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Oral Path 1 > L5 > Flashcards

L5 Flashcards

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1
Q

Candida albicans _____ yeast

A

Dimorphism

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2
Q

Candida albicans yeast form

A

Commensal

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3
Q

Candida albicans hyphal form

A

Pathogen

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4
Q

Ability of Candida albicans to undergo

A

Transformation to hyphal form under appropriate conditions producing germinate energy or germ tubes

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5
Q

Candida albicans depends on 3 factors

A

The host immune statue
Oral mucosal environment
The virulence of the candidal strain

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6
Q

Oral Candida albicans presentation

A

Pseudomembranous

Erythematous

Hyperplastic

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7
Q

Pseudomembranous Candidiasis

A

White curdled milk or cottage cheese like plaque

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8
Q

Pseudomembranous Candidiasis common sites

A

Buccal mucosa palate or tongue

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9
Q

Pseudomembranous Candidiasis symptoms

A

Might be asymptomatic but boring or unpleasant taste occasionally

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10
Q

Erythematous Candidiasis

A

Areas of redness variable borders

tongue is common site may involve palate oral commissures perioral skin

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11
Q

Acute Atrophic Candidiasis

A

AKA antibiotic sore mouth

Diffuse atrophy of dorsal tongue papillae, particularly after broad spectrum antibiotics

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12
Q

Acute Atrophic Candidiasis symptoms

A

Acute onset

Typically associated with burning sensation

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13
Q

Central Papillary Atrophy due to

A

chronic Candidiasis

Usually asymptomatic

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14
Q

Central Papillary Atrophy appearance

A

Well defined area of redness mid posterior dorsal tongue

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15
Q

Denture Stomatitis

A

Denture contaminated with Candidiasis organisms but no invasion of mucosa is seen

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16
Q

Denture stomatitis appearance

A

Erythema of palate denture bearing area typically asymptomatic

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17
Q

Angular Cheilitis

A

Usually related to candidiasis but may have other cutaneous bacterial micro flora admixed

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18
Q

Angular Cheilitis appearance

A

Redness, cracking of corners of mouth

Often waxes and wanes

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19
Q

Angular Cheilitis resents

A

Well to topical antifungal therapy

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20
Q

Perioral Candidiasis

A

Often associated with lip licking or chronic us of petrolatum based materials

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21
Q

Perioral Candidiasis appearance

A

redness cracking of cutaneous surface

Responds to antifungals

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22
Q

Chronic multifocal candidiasis

A

patient will have angular cheilitis, central papillary atrophy and a kissing lesion of the posterior hard palate

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23
Q

Hyperplastic Candidiasis

A

Also known as candidal leukoplakia

CANNOT be rubbed off

Uncommon anterior buccal mucosa

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24
Q

Chronic mucocutaneous candidiasis

A

Associated with specific immunologic defects related to how the body interacts with Candida albicans

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25
Invasive Candidiasis
Seen in situations of severe uncontrolled diabetes mellitus or immune suppression
26
The candidal hypahe never
Penetrate deeper than the keratin layer in almost all cases
27
Candidiasis Treatment
Depends on the severity of the infection Superficial oral mucosal infections can usually be treated with one of the milder topical or systemic antifungal agents
28
Life threatening infections
Intravenous amphotericin B
29
Clotrimazole (Mycelex)
Imidazole antifungal agent No significant absorption or side effect Pleasant lozenges 5x per day
30
Nystatin
Not absorbed systemically Tastes bitter multiple dosing, patient compliance
31
Fluconazole
Triazole antifungal agent Readily absorbed systemically Daily dosing Expensive
32
topical antifungals
Treatment of angular cheilitis or perioral candidiasis Mycolog II cream Vytone Cream
33
Mycolog II cream
Combination of nystatin and triamcinolone
34
Vytone Cream
Combination of iodoquinola and hydrocortisone
35
Histoplasmosis Acute
May have flu like illness
36
Histoplasmosis chronic
Cavitation pulmonary lesions
37
Histoplasmosis disseminated
Elderly debilitated or immunocompromised
38
Histoplasmosis affects
Tongue palate or buccal mucosa
39
Histoplasmosis presents as
A chronic variably painful ulcer or granular erythematous plaque
40
Histoplasmosis
Granulomatous inflammation with or without necrosis
41
Acute histoplasmosis treatment
No treatment is necessary
42
Chronic histoplasmosis Treatment
may be required amphotericin B
43
________ for mild cases or as maintainence therapy
Ketoconazole or itraconzaole
44
Acute histoplasmosis prognosis
Good Chronic -fair Disseminated- Poor
45
Valley fever represents a
A hypersensitivity Coccidioidomycosis
46
Coccidioidomycosis spread
Inhalation of spores
47
Coccidioidomycosis symptoms
Flu like illness in most
48
Coccidioidomycosis appears
Skin of central face may be affected | Oral lesion are rarely described
49
Coccidioidomycosis histopath shows
Large 20-60 micron spherules that contain endospores
50
Coccidioidomycosis host response
Ranging from acute to granulomatous inflammation
51
Coccidioidomycosis diagnosis
Made by culture or biopsy
52
______for disseminated Coccidioidomycosis
Amphotericin B
53
Mild case treatment of Coccidioidomycosis
Fluconazole or itraconazole
54
Coccidioidomycosis may be more aggressive in
POC
55
Coccidioidomycosis fungi
Coccidioides immitis
56
Cryptococcosis fungi
Cryptococcus neoformans
57
Cryptococcus neoformans lives in
Pigeon dropping’s
58
Cryptococcus neoformans transmitted by
Airborn spores
59
Cryptococcus neoformans (cryptococcosis) affects
Immunosuppressed patients almost exclusively
60
Cryptococcosis disseminates to
Meninges resulting in headache vomiting neck stiffness
61
Cryptococcosis initial
Pulmonary infection with flu like symptoms
62
Cryptococcosis histopathology
4-6 micron yeasts with a clear halo-mucopolysacccharide capsule
63
Cryptococcosis severe treated
Amphotericin B and flucytosine
64
Cryptococcosis prognosis
Poor due to patients being immunocompromised
65
Zygomycosis also known as
Mucormycosis
66
Zygomycosis(Mucormycosis) affects
Severe diabetic or immunocompromised patient
67
Zygomycosis(Mucormycosis) _______form in oral region
Rhinocerebral
68
Zygomycosis(Mucormycosis) clinical signs
Black necrotic lesions Bloody nasal discharge Facial swelling Palatal perforation
69
Zygomycosis(Mucormycosis) progresses to
Visual disturbances/blindness | Seizures and death occur with intracranial invasion
70
Zygomycosis (Mucormycosis) diagnosis
Based on histopathology findings cant culture well
71
Zygomycosis (Mucormycosis) histopathology
Large branching nonseptate hypahe with extensive tissue necrosis
72
Zygomycosis (Mucormycosis) hyphae
Are often seen plugging small blood vessels
73
Zygomycosis (Mucormycosis) treatment
Surgical Debridement IV amphotericin B If patient is diabetic control of diabetes is important Poor prognosis
74
Aspergillosis spectrum
Disease that includes: allergy Localized infection Invasive Aspergillosis
75
Aspergillosis spores in
Soil Water Decaying organic debris
76
Aspergillosis can be a ________ infection
Nosocomial
77
Aspergilloma
Maxillary sinus fungus ball
78
Aspergillosis tissue damage
Locally invasive
79
Aspergillosis immunocompromised patient
Disseminated
80
Aspergillosis diagnosis
Biopsy shows branching spectate hyphae
81
Aspergillosis _______by hyphae
Occlusion of small blood vessels
82
Aspergillosis if the patient is not immune compromised
Granulomatous inflammation
83
Aspergillosis Non invasive tx
Debridement
84
Aspergillosis invasive Tx
Voriconazole or itraconazole with or without Debridement
85
Aspergillosis prognosis
Good is normal immune | Poor if immunocompromised
86
Amphotericin B is used
Via IV for life threatening systemic fungal infections
87
Ketoconazole
Systemically absorbed -imidazole Requires acidic stomach environment Single dose daily
88
Itraconzaole
Approved for treating histoplasmosis Well absorbed Minimal side effects
89
Voriconazole
IV or oral Candida Aspergillus Several other species Photosensitive side effect
90
1st line therapy against invasive aspergillosis
Voriconazole

Oral Path 1 (4 decks)

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