Lecture 1 Flashcards

1
Q

What is the structure of actinomyces?

A

-Gram postive rods with branching filaments.
-Soil Microorganisms.
Looks like yeast Hyphae
-Anaerobes
-Source of most antibiotics

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2
Q

What type of pathogen is actinomyces?

A

Its an oppurtunisitc pathogen and is usually found in the normal flora.
-Causes supportive granulomatous lesions.

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3
Q

What are 3 facts associted with actinomyces in the oral cavity?

A
  • Major component of dental plaque
  • Increase in numbers increases risk of gingivits.
  • Increase is associated with root surface carries.
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4
Q

What are some important acinomyoces strains?

A

-Actinomyocin israelii
(Most important pathogen)
-Actinomoyces Odontolyticus
(causes eaerly enamel demeniratilization

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5
Q

What are the 4 stages of plaque formation?

A
  • Early introduction of pellicle
  • Initial bacterial colonization
  • Late phase bacterial colonization
  • Maturation of plaque
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6
Q

What are the facts about step 2 of dental plaque formation?

A

Its known as initial colonization. Usually non pathogenic bacteria. Such as gram postive cocci and Rods.
E.g sterp mutans
-strp snguis
-actinomyoces viscosus.

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7
Q

Why is actinomyces israelii a major pathogen?

A

Common in mouth and female genitourinairy tract.

-Major cause of actinomycosis but not the only reason.

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8
Q

What is Actinomycosis and why is it so dangerous? How is treated? whats the mortality rate?

A
  • Rare but chronic slowly progressive disease. Causes the formation of granulomatous disease.
  • Mimics periapical and periodontal abscesses. Its a malignant disease.
  • Most commonly occuring by actinomyces israelii
  • treated via antibiotics or surgery

Mortality up to 28% depending on site and time of discovery.

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9
Q

What are the different types of actinomycosis and what is the highest percentage?

A
  • Cervicofacial
  • Abodminal
  • Thoracic.
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10
Q

Whats the clincial exam and manifestation of cervicofacial actinomyoces?

A
  • Inflamed mas under the mandible.
  • Low grade fever
  • milky puss with yellow flecks
  • Relapsing refractory clincal course.

-Short term antibiotics

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11
Q

What are sulfur granules?

A

Its centerally calcified but surrouned by branching filaments and pmns/

  • Causes necrosis, abscess formation and draining sinuses.
  • Its not only common in actinomycosis but can also be found in nocardia.
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12
Q

What are other names for cervicofacial actinomycosis? what are the common location? Whats the percentage of bone involvement?

A
  • also known as lumpy jaw syndrom or Wooden tongue
  • usually starts as periapical abscess and mainfests at the angle of the mandible, the chin, Cheek, TMJ and retromandibular area
  • Bone involvment is about 10 %
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13
Q

What are the causes of cervicofacial actinomycosis?

A
  • Tooth extraction
  • dental carries
  • puncturing the mucosa
  • poor oral or dental hygiene
  • Periodontal disease.
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14
Q

How can you diagnose Actinomycosis?

A
  • Patient history
  • Fine needle aspiration
  • Microscopic exam of discharge
  • Culture (less than 50% positive)
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15
Q

Hiw can you treate actinomyoces?

A
  • Prolonged (Months) or antibiotic treatment
  • Penicilin G IV for 4 weeks
  • Then Oral penicilin for 4-6 months
  • Low risk of developing penicilin resistance.
  • Tetracycline
  • erythromyoicn
  • clindamycin

-Drainage via incisions if the antibiotics are doing sheeet.

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16
Q

What are the causes of thoracic actinomycosis? Symptoms?

A

caused by aspirating the pathogen into the lung. Its basically a spread of the cervicofacial form

Signs and symptoms:

  • Lethargy and weight loss
  • Fever, cough shortness of breath
  • Night sweats
  • Chest wall sinus with sulfer granules

About 90% of the time its wrongly diagnosed into something else such as cancer.

17
Q

What are the complications of pulmonary actinomycosis?

A
  • its life threatening
  • Spread into lung and cause pneumonia
  • Thoraci draining fistulas
  • can spread into blood stream and causes bacteremia
  • CNS involvement
  • -Brain abscesses or meningitis.
18
Q

What are the causes and of abdominal actinomycosis?

A

Usually following abdominal surgery

  • Spread from GI tract or femal GU tract
  • Linked to prolonged IUD use.
19
Q

What are other locations can Actinomycoisis be found? What makes someone more likely to develop actinomycosis?

A

Maxilla, Perapical, tonsils and more.

  • Alcoholism
  • steroids
  • immunosuppressents
  • Transplant
  • Trauma or surgery
  • Chemotherapy
20
Q

What are the distinguishing features of spirochetes?

A

-Long slender, helically coiled spiral or corkscrew (Twisty shit)

21
Q

What are the 3 pathogenic genres of spirochetes and what they cause?

A
  • Treponema: causes syphilis, bejel, yaws, pinta and necrotizing ulcerative gingivitis
  • Borrelia- causes relapsing fever and lyme disease
  • Leptospira- leptospirosis
22
Q

What are some features of spirochetes?

A
  • Theyre similar to gram negative bacteria
  • strict anaerobes or microaerophillic
  • Contraction of filaments gives it its heliical shape,
  • Can be seen via darkfield or phase contrast microscopy
23
Q

What are the structures that make up spirochetes?

A
  • Outer envelop
  • Axial filament (gives the spirochete shape)
  • Protoplasmic cylinder
24
Q

What is syphillis?

A

Syphillis is the treponema pallidum stain..

  • transmission is blood, saliva, semen and contact with legions
  • Cant be cultured
  • Sensitive to penicillin

-Its basically legions found in the body. Tongue,

25
Q

What is Yaws?

A

Treponema pallidum with subspecious pertenue cuases yaw which chronic ulcerative lesions of skin, mucosae and bone

-usually in children in tropical countries

26
Q

What is pinta?

A

Pinta is due to spirochee : treponema carateum.

-It causes dipegmentation

  • restricted to dark skin races
  • in the americas and mexico.
27
Q

What are the disnguishing features of oral spriochetes? sight of infecction? primary infection?

What Antibiotic are they sensitive to?
How can you prevent it?

A

Primary intraoral site is the gingival cervice.

Primary infections are necrotizing ulcerative gingivits

-Chronic periodontits.

Sensitive to penicilin and metronidazole

Can be prevented with good oral hygiene

28
Q

What are the features of oral treponemas? how are they classified? can they be grown in vitro?

What type of anaerobes are they

A

-size classification (large- small)

Incontrast to T.Pallidum oral spirochetes can be grown in vitro

-Strict anaerobes but slow growing

29
Q

What are the 4 species of treponemes?

A

1) T. Denticola
2) T. VIncentii
3) T.pectinovarum
4) T.socrasnkii