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Infectious Disease Flashcards

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1
Q

Describe an opportunistic infection.

A
  • non-pathogenic organism
  • low virulence
  • immunocompromised host
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2
Q

Describe mutualism.

A
  • both organisms benefit
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3
Q

describe commensualism

A

one benefits & other is not helped/harmed

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4
Q

Give an example of a commensal bacteria?

A

C. albicans

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5
Q

General principles of viral infections?

A
  • intracellular parasite
  • cell type specific
  • latency
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6
Q

HHV subtypes & the common name

A

1 = HSV1 (oral herpes)
2 = HSV2 (genital herpes)
3 = VZV (chicken pox & shingles)
4 = EBV
5 = cytomegalovirus
5 = kaposi sarcoma

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7
Q

Describe primary herpetic gingivostomatitis.

A
  • generally young age
  • ALL over mouth (masticatory & moveable // keratinized & non)
  • FLU-like (systemic)
    –> fever, malaise, lymphadenopathy, headache
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8
Q

Describe recurrent herpes labialis

A

cold sores / vesicles or ulcers on lips
- 2 weeks

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9
Q

Describe recurrent intra-oral herpes

A

cold sores / ulcers on masticatory / non-moveable / keratinized tissue
(hard palate or gingiva)
-typically clusters
resolves in 2 weeks

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10
Q

Where does HSV lay dormant?

A

Trigeminal ganglion

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11
Q

What cell type does HSV have an affinity for?

A

epithelial

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12
Q

What are tzanck cells?

A

individual cells within serous fluid that have been virally altered

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13
Q

What is herpes gladiatorum?

A

when herpes labialis is in close contact with individuals & ruptures
(wrestlers)

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14
Q

What is herpes whitlow?

A

herpes on fingers (historically prevalent in dentist)

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15
Q

What is HSV autoinoculation?

A

spreading herpes among yourself such as getting it in your eyes

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16
Q

What is recurrent aphthous stomatitis?

A
  • T lymphocyte mediated cytotoxic rxn
  • focal mucosal destruction
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17
Q

Describe the evolution of an aphthous ulcer

A
  • erythematous macule
  • ulceration
  • (yellowish) fibrinous membrane
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18
Q

What are some precipitating factors for recurrent aphthous stomatitis?

A
  • stress
  • trauma
  • SLS (in toothpaste)
  • allergies
  • acidic food/juices
  • gluten
  • endocrine alterations
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19
Q

What are the clinical forms of recurrent aphthous stomatitis?

A
  • minor
  • major
  • herpetiform
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20
Q

Describe minor aphthous ulcers

A
  • shallow, yet painful
  • non-keratinized, moveable tissue
  • single or multiple
  • heal in 2 weeks
    *recurrent
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21
Q

Describe major aphthous ulcers

A
  • larger
  • deeper –> may scar
  • heal slowly (weeks to months)**
  • non-keratinized, moveable tissue
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22
Q

Describe herpetiform aphthous ulcers

A
  • clusters of small, shallow, painful ulcers
  • heal in 2 weeks
  • short remission
  • non-keratinized, moveable tissue
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23
Q

T/F both recurrent herpes & recurrent aphthae have a vesicular stage?

A

false (only herpes)

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24
Q

Primary vs recurrent infection with VZV?

A

primary - varicella (chicken pox)
recurrent - zoster (shingles)

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25
How do you differentiate shingles from chicken pox?
clinical manifestation / presentation
26
How is VZV transmitted?
droplets (respiratory)
27
Where do chicken pox lesions begin? Can they scar?
face/trunk NO
28
Where does vzv lay dormant?
dorsal root ganglion
29
Describe herpes zoster virus.
- prodrome of pain & paresthesia - unilateral dermatomal involvement - can include oral cavity // pos. bone necrosis - lasts >2 weeks
30
T/F herpes zoster can scar?
true
31
What is a dreaded complication of shingles?
post-herpetic neuralgia
32
What is meant by a transforming viral infection? Example?
can become malignant / tumor forming -- EBV (HHV-4)
33
What are the 4 presentations associated with EBV?
- infectious mononucleosis - lymphomas (Burkitt) - nasopharyngeal carcinoma - oral hairy leukoplakia
34
What is the cell specificity for EBV?
- B lymphocytes - infects epithelial cells of oral mucosa, oropharynx, and nasopharynx
35
How common is EBV?
most adults are EBV+
36
Clinical features of infectious mononucleosis? - symptoms, population, prognosis, transmission
- feel like crap (flu-like) - young adults - can be debilitating EBV infection - self-limiting (goes away on own) - saliva
37
What occurs on a cellular level with mononucleosis?
- peripheral blood lymphocytosis (increase in LYMPHOCYTES) - atypical lymphocytes (Downey cells)
38
Oral presentations of infectious mononucleosis?
- petechiae hemorrhage - necrotizing ulcerative gingivitis
39
Lab testing for infectious mono?
- heterophile antibody - monospot test
40
How to treat infectious mononucleosis?
- treat symptoms only - bed rest --> prevent splenic rupture
41
What virus causes oral hairy leukoplaking?
EBV (HHV-4)
42
Describe oral hairy leukoplakia.
- epithelial hyperplasia due to EBV - white striations on lateral tongue - often pt in immunodeficient state
43
What population is HHV-5 most common?
>60 yrs cytomegalovirus
44
T/F most CMV infections are asymptomatic?
true
45
What are some oral symptoms of acute CMV?
Rare: - xerostomia - painful swelling - acute sialadenitis Immunocompromised: - retinitis / blindness - colitis
46
What is coxsackie virus?
- self-limited dx in children - flu-like symptoms - fecal oral / airborne
47
What is herpangina?
- coxsackie virus - small vesicles that rupture & ulcerate - posterior oral cavity & oropharynx
48
What is hand, foot, & mouth dx?
- coxsackie virus - common in daycares - vesicular eruptions on hands, feet, & anterior mouth
49
How does measles present? alternate name?
- skin rash of children - rubeola
50
What is an oral presentation of measles?
Koplik spots -- grains of salt on erythematous base
51
How does mumps present? alternate name?
- salivary gland swelling & discomfort - children - infectious parotitis - 30% subclinical - Lab: elevated serum amylase
52
Complications of mumps?
- rare in young people - orchitis, oophoritis, mastitis, meningitis, thyroiditis, pancreatitis --> sterility & hearing loss
53
What does the histology of tuberculosis look like?
granulomatous (epithelioid macrophage, giant cells, lymphocyte) caseous necrosis
54
What populations do we typically see TB?
- homeless - malnourished - overcrowded *HIV infection * immigrants
55
What type of infection / pathogen is TB?
- intracellular - pulmonary infection common - mycobacterium tuberculosis
56
What are the 2 stages of TB infection?
- infection = growth of organism in pt - active disease = destructive & symptomatic (infectious)
57
How is TB spread?
- droplet nuclei (reach alveoli) - airborne long periods
58
What is the virulent factor of TB?
cord factor --> blocks fusion of phagosome with lysosome
59
Oral manifestations of TB?
- ulceration on any tissue type
60
How to treat TB?
- multi-drug regimens for long period
61
How to test for TB?
mantoux tuberculin skin test - Type IV hypersensitivity - T cells sensitized by prior infection recruited to area **if produces red induration...MUST do other tests (chest xray) to confirm
62
Is there a vaccine for TB?
yes, BCG - live-attenuated, BUT causes positive PPD rxn - not used in US
63
What is scrofula?
- TB lymphadenitis of neck - M. bovis from infected milk -->not common in US bc pasteurization
64
What causes syphilis?
- Treponema pallidum (bacteria) - STD
65
What are the types of syphilis?
- congenital = in utero - acquired = STD
66
What are the clinical stages of untreated acquired syphilis?
- primary (1 week - 3 mo) = chancre - secondary (1-12 mo) = maculopapular patch & condyloma lata - tertiary (1-30 yrs) = gumma & syphilitic glossitis + NS & CV system
67
What stages of syphilis are infectious?
primary & secondary ONLY
68
Lesions of congenital syphilis?
- hutchinson incisors - mulberry molars - snuffles - saddle nose - rhagades: angular fissures/cracks
69
What is hutchinson's triad of congenital syphilis?
- blind: interstitial keratitis - deaf - dental anomalies
70
How to lab test for syphilis?
*cannot culture - serological tests (treponemal & non-treponemal)
71
What is a superficial fungal infection? Example.
- skin, hair & nails - dermatophytes
72
What is subcutaneous fungal infection? Example.
- dermis & subcutaneous tissue - sporotricosis
73
What is a systemic fungal infection? Example.
- deep infection of internal organs - histoplasmosis
74
What is an opportunistic fungal infection? Example.
- immunocompromised host - candidiasis - mucormycosis
75
What is histoplasmosis?
- endemic to MS river valley - bird droppings --> inhaled - usually subclinical / flu-like - deep infection of lungs --> dystrophic calcification
76
What is the most common systemic fungal infection in US?
histoplasmosis capsulatum 80-90% infected
77
What is disseminated histoplasmosis?
- elderly, debilitated, immunosuppressed, AIDS - spreads out of lungs --> adrenal & oral lesions
78
What is coccidioidomycosis?
- deep fungal infection of lungs - 40% respiratory symptoms - disseminated dx may occur - granulomatous inflammation
79
What are the clinical forms of candidiasis?
- pseudomembranous (thrush) - erythematous (atopic) - hyperplastic - angular cheilitis (perleche) - central papillary atrophy (median rhomboid glossitis)
80
Can you wipe off candida?
yes, and leaves behind an erythematous region
81
What can cause erythematous candidiasis?
- steroid inhaler
82
What patients often present with angular cheilitis?
- decreased VDO / edentulous - droolers
83
What is hyperplastic candidiasis?
- does not wipe off --> call leukoplakia - harder to diagnose bc looks pre-malignant (must biopsy)
84
Describe median rhomboid glossitis?
- red patch down dorsal posterior tongue
85
What is sarcoidosis?
- multi-system granulomatous disorder --> non-caseating - unknown cause - younger adults // Af. American - hilar lymphadenopathy & skin/eye lesions
86
How to diagnose sarcoidosis?
diagnosis of exclusion -- biopsy: bronchi & minor salivary gland -- radiograph, clinical, lab (ace, Ca) -- histo: non-caseating granulomas, asteroid bodies & schaumann bodies
87
Oral manifestations of sarcoidosis?
- uncommon to have lesions (submucosal papule) - bilateral parotid enlargement - xerostomia - facial nerve weakness
88
How to treat sarcoidosis?
- mild dx: no tx, may resolve - severe dx: systemic corticosteroids

Pathology (9 decks)

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