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Flashcards in Upper GI Micro - Zimmerman Deck (22)
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1
Q

Risk factor for developing caries:

A

high sugar diet, poor oral hygiene, reduced saliva, smoking, peridontal disease

2
Q

Name for the infectious disease that destroys the supporting structure of teeth?

A

Peridontal disease

Gum involvement = gingivitis
Tissue/bone involvment = peridontitis

3
Q

Peridontitis is associated with what other health problems?

A

Heart attack, stroke, lung disease, premature birth or low birth weights in women

Diabetes increases risk of peridontitis

4
Q

In caries and peridontitis, what is the underlying way that the microorganism causes disease?

A

Caries - it is the growth and spread of microbes themselves that is causing the disease

Peridontitis - it is the host’s own reaction to the microbe that is causing the disease

5
Q

Most basic definition of a biofilm?

A

2+ species of bacteria encolsed in a glycocalyx

6
Q

IF not all plaque is pathological, why yould you still want to remove it once in a while?

A

Plaque is a biofilm, it’s possible that microbial homeostasis to exist. The problem is that a change in that balance could occur because of many factors. This pathological shift could then lead to caries or peridontitis.

7
Q

What is important to know about the Streptococcus Mitis group of bacteria in reference to the mouth?

A

They may play important roles in preventing dental disease.

Could occur by producing hydrogen peroxide to inhibit growth of oral bacteria

8
Q

Microbes that cause caries:
Found where? Gram + or - ?

Microbes that cause peridontal disease:
Found where? Gram + or - ?

A

Caries:

  • located in plaques on tooth surface or in crevices between teeth
  • Gram +

Peridontal:

  • Located below gumline in subgingival space
  • Gram -
9
Q

What kinds of bacteria are you likely going to find in a dental carie?
Gram stain?
Hemolysis?
Special tests?

A

Strep. Mutans(viridans)
Gram +
Alpha hemolysis
Optochin Resistant!

10
Q

What kinds of virulence factors does strep mutans use in causing caries?

A

Adhesin-like surface-associated proteins (AgI/II): bind to receptors in the pellicle called glucans.

The pellicle is a layer of glycoproteins that covers the enamel of the tooth, it’s basically always there and comes back immediately after removal. Glucosyltransferases (Gtfs) are made by S. mutans and excreted, become part of the pellicle and pump out tons of glucans for easier binding.

11
Q

What is a keystone bacteria in reference to peridontal disease?
List a few examples:

A

The presence of certain low-abundance microbes that can quickly turn a symbiotic microbiome into a pathogenic state.

Treponema Denticola
**Porphyromonas Gingivalis
Agrigatibacter Actinomycetemcomitans

12
Q

4 ways to prevent dental caries and peridontal disease:

A

Less sugar in diet
Brush and floss frequently
Fluoride
Increased saliva flow (sugar free gum)

13
Q

In cases of persistent peridontitis, what oral medicine could you prescribe?

A

Amoxicillin and metronidazole

14
Q

A homeless man prevents with breathing difficulty and drooling. He has fever, neck swelling, and a large red reash on his neck. When you look in his mouth you see he has a lot of untreated dental problems. What are you thinking?

A

Ludwig’s angina

15
Q

Walk me through how you would treat candidiasis starting with easiest case and moving toward the worst case scenario:

A

Common case: topical tx of clotrimazole and nystatin suspension (swish and swallow
Unresponsive: Systemic fluconazole
Worse case: IV amphotericin B

16
Q

Your colleague Jesse is confused. Wait, what is the difference between Leukoplakia and Hairy Leukoplakia? Is one clean-shaven?

A

Leukoplakia - caused by tobacco use, NOT microorganism - white macular patch in oral mucosa

Hairy Leukoplakia - caused by EBV, usually in HIV+ patients - Fuzy white patches on lateral tongue that can’t be scraped off

17
Q

I need the distinguishing characteristics of H.Pylori:

A
Gram -
Flagellated
Catalase +
Oxidase +
Urease +
18
Q

Compare and contrast symptoms of gastritis vs gastric ulcer:

A

Gastritis

  • gnawing/burning in upper abdomen
  • nausea/vomiting
  • better of worse with food
  • fullness feeling in upper abdomen after eating
Gastric Ulcer
-Burning abdominal pain
-worse when stomach is empty
-flare at night
Less common sx:
-movit blood
-black tarry stools
-nausea/vomting
-weight loss, appetite changes
19
Q

Why is it important that H. Pylori is urease+ ?

A

Urease is used by the microorganism to neutralize the pH of its surroundings.

The pH near the epithelium is 6 whereas the fluid is more like 2. H.Pylori uses its flagella to stay swimming close to the surface in the basic pH

Converts urea to carbon dioxide and ammonia (ammonia is BASIC)

20
Q

Apart from urease, what are a couple other important virulence factors of H.Pylori?

A

VacA: Pore-forming cytotoxin allowing leakage of Ca from epithelial cell
(think Vaccum sucking out the Ca…)

CagA: Enters through TFSS tube and travels into host cytosol. There it affects the proliferative activities, adhesion and cytoskeletal organization of epithelial cells

21
Q

Tx for gastric ulcer:

A

1 week triple therapy:

  • 2 antibiotics (Clarithromycin and Amoxicillin)
  • Proton pump inhibitor (helps heal)
22
Q

What tests can be used to diagnose H. Pylori?

What tests can be used to confirm cure after tx?

A

Diagnose: Serum, breath, stool

Confirm cure: Breath, stool