LS PII Flashcards
Four distinct forms of primary oral candidiasis
Pseudomembranous candidiasis – “Thrush”
“White Plaques Hide Red Layers Silently”
W: Whitish-yellow plaques on mucosa and tongue.
P: Plaques detach easily, revealing red, slightly bleeding mucosa.
H: Hyphal invasion reaches the stratum spinosum; may extend deeper in immunocompromised patients.
R: Risk factors: Antibiotics, corticosteroids, immunosuppressants, diabetes, anemia, leukemia.
L: Low immunity common in infants (5%) and immunocompromised individuals.
S: Often silent (asymptomatic).
Pseudomembranous candidiasis – “Thrush”
“Pretty Awesome Criminals Hate Hygiene”
P: Pseudomembranous Candidiasis - Whitish-yellow plaques that scrape off, leaving red, bleeding tissue.
A: Acute Atrophic Candidiasis - Localized redness and burning, commonly on the tongue and palate; linked to antibiotics.
C: Chronic Erythematous Candidiasis - Red, inflamed mucosa under dentures due to poor hygiene or continuous wear.
H: Hyperplastic Candidiasis - Thick white plaques, resistant to scraping, with potential for malignant transformation.
H: Hygiene and Host Factors - Loves environments with poor hygiene, reduced saliva, or antibiotic/steroid use.
This mnemonic captures the main oral manifestations and the opportunistic nature of Candida albicans in a memorable way.
Mnemonic for Acute Atrophic (Erythematous) Candidiasis:
“Red Tongue Feels Painful After Antibiotics”
R: Red mucosa on tongue, palate, or buccal surfaces.
T: Tongue and palate are the most common sites.
F: Fewer bacteria due to broad-spectrum antibiotics or corticosteroids, allowing Candida to thrive.
P: Pain or burning may accompany the redness.
A: Antibiotic cessation resolves the condition by restoring bacterial balance.
Mnemonic for Acute Atrophic (Erythematous) Candidiasis:
“Red Tongue Feels Painful After Antibiotics”
R: Red mucosa on tongue, palate, or buccal surfaces.
T: Tongue and palate are the most common sites.
F: Fewer bacteria due to broad-spectrum antibiotics or corticosteroids, allowing Candida to thrive.
P: Pain or burning may accompany the redness.
A: Antibiotic cessation resolves the condition by restoring bacterial balance.
**“Pretty Awesome Criminals Hate Hygiene”
**
P: Pseudomembranous Candidiasis - Whitish-yellow plaques that scrape off, leaving red, bleeding tissue.
A: Acute Atrophic Candidiasis - Localized redness and burning, commonly on the tongue and palate; linked to antibiotics.
C: Chronic Erythematous Candidiasis - Red, inflamed mucosa under dentures due to poor hygiene or continuous wear.
H: Hyperplastic Candidiasis - Thick white plaques, resistant to scraping, with potential for malignant transformation.
H: Hygiene and Host Factors - Loves environments with poor hygiene, reduced saliva, or antibiotic/steroid use.
This mnemonic captures the main oral manifestations and the opportunistic nature of Candida albicans in a memorable way.
Chronic erythematous candidiasis (denture stomatitis)
Red Dentures Cause Messy Nightcare”
R: Red mucosa beneath denture fitting surface (mostly palatal).
D: Denture hygiene is key; Candida colonizes the denture, not the mucosa.
C: Continuous wear or poor fit worsens the condition.
M: Miconazole applied to the denture surface for treatment.
N: Nightcare: Remove dentures while sleeping;
Non-metal dentures: Soak in 0.1% hypochlorite overnight.
Metal dentures: Soak in chlorhexidine.
“Pretty Awesome Criminals Hate Hygiene”
P: Pseudomembranous Candidiasis - Whitish-yellow plaques that scrape off, leaving red, bleeding tissue.
A: Acute Atrophic Candidiasis - Localized redness and burning, commonly on the tongue and palate; linked to antibiotics.
C: Chronic Erythematous Candidiasis - Red, inflamed mucosa under dentures due to poor hygiene or continuous wear.
H: Hyperplastic Candidiasis - Thick white plaques, resistant to scraping, with potential for malignant transformation.
H: Hygiene and Host Factors - Loves environments with poor hygiene, reduced saliva, or antibiotic/steroid use.
This mnemonic captures the main oral manifestations and the opportunistic nature of Candida albicans in a memorable way.
“Pretty Awesome Criminals Hate Hygiene”
P: Pseudomembranous Candidiasis - Whitish-yellow plaques that scrape off, leaving red, bleeding tissue.
A: Acute Atrophic Candidiasis - Localized redness and burning, commonly on the tongue and palate; linked to antibiotics.
C: Chronic Erythematous Candidiasis - Red, inflamed mucosa under dentures due to poor hygiene or continuous wear.
H: Hyperplastic Candidiasis - Thick white plaques, resistant to scraping, with potential for malignant transformation.
H: Hygiene and Host Factors - Loves environments with poor hygiene, reduced saliva, or antibiotic/steroid use.
This mnemonic captures the main oral manifestations and the opportunistic nature of Candida albicans in a memorable way.
“Thick White Smoking Danger”
T: Thickened white plaques (commissural region, dorsum of tongue).
W: White patches don’t rub off (distinguishes from pseudomembranous candidiasis).
S: Smoking habit almost always present.
D: Danger of malignancy (higher dysplasia risk, biopsy essential).
Key Points:
Management: Fluconazole 50 mg daily for 7-14 days + stop smoking.
Message: Inform patients of malignancy risk.
Secondary forms of oral candidiasis
“Angry Rhomboid Chronicity”
A: Angular Cheilitis - Erythematous, fissured lesions at mouth angles; linked to dentures, reduced vertical dimension, or nutritional deficiencies.
R: Rhomboid Glossitis (Median) - Symmetrical midline lesion on the tongue’s dorsum; associated with smoking and steroid inhalers.
C: Chronic Mucocutaneous Candidiasis - Candida infections on mucosa, skin, and nails; caused by congenital impaired immunity against Candida.
Oral Candidiasis Treatment:
Mnemonic for Oral Candidiasis Treatment:
“Never Forget Friendly Miconazole Care”
N: Nystatin - Oral suspension (100,000–600,000 IU/ml) as a rinse; hold before swallowing. Effective for localized oral candidiasis.
F: Fluconazole - Tablets: 200 mg on day 1, followed by 100–200 mg daily for 7–14 days. Suspension available for oral rinses.
F: Flucytosine - Systemic candidiasis: 250 mg twice daily or 10 mg/ml rinse for oropharyngeal forms (7–14 days).
M: Miconazole (Daktarin Oral Gel) - Effective for oral and throat infections but contraindicated with Warfarin.
C: Care for Dentures:
Acrylic: Soak in 0.5% sodium hypochlorite (1:10 bleach to water) for 10 minutes.
Metal-based: Use 0.2% chlorhexidine or antifungal solutions (e.g., Nystatin).
This mnemonic summarizes the treatments, key medications, and special considerations for managing oral candidiasis effectively.
r Rare Fungal Infections:
“All Cool Histories Need Perfect Memories”
A: Aspergillosis
C: Cryptococcosis
H: Histoplasmosis
N: North American Blastomycosis
P: Paracoccidioidomycosis (South American Blastomycosis)
M: Mucormycosis (zygomycosis, phycomycosis)
This mnemonic organizes the rare fungal infections for easier recall.
Aspergillosis – “The Necrotic Nightmare”: A vascular invader that thrives in weakened defenses, leaving necrosis and destruction in its wake.
Cryptococcosis – “The Silent Invader”: Hides in pigeon droppings, infiltrates the lungs, and spreads stealthily to the brain.
Histoplasmosis – “The Granuloma Gangster”: A spore-breathing outlaw causing ulcers and nodules, especially in immunocompromised hosts.
North American Blastomycosis – “The Lung Bandit”: Targets the lungs and spreads its gritty lesions to the skin and bones.
Paracoccidioidomycosis – “The Latin Lurker”: A fungal rogue causing chronic ulcers and scarring, endemic to South America.
Mucormycosis – “The Flesh-Eating Fiend”: Rapidly devours tissue in diabetic and immunocompromised victims, leaving destruction in its path.
Aspergillosis – “The Necrotic Nightmare”: A vascular invader that thrives in weakened defenses, leaving necrosis and destruction in its wake.
Cryptococcosis – “The Silent Invader”: Hides in pigeon droppings, infiltrates the lungs, and spreads stealthily to the brain.
Histoplasmosis – “The Granuloma Gangster”: A spore-breathing outlaw causing ulcers and nodules, especially in immunocompromised hosts.
North American Blastomycosis – “The Lung Bandit”: Targets the lungs and spreads its gritty lesions to the skin and bones.
Paracoccidioidomycosis – “The Latin Lurker”: A fungal rogue causing chronic ulcers and scarring, endemic to South America.
Mucormycosis – “The Flesh-Eating Fiend”: Rapidly devours tissue in diabetic and immunocompromised victims, leaving destruction in its path.
Aspergillosis – “The Necrotic Nightmare”: A vascular invader that thrives in weakened defenses, leaving necrosis and destruction in its wake.
Cryptococcosis – “The Silent Invader”: Hides in pigeon droppings, infiltrates the lungs, and spreads stealthily to the brain.
Histoplasmosis – “The Granuloma Gangster”: A spore-breathing outlaw causing ulcers and nodules, especially in immunocompromised hosts.
North American Blastomycosis – “The Lung Bandit”: Targets the lungs and spreads its gritty lesions to the skin and bones.
Paracoccidioidomycosis – “The Latin Lurker”: A fungal rogue causing chronic ulcers and scarring, endemic to South America.
Mucormycosis – “The Flesh-Eating Fiend”: Rapidly devours tissue in diabetic and immunocompromised victims, leaving destruction in its path.
Mnemonic for Blastomycosis: “BLAST Lesions Often Need Treatment”
B: Blastomyces dermatitidis - Chronic fungal infection.
L: Lungs and Skin commonly affected; oral/nasal lesions in 25%.
A: Any organ can be affected if disseminated (bones, marrow, genitals).
S: Squamous cell carcinoma, TB, and syphilis mimic oral lesions (ddx)
T: Treatment with ketoconazole, fluconazole, itraconazole, or amphotericin B.
Aspergillosis – “The Necrotic Nightmare”: A vascular invader that thrives in weakened defenses, leaving necrosis and destruction in its wake.
Cryptococcosis – “The Silent Invader”: Hides in pigeon droppings, infiltrates the lungs, and spreads stealthily to the brain.
Histoplasmosis – “The Granuloma Gangster”: A spore-breathing outlaw causing ulcers and nodules, especially in immunocompromised hosts.
North American Blastomycosis – “The Lung Bandit”: Targets the lungs and spreads its gritty lesions to the skin and bones.
Paracoccidioidomycosis – “The Latin Lurker”: A fungal rogue causing chronic ulcers and scarring, endemic to South America.
Mucormycosis – “The Flesh-Eating Fiend”: Rapidly devours tissue in diabetic and immunocompromised victims, leaving destruction in its path.
Mnemonic for Paracoccidioidomycosis: “PARA Ulcers Leave Painful Marks”
P: Paracoccidioides brasiliensis - Chronic granulomatous disease.
U: Ulcers with irregular borders and granular surface in oral cavity.
L: Lungs, lymph nodes, and mucocutaneous areas commonly affected.
P: Palate perforation in severe cases; soft/hard palate, tongue, and gingiva involved.
M: Mimics malignancies (SCC, TB, syphilis, lymphoma, etc.).
T: Treatment with Amphotericin B, ketoconazole, or itraconazole.
This mnemonic summarizes the key features and management for easy recall.
Mnemonic for Mucormycosis: “MUCOR Eats Bones Quickly”
M: Mucormycosis - Rare, fatal, acute fungal infection in immunocompromised patients.
E: Eschar lesions - Sharply demarcated ulcers with black necrotic tissue and exposed bone.
B: Blood vessel destruction - Causes thrombosis, ischemia, and necrosis.
Q: Quick spread - Rhino-cerebral form most common; other forms include pulmonary, gastrointestinal, and disseminated.
T: Treatment with Amphotericin B + surgical debridement.
Microorganisms Responsible
The likely culprit for the inflammation under the denture is Candida albicans, a fungus that thrives in moist, warm environments like the area under dentures. This condition is called denture stomatitis, and Candida is the primary pathogen.
Answer in Mnemonic: “RED CANDIDA”
R: Remove dentures overnight to let gums rest.
E: Elderly risk—less saliva and health issues like diabetes increase Candida growth.
D: Disinfect dentures with bleach (acrylic) or chlorhexidine (metal).
C: Clean daily—food and moisture trapped under dentures feed fungi.
A: Antifungals like Nystatin or Miconazole to kill Candida.
N: No tight fit—check dentures for irritation.
D: Don’t ignore redness—it stops at the denture border.
I: Identify systemic issues like diabetes.
D: Dry areas help—removing dentures at night reduces fungal growth.
A: Apply antifungal gel on the denture for quick action.
Summary in Lay Terms: Candida loves dark, moist places under dentures. Clean them daily, disinfect, use antifungals, and let gums rest at night. That’s how to evict this fungal squatter!
Describe the clinical presentation of herpangina and its typical oral manifestations.
“Fevered Ulcers Sorely Taste Painful.”
Fevered = Sudden Fever
Ulcers = Small vesicles rupture to form shallow ulcers
Sorely = Sore throat
Taste = Affects soft palate, tonsils, and uvula
Painful = The ulcers are painful
Co-infection with which virus is known to exacerbate periodontal disease in HIV-positive patients?
A Influenza
B Herpes Simplex Virus HSV C Hepatitis C
D Epstein-Barr Virus EBV
What are non-odontogenic infections?
Answer Infections that come from other areas around the mouth, such as the skin, tonsils, or sinuses.
Explanation Sometimes, infections in the mouth donʼt start with the teeth. They can come from other places like your skin or sinuses and then affect your mouth.
What are the typical clinical features (signs) of an odontogenic infection?Answer Severe pain, tenderness when chewing, fever (pyrexia), and swollen lymph nodes (lymphadenopathy).
Explanation If you have an infection in your teeth, it can make your tooth hurt really badly, feel sore when you chew, give you a fever, or make your neck swell up.
How can odontogenic infections lead to more serious problems in the body?
Answer They can spread to other parts of the face, neck, or even into t
What are the three main pathways through which infections can spread in the body?
Answer Through connective tissue spaces (fascial spaces), the lymphatic system, and the bloodstream.
Explanation Infections can travel around the body by moving through soft tissues, lymph nodes, or the blood.
Infections can spread to certain spaces in the face. Name at least two spaces where infection may spread and mention the type of teeth that usually cause the infection.
Answer Buccal space (between the cheeks) and masseteric space (near the jaw), often caused by molar (back) teeth infections.
Explanation Infections from teeth, especially the back ones, can spread to areas in the cheeks or jaw.
Why is it dangerous if an infection spreads to the lateral pharyngeal space, and what serious complication can occur?
Why is it dangerous if an infection spreads to the lateral pharyngeal space, and what serious complication can occur?
Answer The infection can spread to the neck and cause a descending neck infection, which can affect breathing and even reach the chest (mediastinum).
Explanation If the infection moves to this area, it can cause neck swelling and trouble breathing, and it can spread down to the chest, making it really dangerous.
How do infections that spread through the retropharyngeal space connect with the mediastinum, and why is this dangerous?
Answer The retropharyngeal space connects the back of the throat with the chest (mediastinum), and infection here can spread to the chest area, which can be life-threatening.
Explanation If germs spread from the throat down to the chest, it can cause serious complications, including chest infections that are very hard to treat.
What is the buccal space, and what infection source commonly affects it?
Answer The buccal space is located between the cheek muscles and is commonly affected by infections from the molar (back) teeth.
Explanation The buccal space is in your cheek area, and infections from your back teeth can spread there, causing swelling.
Where is the masseteric space located, and which teeth infections usually cause issues in this space?
usually cause issues in this space?
Answer The masseteric space is between the jawbone (mandible) and the masseter muscle, and it’s usually affected by infections from lower molar teeth.
Explanation This space is near the jaw, and infections from lower back teeth can cause problems there, often leading to trouble opening your mouth.
What is the significance of the pterygomandibular space in dentistry?
What is the significance of the pterygomandibular space in dentistry?
Answer It contains important nerves, including the inferior alveolar nerve, and is important for giving local anesthesia (numbing shots) in dental procedures.
Explanation This space is important because dentists inject numbing medicine here to stop you from feeling pain during certain dental procedures.
Which important structures are found in the carotid sheath, and why are infections in this area a concern?
Which important structures are found in the carotid sheath, and why are infections in this area a concern?
Answer The carotid sheath contains the carotid artery, jugular vein, and vagus nerve. Infections here can affect blood flow and vital functions.
Explanation This area has important blood vessels and a nerve that controls your heart and lungs, so if germs spread here, it can be very dangerous.
What does it mean when the swelling is “fluctuant,” and why is this important?
What does it mean when the swelling is “fluctuant,” and why is this important?
Answer: “Fluctuant” means there is fluid, like pus, inside the swelling, which can be felt when pressing on it.
Explanation If the swollen area feels soft and squishy, it likely means thereʼs pus inside, which signals that the infection needs to be drained.
What supportive treatments may be necessary for severe orofacial infections?
Answer Hydration through IV fluids and keeping the airway open (sometimes through a tracheotomy).
Explanation In serious cases, you might need fluids through a drip to keep hydrated or surgery to help you breathe if the infection is blocking your airway
When would a drain be used, and why is it important in treating an infection?
When would a drain be used, and why is it important in treating an infection?
Answer A drain is used to keep the area open so that pus can continue to drain out after surgery.
Know LO
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Explanation After draining the infection, doctors often leave a little tube in place to keep the area open so the pus doesnʼt build up again.
What is an abscess, and how does the body typically respond to it?
Answer An abscess is a collection of pus that forms due to infection. The body tries to wall it off to prevent the infection from spreading.
Explanation An abscess is like a little pocket of pus that your body creates to trap the infection and stop it from spreading.
fistula vs sinus
A fistula is like a tunnel that forms between an infection (like a dental abscess) and another part of the body, such as the mouth, allowing pus to drain. A sinus, on the other hand, is a one-way track from the infection to the skin or gums, acting as a drain for the abscess.
A fistula is like a secret tunnel that the body creates when an infection (like a dental abscess) needs a way to release pus. This tunnel connects the infected area to another part of the body, like inside your mouth or even another space, so the pus can drain out. It’s a way for your body to relieve pressure, but it means the infection has created a connection it shouldn’t have.
A sinus, on the other hand, is more like a pipe with one end. It starts at the infection and comes out through the skin or gums, letting the pus escape. Unlike a fistula, it doesn’t connect to another internal area—just the outside of the body or mouth.
Think of it this way:
A fistula is a “two-way tunnel” (between two spaces).
A sinus is a “one-way drain” (from inside to outside).
What are the three possible outcomes when the body tries to resolve an abscess?
Answer The abscess can heal and form a scar, form a fistula (a pathway that allows pus to drain), or the infection can spread further.
Explanation The body can either heal the abscess with a scar, create a path for the pus to escape, or the infection can get worse and spread.
What is a fistula, and how is it related to an abscess?
What is a fistula, and how is it related to an abscess?
Answer A fistula is an abnormal pathway that allows pus from the
abscess to drain out of the body.
Explanation A fistula is like a tunnel that the body makes to let the pus from the abscess drain out, which can help relieve pressure.
What is cellulitis, and how is it different from an abscess?
Answer Cellulitis is a diffuse infection that spreads through the skin and tissues, without forming a clear pocket of pus like an abscess.
Explanation Cellulitis is when an infection spreads over a larger area of the skin and tissues, making it swollen and red, but without a pus-filled pocket.
Which of the following is a primary cause of odontogenic infections?
A Viral infections
B Progressive dental caries C Allergic reactions
D Systemic diseases
Correct Answer: B Progressive dental caries
True or False: Odontogenic infections only arise from sources within the oral cavity.
False They can also arise from nonodontogenic sources, such as surrounding skin, tonsils, or sinuses.)
What are the typical clinical features of an odontogenic infection?
Suggested Answer: Typical clinical features include severe pain, tenderness on percussion, pyrexia (fever), and lymphadenopathy (swollen lymph nodes).
Which type of odontogenic infection is commonly associated with trismus and affects the mandibular molars?
A Pterygomandibular space infection B Buccal space infection
C Submental space infection
D Masseteric space infection
D Masseteric space infection
What is the primary difference between a periapical abscess and a periodontal abscess?
What are the potential outcomes if acute periapical periodontitis is left untreated?
Mnemonic: “N.E.S.T.S.”
Necrosis: Untreated leads to pulp death.
End abscess: Progression to a periapical abscess.
Spread: Infection can move to nearby tissues.
Transition: Develops into chronic periapical periodontitis.
Systemic risks: May result in cellulitis, osteomyelitis, or widespread infection.
