Pathogenesis

Question 1

What are the four stages of lesion establishment?

Answer 1

1-inital lesion (2-4 days)
2-Early lesion (4-7 days, acute gingivitis)
3-Established lesion (2-3 weeks, chronic gingivitis)
4-advanced lesion (>3 weeks, periodontitis, pockets form and radiograph shows bone loss)

Question 2

What are the two types of immune responses?

Answer 2

1-innate (non specific)

2-acquired (adaptive and specific)

Question 3

What are the 5 immune components of for plaque accumulation response?

Answer 3

1-mast cells
2-acute phase proteins
3-complement
4-PMNs
5-Antibodies

Question 4

Histamine and leukotrines do what?

Answer 4

-dilates small blood vessels and increases their permeability
-constricts bronchi
(leukotrines also cause chemotaxis of leukocytes)

Question 5

TNF does what?

Answer 5

recruits granulocytes and induces fever

Question 6

Prostoglandins do what?

Answer 6

increase vascular permeability and regulate immune responses

Question 7

What are 6 plasma proteins that increase due to microbial infection? (first 5 are associated with hear disease)

Answer 7

1-C-reactive protein
2-fibrinogen
3-complement
4-mannose-binding protein
5-metal-binding proteins
6-alpha-anititrypsin-anticymotrypsin

Question 8

Which plasma protein in associated with a 2-5 fold increased risk of MI (Myocardial infarction)

Answer 8

C-reactive protein

Question 9

What is complement and where is it synthesized?

Answer 9

11 protein glycoprotein that makes up 10% of normal sera that interacts with IgG and IgM. It is made in the liver and small intestine

Question 10

What are the 3 main types of PMN granules?

Answer 10

1-Azurophilig granules (primary)
2-Specific granules (secondary)
3-Tertiary granules

Question 11

What % of blood leukocytes are neutrophils?

Answer 11

55-65%

Question 12

What % of blood leukocytes are Eosinophils?

Answer 12

2-4%

Question 13

What % of blood leukocytes are basophils?

Answer 13

0-1%

Question 14

What % of blood leukocytes are monocytes?

Answer 14

3-8%

Question 15

What % of blood leukocytes are other types?

Answer 15

25-35%

Question 16

What are 4 types of Professional Antigen Presenting Cells?

Answer 16

1-Macrophages
2-Langerhan cells
3-Dermal dendritic cells
4-B cells

Question 17

Which CD class receptor binds with MHC I?

Answer 17

CD8 (An increase can cause sjogrens, a decrease causes chronic fatigue)

Question 18

What cell type is responsible for most of the localized damage in periodontal inflammation?

Answer 18

Fibroblasts

Question 19

What are 3 main inflammatory mediators that can cause tissue damage in response to sub gingival plaque?

Answer 19

• Cytokines (interleukins)
• Prostanoids
• MMPs

Question 20

Treatment of periodontal disease often lowers levels of what interleukin?

Answer 20

IL-1

High body fat can also increase IL

Question 21

IL-2, IL-4 generally increase in what disease?

Answer 21

Periodontal disease

Question 22

CD4 cells secrete what?

Answer 22

Interleukins

Question 23

Which interleukin plays a role in bone resorption?

Answer 23

IL-6

Question 24

IL-7 is secreted by what?

Answer 24

Bone marrow stromal cells

Question 25

IL-8 stimulates chemotaxis of what?

Answer 25

PMNs (also MMP activity)

Question 26

IL-9 induces growth of what?

Answer 26

Mast cells

Question 27

IL-10 inhibits what?

Answer 27

Antigen presenting capacity of monocytes

Question 28

What helps fight viral infections and inhibits proliferation of osteoblast progenitors?

Answer 28

interferons (IFN)

Question 29

What activates osteoclasts?

Answer 29

TNF (alpha and beta)

Question 30

Which 5 factors are Proinflammatory/destructive?

Answer 30

1-IL-1B
2-Tumor Necrosis factor-a (TNF-a)
3-IFN-y
4-Prostaglandin E2 (PGE2)
5-MMPs

Question 31

Which 5 factors are anti-inflammatory/protective?

Answer 31

1-Transforming Growth factor-B (TGF-B)
2-IL-1 Receptor antagonist
3-IL-10
4-IL-4
5-Tissue inhibitors of MMPs (TIMPs)

Question 32

What are 3 major collegians types?

Answer 32

• 1-Fibroblasts
• 8-Neutrophils
• 13

Question 33

chemically modified Tetracycline and low dose doxycycline inhibit activity of what?

Answer 33

MMPs

Question 34

Arachidonic acid is found where?

Answer 34

Cell membranes