Chapter 5 & 9

Question 1

Inhibits bacterial adherence and Promotes agglutination:

Answer 1

Salivary IgA

Question 2

Necrosis and sloughing of gingival tissue:

Answer 2

“NUG” Necrotizing Ulcerative Gingivitis

Question 3

Outer membrane of Gram (-) organisms
Endotoxins
Elicit strong immune responses

Answer 3

Lipopolysaccharide (LPS):

- Recognized by TLR4/CD14/MD-2 complex

Question 4

Bacterial evasion of host responses

Answer 4

Inhibition of Neutrophils
Production of IgA and IgG proteases
Cytotoxic effects

Question 5

Inhibition of Neutrophils occurs via:

Answer 5

Leukotoxin production
Chemotaxis inhibitors
Impairment of PMN adherence and phagocytosis
Inhibition of Oxygen radical activity
Inhibition of Lysosomal degranulation
Degradation of Lactoferrin

Question 6

Indirect injury by plaque microorganisms occurs via:

Answer 6

Endogenous mediators of inflammation

Question 7

Endogenous mediators of inflammation include:

Answer 7

Cytokines
Vasoactive amines
Plasma proteases
Neutral proteases
Arachidonic acid metabolites
Oxygen-derived metabolites
Lysosomal acid hydrolases

Question 8

Ag/Ab complexes:

Answer 8

Inactivate toxins

Activate complement-mediated bacteriolysis

Question 9

T cell functions include:

Answer 9

Cytotoxic(ity)
helper T cell (assist T and B cell response to Ag)
suppressor T cell (for T and B cells)
Lymphokines

Question 10

Macrophage functions include

Answer 10

Processing and presenting Ag to lymphocytes

Producing: Collagenase, IL-1, IL-6, IL-8, IL-10, IL-13, PGE2

Question 11

IL-1 Functions include:

Answer 11

Promoting T cell helper function
Inhibiting T cell suppressor function
Promoting B cell maturation
Activating Macrophages to produce PGE2
Activating Osteoclasts

Question 12

PGE2 Functions include:

Answer 12

Vasoactivity
Edema, pain, fever
Neutrophil and Monocyte chemotaxis
Osteoclast activation

Question 13

Microorganisms may cause periodontal disease ____ by stimulating a host response or ____ via the production of bacterial toxins

Answer 13

Indirectly

Directly

Question 14

Periodontal disease can result from an ____, ____ or a combination of the two

Answer 14

Inadequate host response

The presence of virulent microorganisms

Question 15

The host response may be both ____ and ____

Answer 15

Protective

Destructive

Question 16

Ig_ is the predominant immunoglobulin of GCF

Answer 16

IgG

Question 17

IgG in GCF can ____ and ____ of bacteria to oral surfaces

Answer 17

Inhibit colonization

Adherence

Question 18

____ and ____ reduce bacterial load via phagocytosis

Answer 18

Neutrophils

Macrophages

Question 19

Lyzozyme ____

Answer 19

Breaks bacterial cell walls

Question 20

Lactoperoxidase ____

Answer 20

Oxidizes susceptible bacteria

Is Bactericidal

Question 21

Lactoferrin ____

Answer 21

Binds iron

Prevents growth of some microorganisms

Question 22

sIgA ____

Answer 22

Helps prevent plaque adherence

Question 23

Biochemical mediators of the inflammatory response in gingivitis include:

Answer 23

Histamine

Serotonin

Question 24

C3b

Answer 24

Induction of Macrophage secretion
Induction of Cytokine production
Opsonization of microorganisms for phagocytosis
Stimulation of leukocyte oxidative metabolism
Increases vascular permeability (via histamine)

Question 25

C5a

Answer 25

``` Activation of Neutrophil degranulation Activation of Mast cell degranulation Leukocyte chemotaxis Stimulation of leukocyte oxidative metabolism Increases vascular permeability ```

Question 26

Cyclic Neutropenia

Answer 26

1-2 days where Neutrophils are not produced Chronically sick Can present with periodontitis Chlorhexidine + Frequent visits

Question 27

Drug-induced agranulocytosis

Answer 27

Fewer than 100 PMNs/um | Drugs = NSAIDs, Acetaminophen, Penicillin, Anticonvulsants

Question 28

Neutrophil disorders resulting from decreased NUMBER

Answer 28

Cyclic Neutropenia | Drug-induced agranulocytosis

Question 29

Chediak-Higashi syndrome

Answer 29

Rare Autosomal recessive Neutrophils contain abnormal, giant lysosomes Decreased: Chemotaxis, Degranulation, and Microbicidal activity

Question 30

Papillon-Lefèvre syndrome

Answer 30

Rare Distinct thickening of hands and feet Decreased: Chemotaxis and Phagocytosis

Question 31

Down's syndrome

Answer 31

Decreased PMN chemotaxis and Phagocytosis

Question 32

Leukocyte-adhesion deficiency

Answer 32

Very rare Neutrophils cannot marginate/emigrate Impaired phagocytosis

Question 33

Neutrophil disorders resulting from decreased FUNCTION

Answer 33

Chediak-Higashi syndrome Papillon-Lefèvre syndrome Down's syndrome Leukocyte adhesion deficiency

Question 34

Bone resorptive cytokines include ____, ____, and ____

Answer 34

IL-1 IL-6 TNF

Question 35

PGE2

Answer 35

Fatty acid derivative of AA Associated with bone resorption Key player in fever and periodontitis

Question 36

Prostaglandins roles in inflammation include

Answer 36

Vasodilation mediation Synergism with histamine and bradykinin to increase vascular permeability Modulation of T lymphocyte functions including inhibition of cytokine production Stimulation of osteoclastic bone resorption

Question 37

The three major bacteria involved in periodontitis are:

Answer 37

Aggregatibacter actinomycetemcomitans Porphymonas gingivalis Tannerella forsythia

Question 38

Endotoxin (LPS):

Answer 38

Can stimulate Macrophages to release IL-1 and IL-6 Can stimulate bone resorption directly Can activate alternate pathway of complement activation

Question 39

Hyaluronidase:

Answer 39

Increases gingival permeability causing apical migration of the junctional epithelium forming recession/pockets

Question 40

Phospholipase A:

Answer 40

Releases AA from cell membranes leading to PGE2 formation

Question 41

A. actinomycetemcomitans:

Answer 41

Destruction of PMNs Inhibition of Oxygen radical activity (with P. Gingivalis) Activation of T suppressor cells

Question 42

P. gingivalis:

Answer 42

Impairment of PMN adherence and phagocytosis Inhibition of Oxygen radical activity Degradation of lactoferrin

Question 43

Leukotoxin:

Answer 43

Kills Neutrophils and Monocytes

Question 44

Localized aggressive periodontitis (LAP) primarily affects ____ and ____

Answer 44

First molars | Incisors

Question 45

75% of LAP patients exhibit a ____

Answer 45

Neutrophil chemotactic defect

Question 46

LAP is associated with ____

Answer 46

A. actinomycetemcomitans | Increased antibody levels to A. actinomycetemcomitans are found in serum, GCF, and saliva

Question 47

Generalized aggressive periodontitis (GAP) is associated with ____

Answer 47

P. gingivalis | Increased antibody levels to P. gingivalis are found in serum, GCF, and saliva

Question 48

GAP patients have a ____

Answer 48

Neutrophil or monocyte chemotactic defect

Question 49

Linear gingival erythema =

Answer 49

A distinct form of gingival inflammation characterized by fiery red gingiva and edema in the attached gingiva which may extend beyond the mucogingival junction

Question 50

Environmental and Acquired risk factors for Periodontal disease include:

Answer 50

Smoking, Diabetes, Xerostomia, Dilantin (gingival overgrowth), Calcium channel blockers (gingival overgrowth), Poor oral hygiene, Leukocyte depression/Acquired immune defects, Vitamin deficiency (C, D, Calcium), Osteoporosis, Stress (immunosuppression), Aging, Education