Chapter 4 Flashcards
Immune response
Acquired response of defense from micro organisms.
Capacity to remember and respond more quickly the 2nd time.
Immunity
Increased responsiveness that results from retained memory of an antigen.
Antibody
Aka immunoglobulin. Protein molecule produced by a plasma cell that is able to react to an antigen.
Carried in blood
Antigen
Foreign substance that induces specific immune response.
Autoimmune disease
Persons own tissues become antigens.
Cytokines
Proteins produced by cells that affect the behavior of other cells.
Includes interferons, interleukins, lymphotoxins, chemotactic factor.
Stimulates leukocytes and macrophages, and destroys macrophages.
Types of antibodies (immunoglobulins)
IgM: first to the site, largest antibody, activates compliment system.
IgG: most numerous, enhances phagocytosis, passive immunity for newborns (helps build immune system as a kid).
IgE: responds in hypersensitivity rxns, acute anaphylaxis allergy.
Binds to mast cells for release of histamine, attacks parasites.
IgD:
stimulates B lymphocytes.
B-Lymphocytes
Immune response cell.
Stem cells in bone marrow that mature/reside in lymphoid tissue.
Two types - plasma cells: produce antibodies
Memory cells: retain memory of antigen
T-lymphocytes
Immune response cell.
Stem cells in bone marrow, mature in thymus gland(chest).
Types include memory, helper, suppressor, and cytotoxic cells.
T-cytotoxic cells destroy virus and tumor infected cells.
Mast cells
Realize HISTAMINE which:
1. Increase permeability of vessels 2. Dilate vessels 3. Edema 4. Constriction of smooth muscle (which can cause shock since airways are lined with smooth muscle)
Macrophages
Phagocytosis and other functions
Esinophils
Functions in immunity
Humoral response
Division of immune response.
Production of antibodies by activated B-lymphocytes (plasma cells).
Cellular response
Division of immune response.
Actions by T-lymphocytes, working alone or with macrophages
Types of immunity
Active: due to host response to antigen, host produces Ig
Natural: immunity from 2nd attack after body recovers from disease
Artificial: vaccination induces memory/antibodies
Passive: using antibodies/immunity from another person or animal
Natural: mother passes her antibodies (igG) to baby
Artificial: injection of antibodies ex. Vaccine
Although ulcer (canker sores)
Painful yellow/white ulcers sourrounded by an erythematous halo.
Minor aphthous- canker sores found on nonkeratinized mucosa.
Major aphthous- larger, deepens, lasts longer, may cause scarring.
TX: topical steroids or anti inflammatory mess
Urticaria
Hives often part of allergic rxn.
Swelling of skin usually with itching (pruritus) due to vascular permeability.
Angiodema
Diffuse swelling, often “puffy lip”
Contact dermatitis and mucositis
Type 4 hypersensitivity rxn like latex allergy
Skin becomes edematous, and red due to direct contact with allergen.
Trxt: steroids
Erythema multiforme
Target or bulls eye lesions
Necrosis of the epithelium due to immune reaction
Cause unknown.
Trxt : steroids
Stevens Johnsons Syndrome
Type of toxic epidermal necrolysis
Extensive painful lesions with severe adverse rxns to certain drugs
Lichen planus
Benign chronic condition with unknown cause
Wickhams striae: lacy white network on mucosa
Buccal mucosa is most common site
Possible increase of developing squamous cell carcinoma
Trxt: steroids
Reiters syndrome
Reactive arthritis.
Benign, self limiting (not life threatening) disease, triad consisting of arthritis, urethritis (inflamed urethra), and conjunctivitis (inflamed eyes)
Unknown cause, but associated with genetics (antigenic marker= HLA-B27)
Abnormal immune response after the body’s response to infection (commonly STD or GI infection)
Langerhans cell disease
Proliferation (excessive growth) of macrophages with unknown cause
- Letterer- Siwe disease (young kids, fatal)
- Hand-Scheller- Christian (young kids)
- Esinophilic granuloma (surgical excision/radiation) best prognosis
Sjogrens syndrome
Auto immune disease causing dryness of the eyes (xerophthalmia) and dry mouth
Sicca syndrome
Rheumatoid arthritis is often associated
Bilateral parotid gland enlargement in 50% of patients
Trxt: steroids, saliva and tear substitutes
Lupus
Autoimmune disease characterized by butterfly rash across the bridge of nose
Arthritis, myalgia, many organs affected.
Women more than men
Trxt: steroids and other immunosuppressant drugs
Pemphigus vulgaris
Severe, progressive autoimmune disease of skin and mucosa
Erythema, vesicles, bullas, ulcers
Destruction of desmosomes (connects cells) in epithelium
Tzanek cells due to separation of epithelial cells (acantholysis).
Results in intra-epithelial blisters
Positive Nikolskys sign (inflamed when rubbed)
Steroidal trx.
Pemphigoid
Benign mucous membrane pemphigoid
Not as severe as pemphigus vulgaris
Autoimmune disease associated with desquamitive gingivitis
Positive Nikolskys sign
Destruction of hemidesmisomes, causing separation of epithelium from basement membrane
Sub-epithelial blisters
Behcets syndrome
Autoimmune disease involving oral, eye, genital lesions
Ulcers like canker sores
Scleroderma
Autoimmune disorder characterized by fibrosis/hardening of the skin and internal organs, esp kidneys.
Hypertension, kidney failure
Raynauds phenomena
Widening of the periodontal ligament space apparent on X-rays.
Impetigo
Bacterial skin infection caused by streptococcus pyrogens and staphylococcus aureus
Young kids
Cuts and scratches allow bacteria to colonize - contagious, transmitted thru direct contact
Antibiotics
Tonsillitis and pharyngitis
Inflammation streptococci strep throat or influenza
May be followed by scarlet fever, rheumatic fever or strawberry tongue
Rheumatic fever is inflammation of the heart, joints and CNS- permenant damage to heart valves.
Herpes simplex virus 1 (HSV-1)
Oral herpes
Herpes simplex virus 2 (HSV-2)
Genital herpes
Varicella-Zosters virus
Chicken pox and shingles
Epstein-Barr virus
Mono and Burkett’s lymphoma (enlarged spleen)
Oral hairy leukoplakia (HIV)
Nasopharyngeal carcinoma
Herpes 6
Roseola
Herpes 8
Karposis sarcoma
AIDS
Measles
Highly contagious
Caused by PARAMYXOVIRUS
Kopliks spots= small, erythematous macules with white, necrotic centers found in oral cavity
CAN cross placenta barrier
Mumps
Viral disease of the salivary glands caused by PARAMYXOVIRUS
Painful, bilateral swelling of the parotid glands
Herpangina
Vesicles on soft palate, fever, malaise, sore throat, mild
COXSACKIE VIRUS
Hand foot mouth
Children under 5 years old, Miculescu, papules, skin and oral mucosa
Resolves in 2 weeks
COXSACKIE VIRUS
Acute lymphonodular pharyngitis
Fever, sore throat, headache, lasting 2 days - 2 weeks.
COXSACKIE VIRUS
Associated oral diseases with AIDS
Candidiasis *Hairy leukoplakia* *Kaposis sarcoma lymphoma* Spontaneous gingival bleeding *Linear gingival erythema * NUG opportunistic diseases and Aphthous ulcers
Recurrent hermetic gingivostomatitis
Cold sores, fever blisters
Most common is herpes labialis on vermillion border
May be brought on by stress, sun, fever, menstruation
Primary herpetic gingivostomatitis
Initial infection with herpes simplex virus (6months to 6years)
Fever malaise, lymphadenopathy, painful red gingiva, vesicles
Vesicles ulcerate, crust over, heal within 10-14 days
Difference between herpes and aphthous ulcers
Herpes Aphthous ulcers
Keratinized mucosa. Non keratinized mucosa
Vesicles first, then ulcers. NO vesicles
Recurrence. Recurrence
Tx- Acyclovier (Zovirax). Tx-topical steroids & anti inflam drugs
Anti viral drugs
Herpetic whitlow
Herpes involving the fingers. HSV 1&2
Chicken pox
2-3 week recovery
Varicella-Zoster virus
Shingles
Herpes -Zoster
Adult chicken pox along a sensory nerve
Mono
Enlarged spleen
Palatial petichiae early in in disease
Resolves in 4-6 weeks
Hairy leukoplakia
Irregular, corrugated white lesions, mostly in lateral border of tongue. Occurs in HIV patients.
Epstein Barr virus
Causes: Mono, hairy leukoplakia, chronic fatigue syndrome, nasopharyngeal carcinoma and Burkett’s lymphoma which are both very rare malignant neoplasms
Pericoronitis
Inflammation of mucosa around the crown if a partially erupted tooth
Osteomyelitis
Inflammation of bone and bone marrow
Caused from access, bone fracture, or surgery
“Moth eaten” radiolucency in bone
Tx- hyperbaric oxygen
Candidiasis
Most common oral infection
Caused by overgrowth of yeast fungus called Candida albicans
Results from immunodeficiency like antibiotics, steroids, HIV…
White material that can be wiped away with red, painful, burning underlying mucosa.
Types
Pseudomembraneous - white that can be wiped away
Erythematous- red and painful
Chronic strophic candidiasis aka denture stomatitis
Chronic hyper plastic candidiasis- white that cannot wipe away
Angular chelitis- red, cracking, commissures
Chronic muccotaneous candidiasis- severe form in immunocomprimised patients
Median rhomboid glossitis- may be related to fungal infection
Tx- Nystatin is antifungal med. or fluconazole
HPV
Viral infection spread through direct contact
Vaccine: Gardasil
Associated with cervical, oral cancer,
Verruca Vulgaris
Viral infection - HPV
Common wart
Lips are most common intraoral site
Condyloma Acuminatum
Viral infection -HPV
Benign papillary lesion
STD - genital warts
Tuberculosis
Contagious, bacterial granulomatous disease in the lungs
Caused by an acid fast rod - mycobacterium tuberculosis
Infection from inhaled droplets
Skin test - Mantoux test
Scrofula- TB of the head and neck w lymph node involvement
Actinomycosis
Bacterial infection from actinomyces israeli found in SOIL
Draining skin lesions with sulfur granules that feel like sand
Abscesses are common
Antibiotics
Syphillis
Bacterial infection from treponema palladium
3 stages
Primary - chancre at site of origin (highly contagious)
Secondary- rash, oral patches occur 6 weeks after primary lesion
Tertiary- gumma, affects nervous system. Not contagious
Congenital syphillis includes mulberry molars, hutchinsons incisors, and deafness (CN VIII)
Penicillin
NUG
Painful erythematous gingiva with punched out papillae
Poor OHI, decreased resistance to infection, stress, malnutrition
Caused by anaerobic organisms, fusiform bacillus and spirochete (borrelia vincenti)
Treponema denticola, prevotella intermedia, porphyomona gingivalis
Do not scale root plane
Flagyl antibiotic
