bacterial infections

Question 1

superficial infection of the skin caused by strep pyogens and/or staph aureus in unsanitary conditions

Answer 1

impetigo

Question 2

during what time is impetigo most common?

Answer 2

summer or early fall in hot moist climates

Question 3

in what age is impetigo most common

Answer 3

school aged children

Question 4

superficial vesicles that quickly rupture and become covered in a thick, amber crust, pruitus common

Answer 4

impetigo

Question 5

facial lesions around the nose and the mouth. many cases arise in areas of damaged skin; prexisting dermatitis, cuts, scratches, insects

Answer 5

impetigo

Question 6

what does the definitive dx of impetigo require?

Answer 6

isolation of causative organisms in culture of skin

Question 7

what is the tx of impetigo?

Answer 7

topical or systemic antibiotic

Question 8

convoluted crypts of the tonsils that are commonly filled with desquamated cells, foreign debris, and bacteria (tonsillar concretions)

Answer 8

tonsillolithiasis

Question 9

what is it called when tonsillolithiasis aggregate and undergo calcification?

Answer 9

tonsilloths

Question 10

what do tonsillolithiasis appear as radiogreaphically

Answer 10

may present as radiopacities overlying the midportion of ascending ramus

Question 11

what is the tx for tonsillolithiasis?

Answer 11

none unless associated with clinical symptoms

Question 12

chronic infection found worldwide caused by the spirochete treponema pallidum

Answer 12

syphillis

Question 13

what three things causes syphillis

Answer 13

• intimate sexual contact
• transplacental transmission
• contaminated blood exposure

Question 14

during which three stages of syphilis are the most highly contagious?

Answer 14

first two

Question 15

which stage of syphilis causes painless ulceration “chancre”

Answer 15

primary syphilis

Question 16

when does primary syphilis occur?

Answer 16

3-90 days after exposure

Question 17

what area is most affected by primary syphilis?

Answer 17

genital (2% oral)

Question 18

when does secondary syphilis occur?

Answer 18

4-10 weeks after initial infection

Question 19

erythematous maculopapular cutaneous eruption with generalized lymphadenopathy

Answer 19

secondary syphilis

Question 20

what is the tx of secondary syphilis?

Answer 20

resolves spontaneously in 8-12 weeks, but may recur

*untreated pts then enter a latent period

Question 21

when does tertiary syphilis occur?

Answer 21

after a latency period of 1-30 years

Question 22

what tissues doe tertiary syphilis affect?

Answer 22

ANY TISSUE, CNS, vascular

Question 23

what are some general findings of congenital syphilis?

Answer 23

• saddle nose deformity
• saber shins
• hutchinson’s triad (malformed incisors, mulberry molars, ocular interstitial keratitis
• eighth nerve deafness

Question 24

which stages of syphilis show intense plasmactic infiltrate

Answer 24

primary and secondary

Question 25

what is tertiary (gumma) syphilis characterized by?

Answer 25

granulomatous inflammation

Question 26

how can the spirochetes of syphilis identified?

Answer 26

warthin-Starry stain

Question 27

what are the screening tests of syphilis?

Answer 27

- VDRL | - RPR

Question 28

what is the specific antibody test of syphilis

Answer 28

FTA

Question 29

what test can be done for non-oral lesions of syphilis?

Answer 29

dark-field microscopy

Question 30

what is the best way to tx syphilis

Answer 30

- penicillin is drug of choice - if allergic, use tetracycline or erythromycin *good prognosis if identified early and tx properly

Question 31

endemic in many areas of the world and is estimated that 9 million ppl around the world develop the disease each year (2 million die)

Answer 31

tuberculosis

Question 32

how is TB spread?

Answer 32

droplet transmission

Question 33

where is TB most often found?

Answer 33

resurgence in inner cities of the US in the 1980s dur to HIV patients and immigrants from endemic regions

Question 34

how many TB pts progress to active disease within 2 years after exposure?

Answer 34

5 percent

Question 35

what are the clinical features of TB?

Answer 35

- low grade fever, night sweats, fatigue - weight loss (consumption) - chronic bloody cough

Question 36

are oral lesions from syphilis common?

Answer 36

no, but if they are they will most likely be on the the gingiva and the tongue

Question 37

solitary chronic painless ulcer or granular lesions

Answer 37

TB oral lesions

Question 38

how do you dx TB?

Answer 38

positive skin test (PPD) *only indicates exposure - chest radiograph - culture - ID of organisms of biopsy material - molecular testing (PCR)

Question 39

TB has what type of cells?

Answer 39

multinucleated giant cells

Question 40

how do you treat TB?

Answer 40

usually combo of antibiotics - isoniazid, rifampin, and pyrainamide daily for 2 months) - then ING and rifampin for 4 months - ehtambutol or streptomycin also used *anti-TB therapy works relatively rapidly resulting in a non-infectious state in two weeks

Question 41

what is the prognosis for TB pts in an immunocompromised pt

Answer 41

generally good

Question 42

what lowers the prognosis for TB?

Answer 42

when pts fail to take prescribed meds | -emergence of resistant strains

Question 43

often associated with local trauma that is caused by any of several Actinomyces species that normally inhabit the mouth

Answer 43

actinomycosis

Question 44

what parts of the body are affected my actinomysis?

Answer 44

- abdominal (25 percent) - pulmonary (15 percent) - cervicofacial (55 percent)

Question 45

may follow dental extractions or untreated dental disease that is associted eith diffuse swelling and erythema and draining sinus tracts. Is associated with SULFUR GRANULES

Answer 45

cervicofacial actinomycosis

Question 46

filamentous bacteria that form colonies surrounded by neutrophils. adjacent tissues may show granulomatous inflammation or granulation tissue

Answer 46

actino

Question 47

what is the tx for actino

Answer 47

- removal of offending tooth - high-dose antibiotics (usually penicillin) - good prognosis with appropriate tx

Question 48

what type of actinomycosis ussually responds to less aggressive treatment?

Answer 48

periapical actinomycosis