Messadi 2.23.15 - Ulcerative and other Immune Mediated Diseases Part II

Question 1

what are the 3 most common diseases of the mouth and in waht order

Answer 1

1. caries
2. periodontal disease
3. RAS

Question 2

aphthous ulcer is well understood

and is what specific agent cauases it?

Answer 2

false, poorly unerstoond

NO specific infectious agent

Question 3

shallow

painful red lesion

with white base

Answer 3

aphthous ulcer

Question 4

do you rarely or often biopsy alphthous ulcer

Answer 4

rarely biopsy

Question 5

PBL of althous ulcer have an

decrese in :______

increase in: ______ _____ ____

Answer 5

decrease in CD4/CD8 ratio

increase in TNF - alpha, IL - 2 and IL - 6

Question 6

genetic predisposition with RAS assoicated with 4 HLA [human leukocyte antigen] ?

Answer 6

B51

A2

B12

Dr5

Question 7

___ and ___ exposure do NOT increase RAS risk

but may actually DECREASE the risk of aphthous ulcers

Answer 7

smoking

nicotine

Question 8

_____ are associated with menstrual cycle,

with outbreaks most commonly occuring during _____ or

before _____

Answer 8

RAU

during ovulation

before menstruation

Question 9

TF

diminished incidence of RAU during pregnancy has been reported

Answer 9

true

Question 10

TF

RAS is more prone to women especially during the menstrual cycle

Answer 10

true

Question 11

dietary risk factors for aphthous ulcer:

Answer 11

Fe

folic acid

Zn

vitamine B, 1, 6, 12

Question 12

TF

food sensitivities can be a triggering factor for RAS, especially tomatoe

Answer 12

true

Question 13

the foaming effect of _____ toothpaste can be a risk factor to develop RAS

Answer 13

SLS

Sodium lauryl sulfate

Question 14

4 ssytemic diseases asscoaited with RAS

Answer 14

behcet’s disease

immune related coniditons

chronic GI Absorption diseases

dermatologic disorder

Question 15

waht are the 3 immne related condiitons

Answer 15

cyclic neturopenia

agranulocytosis

immunodeficiency [HIV} disease

Question 16

3 syndromes associated with RAS

Answer 16

PFAPA - periodic fever, adenitis, pharyngitis, and aphthous ucler

magic - mouth nd genital ulcers, with inflamed cartilage

sweet’s

Question 17

aphthous ulcer occurs more on ____ mucosa and cold sore [herpes] happens more on ____ mucosa

Answer 17

nonkeratinized mucosa - aphthous ulcer

keratinized mucosa -> cold sore

Question 18

TF

when we have multiple lesions have to rule out systemic disease

Answer 18

true

Question 19

red with slight elevation

shallow ucler

round and oval shape

no more than 1/4 in diameter

center covered by lososely attached white or grayish mem

edges are normal [non-jagged]

Answer 19

aphthous ucler

Question 20

which ulcer type looks most like herpes

Answer 20

herpetiform ulcer

Question 21

which of the 3 ulcers is the most common

Answer 21

minor aphthous ulcer

Question 22

TF

minor aphthous ucler will spont heal after 10 days without treatment

also does not have scarring

Answer 22

true

true

Question 23

waht is another name ofr major aphthae

Answer 23

sutton disease

Question 24

what are 3 differences bt minor and major aphtous ucler

Answer 24

major:

scarring

heals 10 - 30 days

GREATER than 10 mm in diameter

Question 25

TF

there are no lab diagnostic test for aphthous ucler

Answer 25

true

so instead we diagnosis by exclusion OF 2ndary SYSTEMIC DISEASES

Question 26

TF

therare 6 ulcer characteristics and based on their score dictates therapy

Answer 26

true

size

of ulcers per episode

duration [#of weeks]

ulcer free period

site [keratinizied or non-keratinizied]

pain

Question 27

TF

histology doesnt give us much about aphthous ucler when we do NOT suspect systemic infection

Answer 27

true

just shows us as non-specific ulceratin

Question 28

Preulcer/ prodrmal stage has ___ cells and __

later stage has _____ and ____

last stage? ___

Answer 28

t4 and lymphocytes

T8 and cytotoxin cells

neutrophils, macrophage,s plasma

Question 29

with mild type A aphtous ulcer we use topical corticosteroids agents like ___ and ____

Answer 29

clobetasol

steroid compunded in Orabase

Question 30

EM Major is also called

Answer 30

stevens - johnson syntrome

Question 31

TEN

toxic epidermal necrolysis is always triggered by _____ ___

Answer 31

drug reaction

Question 32

a subtype of erythema multiforme

diffuse sloughing of the skin and mucosa

[looks like 3rd degree burns]

Answer 32

TEN

Question 33

Chronic ulcerative stomatitis is treated with Plaquinil

what other disease is treated with this

Answer 33

lupus

[most common autoimmune disease]

Question 34

what are other names of geographic tonuge

Answer 34

erythema migrans

and

______

Question 35

orofacial granulomatosis is due to an allergic reaction

Answer 35

true

Question 36

for wegnerners granulomatosis you have to do a blood test to diagnose the disease

TF

Answer 36

true

Question 37

what is a neumonic for wegneers granulomatosis

Answer 37

strawberry gingivitis

Question 38

RAS is most likely caused by

1. bac infection
2. viral infection
3. immune mediated response
4. idiopathic

Answer 38

immune mediated response

bc T and B cells

Question 39

smoking will enhance RAS formation

TF

Answer 39

false

will actually protect your mucosa from RAS

Question 40

behcet disease is found in

colon

kidney

skin

liver

Answer 40

kidney

genitals

eye

Question 41

steven johnson is a type of whic disease

erythema multiforme

behcet disease

RAS

wegner granulomatosis

Answer 41

erythema multiform

Question 42

treatment of erythema multiforme include

corticosterioids

non treatmtmet they normally resolve on their own

systemic antiboides

surgery is needed to remove infection

Answer 42

corticoidsterioids

Question 43

aphthous major is the most coomon form of apthous ucler

Answer 43

false

minor is the most common form

Question 44

some known causes of apthous ulcersare

allergy to certain food

herpes virus

nutritional definicies vitamin B12 folic acid iron

A and C

all the above

Answer 44

A and C

Question 45

the skin lesions in EM are described as

patch

nodule

bull’s eye

saucer

Answer 45

bull’s eye

Question 46

delayed type hypersensitivitiy reaction is more common in oral mucosa then skin

TF

Answer 46

false

oral mucosa is less susceptible beucase the langerhan cells, saliva,