Infective Stomatitis - Bacterial

Question 1

Impetigo is a skin infection caused by:

Answer 1

Streptococcus pyogenes & Staphyloccus aureus

Question 2

Impetigo affects what age group?

Answer 2

Young children

Question 3

What location on the body does impetigo present>

Answer 3

Face & Extremities

Facial lesions usually develop around the nose and mouth.

Question 4

What things predispose someone to impetigo infection

Answer 4

Poor hygiene
Crowded living conditions
Hot & humid climate
Previous trauma: abrasions, insect bites, dermatitis

Question 5

How is Impetigo spread?

Answer 5

Through skin contact

Question 6

How does impetigo present?

Answer 6

Vesicles that rupture, leaving light brown (amber) colored crusts (cornflakes glued to the surface)

Question 7

In what specific way does impetigo differ from HSV

Answer 7

lesions persist until treated. This is unlike HSV

Question 8

How is Impetigo treated?

Answer 8

Topical or Systemic antibiotics

• mupirocin topical
• cephalexin, dicloxacillin

Question 9

Tonsillitis and pharyngitis in origin is due to what?

Answer 9

Bacterial or viral in origin:

group A, beta-hemolytic streptococci

Question 10

Tonsillitis and pharyngitis cause what hallmark condition?

Answer 10

Strep Throat
- sore throat, headache, fever, tonsillar hyperplasia, yellowish tonsillar exudate, erythema, palatal petechiae, and lymphadenopathy

Question 11

What age group does Tonsillitis and pharyngitis target?

Answer 11

Children aged 5-15 years

Question 12

How is Tonsillitis and pharyngitis spread?

Answer 12

Spread by contact with infectious nasal or oral secretions.

Question 13

How to treat Tonsillitis and pharyngitis

Answer 13

Culture & treat with antibiotics:

- penicillin, amoxicillin, cephalosporin

Question 14

Complications of Strep throat

Answer 14

Scarlet fever
Rheumatic fever
Glomerulonephritis

Question 15

Characteristics of Scarlet fever

Answer 15

• Group A, beta-hemolytic streptococci
• children aged 3-12 years
• organisms elaborate an erythrogenic toxin that attacks blood vessels
• Skin rash, fever, palatal petechiae, “strawberry tongue”

Question 16

Characteristics of Rheumatic fever

Answer 16

Affects heart, joints, central nervous system, damages heart valves

Question 17

Syphillis is caused by?

Answer 17

Treponema pallidum

Question 18

How is Syphilis spread?

Answer 18

Direct contact with mucosal surfaces (sexual contact, mother to fetus)

Question 19

There is an increased incidence of Syphilis in what groups of people

Answer 19

African Americans
Prostitutes
Drug abusers

Question 20

How common is Syphilis in the U.S. compared to other countries

Answer 20

50-100x higher prevalence in the U.S. compared with other industrialized countries

Question 21

Describe primary syphilis

Answer 21

• Chancre: painless ulcer at site of inoculation
• External genitalia, anus, lip
• 3-90 days after initial exposure
• regional lymphadenopathy
• TPHA + FTA-ABS (????)
• Highly infectious

Question 22

Describe secondary syphilis

Answer 22

• 4-10 weeks after initial infection
• Mucous patches
• “snail track” ulcers
• Condylomata lata (papillomas), maculopapular cutaneous rash
• Lymphadenopathy, sore throat, fever
• Highly infectious

Question 23

Laten syphilis

Answer 23

1-30 years

Question 24

Describe Tertiary syphilis

Answer 24

• develops in 30% of patients
• Gumma : unique type of necrosis
• indurated, nodular or ulcerated lesion
• intramurally, usually affects palate (perforation) or tongue
• Glossitis, atrophy and loss of dorsal tongue papillae (Luetic glossitis)
• Syphilitic leukoplakia
• Cardiovascular system and CNS involvement

Question 25

Describe congenital syphilis

Answer 25

Frontal bossing Underdeveloped Mx High arched palate Saddle nose deformity

Question 26

Hutchinson's triad

Answer 26

Interstitial keratitis of cornea VIII nerve deafness Dental abnormalities - screwdriver-shaped "Hutchinson's incisors" - "mulberry molars" bumps on occlusal surface

Question 27

Blood tests in Congenital Syphilis

Answer 27

VDRL and RPR - sensitive but not specific TPHA and FTA-ABS Mucosal smear not recommended, oral flora has spirochetes - Antibiotics: penicillin

Question 28

Tuberculosis is caused by:

Answer 28

Mycobacterium tuberculosis: | - acid-fast bacillus

Question 29

What is Tuberculosis

Answer 29

Primary infection of lungs

Question 30

What contributes the progression of Tuberculosis from an infection to active disease?

Answer 30

Immunodeficiency (old age, poverty, HIV/AIDS)

Question 31

How is Tuberculosis spread?

Answer 31

Spread through airborne droplets from patients with active disease

Question 32

Clinical features of Tuberculosis

Answer 32

``` Fever night sweats fatigue weight loss productive cough hemoptysis - Lymph node involvement "Scrofula" ```

Question 33

Tuberculosis chronic direct infection with skin causes what?

Answer 33

Lupus vulgaris

Question 34

Tuberculosis direct infection orally causes what features?

Answer 34

Chronic painless ulceration usually involving tongue or palate - atypical periodontal disease

Question 35

Biopsy of Tuberculosis shows what?

Answer 35

Tissue culture and biopsy shows grandmas with central areas of necrosis

Question 36

What tests are done for Tuberculosis

Answer 36

1. AFB - Acid fast bacillus stain shows typical red bacilli 2. PCR (polymerase chain reaction) 3. PPD skin test and chest radiograph

Question 37

What treatment is used for tuberculosis

Answer 37

Isoniazid (INH) | rifampin

Question 38

Actinomycosis is caused by what?

Answer 38

Actinomyces israelii: normal saprophytic anaerobic inhabitant of oral cavity

Question 39

In what group of people is Actinomycosis common

Answer 39

History of surgery or trauma

Question 40

Where does Actinomycosis occur most commonly?

Answer 40

55% of cases occur in cervicofacial areas | - injury, periodontal pocket, nonmetal tooth, extraction socket, infected tonsil

Question 41

How does Actinomycosis present?

Answer 41

Abscesses and draining sinus tracts | - Culture: colonies of organisms are yellow "sulphur granules"

Question 42

How do you treat Actinomycosis

Answer 42

Long-term high doses of antibiotics - can range from 6 weeks to 12 months, depending on extent of infection. Localized acute infections (periodical or pericoronal actinomycosis) may be treated more conservatively. - removal of infected tissue usually produces sufficient aeration that antibiotics aren't needed (follow-up)

Question 43

Necrotizing Ulcerative Gingivitis is caused by what?

Answer 43

Bacillus fusiformis | Borrelia vincetii

Question 44

When does NUG most frequently occur?

Answer 44

during situations of stress, immunodeficiency or malnourishment

Question 45

What age group is most affected by NUG

Answer 45

Young and middle-aged adults

Question 46

How does NUG present orally

Answer 46

- Interdental papillae are highly inflamed and hemorrhagic - Papillae are blunted with areas of "punched-out" necrosis that are covered with a grape pseudomembrane - Fetid odor and intense pain

Question 47

How do you treat NUG

Answer 47

- Debridement by scaling or curettage - Chlorhexidine rinses - Systemic antibiotics if fever or lymphadenopathy is present.