TEXTBOOK FALL EXAM 2021 > Pathogenesis > Flashcards

Pathogenesis Flashcards

(42 cards)

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1
Q

What is pathogenesis`

A

Origin and development of a disease

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2
Q

What is periodontal disease?

A

Chronic disease that is multifactorial between the biofilm, host and inflammation

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3
Q

What is the relationship between bacteria and inflammation?

A

Bacteria - Initiates

Inflammation - Perpetuates

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4
Q

What is gingival health? (5)

A
  1. Minimal to no bleeding on probing
  2. Pink gingiva
  3. Firmly attached
  4. Shallow probing depths
  5. Minimal to no bone loss
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5
Q

What are the epithelial portions in gingiva?

A
  1. Oral
  2. Sulcular/ Crevicular
  3. Junctional
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6
Q

How does gingiva stay healthy (5)

A
  1. Maintains epithelial barrier
  2. Sloughing/Turnover of epithelium
  3. Antibodies
  4. Neutrophils
  5. Macrophages
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7
Q

Where are antibodies found? (3)

A
  1. Saliva
  2. GCF
  3. Capillaries
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8
Q

What is the histopathology of gingivitis?

A
  1. Tissue infiltrated by defense cells
  2. Release of enzymes
  3. Causes collagen depletion
  4. Reversible
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9
Q

How did Page and Schroder describe gingival inflammation

A

Initial
Early
Established
Advanced

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10
Q

What happens in the Initial Stage of gingival inflammation?

A
  1. Neutrophils dominant
  2. Increased vascular permeability
  3. Increased vasodilation

Appears in 2-4 days

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11
Q

What happens in Early Stage of gingival inflammation? (4)

A
  1. T cells dominate the lesion
  2. Increased GCF
  3. Degeneration of fibroblasts– loss of CT
  4. Collagen fibroblasts– loss of collagen

Appears in 4-7 days

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12
Q

What happens in the Established Stage of gingival inflammation? (5)

A
  1. Chronic Gingivitis
  2. Plasma Cells–> B cells dominate the lesion
  3. Increased CT breakdown
  4. Increased Collagen depletion
  5. JE proliferate in apical direction

Appears in 2-3 weeks

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13
Q

What happens in the Advanced Stage of gingival inflammation?

A
  1. Transition to perio dx
  2. B- cell predominates still
  3. Bone loss occurs by osteoclast resorbing alveolar bone
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14
Q

What are the specific virulence factors (5)

A
  1. LPS
  2. Protease – Bacterial Enzyme
  3. Fimbriae
  4. Microbial Invasion
  5. Bacterial DNA
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15
Q

What are the Host derived inflammatory mediators? (3)

A
  1. Cytokines
  2. Prostaglandin
  3. MMP (matrix metalloproteinases)
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16
Q

What are cytokines?

A

Locally acting soluble messengers that amplify immune response and induce their own expression

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17
Q

What are prostaglandins?

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A
  1. Lipid compound from arachadonic acid
  2. Metabolized by COX1 & 2
  3. Increase vasodilation/ inflammation
  4. Induce MMP and Bone Resorption
18
Q

What are MMPs?

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A

Enzymes that break down structural proteins like collagens

Matrix metalloproteinases

19
Q

What are the Inflammatory mediators in perio disease? (4)

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A
  1. Interleukin (IL-1, IL-6)
  2. TNF Alpha
  3. Prostaglandin (PGE2)
  4. Chemokines - Direct migration of WBCs
20
Q

What are Interleukins?

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A

Type of cytokines linked to innate immune response (they stimulate the immune response)

21
Q

What is TNF alpha?

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A
  1. Inflammatory mediator
  2. Increases neutrophil activity
    (TNF Alpha - Neutrophils)
22
Q

What cells makes/secretes prostaglandin?

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A
  1. Macrophages

2. Fibroblasts

23
Q

What are chemokines?

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A
  1. Chemotactic molecules (Direct WBC to inflammation)

2. Leukocyte migration role

24
Q

How does a pocket develop?

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A
  1. Biofilm causes inflammation which causes sulcus to deepen

2. Defense cells cause CT breakdown –> apical movement of JE

25
What is RANKL?
Pro osteoclast that regulates bone formation
26
Discuss the resolution of inflammation?
ACTIVE process 1. Lipoxins 2. Resolvins 3. Protectins
27
What is innate immunity
1. Non specific barrier to infection 2. Lysozyme 3. Mucin 4. Peroxidase 5. Phagocytic cells (monocytes, macrophages, neutrophils
28
What are the defensive components of saliva? (5)
1. Antibodies 2. Lactoferrin 3. Mucin 4. Lysozyme 5. Perioxidase
29
What are GCF defensive functions? (3)
1. Antibodies 2. Neutrophils 3. Flushing action
30
What is in epithelium to make it a defensive tissue?
Keratin is the barrier
31
What are senteniel cells?
1. Macrophage and dendritic cells (Antigen Presenting Cells and Phagocytic) 2. Provide innate and adaptive immunity
32
What are neutophils?
Type of White Blood Cell 1. Phagocytic Cells 2. Low grade defense- First line of defense in innate immunity
33
What is adaptive immunity?
1. Later immune response with plasma cells/B Cells 2. Slower and more complex 3. Antigen specific 4. Chronic periodontitis is adaptive
34
What are the 3 types of Antigen Presenting Cells and what do they do?
1. B Cell 2. Macrophage 3. Dendritic Cell Go to the lymph node to present to the T Cell
35
REPEAT CARD- IGNORE how do antigen presenting cells function
Go to lymph node and react with T Cells
36
What are T cells?
Cells in adaptive immunity- Develop in the bone marrow and go to the Thymus
37
What are antibodies? What is the most common type?
1. Made by B cells 2. Immunoglobulin for specific antigen Most common is IgG
38
Discuss Host susceptbility
1. Complex immune and inflammatory process 2. Some patients hyper respond 3. Response can be disproportionate
39
What is the role of Toll like Receptors?
proteins on sentinel cell (Macrophages and Dendritic Cells) that recognize pathogens
40
What are NETS?
Neutrophil extra cellular traps
41
What are the main Antibodies to perio disease?
Mainly IgG some IgA and IgM
42
What antibody is present in saliva?
IgA
TEXTBOOK FALL EXAM 2021
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