue, lips and face
  • Often painful and last for 10 days

Skin Features:

  • Can be either HSV1 or HSV2
  • Herpetic Whitlow: small blisters appear on the fingers and the fleshy area around the fingertip

Eye Features:

  • Usually HSV1
  • Corneal involvement is serious as it may cause blindness

Genital/Anal Infections:
-Usually HSV2

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11
Q

Examples of conditions of Herpes Simplex Virus

A
  • Herpetic Gingivostomatitis
  • Herpes Labialis (recurrent herpes)
  • Herpes Genitalis
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12
Q

Diagnosis of Herpes Simplex Virus Conditions

A

-Often clinical

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13
Q

Complications of Herpes Simplex Virus

A
  • Encephalitis- affects temporal lobes
  • Neonatal- serious since mortality is 60%, caused by vertical transmission of HSV2 from mother to child, which is an indication for a caesarian section
  • Erythema Multiforme- hypersensitivity reaction manifesting on the skin
  • Eczema herpeticum- infection causes cold sores to appear around and inside the mouth, leading to oral herpes
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14
Q

Definition and reactivating factors of herpes labialis

A
  • Commonly known as cold sores
  • Follows primary infection
  • Usually HSV1 but can be HSV2
  • Sunlight
  • Trauma
  • Chemical
  • Hormones
  • Stress
  • Immunosupression
  • Concurrent infections
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15
Q

Management of Herpes Simplex Condition

A
  • Hydration and soft diet to prevent pain from ulcers
  • Topical and systemic Acyclovir (antiviral)
  • Valacylcovir
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16
Q

Chickenpox definition, incubation period and spread

A
  • Initial infection of Varicella Zoster Virus
  • Spread through direct contact with patients with chicken pox/ shingles
  • Incubation period is 14-16 days
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17
Q

Clinical features and diagnosis of chickenpox

A

-Diagnosis clinical

  • Rash that progreses from macule to papule to vesicle
  • Starts on trunk of scalp
  • Spreads to limbs and face
  • Vesicles dry and crust
  • Pruritis- very itchy
  • Fever, malaise and lympodenopathy
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18
Q

Complications of chicken pox

A
  • Rare
  • Cellulitis (painful bacterial skin infection)
  • Impetigo (common and contagious skin infection)
  • Pneumonia
  • Congenital abnormalities
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19
Q

Management of chicken pox

A
  • Supportive
  • Antihistamines
  • Acyclovir for very severe cases or complications
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20
Q

55yo man comes to see you with right sided jaw and ear pain. He had an abscess around his upper right molar last year and had a similiar pain. He wonders if a similiar problem has recurred? You notice some a rash on his ear

A
  • Possible Herpes Zoster
  • Shingles where V2 or V3 branches of CNV are involved
  • Check for other symptoms
  • Differential Diagnsosis
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21
Q

Shingles, alternative name, and definition

A
  • Herpes Zoster
  • Characterised by the reactivation of the varicella zoter virus in a dermatomal distribution
  • Can include regions of CN V
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22
Q

Clinical Features of Herpes Zoster

A
  • Preceded by radicular pain and hyperaesthesia of the overlying skin
  • Unilateral, dermatomal rash
  • Intense erythema which rapidly becomes vesicles that crust
  • Oral, palatal or pharyngeal involvement if the trigeminal nerve is affected
  • Ocular involvement causes keratitis or uveitis which may result in blindness
  • Ramsay-Hunt Syndrome: when shingles (reactivation of VZV) occurs in the geniculate ganglion of the VII cranial nerve
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23
Q

Diagnosis of shingles

A

Usually clinical

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24
Q

Complications of shingles

A
  • Post-herpetic neuralgia

- Neurological eg. meningitis

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25
Q

Treatment of shingles

A
  • Acyclovir
  • Reduces the pain and accelerates healing
  • Has no effect on post-herpetic neuralgia
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26
Q

Dental Relevance of Herpes Simplex Virus conditions

A
  • Oral manifestations
  • Vesicles present on pharynx, buccal mucosa, gingiva, tongue, lips and face
  • Often painful and last for 10 days
  • Herpetic whitlow
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27
Q

Dental Relevance of Herpes Zoster Virus

A
  • Oral manifestations in chickenpox and shingles
  • In shingles, pain if V2 or V3 of CN-V is involved
  • Can often be misdiagnosed as tooth ache
  • Post-herpetic neuralgia

-If a patient is having a recurrent zoster, need to question why. Immunosuppressent drugs, HIV, steroidal drugs???

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28
Q

A 5yo boy recently started school

  • Note lesions on palate etc
  • Generally unwell and feverish

Where else would you like to examine to confirm diagnosis

A
  • Perhaps chickenpox
  • Need to inspect
  • Other lesions in any other places
  • Any rashes
  • Any swellings on the glands
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29
Q

Infectious mononucleosis alternative name, definition, incubation period

A
  • Glandular fever, kissing disease
  • Caused by Epstein-Barr Virus
  • Incubation period is 4-14 days
  • Infects B lymphocytes and causes antibody production
  • Not necessarily against EBV
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30
Q

Clinical features of infection mononucleosis

A
  • Sore throat
  • Lymphadenopathy
  • Anorexia, fever, malaise
  • Intra-oral rash between hard and soft palate
  • Tonsilitis with white exudate
  • Palpable spleen
  • Sometimes jaundice
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31
Q

Diagnosis of infectious mononucleosis

A
  • Often clinical
  • PCR
  • Monospot test- rapid blood test to check for EBV
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32
Q

Complications of infectious Mononucleosis

A
  • Hepatitis
  • Respiratory obstruction
  • Ruptured spleen v rare
33
Q

Management of Infectious Mononucleosis

A
  • Supportive

- Paracetemol and water

34
Q

Dental relevance of infectious mononucleosis

A
  • Cervical lymphadenopathy
  • Creamy exudate over tonsils
  • Rash between hard and soft palate
35
Q

Mumps definition, spread, common in and incubation period

A
  • Caused by paramyxovirus (rna)
  • 16-20 days incubation period
  • Spread by droplets from saliva and nasopharyngeal secretions
  • Common childhood infection
36
Q

Differential diagnosis of mumps

A

Swelling of the parotid/submandibular glands

37
Q

Clinical features of mumps

A
  • Asymptomatic in 40%
  • Fever, malaise
  • Enlargement of one of both parotids
  • Earache and displacement of the earlobe
  • Parotid papillae inflamed
  • Difficulty swallowing
  • Submandibular glands may be affected
38
Q

Diagnosis of mumps

A

-Clinical

39
Q

Complications of mumps

A

-Neurological
Aseptic meningitis
Encephalitis

  • Orchitis- inflammation of the testes
  • Non-parotid mumps- ovaries, thyroid, pancreas, breasts
40
Q

Treatment of mumps

A
  • Good oral hygiene as they may have some difficulties with dexterity
  • Prevention by immunisation from vaccine with children 12-15 months (MMR)
  • Supportive (analgesics, bed rest and fluids)
  • Scrotal support
41
Q

Dental Relevance of mumps

A
  • Enlarged, tender parotid gland
  • Oral hygiene may be impaired
  • Difficulty as sore
42
Q

Exanthema definition and examples of childhood infections that can cause it

A

-Skin rash accompanied by a disease or fever

  • Measles
  • German measles
  • Enteroviral infection
  • Infection mononucleosis
  • Scarlet Fever
  • Erythema infectiosum
  • Roseola infactum
  • Drug eruption
43
Q

Measles definition, incubation period and spread

A
  • Paramyxovirus
  • Spread via droplet infection
  • Common childhoood infection
  • Incubation period is 10 days
44
Q

Clinical features of measles

A
  • Conjunctivitis
  • Lymphadenopathy
  • Koplik’s spots on buccal mucosa
  • Florid maculopapular rash which begins behind the ears and spreads to the face and trunk- brownish discolouration remains after
45
Q

Complications of measles

A

Gingivostomatitis

46
Q

Diagnosis of measles

A

Often clinical but uncommon so sometimes lab tests may be done

47
Q

Management of measles

A
  • Supportive treatment (bed rest, analgesics and fluid)
  • Immunisation of children ages 12-15 months
  • MMR vaccine (measles, mumps and rubella)
48
Q

Dental Relevance of Measles

A
  • Koplik spots on the buccal mucosa
  • Pharyngitis
  • Facial rash
49
Q

German Measles alternative name, definition and incubation period

A
  • Rubella
  • Caused by rubivirus
  • Incubation period is 14-21 days
50
Q

Clinical features of german measles

A
  • Fever
  • Malaise
  • Sore throat
  • Lymphadenopathy
  • Rash that begins on the face and spreads to the trunk/limbs
  • Pink, maculopapular, non-confluent
  • Conjunctivitis
  • Macular rash appears on day 3 which coalesces to form a blush
51
Q

Diagnosis of german measles

A
  • Clinical

- Essential in pregnant women

52
Q

Complication of german measles

A

-Congenital rubella

53
Q

Dental relevance of german measles

A
  • Enlarged cervical lymph nodes
  • Pharyngitis
  • Facial rash
54
Q

Enteroviral Infections example and definition

A
  • Caused by Coxsackie virus A and B
  • Very common in kids
  • Eg. Hand-foot and mouth disease
55
Q

Clinical features of enteroviral infection

A
  • Malaise, fever and anorexia
  • Sore mouth and throat
  • Vesicular rash involving buccal mucosa with or without the tongue, palate or gingiva
  • Hand involvement in 65% of cases
  • Feet also affected
56
Q

Management of enteroviral infection

A

No specific treatment

57
Q

Definition, alternative name for Erythema infectiosum

A
  • Fifth Disease

- Parvovirus B19

58
Q

Clinical features of eryhtema infectiosum

A
  • Constitutional symptoms uncommon
  • Rash- livid erythema of cheeks
  • Maculopapular on extremities and trunk
  • As second fades it assumes a lacy reticular appearance
59
Q

Diagnosis of erythema infectiosum

A

-Clinical diagnosis

60
Q

Treatment of erythema infectiosum

A

-No specific treatment

61
Q

Difference between Active and Passive immunity

A
  • Active immunity is where the body develops its own antibodies through a disease or when you get a vaccine
  • Passive immunity is when antibodies are given to you
62
Q

Subsets of active immunity

A

1) Live attenuated vaccine
-Contains a version of living virus that has been weakened
-eg. oral poliomyelitis
measles
mumps
rubella
yellow fever

2) Inactivated organisms
-Made from microorganisms that have been killed through physical or chemical processes
-eg. whooping cough
typhoid
cholera
poliomyelitis
HepB
Rabies

3) Immiunizing components of an organism
-eg. influenza
pneumococcal
meningococcal c conjugate

4) Toxoid (inactivated toxin)
-eg. tetanus
diptheria

63
Q

Examples of passive immunity

A

1) Natural
Mother-foetus

2) Artificial (high levels human/non-human immunoglobulin)
Human normal immunoglobulin from pooled plasma of donors eg Hep A
Specific immunoglobulin from pooled blood of convalescent patients eg. Tetanus and Hep B

64
Q

Hepatitis B Virus definition, spread and incubation period

A
  • Hepatitis B Virus DNA
  • Significant to oral infection
  • Present in saliva
  • 45-180 day incubation period
  • Parental, sexually, contact w infected blood therefore risk for healthcare workers
  • Also present in saliva
65
Q

Clinical features of Hep B

A

-Malaise, Anorexia, nausea, muscle pains

66
Q

Diagnosis of Hep B

A
  • Serological Test

- HBsAg produced during replication of virus

67
Q

Management of Hep B

A
  • All members of dental team should be vaccinated against Hep B
  • Prevention by immunisation with recombinant DNA Hbs Ag vaccine
  • Treatment includes bed test and avoiding hepatotoxins such as alcohol
68
Q

Dental Relevance of Hep B

A
  • Immunisation of all health care workers
  • Cross-infection control
  • Abnormal drug metabolism
  • Abnormal clotting factors
69
Q

Hepatitis C definition and clinical features

A
  • Hep C Virus
  • RNA
  • Acute phase usually asymptomatic
  • Lichenoid reactions and Xerostomia unlike Hep B
  • No vaccination available
70
Q

Dental Relevance of Hep C

A
  • Xerostomia
  • Cross Infection control
  • Abnormal drug metabolism in the liver
  • Abnormal clotting factors
71
Q

HIV dental relevance

A

-Clinical signs of viral infections are early indicator of conversion to aids

Lesions strongly associated with HIV infection include:

  • Candidasis both erythematous and pseudomembranous
  • Hairy Leukoplakia
  • Kaposi’s Sarcoma
  • Non-Hodgkin’s Lymphoma
  • Periodontal disease including linear gingival erythema, necrotising ulcerative gingivitis and necrotising ulcerative periodontitis

Lesions less commonly associated with HIV infection include:

  • Bacterial infections
  • Melanotic pigmentation
  • Necrotizing stomatitis
  • Salivary gland disease
  • Thrombocytopoenic purpura
  • Non-specific ulcerations
72
Q

Scarlet Fever definition

A
  • Group A streptococcus
  • Beta haemolytic
  • Produces an erythrogenic toxin that is responsible for the reddish appearance
73
Q

Clinical features of scarlet fever

A
  • Follows a pharyngeal infection
  • Rash- diffuse erythema which blanches on pressure
  • Skin folds are dark
  • Circumoral pallor
  • Strawberry tongue
74
Q

Tx for scarlet fever

A

-Penicillin

75
Q

Whooping cough definition, incubation period and clinical features

A
  • Gram negative bacteria
  • Bordetella pertusis
  • 7 days incubation
  • Followed by catarrhal phase which lasts 1-2 weeks

-Spasmodic phase occupies the next 4-6 weeks and consists of severe paroxysmal cough with an inspiratory whoop, vomiting, cyanosis

76
Q

Complications of whooping cough

A
  • Bronchopneumonia- secondary to inhalation of secretions during whoops
  • Convulsions
  • Pressure effects- subconjunctival haemorrhage
  • Facial petechiae during spasm
  • Cerebral haemorrhage
  • Prolapse of hernias
  • Laceration of lingual fraenum against the lower incisors
77
Q

Investigations and tx of whooping cough

A
  • Paranasal swabs and culture on bordet-gengou medium
  • Immunofluorescent antibody test
  • Treatment is basically symptomatic
78
Q

Tuberculosis definition, what it affects and prevention

A
  • Myobacterium tuberculosis
  • Becomes dormant before it progresses to active TB
  • Commonly affects the lungs and is communicable in this form
  • May also affect any organ sysstem including lymph nodes, CNS, liver, bones, genitourinary tract and GI tract
  • Prevention with immunization with BCG vaccine
  • Gloves and masks should be worn
79
Q

Most common oral fungal infection and who they can affect

A
  • Oral candidasis
  • Candida albicans
  • Elderly pts
  • Infants
  • Med compromised pts
Signs include
Pseudomembranous
Erythematous
Hyperplastic
Angular Cheilitis
Median rhomboid glossitis

Human Disease (19 decks)

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