Week 3 Flashcards
People who get Opportunistic fungal infections
always found on the body
- Diabetic
- Malignancies (adv.)
- Radiation
- Immunosuppressed
Do opprotunistic fungal infections perforate the palate like Deep fungal infections?
Yes
Anachoresis occurs in Opprotunistic fungal infections?
Yes (true)
Opprotunistic fungal infections
- Which are shaped as L
- Which as Y
L is Aspergillosis
Y is Mucormycosis (Phy)
What is the treatment for Opprotunistic fungal infections
Amphotericin B
3 most common Immunologic diseases
- Aphthous ulcers
- Drug reaction
- Erythema Multiforme
Aphthous Ulcers
-What predisposes one to them? (4)
- Women
- Allergies
- Stress
- Acidic Foods
At what rate in a year would one be concerened about RECURRENT Aphthous ulcers having a systemic underlying CAUSE?
5-6 in SAME location in a Year.
What are some systemic implication for RECURRENT aphthous ulcers? (4)
- Vitamin deficiencies
- Celiacs
- Crohn’s
- AIDS
Three types of Aphthous ulcers? (3)
- Minor
- Major
- Herpetiform
Characteristics of minor Aphthous Ulcers?
-size, shape, Number, location
size-0.5 cm
Shape-oval
Number-1to5
Location-Mucosa (mobile non-keratinized)
Characteristics of minor Aphthous Ulcers?
- Pain
- Scarring
Moderate to mild Pain
No scarring (primary healing)
Characteristics of Major Aphthous ulcers?
-size, shape, Number, location
Size-1.0cm
Shape-RAGGED oval
Number-1to10
Location-Mucosa (mobile non-keratinized)
Characteristics of Major Aphthous Ulcers?
- Pain
- Scarring
ExTREME Pain
Has scarring (secondary healing)
Characteristics of Herpetiform Aphthous ulcers?
-size, shape, Number, location
**PHOTO is on test (MANY little lesions!!!)
Size-0.5cm
Shape-oval
Number-10to100
Location-Usually not gingiva (but can be anywhere)
Aphthous ulcer Differencial (4)
HSV
Truamatic ulcers
Neutropenia
Vesiculobullous ulcers
Treatment of Aphthous ulcer? (4)
Steroids (topical or systemic)
Topical tetracycline
Debacterol–>Chemical cauterization
**Topical tetracycline (Low dose Doxy) Helps to differentiate Seondary HSV from aphthous ulcers, as the tetracycline is NOT effective against HSV (viral).
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Recalcitrant means?
Chronically Recurrent (ulcers) -biopsy them
What is the cause of a recalcitrant Aphthous ulcer?
Crohn’s disease
recalcitrant Aphthous ulcer
-histopathology
-NON-caseating granulomas
***Crohn’s has skip lesions (repeated endoscopes required) hard to diagnose
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Behcet’s Syndrome
- Age
- Sex
- HS Type (1-4?)
age - 20-30
sex - males
Hypersensitivity - IV Delayed
Behcet’s Syndrome
- Triad of involvement (3)
- HLA type
- Mouth
- Eyes
- Genitals
HLA-B51
Behcet’s Syndrome
- Initial manifestation
- Key systemic symptom
MAJOR ‘Aphthous’ ulcers (ragged ovals)
-Systemic Arthritis
Behcet’s Syndrome Treatments (2)
Steroids
Immunosuppresive medications
Reiter’s
- Age
- Sex
- Location
- Age 30-40
- White men
- Location: Hard palate* or tongue
Reiter’s
-Triad
- Polyarthritis(joints)
- Conjunctivitis(eyes)
- Urethritis(PEEPEE)
Reiter’s
-HLA?
HLA-B27
Reiter’s
-Pain level?
No pain
Reiter’s
-Treatment
NSAIDS/Antibiotics for shigella
Erythema Multiforme
- Hypersensitivity type
- Two types
- Hypersensitivity 3 (targets SMALL blood vessels)
1. Major (stevens-johnson)
2. Minor
Erythema Multiforme
- What bring on major vs minor?
- Location of Major vs minor
Major- Drugs (Oral, skin, genital, EYES)
Minor-HSV sequelae (Oral and skin only)
Erythema Multiforme
-What is unique about the systemic distribution of the lesions?
They are symmetrical.
Erythema Multiforme
-Main indicator for MAJOR vs minor
Crusting lips
-and eye involvement/Genital
**Erythema Multiforme can not be differenciated using DIF testing (no antibodies are pathognomic)
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Erythema Multiforme
-Differential (4)
- HSV
- Aphthous
- PV/MMP
- EROSIVE Lichen planus
Erythema Multiforme
-Treatment
Steroids
-and treat sypmtoms
What Antibody is active for Adverse Drug Reactions (ADR’S)
IgE
What is Major symptom of ADR’s?
Angioedema
Angioedema
-Causes of angioedema (3)
- Hereditary (Loss of C1 esterase)
- ACE inhibitor (drug rxn)
- Contact allergy (latex)
Differential for Lichenoid Mucositis (5)
- Lichen planus
- Red and white Plakia
- MMP and PVulgaris
- Erythema Multiforme
- Aphthous
Stomatitis Medicamentosa
Allergic rxn to systemic drugs (FAST) Dangerous
?Probs Type 1 hypersensitivity
Stomatitis Venenata A.K.A=Contact Mucositis
-Type HS?
Allergic reaction via Direct skin contact
-Type 4 hypersensitivity
**Plasma cell GIngivitis is a contact Mucositis
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Wegener’s Granulomatosis
-3 types
- Classic
- Limited
- Superficial
Wegener’s Granulomatosis
-Triad (which TYPE does the tirad apply to?)
- Upper/lower respiratory
- Skin
- Renal
- –Classic Wegener’s
Wegener’s Granulomatosis
Primary oral Finding?
Strawberry gingivitis
***IT is a vasculitis
Wegener’s Granulomatosis
-Problem with Strawberry GING (2)
- Destruction of underlying bone
- –Also causes Ging hyperplasia
Wegener’s Granulomatosis
-What is pathognomic for wegeners?
a POSITIVE cANCA test
Wegener’s Granulomatosis
-Treatment
Immunosuppresion
-chemo
**Tcell lymphoma will perf the palate. Duh
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