Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Professional Practice > Oral Candidiasis > Flashcards

Oral Candidiasis Flashcards

1
Q

Pathophysiology of oral candidiasis

A
  • AKA thursh, oral candidosis, pseudomembranous candidiasis or moniliasis
  • mucocutaneous opportunisic infection caused by Candida species
  • Candida organisms = fungi that noramlly live in oral cavity (25-75% peole have it)
  • if normal flora compromised, Candida voergrowth and direct tissue invasion can occur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is most common fungal infection found in immunocompetent and immunocompromised populations

A
  • oral candidiasis
  • prevalence is greatest among infants and elderly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what disease states are risk factors for developing oral canidiasis

A

Addison disease

Anemia (due to iron, folic acid or vitamin B12 deficiency)

Diabetes mellitus

HIV infection and AIDS

Hypothyroidism

Leukemia and head/neck cancer

Psoriasis

Sjogren syndrome

Xerostomia (dry mouth); may be caused by anticholinergic drugs, radiation therapy, dentures or dental appliances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what mediciations are risk factors for Oral candidiasis

A

Broad-spectrum antibiotics

Cytotoxic chemotherapy

Immunosuppressive drugs

Inhaled corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are risk factors associated with oral candidiasis tht are not diseae states or medications

A
  • infancy/childhood (underveloped immune system)
  • local mucosal trauma
  • organ and stem cell transplantation
  • parenteral nutrition
  • poor dental or denture hygiene
  • pregnancy
  • smoking tobacco

surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what candidia species causes more oral candidal ifnections

A

C. albicans (90% cases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

relationship between HIV and oral candidial ifnection

A
  • HIV pandemic contributed greatly to resurgence of oral candidial infect
  • mitigated by effeective antiretroviral therapy
  • patients with low CD4 counts and/or AIDS can experience recurrent infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are goals of oral candidal infection therapy

A
  • resolve infection or reduce acute candidal overgrowth to level that can be controlled by host defences -> prevent complication
  • prevent recurrences by managing underlying risk factors (use of inhaled corticosteroirds, poor dental hygiene, uncontrolled diabetes mellitus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how to asses patients with oral candidiasis

A
  • based on clinicla recognition of typical lesions, microbiologictests or suspected resistance to antifungal agent
  • can be localized (primary oral candidiasis): acute pseudomembraneous (thursh), erythematous or hyperplastic candidiasis
  • can also be menifestation of a generalized candidal infection (secondar oral candidiasis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

assessment of Acute pseudomembranous candidiasis

(thrush)

A
  • creamy whitish yellow elevated plaques -> tongue, soft palate and inner cheek
  • plaques easily wiped off exposing a raw, erthematous base that is not usually painful
  • commonly diagnoses in frist few weeks of infants life, in elderly patients and those with underling HIV infection
  • can persits for several months or years esp if taking inhaled or intraoral topical corticosteroids or HIV infected individuals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

assessment of Erythematous candidiasis (atrophic candidiasis)

A
  • found on palate and tongue, can cause depapillation and dekeratinization
  • lesions vary in size and accompanied by inflammation of surrounding tissues
  • develop from pseudomembranous candidiasis as plaques are shed, exposing the underlying erythematosus lesions.
  • often follows use of broad spectrum antibiotics or inhaled corticosteroids
  • most common varient in HIV infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

assessment of hyperplastic candidases

A

(candidal leukoplakia)

  • chronic discrete lesions that appear as small translucent white plaques or larger opauqe lesions on tongue, palate or inner cheek
  • cannoy be wiped off easily like with pseudomembranous variant

*less common, often seen in smokers and males over 30y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what type of oral candidiasis is condeired pre maligant

A

Hyperplastic candidiasis (candidal leukoplakia)

(biopsy recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

assessment of Denture stomatitis

A

Chronic, red, edematous lesions on the denture-bearing mucosa of denture wearers.

Although usually symptomless, some result in mild soreness, burning or tingling beneath the denture.

(approx 50% of complete denture wearers experience denture stomatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Assessment of Angular cheilitis

A

Sore, erythematous fissuring at the angles of the mouth due to a mixed bacterial-fungal infection

commonly associated with denture stomatitis.

  • can be sign of vit B12, folic acid or iron deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Non pharmacologic therapy for candidiasis treatment

A

0 elimiate underlying factors for opportunisitc infection can be sufficient to help flora return to normal

  • but usually antifungal agent is required
17
Q

relationship between inhaled corticosteroids and development of oral candidiasis

A
  • assocaited with use of inhaled corticosteroids
  • can reduce the risk by usign a spacer device with metered dose inhalers, rinsing mouth and garlign with water after use, or decreasing dose if appropraite to prevent recurrent episodes of oral candidiasis
18
Q

relationship with dentures and oral candidiasis

A
  • can cause denture stomatitis or angular cheilitis
  • advise patient to:
  • remove dentures overnight and store in water
  • wear for no longer than 6 hours to allow gums to heal and reduce inflammation
  • clear dentures daily with cleaner, soak 30 min daily in proper disinfecting solution,
  • celam gums, tongue and affected mucosa area with soft tootherbursh
  • review proper fitting of dentures with oral health practiioner
  • stop smoking
19
Q

assocaition of xerostomia and oral candidiasis

A

Xerostomia = (Dry Mouth)

  • dry mouth can be caused by medication, and then lead to candidiasis
  • > suggest medication review and assessment: reduce dose or stop offending agent if possible
  • keep mouth moist by frequent sips of water, sucking on ice chips or sugar free lozenges
20
Q

what are the 3 common antifungal categories for treating oral candidiasis

A

Polyees (nystatin), azoles ((fluconazole, itraconazole, posaconazole) and echinocandins (anidulafungin, caspofungin, micafungin)

21
Q

what drug is most commonly used to tear mild oral candidiasis/ initial episodes

A

topical nystatin

  • well tolerated, does not interact with toher medications bc not largely absorbed from GI tract when administed orally

*resistance of fungi to polyenes is rare

22
Q

Why are azoles the second line therapy

A
  • mroe effective but cause mergence of azole resistant Candida strains
  • usually will prescribe fluconazole, but if resistant to that then itraconazole or posaconazole
23
Q

Why is gentian violet no longer used to treat oral candidiasis

A
  • solution was applied locally for treatment
  • the 1% concentration caused mucosal irritation, ulceration and staining -> difficult to determine therapeutic progress and decreasing adherence
  • has also been linked to carcinogenicity in animal studies so health canadia issues recall advising against do to inc risk of cancer upon exposure
24
Q

role of probiotoics for prevention of oral candidiasis

A

-some evidence by decreasing the growth of candida

25
Q

NHP for candidiasis treamtent

A

insufficient evidence

26
Q

monitoring of therapy for treatment of oral candidiasis

A
  • most patients respond to antifunal therapy rapidly - imrpvoement to signs and symptoms can occur within 48-72 hours
  • adivose patients to monitor symptoms on daily basis during treatment and for up to 2 weeks after clearing of symptoms
  • since associated with immunocomprimised states, need to be careful to treat early bc infection could spread
    • monitor patients taking broad spectrum antibiotics, undergoing chemotherapy or rradiation or taking carticosteroids orally or by inhaltion for signs and symptoms of oral candidasis
27
Q
A
28
Q

dose, adverse effects, drug interactions for oral candidiasis treatment with

diflucan

A
  • Dose
    • 100-200 mg daily f7-14d
    • preventative for recurrent infections: 100mg 3x weekly (can be daily for HIV patients(
  • Adverse effects
    • abdonimal pain, diarrhea, neusea, vomiting
  • drug interactions
    • rifampin enhaces fluconazoel metabolism (may need inc dose)
    • monitor prothrombin time in patiens receiving fluconazole and warfarin

*recommended treatment for mederate -> severe

  • drug of choice for HIV/AIDS patients
29
Q

dose, adverse effects, drug interactions for oral candidiasis treatment with

Itraconazole (sporanox)

A
  • Dose
    • capsules: 100-200 mg daily f2w
    • solution: 200 mg daily PO 1-2 weeks (up to 4 weeks to treat in fluconazole refractory disease
  • Adverse efects
    • abdominal pain
    • constipation
    • diarrhea
    • dypspepsia, heart failure, hepatotoxicity, yhpokalemia, nausea, pruritus, pulmonary edma, rash, vomiting
  • Drug interactions
    • mainly metabolized by CYP3A4, if substance share this pathway or modify its activity will influence pharmacokinetics
30
Q

dose, adverse effects, drug interactions for oral candidiasis treatment with

posaconazole (posanol)

A
  • Dose
    • Oral suspension: 100mg BIG day 1, then 100 mg 1d f13d
    • HIV infected patients: 400 mg BIG PO dat 1, then 400 mg 1d f14d
    • fluconazole refractory disease: 400mg bid f3d then 400mg daily f4w
  • Adverse efects
    • diarrhea, headache, nausea
  • Adverse drug interactions
    • medabolized bia UDP glucoronidation -> substrate for P glycoprotein
      • inhibitors or induced of clearance pathway can affect conc
    • strong inhibitor of CYP3A4 to can raise plasma levels of drugs metabolized through that pathway
31
Q

dose, adverse effects, drug interactions for oral candidiasis treatment with

Nystatin

A
  • Dose
    • swish and swallow 400,000 - 600,000 units QID PO x f7-14d
    • infants: 100,000 units in each side of mouth QID f7-14d
  • adverse effects
    • diarrhea, GI irritation, neusea, rash urticaria, vomiting
  • drug interactions
    • no clincally significant drug interactions
    • GI absorption is insignificant

*recommended for initial episodes or mild disease, not as effective as azoles

Professional Practice (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions