Brainscape's Knowledge GenomeTM

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


See full index

Endo > Micro > Flashcards

Micro Flashcards

1
Q

4 types microbes in canal? most common?

A

bacteria (most), fungi, viral, prion

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

What 2 findings ended focal infection era

A
  1. blayney - endo infection can be treated with good tx

2. grossman - pulpless treated tooth can have healthy PDL

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

Culturing established most infected pulps had what bacteria?

A

73-90% anaerobes

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

Pyrosequencing est how many species bacteria in infected pulps? how many possibl?

A

40, 400+

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

Top 3 root canal bacteria

A

F nucleatum
Strep sp
Bacteroides

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

bacteria vs symptomatic teeth?

A

more symptomatic = more bacterial diversity

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

Interactive and associative characteristics of canal infections

A

interactive - selection for anaerobic

Associative - certain bacteria associate with certain others

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

Pathogenesis depends on 3 factors for infection

A
  1. density of bacteria
  2. virulence factors
  3. host resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

4 main ecological factors of canal

A

Low Oxygen Tension
Low Reduction-Oxidation Potential
Nutrient-Rich
Byproducts

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

Fabricius found what about # anaerobes over time in canal?

A

increased over time;

by 1080 days, 98% are obligate anaerobes

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

8 virulence factors

A 
Fimbriae
Capsules
Extracellular vesicles
Enzymes
Metabolic byproducts
LTA
LPS (endotoxin)
Synergism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q 
Effects of:
Collagenase: 
Chondroitin Sulfatase: 
Hyaluronidase: 
Kinases:
Gelatinase: 
Proteases:  
Coagulase:  
Hemolysins:  
Leukocidin:  
DNA-ase:
A 
Collagenase: Destroys collagen
Chondroitin Sulfatase: Digests ground substances
Hyaluronidase: Digests ground substances
Kinases: Fibrinolysin
Gelatinase: Proteolytic
Proteases:  Proteolytic
Coagulase:  Activates fibrin clots
Hemolysins:  Destroys RBCs
Leukocidin:  Destroys WBCs
DNA-ase:  Destroys nucleic acids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

ex of metabolic byproducts

A

sulfur granules produced by israeli

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

LTA is what, stimulates what

A

Lipoteichoic acid, part of gram+ wall, stimualtes specific immune response

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

LPS is what

A

endotoxin/lipopolysaccharides

from gram negative

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

LPS can cause what

A

fever, bone resorption, vasomotor shock, and T-cell stimulation

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

Speed of LPS spread vs bacteria?

A

can progress through canal/tubules faster than bacteria

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

3 patterns of synergism

A

planktonic, aggregates, Biofilms

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

Planktonic synergism most common in what kind of infections

A

acute purulent

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

81% infected RC samples have what kind of synergism

A

co-aggregation

21
Q

what is a biofilm

A

Polybacterial communities embedded in a polysaccharide matrix and attached to a surface

22
Q

communication methods (2) within biofilms

A

quorum sensing, share genes

23
Q

5 ways biofilms resist

A

Diffusion gradient – slow antimicrobial penetration requires 100-1000x [abx|
Many bacteria are in the stationary phase
Neutralizing reactions deplete antimicrobials
Persister cells – spore like/dormant
break down Ca++ from dentin and use as walls

24
Q

Viruses indirectly increase virulence how

A

bacteriophages inject virulence factor DNA into bacteria

25
Q

types of viruses directly implicated in RC infection

A

CMV/EBV

26
Q

Why are CMV/EBV implicated in symptomatic infections?

A

increase proinflammatory cytokines

27
Q

Bleach irrigant composition?
SPectrum?
Unique bc?
bad bc?

A

5.25% NaOCl
Broad spectrum
Only irrigant that dissolves organic material
Toxic if extruded from canal, must continuously replenish

28
Q

Chlorhexidine concentration?
Kills what?
effect on tissue?
Caution when used with what?

A

2%
Kills bacteria
No tissue dissolution
Not toxic unless mixed with bleach, forms parachloroanaline

29
Q

EDTA concentration?
What kind of agent/action?
Action vs microbes?
Used in conjuction with what?

A

17%
chelating - opens tubules and enhances penetration
No antimicrobial activity
Conjunction with bleach

30
Q

MTAD is what?

A

Mixture of Tetracycline, citric Acid, and Detergent (Tween 80)

31
Q

Does MTAD contain bleach?
Affect on tissue?
Adjunct with what? Better than other adjunct?

A

No
No tissue dissolution
Bleach, but not better than EDTA

32
Q

Majority of endo infections require abx?

A

NO

33
Q

Indications of abx in endo (8)

A

Fever
Immunocompromised
Lymphadenopathy
Malaise

Cellulitis
Osteomyelitis
Swelling
Trismus

FILM COST

34
Q

Abx of choice?

Abx for PCN allergic?

A

PenVK

Clinda

35
Q

Considerations for use of Augmentin/Amox?

For Metronidazole?

A

Aug/Amox - broad spectrum and $$$, use only for immunocompromised

Metro - Only affective against obligate anaerobes, cant use alone.

36
Q

Rank abx in decreasing susceptibility?

A 
Augmentin
Clinda
Amox
PenVK
Metro
37
Q

Can abx cure endo infections? What is their function?

A

No, only cured by removing infected tissue; they assist in restoring proper balance

38
Q

Two mechanisms of resistance transfer?

A

vertical (daughter) horizontal (to other strains not even exposed)

39
Q

Contraindications of abx in endo? (3)

What could these be?

A

Pain without signs of infection (Symptomatic irreversible pulpitis, Acute periradicular perio)
Asymptomatic teeth with necrotic pulps (asymptomatic apical perio)
Teeth with sinus tract (chronic apical abcess)

40
Q 
PenVK
Major advantage?
Spectrum?
Drug of choice for?
Major disadvantage?
Dose?
A

Major advantage? Low cost, low toxicity
Spectrum? High effectiveness against anaerobic in root
Drug of choice for? periradicular abcesses
Major disadvantage? can cause allergy in 10%
Dose? 1g loading, 500mg q6h for 5-7d

41
Q 
Amox
Major advantage?
Spectrum?
Drug of choice for?
Major disadvantage?
Dose?
Relationsihp to Augmentin? Dose?
A

Major advantage? More rapid absorption, longer halflife, higher serum levels
Spectrum? extended (vs PenVK)
Drug of choice for? medically compromised, serious odontogenic infections
Major disadvantage? Resistance
Dose? 1g loading, 500mg q8h for 5-7days

Augmentin is Amox + Clavulanate for beta-lactamase bacteria
Dose: 875/125mg q12h for 7d

42
Q 
Clinda
Major advantage?
Spectrum?
Drug of choice for?
Major disadvantage?
Dose?
A

Major advantage? high conc in bone
Spectrum? gram positive, anaerobes
Drug of choice for? pen allergic pt
Major disadvantage? can cause pseudomembranous colitis
Dose? 600mg loading, 300mg q8h for 5-7days

43
Q 
Metronidazole
Major advantage?
Spectrum?
Drug of choice for?
Major disadvantage?
Dose?
A

Major advantage? used in combination with penicillin if symptoms worsen/resistance
Spectrum? narrow; anaerobes only
Drug of choice for? resistant to pcn
Major disadvantage? many bacteria resistant
Dose? 1g loading, 500mg q6h for 5-7d

44
Q

Erythromycin spectrum?

A

none vs anaerobes

45
Q 
Clarithromycin aka?
Clarith and Azith
Spectrum?
Major disadvantage?
Dose?
A

Spectrum aerobic coverage but not ideal
food/metal slow absorption
500mg loading, 250mg q12h for 5-7d
Azith same but qd

46
Q

Cephalosporins first vs second gen?

How many % cross react with pen?

A

1st - no efficacy

2nd - better vs aerobes

15% cross react

47
Q

Tetracycline/Doxycycline good b/c but bad bc?

A

very broad spectrum but may produce resistance

48
Q

Quinolones aka?
Spectrum?
Good for?

A

Ciprofloxacin
Bad against anaerobes in RC infections
Persistent infections with sensitivity testing

49
Q

Abx treat ____ not ____

A

treat infection not pain

Endo (9 decks)

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