oral med - candida and viral lesions

Question 1

predisposing factors for candida infection - local and systemic

Answer 1

local - xerostomia, denture wearer, poor denture hygiene
systemic - smoking, radiotherapy, HIV, corticosteroid therapy, diabetes, nutritional deficiencies

Question 2

diagnostic tests for candida

Answer 2

swab/ smear - localised area
rinse - widespread area but dilute sample

Question 3

what are the 4 categories or oral candida infection

Answer 3

pseudomembranous - white plaques that can be scraped off
erythmatous - usually denture stomatitis or HIV induced
angular chelitis - commisures of mouth
chronic hyperplastic - OPMD!, white lesion at commisures/ angles

Question 4

local measures for candida infections

Answer 4

• good denture and oral hygiene
• advice re inhaler use (use spacer, rinse after use)
• CHX 0.2% MW
• tissue condioner (denture stomatitis)

Question 5

antifungal medications for candida infections

Answer 5

miconazole 2% cream for angular chelitis
miconazole 20mg/g gel for denture stomatitis
nystatin 100000 unit oral rinse
fluconazole 50mg capsules

Question 6

typical appearance of chronic hyperplastic candidosis

Answer 6

white lesion at commisures/ angle of mouth
requires biopsy - OPMD!

Question 7

tx of chronic hyperplastic candidosis

Answer 7

requires biopsy - OPMD
risk factor modification - smoking, nutritional deficiencies
antifungal tx - fluconazole
- excision may be indicated if dysplasia present

Question 8

how does herpes simplex infection present

Answer 8

primary infection
- children - gingivostomatitis
- adults - pharyngitis
secondary infection - herpes labialis (cold sores)

Question 9

varicella zoster infection

Answer 9

primary - chicken pox
secondary - shingles

Question 10

signs/ symptoms of herpetic gingivostomatitis

Answer 10

common in children
- fever
- irritable
- painful mouth ulcers and lip blisters
- poor appetite or reluctance to drink

Question 11

herpetic gingivostomatitis intra oral findings

Answer 11

vesicular lesions on gingivae, palate, buccal and labial mucosa that rupture
desquamative gingivitis

Question 12

treatment of herpetic gingivostomatitis

Answer 12

1 - bed rest, fluids, CHX MW
severe infection or immunocompromised - aciclovir 5 day regimen

Question 13

cold sore treatment

Answer 13

aciclovir 5% cream
best results if applied in prodromal phase

Question 14

intra oral manifestations of HIV

Answer 14

ANUG
erythmatous and pseudomembranous candida
hairy leukoplakia

Question 15

hairy leukoplakia presentation

Answer 15

white corrugated patches on side of tongue

common in HIV patients, brought on by EBV