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Oral biology - histology and oral med > Microbiology - candida/caries/perio > Flashcards

Microbiology - candida/caries/perio Flashcards

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1
Q

Patients at risk of candidal inf

A 
Immuno-compromised patients
Immunosuppressive drugs
Advanced HIV infection
Intra-abdominal surgery
Central venous catheter
Parenteral nutrition
Broad-spectrum antibiotics
Dialysis
Colonization at a sterile site
Diabetes
Burn unit patient
Trauma patient
Long-term corticosteroid use
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2
Q

classifications of oral candidosis

A
  • pseudomembranous - thrush
  • erythematous - denture induced stomatitis
  • Hyperplastic - chronic hyperplastic candidosis
  • angular chelitis
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3
Q

denture induced stomatitis - classification

A

Newton’s classsification

  • 1 - localised inflam
  • 2 -diffuse inflam
  • 3 - Granular inflam
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4
Q

signs/symps of denture induced stomatitis

A 
Signs and symptoms
• Inflamed mucosa – particularly under
upper denture
• Burning sensation
• Discomfort
• Bad taste
• In most cases patients are unaware
of the problem!
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5
Q

name some candida species

A

Candida albicans
• Candida glabrata
• Candida parapsilosis
• Candida tropicalis

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6
Q

name some hydrolytic enzymes

A

Phospholipase Lipid Host cell penetration
Haemolysin Red blood cells Facilitates hyphal invasion
Proteinase Proteins Adhesion to epithelial cells

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7
Q

antifungal drugs and their action
-what drugs are sensitive
-

A

-Nystatin - all species sensitive/poor patient compliance
NOT ANTIBACTERIAL

  • miconazole - variable sensitivity/ANTI STAPHLOCOCCAL
  • Fluconazole - C. GLABRATA IS RESISTANT
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8
Q

what branch of antifungals are INEFFECTIVE against biofilms

A

AZOLES

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9
Q

what is plaque

A 
‘a diverse microbial community
(predominantly bacteria) found
on the tooth surface, embedded
in a matrix of polymers of
bacterial and salivary origin
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10
Q

what is the SDCEP treatment for pseudomembranous and erythematous candidosis

  • local
  • antifungal
A
  1. local - if inh user - wash out with water after use and brush teeth after
  2. antifungals
    - fluconazole 50mg capsules
    - miconazole - oromucosal gel 20mg
    - Nystatin oral suspension - 100,000 units
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11
Q

treatment for denture induced stomatitis

  • local
  • antifungals
A

denture OHI

  • fluconazole 50mg capsules
  • micoazole oromucosal gel
  • nystatin oral suspension 100,000u
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12
Q

why is miconazole used in cases of angular chelitis

A

miconazole is affective against gram positive cocci and candida species, except those on statins

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13
Q

treatment for angular chelitis

A

miconazole cream - 2%
sodium fusidate ointment 2%
miconazole cream 2% and hydrocortisone cream 1%
miconazole cream2% and hydrocortisone ointment 1%

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14
Q

name some cariogenic bacteria

A

Streptococcus mutans
– Lactobacillus acidophilus
– Actinomyces viscosus
– Nocardia spp.

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15
Q

caries progression - biofilm stages

A

adhesion/survival and growth/biofilm production/complex plaque/acid/caries

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16
Q

virulence factors of strp mutans

A

Adhesins
– SpaP (AgB, AgI/II, PI) – makes up fibrillar layer of cell wall
• Binding proteins
– glucosyltransferases, frucosyltransferases, glucan binding protein
• Sugar modifying enzymes
– Fructanase, dextranase
• Polysaccharides
– Protection (matrix) and storage (glycogen)
• Acid tolerance and adaptation
– ATPase (F1F0 ATPase or H+ ATPase)

17
Q

critical pH of mouth - caries

A

pH 5.5

18
Q

acid tolerance properties

A

Maintains pH balance
– Extrusion of H+ ions through a proton translocating F1-F0
ATPase (maintains physiological pH levels)
• Alters cell membrane
– Increase in the proportion of mono-unsaturated
membrane fatty acids – decreased proton permeability
• Protection and repair mechanisms
– Up-regulation of molecular chaperones, proteases and
DNA repair mechanisms

19
Q

virulence factors of P ging

A 
Host cell 0ssue adherence and invasion
– Fimbriae
• Elabora0on of proteases – ‘cocktail of degrada0ve enzymes’
– collagenase
– fibrinolysin
– phospholipase A
– phosophatases
• Endotoxin (LPS)
• Capsular polysaccharide & outer membrane vesicles
• Tissue toxic metabolic by-products
– hydrogen sulfide
– ammonia
– faey acids
20
Q

how does perio disease manipulate the host immune system

A

Biofilm lifestyle
• Gingipains
– Degrada0on of innate receptors
– Degrada0on of cytokines – e.g. IL-8, ICAM-1
• Induc0on of 0ssue destruc0on – MMP’s
• Subversion – intracellular and ‘tricking’ host
immunity

Oral biology - histology and oral med (3 decks)

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