Orofacial fungal infections

Question 1

Chronic use of broad spectrum antibiotics and corticosteroid use can lead to what?

Answer 1

Erythematous candiaisis

Question 2

What can a patient consume to help manage Pseudomembranous candidiasis?

Answer 2

Live active yoghurt

Question 3

What is the mechanism of action for echinocandins antifungal agents?

Answer 3

Inhibition of β1,3 D-glucan synthesis

Question 4

What condition is this?

Answer 4

Chronic hyperplastic candidosis (candidal leukoplakia)

(white erythematous raised lesions which do NOT rub off)

Question 5

What is the mechanism of action for polyene antifungal agents?

Answer 5

Disruption of fungal cell membrane

Question 6

What condition is this?

Answer 6

CHRONIC ERYTHEMATOUS CANDIDOSIS

(DENTURE STOMATITIS)

Question 7

What topical agents can be given to the patient to manage Pseudomembranous candidiasis? (3)

Answer 7

Cholorhexidine mouth wash

Nystatin suspension

Miconazole oral gel

Question 8

Where does Erythematous candidosis commonly occur?

Answer 8

Commonly occurs on dorsum of tongue and palate

Question 9

Clinically what can you see in this image?

Answer 9

Hyperplastic white areas

Question 10

What are the newton classifications for denture stomatitis?

Answer 10

Type 1 - pinpoint inflammation

Type 2 - Diffuse inflammation in denture area

Type 3 - Granular inflammation

Question 11

Give some examples of azole anti fungal agents (3)

Answer 11

Fluconazole

Miconazole

Ketoconazole

Question 12

What are the types of acute candidosis?

Answer 12

Pseudomembranous candidosis

Erythematous candidosis

Question 13

What is a common site for erythematous candidosis?

Answer 13

Common on the dorsum of the tongue and palate

Question 14

What is this condition?

Answer 14

Denture stomatitis (Chronic erythematous candidosis)

Question 15

What dieatry factors could lead to an increased risk of candidosis?

Answer 15

Deficiencies in the following;

Iron

Folate

Vitamin A

Vitamin B12

Vitamin C

Question 16

What are some factors that could increase the chance of angular chelitis? (5)

Answer 16

Lip morphology

Xerostomia

Broad spectrum antibiotics

Diabetes

HIV

Question 17

Consuming live active yogurt can help treat what condition?

Answer 17

Psuedomembranous candidiasis

Question 18

What is the link between xerostomia and candidiasis?

Answer 18

Reduced salivary flushing leads to a reduction in anti fungal salivary components

Question 19

What can be prescribed to manage Chronic hyperplastic candidiasis?

Answer 19

2-4 weeks of oral fluconazole

Question 20

What is the mechanism of action for azoles antifungal agents?

Answer 20

Inhibition of ergosterol synthesis

Question 21

What demographics have increases of candida species in the mouth? (3)

Answer 21

Pregnancy

Smokers

Denture wearers

Question 22

What condition is this?

Answer 22

Median rhomboid glossitis

(you can see diamond-shaped smooth area anterior to circumvallate pappillae)

Question 23

Give some examples of polyenes anti fungal agents (2)

Answer 23

Nystatin

Amphoterecin

Question 24

What is the link between diabetes and candida?

Answer 24

Poorly controlled diabetics have a higher Candidal carriage

Question 25

What is the clinical presentation of Chronic hyperplastic candidiasis?

Answer 25

White to erythematous raised lesions which do not rub off

Question 26

What can be applied to the surface of a denture to manage denture stomatits?

Answer 26

Miconazole gel

Question 27

What is the principle oral fungi found in the mouth?

Answer 27

Candida albicans

Question 28

Give some examples of echinocandins anti fungal agents (3)

Answer 28

Caspofungin Micofungin Anidulafungin

Question 29

Which blood type is at an increased risk of candidosis? What antigens are present in this blood type?

Answer 29

Blood type O Large amount of H antigens present in O blood which acts as receptors for C. albicans

Question 30

What condition is this?

Answer 30

Chronic hyperplastic candidosis (candidal leukoplakia) (white erythematous raised lesions which do NOT rub off)

Question 31

What may you see on the mucous surface of a patient with Pseudomembranous candidosis?

Answer 31

Detachable confluent creamy-white or yellowishpatches

Question 32

What is the clincial name for denture stomatitis?

Answer 32

Chronic erythematous candidosis

Question 33

What is the mechanism of action for 5-FLUCYTOSINE antifungal agents?

Answer 33

Inhibition of protein and DNA synthesis

Question 34

What is the link between immunodeficency and candidosis?

Answer 34

Oral candidosis may be first presentation of immunodeficiency Cell-mediated immunity and humoral immunity important in prevention and elimination of fungal infections

Question 35

What topical agents can be prescribed to patients in the management of angular chelitis? (2)

Answer 35

Miconazole oral gel Trimovate cream

Question 36

What can be prescribed to a patient with Chronic hyperplastic candidosis (candidal leukoplakia)?

Answer 36

2-4 weeks oral fluconazole | (50mg OD)

Question 37

What medications lead to a predisposing factor for candidiasis?

Answer 37

Broad spectrum antibiotics Corticosteroids