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Periodontics > Exam 2 Ch. 16 Systemic Risk Factors that Amplify... > Flashcards

Exam 2 Ch. 16 Systemic Risk Factors that Amplify... Flashcards

1
Q

Systemic risk factors are conditions or diseases that increase an individual’s _______ to periodontal infection by modifying or amplifying the _________to microbial infection.

A

A: susceptibility; host response

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2
Q

The most important known risk factor for periodontitis is ________.

A

A: cigarette smoking

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3
Q

All of the following are examples of systemic risk factors EXCEPT

  1. Infrequent care
  2. Tobacco use
  3. Osteoporosis
  4. Medication side effects
A

a. Infrequent care

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4
Q

In the United States’ population approximately 8.1 million people in the United States have _______ while 21 million Americans have_______.

A

A: undiagnosed diabetes; diagnosed diabetes

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5
Q

Diabetic individuals tend to show greater severity of _______ compared to non diabetics.

A

A: periodontitis

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6
Q

Diabetes is a chronic metabolic disorder in which the body improperly uses insulin.

True

False

A

True

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7
Q

Findings from many studies corroborate that diabetes mellitis leads to ________ response to oral _________.

A

hyperinflammatory; microbial biofilms

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8
Q

Insulin is a ______ needed to convert sugar and starches into energy.

A

A: hormone

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9
Q

____ to ____ of Type I diabetes is caused by damage to the ______.

A

A: 5%; 10%; pancreas

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10
Q

____ to ____ of type II develops when the body does not make enough and/or properly use _____.

A

A: 90%; 95%; insulin

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11
Q

Diabetes is considered an _________ factor for _______ and contributes to increased prevalence, severity, and progression.

A

A: Established risk; periodontitis

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12
Q

Individuals with well-controlled diabetes are at greater risk for periodontal disease than persons without diabetes.

True

False

A

False

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13
Q

Individuals with poorly controlled diabetes are _____ more likely to develop periodontitis.

  1. 2x
  2. 3x
  3. 4x
  4. 5x
A

B. 3x

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14
Q

Individuals with diabetes and who smoke are ___ more likely than nondiabetics to experience severe periodontitis

  1. 20x
  2. 10x
  3. 30x
  4. 5x
A

A. 20x

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15
Q

Individuals with undiagnosed or poorly controlled diabetes have high ______ levels.

A

A: blood glucose

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16
Q

The _____ is a measurement of the average blood glucose level over the past ____ months.

A

A: HbA1c; 2 to 3

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17
Q

A normal HbA1C level for nondiabetics is ______

  1. 5.6% and lower
  2. below 5.6%
  3. less than 7%
  4. 7% and lower
A

B. below 5.6%

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18
Q

At SPC, a patient who has diabetes presents with an HbA1c of less than 7% with less than 2mm of CAL is given a grade C for periodontal disease progression. A normal HbA1C level for nondiabetics is at least 5.6%.

  1. The first statement is true. The second statement is false.
  2. the first statement is false. The second statement is true.
  3. Both statements are true.
  4. Both statements are false.
A

D. Both statements are false.

Explanation: The first statement would be true if it said …”grade B”. The second statement would be true if it said below 5.6%

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19
Q

The hyperinflammatory response to the ______ challenge in periodontitis and impaired repair are at least partly mediated by the signaling mechanisms of the _______ interaction.

A

A: microbial; AGE-RAGE

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20
Q

_____ is a natural metabolic process in which the glucose in the bloodstream attaches to proteins and lipids forming harmful molecules called _____.

A

A: Glycation; AGEs

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21
Q

AGE is an acronym that stands for ______ _____ ______

A

A: advanced; glycation; end products

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22
Q

The interaction of _____ stimulates the release of proinflammatory cytokines, TNF-⍺ and interleukin-1β.

A

A: AGE-RAGE

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23
Q

In diabetic patients with periodontitis, the AGE-RAGE interaction is a major factor that contributes to

  1. Exaggerated periodontal inflammation
  2. Insulin resistance
  3. Impaired tissue repair
  4. A and C
  5. A, B and C
A

E. A, B and C

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24
Q

In uncontrolled diabetes, it is the ______ challenge combined with an environment of enhanced _____ expression that leads to accelerated inflammation.

A

A: microbial; RAGE

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25
Q

RAGE stands for _________ for ________ _______ ________

A

A: Receptor for Advanced Glycation End products

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26
Q

Closer _______ between medical and dental clinical teams is necessary for the joint management of people with diabetes and periodontitis

A

A: collaboration

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27
Q

The goal for most individuals with diabetes is a glucose level _____.

A

A: less than 7%.

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28
Q

High susceptibility to infection occurs when the glucose level is ____.

A

A: above 8%

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29
Q

The target range of glucose level at appointment time is

  1. 80 to 120 mg/dL
  2. 70 to 120 mg/dL
  3. 180 to 300 g/dL
  4. 80 to 150 mg/dL
A

A. 80 to 120 mg/dL

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30
Q

Glucose level

Increased risk of infection is _____ mg/dL

A

A: 180-300 g/dL

31
Q

Glucose level

Unacceptable range for treatment in clinic is _____ mg/dL

A

A: greater than 300 mg/dL

32
Q

Composition of subgingival microbiota in a diabetic patient is different than that found in a nondiabetic patient.

True

False

33
Q

List four oral complications of poorly controlled diabetes mellitus.

A
  • Reduced salivary flow
  • Encourages growth of Candida Albicans
  • Multiple abscess formation
  • Rapid destruction of alveolar bone
  • Cheilosis
  • Burning mouth and tongue
34
Q

The following are examples of what

A

A: Tissue swelling due to uncontrolled diabetes

35
Q

AGE degrades _____ and ____, causing these fibers to harden and lose elasticity.

A

A: collagen; elastin

36
Q

In diabetes levels of AGE can contribute to neuropathy, ______ and _____ failure.

A

A: retinal disease; kidney

37
Q

Direct interaction of AGE to a cell surface receptor is known as ______.

38
Q

When AGEs interact with a surface receptor called RAGE, it triggers _______ tissue _______.

A

A: pathologic; destruction

39
Q

Detrimental effects of stress on periodontal health include all of the following EXCEPT

  1. Poor self-care
  2. Changed dietary habits
  3. Increased smoking
  4. Increased alcohol consumption
  5. Nonadherence to periodontal maintenance
  6. All are effects of stress
A

F. All are effects of stress

40
Q

Chronic stress can be immunoenhancing. Acute stress can impair physiological regulatory mechanisms that governs the immune system.

  1. The first statement is true. The second statement is false.
  2. The first statement is false. The second statement is true.
  3. Both statements are true.
  4. Both statements are false.
A

D. Both statements are false.

Explanation:

Acute stress can be immunoenhancing. Chronic stress can impair physiological regulatory mechanisms that governs the immune system.

41
Q

Hormone cortisol has ______ and _____ properties.

A

A: anti-inflammatory; immunosuppressive

42
Q

______ may become elevated in response to physical and psychological stress.

A

A: cortisol levels

43
Q

Changes in _______ occurring in puberty, pregnancy, and following menopause can influence the _______ tissues.

A

A: sex hormones; periodontal

44
Q

During puberty there are increased levels of _____ in females and ______ in males.

A

A: estradiol; testosterone

45
Q

During puberty increased blood circulation to gingival tissue may cause increased ______ to local ______.

A

A: sensitivity; irritants

46
Q

Tendency for plaque-induced gingivitis increases as a person progresses through puberty.

True

False

47
Q

During pregnancy high levels of _____ and _____have been shown to suppress the immune response to biofilm.

A

A: progesterone; estrogen

48
Q

_______ and phagocytosis have been reported to be depressed in response to high levels of _______ hormones.

A

A: Chemotaxis; gestational

49
Q

A localized overgrowth of gingival tissue during pregnancy is called pregnancy-_______ pyogenic ______. This pregnancy tumor is formed on the ______ gingiva or gingival margin.

A

A: associated; granuloma; interdental

50
Q

If growth of a pregnancy tumor persists after delivery the granuloma can be surgically removed.

True

False

51
Q

All of the following medications cause gingival enlargement EXCEPT

  1. Phenytoin
  2. Gabapentin
  3. Cyclosporine
  4. Nifedipine
A

B. Gabapentin

52
Q

_____ is a disorder characterized by loss of bone mineral in postmenopausal women.

A

A: Osteoporosis

53
Q

______ is a communicable disease caused by human immunodeficiency virus.

A

A: Acquired immunodeficiency syndrome (AIDS)

54
Q

People with AIDS are at an increased risk for developing certain _____ and for infections that usually occur in individuals with a _______ system.

A

A: cancers; weak immune

55
Q

Down syndrome is a ______ disorder caused by gene disturbance during _____ development.

A

A: genetic; fetal

56
Q

In some individuals the first signs of _____ show up in the ______.

A

A: leukemia; oral cavity.

57
Q

______ is an oral complication of leukemia therapy due to damage of salivary glands during radiation therapy.

A

A: Xerostomia

58
Q

Leukemic patients should postpone a dental appointment until 6 months after their last radiation therapy session due to a weakened immune system.

True

False

59
Q

All of the following are systemic risk factors EXCEPT

  1. diabetes mellitus
  2. leukemia
  3. hormonal fluctuation
  4. All are systemic risk factors
A

D. All are systemic risk factors

60
Q

________ practice occurs when health care providers from different professional backgrounds work together to deliver the highest quality of patient-centered care.

A

A: Interprofessional collaborative

61
Q

Closer collaboration with other health care professions make it easier to educate patients about the relationship between _____ and______.

A

A: disease; periodontitis

62
Q
  1. Factors that increase an individual’s susceptibility to periodontitis by modifying the host response to bacterial infection are called:

A. Systemic risk factors

B. Genetic influences

C. Neutrophils

D. Biologic equilibrium

A

A. Systemic risk factors

63
Q
  1. In smokers, smoking cessation might prevent more periodontal disease than daily plaque control.

A. True

B. False

64
Q
  1. Smoking may increase the risk for periodontal disease by at least two to three times.

A. True

B. False

65
Q
  1. Persons with well-controlled diabetes have no more periodontal disease than persons without diabetes.

A. True

B. False

66
Q
  1. Which of the following individuals is MOST likely to have periodontitis?

A. An individual with well-controlled diabetes

B. An individual who does not have diabetes

C. An individual with poorly controlled diabetes

A

C. An individual with poorly controlled diabetes

67
Q
  1. Levels of sex hormones may have an effect on the periodontium.

A. True

B. False

68
Q
  1. ALL pregnant women develop gingivitis.

A. True

B. False

69
Q
  1. Certain individuals have a genetically determined immune response that predisposes them to periodontal disease.

A. True

B. False

70
Q
  1. Abnormalities in PMN function can lead to overwhelming systemic bacterial infection and increased susceptibility to severe periodontal destruction.

A. True

B. False

71
Q
  1. Individuals with Down Syndrome rarely develop periodontitis.

A. True

B. False

72
Q
  1. Which of the following medications commonly cause gingival hyperplasia?

A. Tetracycline (Achromycin)

B. Ibuprofen (Advil, Midol, Nuprin)

C. Phenytoin (Dilantin)

D. Alprazolam (Xanax)

A

C. Phenytoin (Dilantin)

73
Q
  1. High financial stress increase incidence of periodontal disease

A. True

B. False

74
Q
  1. All of the following are metabolic syndrome disturbances that increase risk for periodontal disease EXCEPT:

A. High blood pressure

B. High blood sugar

C. Abnormal cholesterol levels

D. Gout

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