Infective Soft Tissue Lesions II - Bacterial, Fungal Flashcards
Which of the following bacterial or fungal infections is characterized by the formation of a painless, white patch on the oral mucosa that cannot be scraped off?
A) Herpetic stomatitis
B) Oral thrush
C) Oral lichen planus
D) Syphilis
D
Which of the following is true about median rhomboid glossitis?
A) Depapillation on dorsum surface of tongue
B) Papillation on dorsum surface of tongue
C) White anular ring present
D) White patches which can be rubbed off
A
The ideal first line of treatment to a simple pseudomembranous candidiasis infection is?
A) Amphotericin B
B) Nystatin
C) Topical corticosteroids
D) Use of enzymatic saliva stimulants
B
Patient presents with fever, malaise and lymphadenopathy. Upon examination there is a fetid odour and exquisite pain. Which is NOT a causative organism of this condition?
A) Borrelia vincetti
B) Fusobacterium nucleatum
C) Porphyromonas gingivalis
D) Tannerella forsythia
D
Patient presents with white lesions on the buccal mucosa in the oral cavity, cytological smear reveals the following:
(Picture shows branching thread-like hyphae structures and yeast cells)
What is the clinical diagnosis?
A) Acute necrotising ulcerative gingivitis
B) Angular Cheilitis
C) Mucormycosis
D) Pseudomembranous candidiasis
D
Which of the following clinical signs are associated with zygomycosis
A) Covered by diffuse white plaques that are able to be wiped off
B) Proptosis, palatal ulcers and facial swelling
C) Papillae are blunt and “punched out” along with a very distinctive fetid odor
D) Tenderness, erythema and fissuring at labial commissures
B
56 year old diabetic patient on concurrent corticosteroid therapy presents with extreme facial swelling and bulging eyes. Necrosis of the palatal mucosa is observed clinically. What is the likely diagnosis?
A) Median Rhomboid Glossitis
B) Necrotising Ulcerative Gingivitis
C) Pseudomembranous candidiasis
D) Zygomycosis
D
Which of the following statements regarding necrotizing ulcerative gingivitis/periodontitis is most likely FALSE?
A) Can spread to adjacent soft tissues in necrotizing ulcerative stomatitis/mucositis
B) Clinically presents in young and middle-aged adults
C) Increased prevalence in third world countries
D) Papillae appear fuller and have sharp, defined edges
D
A 20 year old patient presents with white plaques on the buccal mucosa and the palate resembling cheese curds. When you use a gauze to wipe at the white patch, it can be wiped off. The patient complains of a burning sensation and bitter taste in his mouth. What would be the most appropriate differential diagnosis in this case?
A) Angular Cheilitis
B) Erythematous Candidiasis
C) Median Rhomboid Glossitis
D) Pseudomembranous Candidiasis
D
Which of the following is least likely to increase the rate of development of candidiasis infection in a patient wearing complete dentures?
A) Excess production of saliva
B) Immune status of host
C) Medications such as antibiotics and corticosteroids
D) Strain of organism present
A
Which of the following statements is false of zygomycosis?
A) Arises from inhalation or implantation of spores by minor trauma or insect bites
B) Clinical signs include: palatal ulcer, facial swelling, multiple clouded sinuses
C) Leukemia is the condition most strongly correlated with zygomycosis
D) Tissue necrosis occurs as it is angioinvasive, leading to arterial occlusion and infarction
E) Ubiquitous fungus becomes pathogenic in immunocompromised host
C
What is not a clinical sign of Zygomycosis
A) Proptosis
B) Cranial Nerve Defect
C) Palatal Ulcer
D) Rapid Heart Rate
D
Which of these is a causative organism of necrotising ulcerative gingivitis?
A) Bacillus fusiformis
B) Candida albicans
C) Epstein Barr virus
D) Aspergillus
A
What is the most appropriate differential diagnosis for the below condition?
(Image shows diamond shape inflammation of the tongue with no white changes surrounding it)
A) Benign migratory glossitis
B) Chronic hyperplastic oral candidiasis
C) Median rhomboid glossitis
D) Pseudomembranous oral candidiasis
C
Patient wearing complete dentures presents with redness of mucosa on the denture bearing areas. Upon taking his denture history, the patient reveals that he wears his denture 24 hours a day and does not clean his dentures. What is the most appropriate differential diagnosis?
A) Chronic Erythematous Candidiasis
B) Chronic Hyperplastic Oral Candidiasis
C) Necrotising Ulcerative Periodontitis
D) Pseudomembranous Candidiasis
A
Which of this stains are used to detect Oral Candidiasis through cytologic preparations?
A) Periodic acid-Schiff stain
B) Hematoxylin and eosin stain
C) Gomori methanamine silver (GMS) stain
D) Prussian blue stain
A
Which of the following does not accurately describes the histopathologic features of necrotising ulcerative gingivitis?
A) Extensive bacterial colonization present
B) Finger-like processes of proliferating stratified squamous epithelium
C) Lamina propria infiltrated by thick band of mixed inflammatory cells
D) Non specific features showing ulcerative changes with thick fibrinopurulent membrane
B
Your patient comes in with oral candidiasis. You want to prescribe her with oral fluconazole. She mentions that she is taking a few other medications. Which of the following drugs do you need to ask her to stop taking while she is taking fluconazole?
A) Diclofenac
B) Metformin
C) Paracetamol
D) Simvastatin
D
A 30 year old male comes into your clinic complaining of irritation at his cheek area. He has asthma and uses an inhaler. He has no other medical history, and is alert, normally developed and in no distress when he enters the clinic. He brushes his teeth and flosses twice a day. When you examine his mouth, you notice white patches on his left and right buccal mucosa. You use a gauze to wipe it off and notice the mucosa below is erythematous. No other abnormalities noted.
What would be your clinical diagnosis?
A) Erythematous oral candidiasis
B) Hyperplastic oral candidiasis
C) Pseudomembranous oral candidiasis
D) Zygomycosis
C
Which of the following is false about oral candidiasis?
A) Development of infection is independent of the strain of organisms present.
B) It is the most common oral fungal infection.
C) Usage of Nasonex nasal spray for sinusitis is a risk factor.
D) White lesions can be wiped off by gauze.
A
Your patient is a middle aged male who complains of a foul odour in his mouth and bleeding gums. You observe his papilla have a “punched out” appearance and there are ulcerative lesions covered by greyish pseudomembrane. He shares that he is stressed by his long working hours and has no time to brush his teeth twice a day. Which is not an appropriate treatment for this patient?
A) Frequent rinse with Chlorhexidine
B) Debridement
C) Oral health education to improve oral hygiene
D) Application of Miconazole 2% gel on ulcerated gingiva
D
Which of the following is not a predisposing factor for oral fungal infections?
A) Antibiotic therapy
B) Hyperthyroidism
C) Topical steroids
D) Xerostomia
B
Which of the following is false when considering the type of antifungal therapy the patient needs?
A) Miconazole should not be prescribed to patients who are on statins for hyperlipidemia due to the possible drug-drug interactions
B) Antifungal tablets are the preferred route of delivery for patients with reduced salivary production
C) Gel or topical forms of antifungals are the preferred route of delivery for patients with reduced salivary production
D) Different antifungals are given depending on the ability of the drug to eliminate or control the causative factor
B
Which of the following is NOT a method for diagnosis of oral candiasis?
A) Check Clinically
B) Cytologic Preparations
C) Biopsy
D) Blood Test
D
