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Pathology · single question

An HIV-positive patient presents for a routine check-up. All of the following contribute to oral candidiasis in HIV patients EXCEPT:

  1. Increased vertical dimension of occlusion (VDO)
  2. Immunosuppression (low CD4 count)
  3. Xerostomia
  4. Broad-spectrum antibiotic use
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Correct answer: A. Increased vertical dimension of occlusion (VDO)

  • A. CORRECT. Increased vertical dimension of occlusion is NOT a risk factor for candidiasis. Angular cheilitis (associated with Candida) is linked to DECREASED VDO with overclosure creating persistent skin folds — not increased VDO. This is the EXCEPTION.
  • B. Incorrect. Low CD4 count (immunosuppression) IS a major risk factor — reduced T-cell immunity allows opportunistic Candida proliferation.
  • C. Incorrect. Xerostomia IS a risk factor — reduced salivary IgA and flow eliminate antimicrobial protection, allowing Candida overgrowth.
  • D. Incorrect. Broad-spectrum antibiotics eliminate competing oral bacteria, disrupting the normal microbiome and permitting Candida overgrowth (antibiotic-associated candidiasis).

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