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NBDE Pt. I > Dental Articles - Truncated > Flashcards

Dental Articles - Truncated Flashcards

1
Q

Obligate anaerobic microorganisms

A

Normal flora, gingival sulcus
Opportunistic (pathogenic in prime conditions)
Gram (+, eubacterium) or (-, actinobacillus)
Cannot isolate spirochetes
Cannot be completely controlled by antibiotics

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2
Q

Malignant epithelial cells have an increased number and wider distribution of which of the following receptors?

A

LAMININ

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3
Q

Risk factors of atherosclerosis (narrowing of arteries due to the accumulation of fatty plaque along the arterial walls)

A
  • HYPERLIPIDEMIA (esp. LDL)
  • HYPERLIPOPROTEINEMIA (exacerbated by high fat diet, esp. saturated fat)
  • HYPERTENSION (high BP, particularly diastolic = when heart is resting)
  • DIABETES (hyaline material deposited on aterial walls –> reducing blood flow)
  • INCREASING AGE
  • CIGARETTE SMOKING
  • OBESITY
  • SEDENTARY LIFESTYLE
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4
Q

*MOST numerous group of microorganisms in oral cavity

A

Facultative streptococci - survive in aerobic and anaerobic conditions

NON-­betahemolytic Streptococci, such as:
S. mutans
S. salivarius
S. mitor.

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5
Q

Chlamydial Infection Charactersitics

A
  • Large numbers of asymptomatic carriers
  • Frequent co-­infection with gonorrhea
  • The greater likelihood that younger women will acquire salpingitis
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6
Q

An autosomal dominant trait showing 50% penetrance will be phenotypically expressed in what percent of the offspring?

A

25%

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7
Q

RSV differs from influenza because…

A

Causes disease primarily in infants; cannot be prevented with vaccines, but influenza can with correct serological determinants

Amantadine = treats type A influenza, decreases symptoms

Influenza = inhalation
RSV = aerosolized droplets, fomites

IgA (gut, breast milk, lungs, tears) effective in preventing RSV and influenzae

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8
Q

MOST common source of pulmonary embolism

A

Thrombophlebitis = clots formed within veins, esp. deep leg veins

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9
Q

Aflatoxin is produced by…

A

Aspergillus (its spores are readily disseminated into the air)

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10
Q

Condition that predisposes to lung cancer by causing squamous metaplasia of bronchial
epithelium

A

Chronic bronchitis

In chronic smokers, pseudostratified ciliated is replaced by stratified squamous – thus, loss of protective function – precancerous state

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11
Q

The likelihood that oral bacteria play an important role in gingival inflammation is evidenced by

A

A reduction of inflammation with reduction of plaque (condition of Koch’s postulate)

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12
Q

Significant cause of meningitis

A

Neisseria meningitidis
Streptococcus pneumoniae (#1 cause in elderly)
Coxsackievirus

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13
Q

Most antigenic substance ( = produces immune response)

A

PROTEINS (glyco, lipo, nucleo)

Only SOME carbohydrates (large polysaccharides) can activate B cells - thus, antigenic

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14
Q

Characterizes victims of fatal, acute carbon monoxide poisoning

A

Cherry red blood

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15
Q

Chief complication of mumps in the adult male

A

Orchitis

  • Swelling of testes in male mumps patients
  • Develops about 1 week after the parotid gland swelling
  • Common in older male patients

ACUTE sialadenitis (not chronic) = inflammation of the salivary gland; associated with mumps (paramyxovirus, non-specific)

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16
Q

Fungus that causes systemic disease (most commonly of the lungs) and characterized by its production of tubercolate chlamydospores in culture is…

A

Histoplasma capsulatum (airborne transmission via inhalation of spores)

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17
Q

Genera is MOST likely involved in bacillary dysentery (feces contain blood, polymorphonuclear leukocytes, and mucus)

A

Shigella

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18
Q

MOST important viral cause of gastroenteritis in children

A

Rotavirus (seasonal disease, classically occurs in the fall and winter months)

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19
Q

A 17-­year-­old patient has (juvenile) periodontitis involving the anterior teeth (site predilection for incisors and first molars) with sparse plaque/calculus levels. Probable primary pathogen?

A

Actinobacillus actinomycetemcomitans (AA)

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20
Q

MOST reliable postmortem indicator of LEFT ventricular cardiac failure

A

Chronic passive congestion of the lungs

OR

Hypoperfusion of the kidney and brain

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21
Q

MOST frequent cause of a clinically palpable breast mass in an adult woman

A

Fibrocystic disease = most common breast disorder; more common than all tumors

Includes:

  • Fibrosis of areas of the breast
  • Formation of serous fluid-­filled cysts
22
Q

Adjuvants

A

Enhance antibody response

Chemicals (usually proteins) that enhance immune response (i.e. if you wish to induce delayed hypersensitivity in an experimental animal, a protein antigen is mixed with an adjuvant to obtain a greater response)

23
Q

Chemical substance is usually secreted by pheochromocytomas (tumors in adrenal medulla)

A

Catecholamines (epinephrine and norephineprhine) – oversecretion results in severe hypertension

24
Q

MOST likely to cause a sudden arrest of heart function

A

Cardiac tamponade (acute life-threatening condition, thus SUDDEN) = a condition in which fluid fills the pericardial space, produces pressure on the ventricles and prevents filling of the ventricles during diastole

25
Q

Neoplasms appearing MOST often in children

A

Neuroblastoma = most common extra-cranial solid tumor in children; often found in the adrenal medulla, causes elevated catecholamines (EPI/NOREPI) and metastasizes readily

26
Q

Gout results from a metabolic defect in:

A

PURINES … excreted as uric acid (more soluble purine ring form, sodium urate crystals) however, excess (caused by excess production, insufficient excretion, or some inborn error of purine metabolism) –> GOUT (collects in synovial capsules of joints of the lower extremity i.e. big toe)

27
Q

Characteristic of blood in sputum

A

Tuberculosis = necrosis of lung tissue and destruction of blood vessels in lung parenchyma

Lobar pneumonia = infection erode surrounding blood vessels

Pulmonary embolism = septic embolus can erode blood vessels

Bronchogenic carcinoma = can cause bleeding as it expands into nearby vascular tissue

28
Q

Majority of cases of pharyngitis are caused by

A

A variety of viruses = picornaviruses. orthomyxoviruses, Epstein-­Barr, etc …

29
Q

Hypersensitive to M Tuberculosis is manifested by

A

Necrosis

30
Q

Administration of tetanus toxoid provides what type of immunity?

A

Artificial, Active

31
Q

Common proven chemical carcinogens

A
  • Benzpyrene
  • Benzene
  • Aniline dyes
  • Asbestos
32
Q

The MOST important characteristic of malignant neoplasms (distinguishes them from benign neoplasms)

A

Ability to metastasize

33
Q

Increases the risk of developing osteosarcoma

A

Osteitis deformans (Paget’s) = unknown origin; disease of bone where bone is replaced by disorganized soft matrix (changed size/shape of bone + pain) –> deformity + fracture;

34
Q

Histologic features of malignant tumor growth

A
  • Anaplasia
  • Pleomorphism
  • Hyperchromatism
  • Abnormal mitosis
35
Q

Important factors for initiation of caries by oral streptococci

A

[1] Synthesis of insoluble dextran = adherent that promotes accumulation of bacteria on tooth enamel + prevents diffusion of organic acids produced by the bacteria

[2] Production of glucosyltransferase = enzyme projecting form the outer membrane of the bacteria

36
Q

Viral-­associated enzyme unique to RNA tumor viruses

A

Reverse transcriptase

37
Q

Characteristics of prokaryotic cell

A

Simple cells, small (1-10 micrometers), rarely aggregate to form multi-cellular units; modified prokaryotic cells (bacteria, blue algae)

LACK:

  • Specialized organelles (nucleus, mitochondria, ER, Golgi, peroxisomes, lysosomes)
  • Cytoskeleton (unable to perform endo/exocytosis)
  • Krebs’ cycle enzymes (dependent on glycolysis for ATP production)
38
Q

Multiple drug resistance is related most closely to

A

Plasmids = self-­replicating, autonomous segments of DNA; they confer drug resistance, R factors = encode enzymes which inactivate various antibiotics

39
Q

Characterized by a cumulative antimicrobial effect

A

Chlorhexidine gluconate = antiseptic; kills gram-­(+) bacteria & other organisms by disrupting their plasma membranes; accumulates to produce an enhanced antimicrobial effect

40
Q

Most accurately describes the antibacterial mechanism of penicillin

A

Inhibits the terminal step in peptidoglycan ( in gram + & - organism) synthesis = interferes with cross-­linking step of peptidoglycan polymers –> prevents the formation of a durable cell coat –> highly susceptible to rupture and fragmentation

41
Q

A common oral manifestation of Addison’s disease (adrenal insufficiency of any etiology) is:

A

Melanosis from PRIMARY Addison’s = feedback inhibition of adrenal hormones on the hypothalamus and pituitary is lost –> increased production of ACTH –> over production of melanotropin = melanosis (pigmentation of the skin + mucous membranes)

42
Q

The first human cancer that has been strongly linked to a virus is

A

Burkitt’s lymphoma (human tumor of the lymphoid) = B-­cell tumor (most common neoplasm in children in regions of the world where Epstein-­Barr Virus [EBV] is endemic – i.e. New Guinea, Central Africa)

Unhindered EBV (DNA virus, herpes family) w/ concomitant infection (malaria) –> clonal expansion of B-­cells –> increased likelihood of producing malignant strain of B-­cells via random mutation –> mutation = most commonly gives rise to Burkitt’s lymphoma [translocation of genes from chromosome 8 to 14]

Relevant:

  • EBV = Burkitt’s lymphoma
  • Human immunodeficiency virus [HIV] = Kaposi’s sarcoma
  • Hep B virus = Hepatocellular carcinoma
  • Herpes simplex II = Cervical carcinoma
43
Q

Osteomyelitis (bone infection mostly in children/adolescents) is most commonly caused by

*requires a protracted course of IV antibiotics + surgical debridement

A

Staphylococcus aureus (blood-borne organism deposited in bone)

But also, various strains of Streptococci, Pneumococci and Neisseria too; Pseudomonas aeruginosa (drug abuseres)

44
Q

Elevated in the serum of patients with prostate cancer

A

Acid phosphatase

Typical Prostate Cancer Patient Scenario:
67 yo black male; hard nodule (1 cm) on prostate
Serum acid phosphatase = 2x normal.
Then prostatectomy, acid phosphatase level = normal.
Acid phosphatase measurements every six months.
Two years post-­op, acid phosphatase = 6x normal + back pain; bone scan = diffuse bony/liver metastases

45
Q

Immunosuppressed patients are particularly prone to develop severe oral disease caused by

A

Candida albicans = marker of immunosuppression, presents as white curd-­like lesions of the tongue and buccal mucosa; ubiquitous organism that does not cause infection in the normal host, only immunocompromised (AIDS, congenital disease, renal transplantation therapy or leukemia, or if the normal flora in the oral cavity has been cleared by long-­term treatment with broad spectrum antibiotics)

46
Q

Tetany (syndrome characterized by muscle spasms, cramps and seizures; associated with hypocalcemia) may result from hypofunction of the…

A

Parathyroid gland

Hypofunction of the parathyroid gland –> decreased PTH –> decreased serum calcium levels

PTH = important hormone in calcium metabolism; elevates serum calcium levels by stimulating osteoclastic activity + bone dissolution via activating vitamin D (absorbs calcium from the gut + increasing renal resorption of calcium)

47
Q

Significant effect of pheochromocytoma

A

Hypertension

Pheochromocytoma = tumor of chromaffin cells, neoplasm that secretes catecholamines (esp. norepinephrine, which causes paroxysmal hypertension); commonly located in the abdomen, 80% are found in the adrenal medulla; others in aortic bifurcation. If tumor is resected, hypertension relieved.

48
Q

The indiscriminate use of broad-­spectrum antibiotics is contraindicated because they frequently

A

Interfere with indigenous biota

*Use with extreme caution; utilization of broad-spectrum antibiotics leads to the eradication of the normal flora (holds growth of organisms resistant to antibiotics in check) colonizing many sites throughout the body – if normal flora cleared, resistant organisms can replicate freely as competition for nutrients decreases. Resistant organisms (Pseudomonas, E. coli, Klebsiella species) cause SEPSIS – can only be treated with newer, more powerful antimicrobial agents that select for resistant strains for which no antibiotic treatment is available

49
Q

A positive skin test in an individual who has had tuberculosis is an example of

A

Hypersensitivity

Tuberculin injection into an individual who has had TB in the past –> Result: Delayed type hypersensitivity

Reaction (24 hours): Memory T-lymphocytes recognize tuberculin (protein lipopolysaccharide extract of the Mycobacterium) –> T-lymphocytes secrete lymphokines (chemicals that attract macrophages + other mononuclear inflammatory cells) –> fibrin deposited –> induration (hardening) –> increased vascular permeability –> edema –> vasodilation –> erythema (reddening of skin)

50
Q

Following pneumoconiosis is most often associated with bronchogenic carcinoma and mesothelioma in man

A

Asbestos exposure

Linked to the development of:

  • Mesothelioma (rapidly fatal tumor arising from the pleura or peritoneum; rare disease, but 10% develop if heavily exposed); cancer shows long latency period, doesn’t occur for up to 50 years following asbestos exposure
  • Bronchogenic carcinoma (increased incidence from exposure + heavy smokers (90-fold)
Bronchogenic carcinoma/mesothelioma causes:
#1 Pneumoconiosis 
#2 Asbestos exposure
51
Q

Microcytic hypochromic anemia is most often due to

A

CHRONIC BLOOD LOSS –> iron deficiency

Causes of iron deficiency:
#1 Acute/chronic hemorrhage OR physiologic bleeding i.e. menses; occurs when iron demand increases (pregnant), little iron intake (impoverished countries)
#2 Blood loss ***
#3 Increase in iron demand (pregnancy)
#4 Decreased iron intake (impoverished countries)
#5 Malabsorption [only common in Crohn's disease]
#5 Unable to utilize iron body stores due to chronic inflammatory diseases/cancer

NBDE Pt. I (6 decks)

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