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Front 1

Actinomycetes:
Actinomycosis:
type of bacteria?
enter tissue how?
Present as an? characterized by?
dx?
tx?

Back 1

- gram + filanmentous anaerobic, 50% cervicofacial
-actinomyces israelii-normal oral flora
-through opening via trauma
-acute deep suppurative abscess with draining sinus tract(acute response)
-colonies of actinomycotic organisms surrounded by neutrophils
-sulfar granules: yellowish flecks seen clinically representing colonies of actinomyces

dx: histology+culture
tx: surgican drainage/debridement and antibiotics

Front 2

Noma
-type of infection frrom?
-common in?
-clinical manifestation
-result
-tx?

Back 2

-opportunistic infection from normal oral flora in severly immunodeficient

-malnourished in 3rd world
-aids

-necrotizin ulcerative gingivitis extends to involve adjacent soft issue and beyond
-extensive necrosis and makred tissue destruction, facial disfigurement

-death

-tx: correct underlyin disease, debridement antibioti

Front 3

• HIV-Associated Kaposi’s Sarcoma

most common?
compared to non HIV Kaposis?
type of tumor? caused by?
manfiests as?
what can be seen in the oral cavity?
requires a ___ for dx?
Therapy?

Back 3

o The most common malignancy in HIV patients
 Non-HIV associated in older/lower extremeties
 HIV-assoicated: younger, on trunk, mucous membranes and internal organs
o A malignant vascular tumor caused by HHV8/KSHV
 Vascular proliferation
o Manifest as multiple lesions of the skin. oral mucosa & viscera
o Oral cavity: palate, tongue & gingiva
 starts as purple macular lesions on skin and later develops into nodules
 Invade bone
o Biopsy is necessary
o HAART has significantly reduced KS prevalence

Front 4

• HIV-associated Non-Hodgkin’s Lymphoma

-how common is it?
-caused by?
-majority are what type?
-occur where?

Back 4

o The 2nd most common malignancy in HIV patients
o Caused by EBV (KSHV?)
o Majority are high grade B-cell lymphoma
o Usually occur in extranodal locations
 CNS is the most common location

Front 5

o Human Papillomavirus
- clinical manifesation
- HAART has what affect?
- Normal vs. HIV
-normal do occur in

Back 5

Verruca vulgaris (common wart) and oral squamous papilloma
• Multiple exophytic on papillary nodules
 HAART treated patients show increased prevalence of HPV-related lesion
 More exaggerated in HIV patients
• Surface corrugated and covered with keratin
• Lesions merge together(usually single isolated)never happens in normal patient

Front 6

Aphthous Ulcerations “canker sore”
HIV patients see?

Back 6

HIV patients have increased frequency to develop all forms of aphthous ulcer (minor, major and herpetiform)
 In contrast to normal patients, most HIV patients develop major or herpetiform variants
• Herpetiform: resembles herpetic ulcer, cluster of small pinheadlesions

Front 7

Cytomegalovirus-transmission?
immunocomrpomised patients?
histpathology?

Back 7

Transmission:
 exchange of body fluid, organ transplant
 Infection ubiquitous, most subclinical
o Immunocompromised patients: affects many organs
 Oral manifestation:
• Chronic oral ulcer: often co-infect with HSV
• Cytomegaloviral sialadenitis
o Histopathology:
 CMV infected cells are massively enlarged. They contain intranuclear and cytoplasmic inclusions and exhibit “owl eye” alteration
 Attacks salivary gland too

Front 8

• Acute Lymphonodular Pharyngitis

clinical:
nodules caused by?
treatment?

Back 8

o Clinical: sore throat and flue-like symptom(similar to strept pharyingitis)
 Low number of yellow nodules develop in oropharynx area
 No vesiculation or ulceration
o Nodules are caused by lymphoid hyperplasia
o Tx: self limiting

Front 9

Chronic Hyerplastic Candidiasis
clinical?
sx?
dx?
histology?

Back 9

o Clinical:
 White plaque that is not removable, background may be red and inflamed
• White from hyperplastic epithelium and increased keratin
o Sx
 Usually asymptomatic
o Dx
 Biopsy is necessary: clinically resemble premalignant lesions
o Histology: candidal hyphae penetrating the hyperparakeratotic layer of the epithelium

Front 10

Acute Atrophic Candidiasis
-occurs after?
-clinical?
-sx?
tx?

Back 10

Often after broad spectrum antibiotics, or suffer from xerostomia
• Diffuse loss of the filiform papillae of the dorsal tongue
o Burning tongue sensation
o Sensitive to spices
• White area is normal area
• Red area = no filiform papillae
• Tx:
o Antifungals or treat underlying cuase(stop antibiotics or treat xerostomia)

Front 11

• Mucocutaneous Candidiasis

-immunological disorders
-complications

Back 11

• Mucocutaneous Candidiasis
o Immunological disorders
 Congenital immunodeficient patients: Patients develop immune disorder during the first few years in life
 Candidal infections of the mouth, nails, skin and other mucosal surfaces
 Endorince-candidiasis syndrome, autoimmune polyendocrinopathy-candidasis-ectodermal dystrophy
• Some patient develop autoantibody attacking endocrine glands
• Develop endocrine abnormalities later in the life: hypothroidism, hypoparathyroidism, Addison’s disease and DM etc
• Patients need to be periodically evaluated for their endocrine function.

Front 12

• Histoplasmosis, Coccidiodomycosis & Cryptococcosis : Oral Lesions

clinical features:
DDH:
Dx?
histopathlogy?
tx?

Back 12

Clinical features:
 chronic non-healing ulcer(s), may penetrate bone
o DDH for non-healing ulcer:
 Deep fungal infections, oral squamous cell carcinoma, tramatic ulceration, oral TB and primary syphilis have similar clinical pictures
o Biopsy is needed. Serology and cultures are also helful.
o Histopathology:
 granulomatous inflammation. Special stains are used to demonstrate the fungus.
 Oral lesion is not the primary lesion
o Tx: antimicrobial agents

Front 13

Zygomycosis
type of organisms?
also know as?
-type of infection which infects?
-pathogensis
-histology

Back 13

Zygomycosis(Zebra)
o Caused by fungal organisms of the phylum Zygomycota
o Also called “mucormycosis”, “phycomycosis”
o An opportunistic infection affecting
 Uncontrolled diabetes mellitus patients that develop ketoacidosis –thrive in iron
 Immunocompromised patients
o Angiotropic: Invade/grow the arterial wall, result in ischemia, infarction and necrosis
o Histology:
 extensive tissue necrosis and the characteristic fungal hypahe