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What’s humoral immunity effective against?
is an effective defence against some microorganisms
What’s cell mediated immunity effective against?
intracellular bacteria, viruses and fungi
What do opportunists pathogens do to the oral microflora?
decrease in salivary Flow, antibiotic administration, immune system alterations such as immunosupreesion
What’s Impetigo caused by?
streptococcus pyogenes and staphylococcus aureus
Who does Impetigo usually effect?
young children
What does Impetigo require for infection?
non intact skin
is there treatment for Impetigo
topical or systemic antibiotics
What does group AB-hemlotyic streptococci cause?
scarlet fever and rheumatic fever
Who does Scarlet fever occur in?
children
symptoms of Scarlet Fever?
fever, generalized red skn rash caused by a toxin released by bacteria
What are some oral manifestations in Scarlet Fever?
tonsillitis, pharyngitis, petechiae on soft palate and strawberry tongue
What’s strawberry tongue?
fungiform papillae are red and prominent, dorsal surface of tongue exhibits white coating or erythema
Treatment for Scarlet Fever
No
What’s Rheumatic Fever?
a childhood disease that follows a group AB hemolytic streptococcal infection
What is Rheumatic Fever characterized by?
inflammatory reaction involving the heart, joints, and CNS
What might happen to the heart with Rheumatic Fever?
heart valve damage
How might a heart valve damage affect client care?
might need a premedication
What bacteria s TB caused by?
mycobacterium tuberculosis
What kind of ulcerations are seen orally in someone that has TB?
panful, non healing and slowly enlarging
signs and symptoms of TB?
fever, chills, fatigue, malaise, weight loss, persistent cough, oxygen deprivation, shortness of breath, submandibular and cervical lymph node enlargement
What are chronic granulomatous ?
areas of necrosis surrounded by macrophages, multinucleate giant cells and lymphocytes
What’s actinomycosis?
an infection caused by a filamentous bacterium: Acintomyces israelli
Where do draining abscesses due to Actinomycosis usually originate from?
mandible
Another name for Actinomycosis?
lumpy jaw
Treatment for Actinomycosis?
long term - high dose antibiotics
What bacteria is Syphillis caused by?
Treponema Pallidum (a spirochete)
Primary stage of Syphillis caused what kind od symptoms?
flu like
How is Syphillis spread?
direct contact, auto inoculation, sexual contact, transfusion
What’s an autoinoculation
touching a sore and then touching an opening in the epidermis
What’s the secondary stage of Syphilis?
diffuse eruptions occur on skin and mucous membranes
What are mucous patches?
associated with the secondary stage of Syphilis, most infectious
What’s the tertiary stage of Syphilis?
chiefly involves the destruction of the cardiovascular system and the nervous system
What’s the Gumma appear in Syphilis?
a firm mass, non infectious, a destructive lesion that can result n perforation of palate bone
What’s congenital syphilis?
T. Pallidum can cross the placenta and enter the fetal circulation
What are two dental abnormalities seen associated with congenital Syhpilis?
mulberry molars and hutchnsons incisors
What’s treatment of Syphlis?
penicillin
What is Necrotizing Ulcerative Gingivitis?
a painful erythematous gingivitis with necrosis of interdental papillae
What is NUG caused by?
a fusiform bacillus and a spirochete
what is NUG associated with?
decreased resistance to infection and immunosupression
What might you see intramurally in someone with NUG?
cratering of interdental papillae and sighing of necrotic tissue
Treatment of someone with NUG
gentle, antibiotics if fever present
What’s pericoronitits?
inflammation around the crown of a partially erupted impacted tooth
What’s acute Osteomyelitis?
acute inflammation of the bone and bone marrow
What’s the most common reason acute osteomyelitis occurs?
chronic periodical absecc
What’s the diagnosis of acute osteomyelitis?
nonviable bone, necrotic debris, acute inflammation and bacterial colonies in marrow spaces
treatment of acute osteomyelitis?
drainage of purulent exudate and antibiotics
What’s chronic osteomyelitis?
a long standing inflammation of bone, painful and swollen
what can be seen on an x ray when chronic osteomyelitis is present?
a diffuse and irregular radiolucency that can eventually become opaque
treatment of chronic osteomyelitis?
decried, antibiotics, hyperbaric oxygen
What does candida albicans mostly occur from?
dentures and improper denture care
how can Candida albicans be identified?
scarping lesion
what’s pseudomembranous candidacies?
a white curdle material is present on the mucosal surface, mucosa is erythematous underneath
what might a patient complain of with Psuedomembranous Candidiasis?
a burning sensation and or a metallic taste
what’s erythematous candidiasis?
painful, can be localized or generalized
What’s the most common type of candidiasis?
Denture Stomatitis (Chronic Atrophic Candidiasis)
Diagnosis of Denture Stomatitis?
can be asymptomatic as client associates discomfort with poor denture fit
Where is denture stomatitis most commonly found?
on palate and maxillary alveolar ridge
What’s Chronic Hyperplastic Candidiasis (Candidal Leukoplakia)
a white lesion that does not wipe off, responds to antifungals
What’s angular cheilitits?
erythema or fissuring at the labial commissures, most commonly from candida
What’s Chronic Mucotaneous Candidiasis?
a severe form that usually occurs in patients who are severely immunocompromised
What’s Median Rhomboid Glossitis?
an erythematous, often rhomboid shaped, flat to raised area on the midline of the posterior dorsal tongue
diagnosis of Median Rhomboid Glossitis
a mucosal smear is obtained and sent to the laboratory for staining and examination
Oral lesions may be caused by ____ _____ ________ such as histoplasmosis, coccidiomycosis, blastomycosis and crptococcis
deep fungal infections
what do all deep fungal infections alll involve?
the lungs
clients who are immunosuppressed or suffering from any type of COPD should be assessed before _______ _______ _________ are used during debridement
aerosol generating procedures
how is a diagnosis of deep fungal infections made?
made by biopsy and microscopic examination
What’s mucormycosis?
rare fungal infection
What’s aspergillosis?
rare fungal infection
Always refer to oral surgeon and MD once suspected _____ is noted due to ________ _____
HPV, malignancy risk
What’s Verruca Vulgaris
common wart, cauliflower like appearance
how is a Verruca Vulgaris diagnosis?
biopsy and examination
What’s Condyloma Acuminatum?
a benign papillary lesion caused by a papillomavirus
whats treatment for Condyloma Acuminatum?
conservative surgical excision and recurrence is common
What’s Multifocal Epithelial Hyperplasia (Heck Disease)
characterized by the presence of multiple whitish/pale pink nodules distributed throughout oral mucosa
who is multifocal epithelial hyperplasia most common in?
children
What’s the initial infection like with Primary Herpetic Gingivostomatitis?
painful, erythematous, and swollen gingiva, multiple tiny vesicles, vermillion borders and oral mucosa
Where is the most common spot for recurrent herpes simplex infection?
herpes labials
What kind of symptoms might patient have before a cold sore appears?
prodromal signs
What are the 2 Epstein Barr virus infections?
infectious mono and hairy leukoplakia
What does Hairy Leukoplakia associated with Epstein bar look like?
an irregular, corrugated, white lesion most commonly occurring on lateral border of the tongue
what is the coxsackievirus infections transmitted by?
fecal-oral contamination, saliva, respiratory droplets
three distinctive oral lesions of coxsackievirus infection?
herpangina, hand-foot and mouth disease, acute lymphonodular pharyngitis
What is Herpangina characterized by?
malaise, dysphagia (trouble swallowing), vesicles on the soft palate, red pharyngitis (resolves in 1 week)
what is acute lymphonodular pharyngitis characterized by?
fever, sore throat and mild headache, hyperplasticity lymphoid tissue of the soft palate or tonsillar pillars appear yellowish
What might you see intramurally with measles?
koplik spots
what are Koplik spots?
small erythematous macule may occur in the oral cavity, blueish colour
what is mumps?
a viral infection of the salivary glands
HIV/AIDS infects cells of the immune system, particularly ________
CD4 T-helper lymphocytes
in HIV-positive partners, ______, generally signals the beginning of progressively sever immunodeficiency
thrush/oral candidiasis
Shingles generally follows the usual pattern when it occurs in a person who is?
HIV positive
What is Kaposi Sarcoma?
an opportunistic neoplasm that may occur in patients with HIV infections, dark purple lesion
diagnosis for Kaposi sarcoma
biopsy
treatment of Kaposi Sarcoma?
surgical exo, radiation tx, chemotherapy
What is Lymphoma associated with?
HIV
tx of Lymphoma?
chemotherapeutic drugs
2 unusual forms of perio/gingiviits may develop in pts with HIV
Linear gingival erythema and necrotizing ulcerative periodonitits
three characteristics of Linear Gingival Erythema (LGE)
spontaneous bleeding, petechiae-like lesions on attached gingiva and alveolar mucosa, sandlike erythema of the gingiva that does NOT responded to therapy
LGE occurs independently of ___________
oral hygiene status
whats necrotizing ulcerative periodontitis (NUP)
characterized by intense erythema and extremely rapid bone loss
a devrease in platelets may occasionally be seen in patients with ___
HIV