Maxofacial Patho Part 2 Flashcards
Cause of Tb
Mycobacterium tuberculosis, bacterial, less common than the other two
Canididiasis
Fungal disease, common
number of deaths from tb
2-3 million per year, particularly immunosuppressed; increasing in foreign born (unmonitored)
Infection of Tb
DOES NOT mean active disease; most that get active disease are simply immunosupressed
where tb effects
pulmonary of course, also extrapulmonary (skin-lupus vulgaris and Cervical Lymph nodes-scrofula)
Scrofula
tb in cervical ln
lupus vulgaris
skin tb
% of people with active oral tb and what is
.5-5%; non healing ulcerus
PPD test
skin test for tb, concern when one goes from negative to positive
Ways to diagnose tb
PPD, Sputum Culture, Histopathology
Microscopic features of Tb
formulation of granulomas-Caseating granuloma-wall of from the body
Caseating Granulomas
in pulmonary Tb-multinucleated balls of macrophages
Langhans Giant cells
Tb
Treatment
- Multi-drug therapy
- MDR-TB
- XDR-TB (extremely resistant to everything)
MDR TB
Multi-Drug Resistance
Moniliasis
Candidiasis-Dimorphic fungus
Dimorphic fungus
yeast form-innocuous
Hyphal form-disease causing
Percentage of population with candidiasis
Common, in elderly, under dentures, not always disease causing
Forms of Candidiasis
Many..
Psudeomembranous
“thrush” white/yellow plaque-red; removable; common in children and geriatric patients
erythematous
Redness; baldness of tongue (lack papilla); scalded symptom (burned tongue)
central papillary atrophy
on dorsal surface of tongue- loss of texture in middle of tongue in circle shape-old name is median rhomboid glossitis
chronic multifocal
many places in the mouth; central pappillary and palate
angular cheilitis
fungal infection at the corner of the mouth
denture stomatitis
under the dentures; often asymptomatic
Hyperplastic
candidiasis-invade epithelium- Will NOT rub off; byproducts are known carcinogens ; topical medications will not work due to penetration
Thrush
psuedomembranous candidiasis; resembles cottage cheese
resembles cottage cheese/curdled milk
thrush, or psuedomembranous candidiasis
stromatopyrosis
burning mouth, thrush
Stomatodynia
sore mouth; thrush
bald tongue
erythematous candidias
rhomboid glossitis aka central papillary atrophy location
@jcn of ant 2/3 and post 1/3 of dorsal tongue
Cause of median rhomboid glossitis
NOT developmental; caused by candidias; do not treat; triangular loss of pappila
Candidiasis that will not rub off
chronic hyperplastic-use systemic antifungals
therapeutic diagnosis
treat without confirming organism; retrospectively note if you were correct
Flourhexidine
Use commonly for perio diseases and candidiasis
Topical or oral for candiadis
topical common; use systemic anti fungal when needed
Double stranded DNA viruses
Herpes
HHV-1
recurrent, travels in nerve ganglia in latent state
reactive HHV
traumas (UV, hormones, illness)
Asymptomatic shedders
shed the virus for 24hrs at a time without showing symptoms-70% of people do
Site Specific
Recurrent lesions found on vermillion border, attached gingiva (keratinized and to bone), and hard palate (keratinized and to bone)
differentiate ulcerus/canker sore cores from HHV
canker sores-everywhere except gingiva an d hard palate (where HHV is)
Tzanch cells
in recurrent herpes simplex; virus travels down the nerve to epithelium; destroys connection between adjacent cells; these cells float around in the blister fluid; these are tzanch cells
Diagnosis of Recurrent herpes simplex
clinical; or serological (detect antibodies) which is less common
