Chapter 3 DENT 1060 Flashcards

Immunity and Immunologic Oral Lesions

1
Q
The immune system usually defends the body against foreign substances that are called
A. Plasma cells
B. Antibodies
C. Antigens
D. Lymphocytes
A

C. Antigens

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2
Q
Memory is an important function of the immune system because it 
A. Retains the memory of the antibody
B. Allows faster future immune responses
C. Allows faster inflammatory responses
D. Weakens future immune responses
A

B. Allows faster future immune responses

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3
Q

Immunization with a vaccine works by
A. Increasing the risk of an antigen-causing disease
B. Using antibodies produced by another person
C. Passing antibodies from the mother to the fetus
D. Producing active acquired immunity

A

D. Producing active acquired immunity

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4
Q

Which of the following is an important fact about the B-cell lymphocyte?
A. It is derived from a precursor stem cell.
B. It matures and resides in the thymus.
C. It is produced from plasma cells.
D. It is active in foreign substance surveillance.

A

A. It is derived from a precursor stem cell.

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5
Q

A macrophage is a cell of the immune system that
A. Retains a memory of an encountered antigen
B. Produces antibodies
C. Undergoes B-cell phagocytosis initially during inflammation
D. Can be activated by lymphokines

A

D. Can be activated by lymphokines

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6
Q

Which statement is CORRECT when applied to natural killer cells?
A. They do not circulate within the body.
B. They secrete antibodies.
C. They are part of the body’s innate immunity.
D. They are a type of T-cell lymphocyte.

A

C. They are part of the body’s innate immunity.

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7
Q
In which type of immunopathology are the cells of the body no longer tolerated and treated by the immune system as antigens?
A. Hypersensitivity
B. Immunodeficiency
C. Hyperplasia
D. Autoimmune disease
A

D. Autoimmune disease

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8
Q
During the anaphylactic type of hypersensitivity reaction, the plasma cells
A. Produce antibody called IgE
B. React with lymphocytes
C. Combine with antigen
D. Form immune complexes with antigen
A

A. Produce antibody called IgE

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9
Q
Which type of hypersensitivity reaction involves activated complement?
A. Type I
B. Cytotoxic
C. Type III
D. Anaphylactic
A

B. Cytotoxic

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10
Q
What type of lymphocyte matures in the thymus, produces lymphokines, and can increase or suppress humoral immunity?
A. T-cell lymphocyte
B. Plasma cell
C. Natural killer cell
D. Macrophage
A

A. T-cell lymphocyte

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11
Q
In the immune system, antibodies are proteins that are
A. Also called immunoglobulins
B. Also called cytokines
C. Directly produced by lymphocytes
D. Directly produced from mast cells
A

A. Also called immunoglobulins

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12
Q
Which of the following types of immunologic disease involve a decreased number or activity of lymphoid cells?
A. Autoimmune
B. Hypersensitivity
C. Immunodeficiency
D. Ractive hyperplastia
A

C. Immunodeficiency

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13
Q
Humoral immunity involves the production of 
A. Antigens
B. Antibodies
C. Autoimmune cells
D. Toxins
A

B. Antibodies

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14
Q
The laboratory measurement of a specific antibody level in the blood is called
A. Phagocytosis
B. Immunization
C. Titer
D. Pavementing
A

C. Titer

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15
Q
Which type of immunity may be provided immediately to dental personnel after needlestick accidents?
A. Natural passive immunity
B. Acquired passive immunity
C. Natural active immunity
D. Acquired active immunity
A

B. Acquired passive immunity

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16
Q
Which of the following situations would result in the LEAST risk of drug allergy?
A. Application of topical medication
B. Presence of infection
C. Presence of multiple allergies
D. Use with children
A

D. Use with children

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17
Q
Which of the following is involved in the regulation of BOTH humoral and cell-mediated immunity?
A. Humoral immunity
B. Cell-mediated immunity
C. Innate immunity
D. Bone marrow cells
A

B. Cell-mediated immunity

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18
Q
Which of the following is involved in the communication between lymphocytes within the immune system?
A. Histamine
B. Complement
C. Bradykinin
D. Cythokines
A

D. Cythokines

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19
Q
All of the following are examples of hypersensitivity reactions EXCEPT
A. Systemic lupus erythematosus 
B. Urticaria
C. Angioedema
D. Contact dermatitis and mucositis
A

A. Systemic lupus erythematosus

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20
Q
Reactive arthritis is known for being
A. An infectious disease
B. An immunodeficiency disease
C. An immunologic disorder
D. More common in women than in men
A

C. An immunologic disorder

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21
Q
Which one of the following types of hypersensitivity reactions is referred to as delayed hypersensitivity?
A. Type I
B. Type II
C. Type III
D. Type IV
A

D. Type IV

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22
Q
A target lesion on the skin is associated with which of the following diseases?
A. Behcet syndrome
B. Systemic lupus erythematosus
C. Lichen planus
D. Erythema multiforme
A

D. Erythema multiforme

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23
Q
Tzanck cells are seen in which of the following conditions?
A. Pemphigus vulgaris
B. Erythema multiforme
C. Systemic lupus erythematosus
D. Behcet syndrome
A

A. Pemphigus vulgaris

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24
Q
The oral lesions in Reiter syndrome may resemble
A. Pemphigus vulgaris
B. Lichen planus
C. Angioedema
D. Geographic tongue
A

D. Geographic tongue

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25
Q
Aphthous ulcers are seen in each of the following systemic diseases EXCEPT
A. Behcet syndrome
B. Langerhans cell histiocytosis
C. Ulcerative colitis
D. Cyclic neutropenia
A

B. Langerhans cell histiocytosis

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26
Q
The two cell types that microscopically characterize Langerhans cell histiocytosis are 
A. Lymphocytes and plasma cells
B. Fibroblasts and lymphocytes
C. Eosinophils and mononuclear cells
D. Neutrophils and lymphocytes
A

C. Eosinophils and mononuclear cells

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27
Q
Which one of the following is the form of Langerhans cell histiocytosis that is characterized by a triad of symptoms?
A. Letterer-Siwe disease
B. Hand-Schuller-Christian disease
C. Eosinophilic granuloma
D. Behcet syndrome
A

B. Hand-Schuller-Christian disease

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28
Q
The most benign type of Langerhans cell histiocytosis is
A. Hand-Schuller-Christian disease
B. Eosinophilic granuloma
C. Letterer-Siwe disease
D. Chronic disseminated reticulosis
A

B. Eosinophilic granuloma

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29
Q
The MOST characteric oral manifestation of Sjogren syndrome is
A. Xerostomia
B. Geographic tongue
C. Erythema multiforme
D. Acute disseminated reticulosis
A

A. Xerostomia

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30
Q

Which of the following statements about autoimmune disease with oral manifestations is considered FALSE?
A. The bullae in pemphigus vulgaris are more fragile than those in bullous pemphigoid.
B. Acantholysis of the epithelium is seen in pemphigus vulgaris
C. In pemphigoid the separation of the epithelium from the connective tissues occurs at the basement membrane.
D. Skin lesions are common in mucous membrane pemphigoid.

A

D. Skin lesions are common in mucous membrane pemphigoid.

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31
Q
Which is the MOST distinct and definitive characteristic that distinguishes pemphigus from pemphigoid?
A. Size of the ulcerations
B. Age and gender of the patient
C. The microscopic findings
D. Nikolsky sign
A

C. The microscopic findings

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32
Q
Desquamative gingivitis may be present in all of the following EXCEPT
A. Cicatricial pemphigoid
B. Pemphigus vulgaris
C. Lichen planus
D. Aggressive periodontal disease
A

D. Aggressive periodontal disease

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33
Q
Which of the following orofacial structures could create a life-threatening situation for the patient from angioedema involvement?
A. Lips
B. Mucosa
C. Eyelids
D. Epiglottis
A

D. Epiglottis

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34
Q
Which of the following is a pathologic condition producing a characteristic butterfly-shaped lesion on the face and oral ulcers, occurs more frequently in females than males, and for which the result of a blood test is important in its diagnosis?
A. Pemphigus
B. Erosive lichen planus
C. Desquamative gingivitis
D. Lupus erythematosus
A

D. Lupus erythematosus

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35
Q

Which of the following statements concerning the dendritic cell is considered CORRECT?
A. It is found in an immature state within tears
B. It is a specialized type called a Langerhans cell that is found in the mucosa.
C. It is similar to lymphocytes in morphology and function.
D. It interacts only with macrophages during the immune response.

A

B. It is a specialized type called a Langerhans cell that is found in the mucosa.

36
Q
What marker does the T-cytotoxic cell carry?
A. CD4
B. CD8
C. C-reactive protein
D. IgG
A

B. CD8

37
Q
Which of the general types of immunoglobulin is a MAJOR antibody found in blood serum and serves as the first passive immunity for the newborn?
A. IgA
B. IgD
C. IgG
D. IgM
A

C. IgG

38
Q
Which one of the following is the most common cause of serum sickness?
A. Aspirin
B. Antihistamines
C. Corticosteroids
D. Penicillin
A

D. Penicillin

39
Q
Which type of IgA is present in both tears and saliva?
A. Purulent
B. Serous
C. Secretory
D. Reactive
A

C. Secretory

40
Q
Which one of the following is involved in the Raynaud phenomenon?
A. Kidney tissue
B. Ocular components
C. Fingers and toes
D. Joints
A

C. Fingers and toes

41
Q
What type of hypersensitivity reaction is involved in a fixed drug eruption when it occurs in the oral cavity?
A. Type I
B. Type II
C. Type III
D. Type IV
A

C. Type III

42
Q
Which of the following can be used in the management of herpetiform ulcerations?
A. Laser nephelometer
B. Topical tetracycline
C. Rheumatoid factor
D. Rh incompatibility
A

B. Topical tetracycline

43
Q
Which factor is important for safety when using a live vaccine?
A. Heat stable
B. Attenuated
C. Virulence
D. Synthetic peptides
A

B. Attenuated

44
Q

Which of the following descriptions is CORRECT when used to describe cytokines?
A. Affect only nephrons within the kidneys
B. Include lymphokines and monokines
C. Administered parentally with asthma attacks
D. Produced in the liver in response to low serum levels

A

B. Include lymphokines and monokines

45
Q
What is the MOST common location for Wickham striae in the intraoral region?
A. Dorsal surface of tongue
B. Floor of mouth
C. Buccal mucosa
D. Vermilion border
A

C. Buccal mucosa

46
Q

Acantholysis

A

dissolution of the intercellular bridges of the prickle cell layer of the epithelium

47
Q

Acquired immune response

A

immune response to a foreign substance, based on the specific memory of a past exposure to that same foreign substance; the second, acquired immune response is quicker than the initial response

48
Q

Active immunity

A

type of immunity based on antibodies developed in response to an antigen; there are two types of active immunity: natural and acquired

49
Q

Allergen

A

antigen producing a hypersensitivity, or allergic, reaction

50
Q

Allergy

A

hypersensitivity acquired through exposure to a particular allergen that elicits an exaggerated reaction on reexposure to the same allergen

51
Q

Anaphylaxis

A

severe, immediate type of hypersensitivity or allergy in which an exaggerated immunologic reaction occurs on reexposure to a foreign protein or other substance after sensitization, resulting in hives, itching, swelling, vascular collapse, and shock; also called ANAPHYLACTIC SHOCK

52
Q

Antibody

A

protein molecule, an immunoglobulin, that is secreted by plasma cells and reacts with a specific antigen; there are five classes: IgA, IgD, IgE, IgG, and IgM

53
Q

Antibody titer

A

level of a specific antibody in the blood

54
Q

Antigen

A

any substance able to induce a specific immune response

55
Q

Attenuate

A

to reduce the severity of a disease or the virulence of a pathogenic agent, as is done in the development of certain vaccines

56
Q

Autoantibody

A

antibody that reacts against a normal tissue constituent of one’s own body

57
Q

Autoimmune disease

A

disease characterized by tissue trauma caused by an immune response against tissue constituents of one’s own body

58
Q

B-cell lymphocyte

A

type of lymphocyte that develops in lymphoid tissue other than the thymus, and that can later develop into a plasma cell that produces antibody, the main initiator of humoral immunity

59
Q

Cell-mediated immunity

A

type of immunity in which the major role is played by T-cell lymphocytes

60
Q

Cytokines

A

proteins produced by various cell types for the purpose of intercellular communication; immunological cytokines are involved in the immune response

61
Q

Dendritic cell

A

a type of white blood cell that acts as an antigen-presenting cell in the skin and mucosa

62
Q

Humoral immunity

A

type of immunity in which both B-cell lymphocytes and the antibodies they produce as plasma cells play the predominant role

63
Q

Hyposlivation

A

decreased salivary flow that may result in xerostomia (dry mouth)

64
Q

Hypersensitivity

A

altered state of reactivity in which the body reacts to a foreign agent, or allergen, with an exaggerated immune response; there are four types of hypersensitivity: types I through IV

65
Q

Immune complex

A

Combination of an antibody and antigen, producing a complex that can initiate a hypersensitivity reaction

66
Q

Immunization

A

Induction of active immunity; when the pathogenic microorganism used to induce active immunity is encountered after vaccination, a stronger, faster immune response is produced, which prevents disease development

67
Q

Immunodeficiency

A

Reduced immune response resulting from hypoactivity or decreased numbers of lymphoid cells

68
Q

Immunoglobulins

A

Proteins that, when secreted by plasma cells, serve as antibodies designed to respond to a specific antigen; surface immunoglobulins remain attached to the surface of certain B cells and function as receptors

69
Q

Immunomodulator

A

a substance that alters the immune response by augmenting or reducing the ability of the immune system to produce antibodies or sensitized cells that recognize and react with the antigen that initiated their production

70
Q

Langerhans cells

A

specialized dendritic cell, found in the skin and mucosa, that is involved in the immune response

71
Q

LE cell

A

mature neutrophil with a phagocytized spherical inclusion derived from another neutrophil; it is used as a marker of autoimmune diseases

72
Q

Lymphoid tissue

A

tissue composed of lymphocytes supported by a meshwork of connective tissue; includes tonsillar tissue, lymph nodes, and lymphatic organs

73
Q

Lymphokines

A

cytokines produced by B-cell or T-cell lymphocytes in contact with antigens; mediator in an immune response

74
Q

Macrophage

A

large tissue-bound mononuclear phagocyte derived from monocytes circulating in the blood, which can become mobile when stimulated by inflammation and interact with lymphocytes in a immune response

75
Q

Monokines

A

cytokines produced by monocytes or macrophages; mediators in an immune response

76
Q

Mucositis

A

mucosal inflammation due to a disease process

77
Q

Natural killer cell

A

type of lymphocyte that is part of the initial innate immune response, which by unknown mechanisms is able to directly destroy cells recognized as foreign

78
Q

Nikolsky sign

A

diagnostic sign whereby the superficial epithelium separates easily from the basal layer on exertion of firm, sliding manual pressure with the fingers

79
Q

Passive immunity

A

type of immunity that uses antibodies produced by another person to protect an individual against infectious disease; there are two types of passive immunity: natural and acquired

80
Q

Plasma cell

A

cell derived from B-cell lymphocytes that produces antibodies in response to the presence of antigen

81
Q

Pruritus

A

itching

82
Q

Rheumatoid factor

A

antibody that binds to certain antibodies found in the serum of patients with rheumatoid arthritis and connective tissue diseases such as Sjogren syndrome; current assays test for IgM class rheumatoid factor

83
Q

Syndrome

A

group of signs and symptoms that occur together

84
Q

T-cell lymphocyte

A

lymphocyte that matures in the thymus and is mainly responsible for initiating cell-mediated immunity, as well as also modulating humoral immunity

85
Q

Thymus

A

organ consisting of lymphoid tissue located high in the chest, which is large in an infant and gradually shrinks in size in adulthood; site of T-cell lymphocyte maturation

86
Q

Xerophthalmia

A

Abnormal dryness of the eyes

86
Q

Xerostomia

A

dryness of the mucus membranes, including the oral cavity; usually caused by hyposalivation or decreased salivary flow