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CH 20 ORAL PATH 2
Infectious disease
| Question | Answer |
|---|---|
| what is the portal of entry for many pathogens? | oral cavity |
| what are some causes of localized diseases? | Neisseria gonorrhoeae, Herpes zoster |
| What are some diseases that proliferate locally in the oropharynx with or without apparent tissue damage and gain entry in bloodstream | Treponema pallidum, HIV |
| HIV stands for? | Human immunodeficiency Virus |
| 5 main categories of Infectious Diseases of Oral cavity? | 1. Bacterial 2. Chlamydial 3. Rickettsial 4. Fungal 5. Viral |
| What are examples of definitive diagnosis that requires collecting and evaluating several key factors? | 1. clinical signs and symptoms 2. Past medical, dental, social history 3. Proper specimen collection & transport 4. Accurate interpretation of laboratory results |
| Oral lesions may be ______ infections or ________ manifestations of ______ infections? | Localized, Secondary systemic |
| Systemic clues suggest a generalized disease include? | Fever, malaise, headache, sore throat, join pain, rash, pain, lesion |
| what other conditions to rule out? | traumatic, neoplastic, or immunoinflammatory disease _ these may mimic infections |
| Is pain a reliable indicator? | no, since almost all can be painful |
| What does definitive diagnosis relies on? | rapid diagnostic test & laboratory investigations |
| What is main infecting organism of Actinomycosis? caused by endogenous granulomatous infection | Actinomyces israelii , |
| Where does actinomycosis occur? | cervicofacial region (60-65%), abdoment (10-20%) , lung and periperhal skin |
| what is most common in actinomycosis? | swelling, localized or diffused |
| what age for actinomycosis? | Younger, can affect all tho |
| What does the discharge of pus contain in actinomycosis? known as? | Granules "gritty, yellow" Sulfur granules |
| Where is actinomycosis most commonly affected? | submandibular region |
| if fluctuant abscess is present in actinomycosis, | aspiration syringe , but if external incision -> drainage |
| how many weeks of antibiotics of actinomycosis? and what type | 2-3 weeks, penicillin, other (if Px is Hypersensitive) is erythromycin, tetracycline |
| Differential diagnosis of Actinomycosis? | TB, systemic mycoses, nocardiosis, periodontal & dentoalveolar abscess, donovanosis |
| what is the bacteria caused by Anthrax | Bacillus Anthracis , animal, rare in west, human infected by animal, contaminated meat, animal products, it can be thru spores abrasion, skin or inhaled |
| this infection cause septicemia and death, pulmonary ____? other wise known as ? | woolsorter's disease |
| most common site of anthrax? | arms, face, or neck |
| initial lesion of anthrax, so called ??? | Malignant pustule, is a misnomer, either malignant or do they contain pus |
| Oral manifestation of anthrax is??? cases have been described with?? | rare swelling, edema of hard palate, loss of alveolar bone, vesicular, oral mucosa, tonsils, posterior pharyngeal wall |
| Diagnosis of anthrax? | swab and smear of lesion |
| Antibiotic of anthrax? | Penicillin |
| what is the primary cause disease of Brucellosis? | gram negative cocobacilli , GENUS |
| humans can be infected thru? | infected animal, farmers abbatoir, milk products |
| what are the five main forms of Brucellosis? | fever, headache, sweating, fatigue, joint pains |
| incubation period of Brucellosis? where does it enter? | 2-4 weeks, gastrointestinal tract, skin abrasions, human to human possible |
| Oral manifestations of Brucellosis? | red and edematous gingivae, small ulcers, grayish surfaces |
| Diagnosis of Brucellosis?specifically? | Blood and emulsified biopsy material (ELISA) |
| Treatment/management of Brucellosis? | Streptomycin & Tetracycline , 3 week |
| Other name for Granuloma Inguinale? | Donovanosis |
| is a chronic ulcerative, granulomatous disease transmitted thru sexual intercourse? | Granuloma Inguinale (Donovanosis) |
| the causative agent of Granuloma Inguinale is? | Calymmatobacterium, gram negative bacillus, prominent polar granules, incubation period 1 week to 1 yr, initial lesion is papule.nodule |
| the most commonly involved in Granuloma inguinale is? | mucous membrane of the orpharynx, eyes, skin, and subcutaneous tissues |
| cases of donovanosis is rampant where? age? | america, far east, africa, 20-40 yrs old US, more on colored population |
| Primary infection is rare, majority of oral lesions of donovanosis (Granuloma Inguinale) are? | secondary to primary genital infection |
| sites of infections of Granuloma Inguinale are? | lips, gums, cheek, palate, pharynx etc. |
| what are the 3 main types of Donovanosis? (Granuloma Inguinale)? | Ulcerative, exuberant, cicatricial |
| this type of Donovanosis (Granuloma Inguinale) is extensive, painful, punched out? | Ulcerative lesion |
| this type of Donovanosis (Granuloma Inguinale) is sharply defined border and may be single or extensive, rough sufrace | Exuberant lesion |
| This type of Donovanosis (Granuloma Inguinale) apppears as areas of Fibrous scar tissue tha are often extensive | Cicatricial lesion |
| Diagnosis of Donovanosis (Granuloma Inguinale)? | Direct examination, Giemsa's method |
| treatment of Donovanosis (Granuloma inguinale)? | azithromycin |
| is a sexually transmitted infection with a world wide distribution epidemic? | Gonorrhea |
| Causative agent of Gonorrhea | Neisseria gonorrhea |
| it is the main site of initial infection for females?, and presentation is less acute for?? | Urethra, male, human to human transmission, unprotected sexual activity |
| oral mucosa is relatively resistant to infection By N. Gonorrhea, however this is rampant in adults? | Gonorrhea stomatitis |
| the clinical presenation of this primary oral problem is burning, itchy sensation hot feeling of mouth, 24 to 48 hrs, foul oral tase fetid, salivary flow up/down, nodes enlarged | Gonorrhea |
| clinical signs of this oral mucosa lesion is inflammation, edema, vesiculation, ulceration, pseudomembranes, latter are white yellow or gray , scraped | Gonorrhea |
| Primary oral sites of Gonorrhea | gingivae, tongue, buccal mucosa, H and S palate, oropharynx |
| 2 oral manifestations of disseminated gonoccocal infection are? | septic embolic phenomena & hypersensitivity reactions |
| this type of gonoccocal infection consist of erythematous , purpuric, vesiculopustular, hemorrhagic and ulcerative lesions? | Septic Gonococcal lesions - oral site infections are gingivae, tongue, and hard soft palate |
| is is one common sequel of urogenital infection | Gonococcal arthritis |
| clinical symptoms of this type gonorrhea is rapid onset fever, migrating polyarthritis, inflamed swollen joints | Gonococcal arthritis |
| recognition and diagnosis of oropharyngeal gonorrhea is important 3 main reasons: | 1. act as reservoir 2. potential source for Gonoccocemia 3. Cause significant localized tissue damage |
| Diagnosis and management of Gonorrhea? | laboratory investigations, DNA probe system, B-lactamase stable, cephalosporins |
| 2 major types of mycobacterial diseases are endemic globally which are? | TB (tuberculosis) & leprosy |
| Tuberculosis killers age of?____, it is also the ___ leading cause of death by infection after HIV | Young, second |
| Diagnosis of tuberculosis? | skin test with PPD |
| Main cause bacteria of Tuberculosis? pathogenesis | Mycobacterium Tuberculosis airborne transmission, grows in pulmonary alveoli, T helper cells activage macrophages |
| Signs and symptoms of this mycobacterial disease are, cough fever chills night sweats, pulmonary involvement | Tuberculosis |
| Medical Management of Tuberculosis? | Rifampin, drug therapy 6-9 months |
| Vaccine for TB? | Bacille Calmette-guerin (BCG) |
| Oral consideration of TB? | oral tissues neck lymph nodes (scrofula) Px are no longer considered infectious if they have consecutive 2 negative sputum |
| is a type of mycobacterial disease that is chronic, granulomatous systemic disease that is mostly prevalent in developing world, africa and asia> | Leprosy |
| is a chronic infectious disease of peripheral nerves, skin, and sometimes other tissues, caused by Mycobacterium leprae, mild, sublicnical infection | Leprosy |
| this mycobacterial disease affects mouth and face, if trigmeinal involved, hyperesthesia or paresthesia of face, lips and tongue, palate cheeks, paralyzed | leprosy |
| lesions consist of dry, hairless well defined and raised border about ___ cm in diameter on white skin red, dark are hypopigmented | leprosy, 2.5cm |
| sites most commonly involved are premaxillary gingivae, H & S, uvula, tongue Cobblestone appearance, geographic tongue | Leprosy |
| Diagnosis of leprosy? | incision, scarped using blade, Ziehl-neelsens method, biopsy Dapsone with rifampicin |
| is a classic disease with protean manifestations, particularly striking eastern europe? | Syphilis rise in children born with congenital syphylis |
| the causative bacteria agent of Syphylis is? | T. Palladium syphilis spirochete incubation 10-90 days |
| four main clinical stages of Syphylis? | Primary, secondary, tertiary, late/quaternary |
| this type of syphilis is pass thru mucous membrane, 3-4 weeks incubation, develops ulcerated lesions called primary _____? it is flat, red , indurated, painless , edema, 2 weeks enlarged nodes | Primary syphylis |
| this type of syphilis is 2 months after healing, generalized skin lesions 75%, mucosal ulcers%, 33% generalized lymphadenomaty, 50% influenza like, fever, headache, malaise, genral aches, hands feet genitalia, red macular or papular spots | Secondary syphylis |
| this type of syphilis is 2-3 years, localized single, lesion is GUMMA, pin head, other organs involved is cardiovascular system and nervous system | Tertiary syphylis |
| this type of syphilis is seen 1 to 2 decades , main clinical forms are cardiovascular syphilis and neuro | quaternary/late syphylis |
| this type of syphilis after many years seen without symptoms, lies dormant no sign | Latent syphilis |
| this syphilis is caused by T. palladium, during 2nd-3rd trimester of the mother, it is either latent, early, late infection, after 2nd yr, there is hutchinsons incisor, mulberry molar | Congenital syphilis |
| the normal site for the chancre is on genitalia, chancre of lip is most common extragenital lesion, male is is where located lip? female? | Primary syphilis men upper lip female lower lip there is intra oral chancres, slightly painful, enlarged nodes, submaxillary, mental and cervical regions |
| the characteristics of this type of syphilis is slightly raised, grayish, white, glistening patches on muscous membrane so called "____ patches" tongue, soft palte, tonsil, cheek | Secondary syphilis, Mucous patches |
| this type of syphilis of this stage is GUMMA, small pale, raised area of mucosa, ulcerative, rapid large necrosis, denudation of bone, perforate nasal cavity | Tertiary Syphilis |
| these are dental lesions of syphilis due to infection of tooth Germ T.Palladium, spirochetes, minimally affected | Congenital syphilis |
| Early oral manifestation of congenital, this type is diffuse, maculopapular rash, periostitis (frontal bossing of parrot, rhinitis | Malformed teeth |
| late manifestation after 24 months, hutchinsonian triad, keratitis cornea, sensorineural, hearing loss | late manifestation, hutchinsons |
| the most common dental manifestation of congenital syphilis is? | Mulberry molar teeth usually dirty,yellow, hypoplastic, poorly developed cusp, other is hutchinson disease (incisor) |
| the upper central incisor are usually involved and have cresentic notches in middle , SCREWDRIVER appearance | Hutchinson's incisor |
| Diagnosis and treatment of Syphilis? | Dark-ground microscopy, serology, cardiolipin/lipoidal antigen specific treponemal antigen |
| the differential diagnosis of this type of bacterial disease is candidiasis, leuplakia, hairy leukplakia, lichen planus, ulcers, tb, herpes, ETC. | Syphilis |
| Treatment for Syphilis? | procaine benzylpenicillin |
| is a rare disease in developed world, 800k to 1m death each year, is a spore-forming gram positive bacillus? | Tetanus |
| Causative agent of Tetanus | Clostridium tetani produces exotoxin, tetanospasmin, hemolysin, causes muscle rigidity, muscle spasm, few days to 3 weeks |
| oral consideration of this type of disease is tonic rigidity of the muscles of mastication , stiffness of face followed by difficulty chewing and swallowing | |
| the most common causes of trismus are? | impacted 3rd molar |
| is a classic disease with protean manifestations, particularly striking eastern europe? | Syphilis rise in children born with congenital syphylis |
| the causative bacteria agent of Syphylis is? | T. Palladium syphilis spirochete incubation 10-90 days |
| four main clinical stages of Syphylis? | Primary, secondary, tertiary, late/quaternary |
| this type of syphilis is pass thru mucous membrane, 3-4 weeks incubation, develops ulcerated lesions called primary _____? it is flat, red , indurated, painless , edema, 2 weeks enlarged nodes | Primary syphylis |
| this type of syphilis is 2 months after healing, generalized skin lesions 75%, mucosal ulcers%, 33% generalized lymphadenomaty, 50% influenza like, fever, headache, malaise, genral aches, hands feet genitalia, red macular or papular spots | Secondary syphylis |
| this type of syphilis is 2-3 years, localized single, lesion is GUMMA, pin head, other organs involved is cardiovascular system and nervous system | Tertiary syphylis |
| this type of syphilis is seen 1 to 2 decades , main clinical forms are cardiovascular syphilis and neuro | quaternary/late syphylis |
| this type of syphilis after many years seen without symptoms, lies dormant no sign | Latent syphilis |
| this syphilis is caused by T. palladium, during 2nd-3rd trimester of the mother, it is either latent, early, late infection, after 2nd yr, there is hutchinsons incisor, mulberry molar | Congenital syphilis |
| the normal site for the chancre is on genitalia, chancre of lip is most common extragenital lesion, male is is where located lip? female? | Primary syphilis men upper lip female lower lip there is intra oral chancres, slightly painful, enlarged nodes, submaxillary, mental and cervical regions |
| the characteristics of this type of syphilis is slightly raised, grayish, white, glistening patches on muscous membrane so called "____ patches" tongue, soft palte, tonsil, cheek | Secondary syphilis, Mucous patches |
| this type of syphilis of this stage is GUMMA, small pale, raised area of mucosa, ulcerative, rapid large necrosis, denudation of bone, perforate nasal cavity | Tertiary Syphilis |
| these are dental lesions of syphilis due to infection of tooth Germ T.Palladium, spirochetes, minimally affected | Congenital syphilis |
| Early oral manifestation of congenital, this type is diffuse, maculopapular rash, periostitis (frontal bossing of parrot, rhinitis | Malformed teeth |
| late manifestation after 24 months, hutchinsonian triad, keratitis cornea, sensorineural, hearing loss | late manifestation, hutchinsons |
| the most common dental manifestation of congenital syphilis is? | Mulberry molar teeth usually dirty,yellow, hypoplastic, poorly developed cusp, other is hutchinson disease (incisor) |
| the upper central incisor are usually involved and have cresentic notches in middle , SCREWDRIVER appearance | Hutchinson's incisor |
| Diagnosis and treatment of Syphilis? | Dark-ground microscopy, serology, cardiolipin/lipoidal antigen specific treponemal antigen |
| the differential diagnosis of this type of bacterial disease is candidiasis, leuplakia, hairy leukplakia, lichen planus, ulcers, tb, herpes, ETC. | Syphilis |
| Treatment for Syphilis? | procaine benzylpenicillin |
| is a rare disease in developed world, 800k to 1m death each year, is a spore-forming gram positive bacillus? | Tetanus |
| Causative agent of Tetanus | Clostridium tetani produces exotoxin, tetanospasmin, hemolysin, causes muscle rigidity, muscle spasm, few days to 3 weeks |
| oral consideration of this type of disease is tonic rigidity of the muscles of mastication , stiffness of face followed by difficulty chewing and swallowing | |
| the most common causes of trismus are? | impacted 3rd molar w/ pericoronitis, periapical abscesses posterior teeth |
| Diagnosis and management of Tetanus | clinical history and presentation, microbiologic results antitoxin - Human tetanus immunoglobulin Penicillin |
| this type of disease has been reported most frequently in the united states and russia, parts of europe | Tularemia |
| causative agent bacteria of this disease of Tularemia is? | Francisella tularensis came from mammals, squirrelsm , hares, rabbit |
| this type of disease symptoms include headache, fever, chills, profuse sweats, body pain, nausea, vomit, history of tick/deerfly bite | Tularemia |
| this type of disease is relatively and common present as stomatitis, pharyngitis, tonsilitis, infected meat, soft palate, tongue, gingiva, angle of mouth, whitish fibrinous pseudomembrane extend to secondary infection | Tularemia |
| Diagnosis and treatment of Tularemia? | Elevated serum antibody titers fluorescent assay streptomycin/tetracycline |
Created by:
JohnPasco