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Oral Path 1 > L5 > Flashcards

L5 Flashcards

1
Q

Candida albicans _____ yeast

A

Dimorphism

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2
Q

Candida albicans yeast form

A

Commensal

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3
Q

Candida albicans hyphal form

A

Pathogen

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4
Q

Ability of Candida albicans to undergo

A

Transformation to hyphal form under appropriate conditions producing germinate energy or germ tubes

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5
Q

Candida albicans depends on 3 factors

A

The host immune statue
Oral mucosal environment
The virulence of the candidal strain

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6
Q

Oral Candida albicans presentation

A

Pseudomembranous

Erythematous

Hyperplastic

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7
Q

Pseudomembranous Candidiasis

A

White curdled milk or cottage cheese like plaque

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8
Q

Pseudomembranous Candidiasis common sites

A

Buccal mucosa palate or tongue

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9
Q

Pseudomembranous Candidiasis symptoms

A

Might be asymptomatic but boring or unpleasant taste occasionally

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10
Q

Erythematous Candidiasis

A

Areas of redness variable borders

tongue is common site may involve palate oral commissures perioral skin

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11
Q

Acute Atrophic Candidiasis

A

AKA antibiotic sore mouth

Diffuse atrophy of dorsal tongue papillae, particularly after broad spectrum antibiotics

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12
Q

Acute Atrophic Candidiasis symptoms

A

Acute onset

Typically associated with burning sensation

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13
Q

Central Papillary Atrophy due to

A

chronic Candidiasis

Usually asymptomatic

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14
Q

Central Papillary Atrophy appearance

A

Well defined area of redness mid posterior dorsal tongue

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15
Q

Denture Stomatitis

A

Denture contaminated with Candidiasis organisms but no invasion of mucosa is seen

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16
Q

Denture stomatitis appearance

A

Erythema of palate denture bearing area typically asymptomatic

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17
Q

Angular Cheilitis

A

Usually related to candidiasis but may have other cutaneous bacterial micro flora admixed

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18
Q

Angular Cheilitis appearance

A

Redness, cracking of corners of mouth

Often waxes and wanes

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19
Q

Angular Cheilitis resents

A

Well to topical antifungal therapy

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20
Q

Perioral Candidiasis

A

Often associated with lip licking or chronic us of petrolatum based materials

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21
Q

Perioral Candidiasis appearance

A

redness cracking of cutaneous surface

Responds to antifungals

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22
Q

Chronic multifocal candidiasis

A

patient will have angular cheilitis, central papillary atrophy and a kissing lesion of the posterior hard palate

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23
Q

Hyperplastic Candidiasis

A

Also known as candidal leukoplakia

CANNOT be rubbed off

Uncommon anterior buccal mucosa

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24
Q

Chronic mucocutaneous candidiasis

A

Associated with specific immunologic defects related to how the body interacts with Candida albicans

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25
Q

Invasive Candidiasis

A

Seen in situations of severe uncontrolled diabetes mellitus or immune suppression

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26
Q

The candidal hypahe never

A

Penetrate deeper than the keratin layer in almost all cases

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27
Q

Candidiasis Treatment

A

Depends on the severity of the infection

Superficial oral mucosal infections can usually be treated with one of the milder topical or systemic antifungal agents

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28
Q

Life threatening infections

A

Intravenous amphotericin B

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29
Q

Clotrimazole (Mycelex)

A

Imidazole antifungal agent

No significant absorption or side effect

Pleasant lozenges

5x per day

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30
Q

Nystatin

A

Not absorbed systemically

Tastes bitter multiple dosing, patient compliance

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31
Q

Fluconazole

A

Triazole antifungal agent

Readily absorbed systemically

Daily dosing

Expensive

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32
Q

topical antifungals

A

Treatment of angular cheilitis or perioral candidiasis

Mycolog II cream

Vytone Cream

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33
Q

Mycolog II cream

A

Combination of nystatin and triamcinolone

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34
Q

Vytone Cream

A

Combination of iodoquinola and hydrocortisone

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35
Q

Histoplasmosis Acute

A

May have flu like illness

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36
Q

Histoplasmosis chronic

A

Cavitation pulmonary lesions

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37
Q

Histoplasmosis disseminated

A

Elderly debilitated or immunocompromised

38
Q

Histoplasmosis affects

A

Tongue palate or buccal mucosa

39
Q

Histoplasmosis presents as

A

A chronic variably painful ulcer or granular erythematous plaque

40
Q

Histoplasmosis

A

Granulomatous inflammation with or without necrosis

41
Q

Acute histoplasmosis treatment

A

No treatment is necessary

42
Q

Chronic histoplasmosis Treatment

A

may be required amphotericin B

43
Q

________ for mild cases or as maintainence therapy

A

Ketoconazole or itraconzaole

44
Q

Acute histoplasmosis prognosis

A

Good

Chronic -fair

Disseminated- Poor

45
Q

Valley fever represents a

A

A hypersensitivity Coccidioidomycosis

46
Q

Coccidioidomycosis spread

A

Inhalation of spores

47
Q

Coccidioidomycosis symptoms

A

Flu like illness in most

48
Q

Coccidioidomycosis appears

A

Skin of central face may be affected

Oral lesion are rarely described

49
Q

Coccidioidomycosis histopath shows

A

Large 20-60 micron spherules that contain endospores

50
Q

Coccidioidomycosis host response

A

Ranging from acute to granulomatous inflammation

51
Q

Coccidioidomycosis diagnosis

A

Made by culture or biopsy

52
Q

______for disseminated Coccidioidomycosis

A

Amphotericin B

53
Q

Mild case treatment of Coccidioidomycosis

A

Fluconazole or itraconazole

54
Q

Coccidioidomycosis may be more aggressive in

A

POC

55
Q

Coccidioidomycosis fungi

A

Coccidioides immitis

56
Q

Cryptococcosis fungi

A

Cryptococcus neoformans

57
Q

Cryptococcus neoformans lives in

A

Pigeon dropping’s

58
Q

Cryptococcus neoformans transmitted by

A

Airborn spores

59
Q

Cryptococcus neoformans (cryptococcosis) affects

A

Immunosuppressed patients almost exclusively

60
Q

Cryptococcosis disseminates to

A

Meninges resulting in headache vomiting neck stiffness

61
Q

Cryptococcosis initial

A

Pulmonary infection with flu like symptoms

62
Q

Cryptococcosis histopathology

A

4-6 micron yeasts with a clear halo-mucopolysacccharide capsule

63
Q

Cryptococcosis severe treated

A

Amphotericin B and flucytosine

64
Q

Cryptococcosis prognosis

A

Poor due to patients being immunocompromised

65
Q

Zygomycosis also known as

A

Mucormycosis

66
Q

Zygomycosis(Mucormycosis) affects

A

Severe diabetic or immunocompromised patient

67
Q

Zygomycosis(Mucormycosis) _______form in oral region

A

Rhinocerebral

68
Q

Zygomycosis(Mucormycosis) clinical signs

A

Black necrotic lesions
Bloody nasal discharge
Facial swelling
Palatal perforation

69
Q

Zygomycosis(Mucormycosis) progresses to

A

Visual disturbances/blindness

Seizures and death occur with intracranial invasion

70
Q

Zygomycosis (Mucormycosis) diagnosis

A

Based on histopathology findings cant culture well

71
Q

Zygomycosis (Mucormycosis) histopathology

A

Large branching nonseptate hypahe with extensive tissue necrosis

72
Q

Zygomycosis (Mucormycosis) hyphae

A

Are often seen plugging small blood vessels

73
Q

Zygomycosis (Mucormycosis) treatment

A

Surgical Debridement

IV amphotericin B

If patient is diabetic control of diabetes is important

Poor prognosis

74
Q

Aspergillosis spectrum

A

Disease that includes:
allergy
Localized infection
Invasive Aspergillosis

75
Q

Aspergillosis spores in

A

Soil
Water
Decaying organic debris

76
Q

Aspergillosis can be a ________ infection

A

Nosocomial

77
Q

Aspergilloma

A

Maxillary sinus fungus ball

78
Q

Aspergillosis tissue damage

A

Locally invasive

79
Q

Aspergillosis immunocompromised patient

A

Disseminated

80
Q

Aspergillosis diagnosis

A

Biopsy shows branching spectate hyphae

81
Q

Aspergillosis _______by hyphae

A

Occlusion of small blood vessels

82
Q

Aspergillosis if the patient is not immune compromised

A

Granulomatous inflammation

83
Q

Aspergillosis Non invasive tx

A

Debridement

84
Q

Aspergillosis invasive Tx

A

Voriconazole or itraconazole with or without Debridement

85
Q

Aspergillosis prognosis

A

Good is normal immune

Poor if immunocompromised

86
Q

Amphotericin B is used

A

Via IV for life threatening systemic fungal infections

87
Q

Ketoconazole

A

Systemically absorbed -imidazole

Requires acidic stomach environment

Single dose daily

88
Q

Itraconzaole

A

Approved for treating histoplasmosis

Well absorbed

Minimal side effects

89
Q

Voriconazole

A

IV or oral

Candida
Aspergillus
Several other species

Photosensitive side effect

90
Q

1st line therapy against invasive aspergillosis

A

Voriconazole

Oral Path 1 (4 decks)

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