Brainscape's Knowledge GenomeTM

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


See full index

DMD3 > Orofacial Infections in Paediatric Dentistry > Flashcards

Orofacial Infections in Paediatric Dentistry Flashcards

1
Q

handbook of paediatric dentistry

A

chapter 10

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

What should be investigated when looking at an oral lesion?

A

VITAMIN DIC

Vascular
Inflammatory
Traumatic
Autoimmune
Metabolic
Infection
Neoplastic
Degenerative
Idiopathic
Congenital
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the types of orofacial infections?

A

Viral (Primary herpetic gingiva-stomatitis, herpes labialis, herpangina, hand foot mouth disease, infectious mononucleosis, and varicella)

Bacterial (odontogenic, scarlet fever, TB, etc)

Fungal (candidosis)

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

What are the most common viral aetiologies for infections of the mouth?

A

Herpes simplex virus type 1 (Primary herpetic gingivostomatitis and herpes labialis)

Epstein Barr virus (Infectious mononucleosis)

Coxsackie A, B, enterovirus 71 (Hand foot mouth disease)

Coxsackie A (herpangina)

Varicella zoster virus (Chickenpox)

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

What is the most common symptom associated with herpes simplex?

A

Ulceration (usually occurs at 6 months of age and coincides with eruption of primary incisors)

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

How common is infection with herpes simplex type 1?

A

60% infected 1% show symptoms

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

What is the clinical presentation of primary herpetic gingivostomatitis?

A

General:

Febrile illness with raised temperature of 37.8 - 38.9 degrees celsius

Headaches, malaise, irritability

Cervical lymphadenopathy

Oral:

Oral pain, mild dysphagia

Stomatitis

Intraepithelial fluid-filled vesicles appear on tongue, lips, buccal and palatal mucosa.

Ulcers can be solitary (Usually small and painful with erythematous margins) or larger and irregular due to coalescence of individual lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Can secondary herpetic gingivostomatitis occur?

A

Secondary recurrent infection can occur and usually occurs in older kids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the incubation time of primary herpetic gingivostomatitits?

A

3 - 5 days (with a prodromal 48-h history of irritability, pyrexia, and malaise)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is primary herpetic gingivostomatitis transmitted?

A

Direct contact with lesions

Contact with infected oral secretions (droplet infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the typical course of primary herpetic gingivostomatitis?

A

Disease is self-limiting

Ulcers heal spontaneously without scarring within 10 - 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the histological features of primary herpetic gingivostomatitis?

A

Tzanck cells: Multinucleated giant cells with jig saw nucleus

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

How is primary herpetic gingivostomatitis diagnosed?

A

History, clinical features and age group of affected children

Exfoliative cytology: presence of multinucleated giant cells and viral inclusion bodies can be used for rapid diagnosis.

Viral antigen

Viral culture

Viral antibody detection in blood samples

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

What are the differentials for primary herpetic gingivostomatitis?

A

Necrotizing ulcerative gingivitis

Erythema multiforme

Herpangina

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

What are the complications that can arise from primary herpetic gingivostomatitis?

A

Very rarely, it can lead to:

Aseptic meningitis

Encephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is primary herpetic gingivostomatitis treated?

A

Encourage oral fluids

Bed rest + soft diet

Analgesics (paracetamol 15mg/kg, 4 - 6 hourly)

Mouthwashes (chlorhexidine can be swabbed over the affected areas in younger children and in older children mouthwash can be used 10mL 4 hourly)

Antiviral chemotherapy: Oral and intravenous acyclovir is approved for use in children (20mg/kg body weight 5 hourly or IV 10mg/kg) although evidence of efficacy is limited.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Should topical therapies be used for primary herpetic gingivostomatitis?

A

No recommended due to concern over systemic overdose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which mouthwashes can be used for primary herpetic gingivostomatitis?

A

Young children: Swab chlorhexidine on the ulceration.

Older children: Chlorhexidine mouthwash 0.2%, 10mL 4 hourly

Children >12 years old: Tetracycline or minocycline mouthwashes can be used.

Difflam C can be helpful in addition.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What causes herpes labialis?

A

Recurrence of herpes simplex virus type 1 on the vermilion border and adjacent skin of the lips.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What triggers herpes labialis?

A

UV light and trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the prodromal signs and symptoms of herpes labialis?

A

Symptoms most severe in the first 8 hours

Pain, burning, itching, tingling, and warmth

Erythema 6 - 24 hours before lesions develop

Multiple small, erythematous papules develop

Clusters of fluid filled vesicles

Vesicles rupture and crust within 2 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the the typical course of herpes labialis?

A

It is self limiting and heals within 7 - 10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is infectious mononucleosis transmitted?

A

Intimate contact usually:

Main route of transmission is by blood or saliva

Intrafamilial spread is common, once a person is exposed EBV remains in the host for life.

Children get it often from contaminated saliva on fingers, toys, or other objects.

Adults usually contract the virus directly through salivary transfer such as shared straws or kissing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the symptoms of infectious mononucleosis?

A

Low-grade fever

Hepatosplenomegaly

Rhinitis or cough

Malaise, headache

Cervical lymphadenopathy and tenderness

Oral ulcers, palatal petechiae, and gingival ulcerations (necrotizing ulcerative gingivitis), tonsillitis with or without pharyngitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the typical course of infectious mononucleosis?

A

The disease is self-limiting and resolves within one or two weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the histopathological features of infectious mononucleosis?

A

Downey cells - atypical lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the differentials for infectious mononucleosis?

A

Trauma

Reactive gingival lesions

Haematological disorders (Thrombocytopaenia, platelet disorders, and haemorragic telengiactasia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How is infectious mononucleosis diagnosed?

A

History + clinical features

Atypical lymphocytes on blood film

Positive heterophile antibody test (Monospot test and Paul-Bunnel agglutination test)

Indirect immunofluorescent assays

Real-time PCR

29
Q

How is infectious mononucleosis treated?

A

Most cases resolve within 4 to 6 weeks

Otherwise symptomatic treatment.

30
Q

What are the potential significant complications of EBV infection?

A

Splenic rupture

Thrombocytopaenia

Autoimmune haemolytic anaemia

Aplastic anaemia

Neurological problems

Myocarditis

Haemophagocytic lymphohistiocytosis

Patients experience fatigue lasting for several weeks to months in <10% of cases)

Increased risk for developing MS later in life

Burkitt lymphoma association with EBV

31
Q

What causes herpangina?

A

Coxsackie group A viruses

32
Q

Who is most commonly affected by herpangina?

A

Mainly children <10 years of age

33
Q

How is herpangina transmitted?

A

Faecal-oral route

34
Q

How long is herpangina’s incubation time?

A

4 - 7 days

35
Q

What are the general symptoms fo herpangina?

A

Low-grade fever, malaise, headache

Sore throat, dysphagia, anorexia, rhinorrhea

Vomiting diarrheoa

Myalgia

Oral lesions

36
Q

What do herpangina oral lesions look like?

A

Red macules (usually 2 - 6) which form fragile vesicles that ulcerate rapidly (2 - 4mm)

37
Q

Where do herpangina oral lesions form?

A

Palate

Pillars of the fauces and pharynx

Herpangina lesions do not coalesce to form large areas of ulceration

38
Q

What is the course of disease of herpangina?

A

Self-limiting healing occurs within 1 - 2 weeks

39
Q

What are the histopathological features of herpangina?

A

Intraepithelial vesicles containing eosinophilic exudate.

Nuclear ballooning degeneration of epithelial cells

40
Q

What is the differential diagnosis of herpangina?

A

Other viral mucosal ulcers

41
Q

How is herpangina diagnosed?

A

Known epidemic

Viral culture from swab

Clinical appearance and history

42
Q

How is herpangina managed?

A

Symptomatic care

Adequate hydration

Analgesisa for pain control and antipyretics

43
Q

What are the potential complications of herpangina?

A

Pneumonia

Pulmonary oedema

Haemorrhage

Acute flaccid paralysis

Encephallitis meningitis

Carditis

44
Q

What is the viral aetiology of hand foot and mouth disease?

A

Coxsackie A

Coxsackie B

Enterovirus 71

45
Q

What age and gender commonly is affected by hand foot and mouth disease?

A

Mainly children <10 years old

No gender predilection

46
Q

What are the general features of hand foot mouth disease?

A

Low-grade fever

Sore throat, dysphadia

Cough, rhinorrhea, anorexia, vomiting, diarrhoea, myalgia and headache

Cutaneous lesions on the palms and soles and ventral surfaces and sides of he fingers and toes, buttocks

47
Q

What do the oral lesions in hand foot mouth disease look like?

A

Resemble those of herpangina (more numerous and frequently involve anterior regions of the mouth)

Appearance of red macules which form fragile vesicles that rapidly ulcerate

Number of lesions ranges from 1 to 30

48
Q

Where are the oral lesions usually appear in the oral mucosa?

A

Buccal and labial mucosa

Tongue

Palate

Pillars of the fauces and the pharynx

49
Q

How do the cutaneous lesions in hand foot mouth disease form?

A

Cutaneous lesions begin as erythematous macules that develop central vesicles and heal without crusting

Nail loss or ridges form and may ensure after several weeks

50
Q

What is the typical course of disease hand foot mouth disease?

A

Usually a self limiting disease

51
Q

What are the histopathological features of hand foot mouth disease?

A

Intraepithelial vesicles: early stages with intracytoplasmic eosinophilic inclusion bodies

Later stages: Shallow ulcerations and erosions with regeneration of the amrginal epithelium

Superficial inflammatory cell infiltrate in submucosa

52
Q

What are the differentials for hand foot and mouth disease?

A

Herpetic gingivostomatitis

Herpangina

Varicella

Aphthous stomatitis

53
Q

How is hand foot and mouth disease diagnosed?

A

Clinical appearance and history

Known epidemic

Viral culture from swab

54
Q

What are the complications of hand foot mouth disease?

A

Neurological complications

Viral meningitis

Encephalitis

Cerebellar ataxia

55
Q

Who most commonly gets varicella?

A

Chicken pox in children

Shingles in older adults

56
Q

How is varicella transmitted?

A

Spread through air droplets

Direct contact with active lesions

57
Q

What is the incubation period of varicella?

A

10 to 21 days (avg 15 days)

58
Q

How does chickenpox present in immunized children?

A

Maculopapular, cutaneous rash with only a small number of lesions

Oral: Few or no vesicles.

59
Q

What is the typical course of varicella?

A

A shortened disease course of 4 - 6 days

60
Q

How does chickenpox present in unimmunized children?

A

General:

Malaise, pharyngitis, nausea, anorexia, and vomiting.

Skin:

intensely pruritic exanthema

Vesicular stage (each vesicle is surrounded by a zone of erythema.

Lesions continue to erupt for 4 or more days and old crusted lesions intermixed with newly formed, intact vesicles

61
Q

What do the oral lesions of varicella look like?

A

Begin as 3 to 4mm, white, opaque vesicles.

Vesicles rupture to form 1 to 3 mm ulcerations.

62
Q

Which sites on the oral mucosa are mostly affected by varicella?

A

Vermillion border and palate most frequently

Buccal mucosa and gingival less frequently

63
Q

How long do oral ulcerations last in varicella infections?

A

In mild cases = 1 to 3 days. (1 - 2 ulcers)

In severe cases = 5 - 10 days. (up to 30 ulcers)

64
Q

When is the immunization to chickenpox provided?

A

at 18 months MMR, and chickenpox

65
Q

What are the histopathological features of varicella?

A

Cytological alterations identical to HSV

Virus causes acantholysis, formatino of numerous free-floating Tzanck cells, which exhibit nuclear margination of chromatin and occasional multinucleation

66
Q

How is varicella diagnosed?

A

Viral cytology

PCR on vesicular fluid/cells from base of lesion/scab from resolving skin lesion

Direct fluorescent antibody assay

67
Q

How is varicella treated?

A

Symtomatic treatment: Warm baths with soap, baking soda, or colloidal oatmeal.

Application fo calamine lotion

Antihistamines

Antipyretics

Antiviral meds have been shown to reduce duration if administered with 24 hours of the rash

68
Q

What are the potential complications of a varicella infection?

A

Encephalitis

Pneumonia

Necrotizing fasciitis

Septicemia

Toxic shock syndrome

Other life threatening conditions

DMD3 (53 decks)

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