Microbiology-Oral, Esophagus & Stomach Infections Flashcards

1
Q

What pathogens have adapted to overcome the natural defense of secretory IgA in the saliva?

A

Neisseria gonorrhoeae, strep pneumoniae and Hib all release proteases that destroy IgA.

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2
Q

Which streptococcus species are found in our normal oral flora?

A

Alpha-hemolytic (green partial hemolysis). This group includes strep pneumoniae and strep viridans.

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3
Q

What bacteria are included in the strep viridans group?

A

Strep with no defined Lancefield carbohydrate antigen on its surface. (mutans, mitts, sanguinis, etc.)

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4
Q

A patient comes to see you with many dental caries. Analysis of the bacteria in her mouth shows over-colinization of a normal flora that also exists in the vaginal and GI tract. What is the bug?

A

Gram-positive lactobacilli.

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5
Q

What is bacteria’s role in development of periodontitis?

A

It must be present, but is not sufficient to cause disease. Typical periodontitis happens when the ratio of anaerobes : aerobes is 1000:1.

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6
Q

What systemic problems can be caused by periodontitis?

A

Diabetes, Cardiovascular disease and adverse pregnancy outcomes.

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7
Q

Name 7 common oral pathogens

A

Staph, strep pyogenes (beta hemolytic), HSV, HPV, Coxsackievirus, Candida and many anaerobes.

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8
Q

Over-colonization of strep pyogenes can cause what condition in the throat? The skin?

A

Throat: pharyngitis Skin: scarlet fever, impetigo and cellulitis

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9
Q

What organism likely caused the lesions shown below?

A

Staph. Coagulase negative (mucosistis) and positive (aureus) staph causes stomatitis (colonization and ulcerations in the oral cavity)

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10
Q

What virus can cause these types of oral lesions?

A

HSV-1. Rarely HSV-2 can cause these lesions during oral sex.

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11
Q

What virus can cause these types of infections?

A

Coxsackie A virus, a picornavirus, is responsible for the herpangina seen in hand, foot and mouth disease.

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12
Q

What virus is responsible for the oral lesions shown below?

A

HPV 16 & 18 are responsible for these verrucous lesions. Note that these are the most common STI.

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13
Q

Which of the images below is pathogenic?

A

The hyphal form (right) is the form in which candida has ability to invade tissue and cause oral thrush.

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14
Q

What microbes can be responsible for esophagitis?

A

HSV, CMV, HPV and Candida. Note that these types of infections are typically found in immunocompromised individuals.

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15
Q

What microbes can cause gastritis?

A

1) Gram negative, urease positive, microaerophilic H. pylori. CMV and HSV can also cause gastritis.

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16
Q

50% of the world is colonized with H. pylori in their stomach. What percentage of people will go on to develop symptoms?

A

Of that 50%, 20% will go on to develop clinical symptoms to include: gastritis, adenocarcinoma, ulcers and MALT lymphoma.

17
Q

What percentage of gastric cancers are associated with H. pylori? MALT lymphoma?

A

70-90% of gastric cancers. 90% of MALT lymphoma

18
Q

How does H. pylori survive in the acidic stomach?

A

Urease. It catalyses urea to ammonia and CO2, which neutralizes the environment.

19
Q

What toxins released by H. pylori contribute to its pathogenicity?

A

VacA activates mitochondria apoptosis signals and inhibits T-cell activation. CagA is an oncoprotein because it changes many cellular signaling pathways.

20
Q

Diagnosing H. pylori infection

A

Clo test (culture after biopsy, shown below), radioactive breath test, biopsy, stain (Wurthin-Starry shown below), serum antibodies, fecal antibodies.

21
Q

Treating H. pylori

A

Triple therapy (Amoxicillin, Clarithromycin + PPI)

22
Q

Why not treat everybody with triple therapy?

A

It may be a protective normal flora and getting rid of it may cause esophageal cancer, active Tb and asthma.