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Keeling Summer Textbook > Pathogenesis > Flashcards

Pathogenesis Flashcards

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 with interplay between biofilm, host and inflammation

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3
Q

What is the relationship between bacteria and inflammation

A

Bacteria - Initiate

Inflammation - Perpetuates

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4
Q

Whatis gingival health

A

Not bleed on probing
Pink
Firmly attached

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5
Q

What are the epithelial portions in gingiva

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

How does gingiva stay healthy

A 
Maintains epithelial barrier
Sloughing of epithelium
Antibodies
Neutrophils
Macrophages
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7
Q

Where are antibodies found

A

Saliva
GCF
Capillaries

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8
Q

What is the histopath of gingivitis

A

Tissue infiltrated by defence cells
Release of enzymes
Causes collagen depletion
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 Stage 1

A

Increased vascular permeability
Increased vasodilation
Increased GCF
Neutrophil and leukocyte in CT

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11
Q

What happens in stage 2

A 
Increase vascular permeability
Increased vasodilation
Increased GCF
Neutrophil
Degeneration of fibroblast
Collagen fibroblasts
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12
Q

What happens in stage 3

A 
Chronic Gingivitis
Dense inflammation
Plasma Cells
Increased MMP
Increased Collagen depletion
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13
Q

What happens in stage 4

A

Transition to perio dx
Apical migration of JE
Increased collagen breakdown
Osteoclast resorb alveolar bone

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14
Q

What are the specific virulence factors

A
  1. LPS
  2. Protease
  3. Fimbriae
  4. Bacterial DNA
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15
Q

What are the host derived mediators

A

Cytokines
Prostaglandin
MMP

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16
Q

What are cytokines

A

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

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17
Q

What are prostaglandins

A

Lipid compound from arachadonic acid
Metabolized by COX
Increase vasodilation
Induce MMP and bone resorption

18
Q

What are MMP

A

Enzymes that break down structural proteins like collagens

19
Q

What are the inflamm mediators in perio disease

A

Interleukin
TNF Alpha
Prostaglandin
Chemokines

20
Q

What are interleukins

A

Family of cytokines linked to innate immune response

21
Q

What is TNF alpha

A

Inflamm mediator
Increases neutrophil activity
TNF Alpha - Neutrophils

22
Q

What makes prostaglandin

A

Macrophage

Fibroblast

23
Q

What are chemokines

A

Chemotactic molecules

Leukocyte migration role

24
Q

How does a pocket develop

A

Biofilm causes inflamm which causes sulcus to deepen

Defense cells cause CT breakdown apical movement of JE

25
Q

What is RANKL

A

Pro osteoclast that regulates bone formation

26
Q

Discuss the resolution of inflammation

A

Active process
Lipoxins
Resolvins
Protectins

27
Q

What is innate immunity

A

Non specific barrier to infection
Lysozyme
Mucin
Peroxidise

28
Q

What are the defensive components of saliva

A 
Antibodies
Lactoferrin
Mucin
Lysozyme
Perioxidase
29
Q

What is GCF defensive function

A

Antibodies
Neutrophils
Flushing action

30
Q

What is epithelial defensive tissue

A

Keratin is the barrier

31
Q

What are senteniel cells

A

Macrophage and dendritic cells

Provide immediate and adaptive immunity

32
Q

What are neutophils

A

Professional phagocyte

Low grade defense

33
Q

What is adaptive immunity

A

Focused intense defence
Slower and more complex
Anti gen specific
Chronic perio is adaptive

34
Q

What are antigen presenting cells

A

B Cell
Macro
Dendritic
Go to T Cell inlymph node

35
Q

how do antigen presenting cells function

A

Go to lymph node and react with T Cells

36
Q

What are T cells

A

Adaptive immune cells in bone marrow to thymus

37
Q

What are antibodies

A

Endpoint in B cell activation

Mostly IgG

38
Q

Discuss Host susceptbility

A

Complex immune and inflamm process
Some pt hyper respond
Response can be disproportionate

39
Q

What is the role of Toll like Receptors

A

proteins on sentinel cell that recognizes pathogens

40
Q

What are NETS

A

Neutrophil extra cellular traps

41
Q

Antibodies to perio dx

A

IgG

some IgA and IgM

42
Q

What antibody in saliva

A

IgA

Keeling Summer Textbook (11 decks)

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