DHE120 Chapter 3 Quiz#3

  1. Acantholysis:
    Dissolution of the intercellular bridge of the prickle cell layer of the epithelium.
  2. Acquired immune response:
    An immune response to a foreign substance based on the specific memory of a past exposure to that same foreign substance.
  3. Active immunity:
    A type of immunity based on antibodies developed in response to an antigen, which includes both natural and acquired types.
  4. adjuvants:
    the agents that can be added to a vaccine to modify the immune response.
  5. Allergen:
    An antigen that produces a hypersensitivity or allergic reaction.
  6. Allergy:
    Hypersensitivity acquired through exposure to a particular allergen that elicits an exaggerated reaction on preexposure to the same allergen.
  7. Anaphylaxis:
    A severe immediate type of hypersensitivity in which and exaggerated immunologic reaction occurs on reexposure to a foreign protein or other substance after sensitization, resulting in not only hives, itching, and swelling, but also vascular collapse and shock, as well as death.
  8. Antibody:
    • A protein molecule or immunoglobin thats is secreted by plasma cells and reacts with a specific antigen.
    • Five classes: IgA, IgD, IgE, IgG, IgM.
  9. Antibody titer:
    The level of antibody in the blood that can be measured by a diagnostic laboratory test.
  10. Antigen:
    (immunogens) Any substance able to induce a specific immune response.
  11. Attenuated:
    The ability to reduce the virulence of a pathogenic microorganism but still keep it viable, as is done in the development of certain vaccines.
  12. Autoantibody:
    An antibody that reacts against a tissue constituent of ones own body.
  13. Autoimmune disease:
    An immunopathologic condition characterized by tissue trauma caused by an immune response against tissue constituents of one's own body.
  14. B-cell lymphocyte:
    A type of lymphocyte that develops in lymphoid tissue other than the thymus and that can later differentiate into a plasma cell that produces antibody, the main initiator of humoral immunity.
  15. Cell-mediated immunity:
    A type of immunity in which the major role is played by T-cell lymphocytes.
  16. Connective tissue disease:
    A category of autoimmune diseases with connective tissue as a primary target the pathology.
  17. Cytokenisis:
    The proteins produced by various cells types for the purpose of intercellular communication or signaling; immunologic cytokines are involved as biochemical mediators in the immune response.
  18. Delayed hypersensitivity:
    A type of hypersensitivity reaction that takes time to develop after T-cell lymphocytes re previously introduced to an antigen to either directly cause damage to the tissue cells or recruit other cells that cause the damage.
  19. Dendritic cell:
    A type of white blood cells that acts as an antigen-presenting cell in the skin a mucosa.
  20. Dysgeusia:
    An alteration in taste.
  21. Humoral immunity:
    A type of immunity in which both the B-cell lymphocytes and the antibodies they produce as plasma cells play a predominant role.
  22. Hypersensitivity:
    An altered state of reactivity in which the body reacts to a foreign agent such as an allergen with an exaggerated immune response; includes the four types I through IV.
  23. Hyposalivation:
    decreased salivary flow that may result in xerostomia(dry mouth).
  24. Immune complex:
    The combination of an antibody and antigen, producing complex that can initiate a hypersensitivity or allergic reaction.
  25. Immunization:
    An induction of active immunity, such as when the pathogenic microorganism used to induce active immunity in encountered after vaccination.
  26. Immunodeficiency:
    A type of immunopathologic condition that involves a compromised or entirely absent immune system involving its white blood cells and their products.
  27. Immunoglobulins:
    the proteins tha, when secreted by plasma cells, serve as antibodies designed to respond to a specific agent.
  28. Immunomodulator:
    A substance that alerts the immune response by augmenting or reducing the ability of the immune system to produce antibodies or sensitized cells that recognize and react with the antigen that initiated their production.
  29. Interferon:
    A family of glycoproteins that have immunoregulatory, antineoplastic, and antiviral activity; it is one of the cytokines.
  30. Langerhans cell:
    A specialized dendritic cell found in the skin and mucosa that is involved in the immune response.
  31. LE cell:
    Mature neutrophil with a phagocytized spherical inclusion derived from another neutrophil; it is used as a marker of autoimmune diseases.
  32. Lymphocytes:
    The white blood cells involved in the immune response that have three major subsets; B-cell lymphocyte, T-cell lymphocyte, natural killer cell.
  33. Lymphoid tissue:
    Tissue composed of lymphocytes supported by meshwork of connective tissue; includes tonsils tissue, lymph nodes and lymphatic organs.
  34. Lymphokines:
    The subset of cytokines produced by B-cells or T-cells lymphocytes in contact with antigens that serve as biochemical mediators in an immune response.
  35. Macrophage:
    A large tissue-bound mononuclear phagocyte derived from monocytes circulating in the blood, which can become mobile when stimulated by inflammation and interact with lymphocytes in an immune response as well as during inflammation.
  36. Monokines:
    the subset of cytokines primarily produced by monocytes or macrophages that serve as biochemical mediators in an immune response.
  37. Mucositis:
    The inflammation of a mucosal tissue due to disease process.
  38. Natural killer cell:
    Type of lymphocyte that is part of the initial innate immune response, which by unknown mechanisms is able to directly destroy cells recognized as foreign.
  39. Nikolsky sign:
    Diagnostic sign whereby the superficial epithelium separates easily from the basal layer on exertion of firm, sliding manual pressure with the fingers or a tongue blade.
  40. Passive immunity:
    Type of immunity that uses antibodies produced by another person to protect an individual against infectious disease, which include both natural and acquired.
  41. Plasma cell:
    The cell derived from B-cell lymphocytes that produces antibodies in response to the presence of antigen.
  42. Pruritus:
    The symptom of severe itching due to a disease process, possibly a hypersensitivity reaction or allergy.
  43. Rheumatoid factor:
    • Antibody that binds to certain antibodies found in the serum of patients wit rheumatoid arthritis and connective tissue diseases such as Sjögren syndrome.
    • Current assays test for IgM-class rheumatoid factor.
  44. Schirmer test:
    A test that measures lacrimal gland flow by placing special filter paper strips inside the lower eyelid for 5 minutes.
  45. Serum sickness:
    A classic example of type III hypersensitivity that involves a drug allergy to antitoxin serum from horses.
  46. syndrome:
    A group of signs and symptoms that occur together.
  47. Symblepharon:
    Fibrous adhesion between the eyeball and conjunctiva.
  48. Immune response:
    • Follows inflammatory response as the second line of defense necessary for recovery.
    • can be either innate or acquired 
    • May resulting increased level of tissue damage and disease as it fights against what it considers foreign.
  49. 3 main types of lymphocytes are?
    • B-celllymphocyte
    • T-cell lymphocyte
    • Natural Killer cell
  50. What are the 2 main types of B cells that develop when stimulated by an antigen?
    • B-memory cell
    • Plasma cell
  51. B-memory cell:
    • retain memory of the antigen.
    • Replicates by clonal selection
  52. IgA:
    • 2 subgroups: serous in the blood and secretory in the saliva and other secretions such as tears and breast milk.
    • aids in defense against proliferation of microorganisms in body fluids as well as protecting mucosal sites.
  53. IgD:
    Functions in the activation of B-cell lymphocytes and is only fund on their surface.
  54. IgE:
    • involved in hypersensitivity or allergic reactions because it can bind to mast cells and basophils to bring about the release of biochemical mediators such as histamine.
    • attacks parasites
  55. IgG:
    • major antibody in blood serum at about 75% and as the smallest it can pass the placenta barrier.
    • serves as 1st passive immunity for newborn
  56. IgM:
    • involved in early immune response because of its involvement with IgD in the activation of B-cell lymphocytes.
    • activates complement 
    • neutralize microorganisms
  57. T-helper cell:
    increases the function of B-cell
  58. T-memory cell:
    retain memory of the antigen.
  59. interleukins:
    stimulate with blood cell proliferation and other functions.
  60. Lymphotoxin:
    Destroys fibroblast.
  61. Macrophage-activating factor:
    Activates macrophages to produce and secrete lysosomal enzymes.
  62. macrophage chemotactic factor:
    stimulates macrophage emigration
  63. Migration inhibitory factor:
    inhibits macrophage activity.
  64. Tumor necrosis factor:
    Various functions involving white blood cells and fibroblasts.
  65. two types of immunity?
    passive and active
  66. booster:
    repeated exposure by way of vaccination
  67. Type I or anaphylactic type:
    hay fever, asthma, anaphylaxis
  68. Type II or cytotoxic type:
    Autoimmune hemolytic anemia
  69. Type III or immune complex type:
    Autoimmune disease such as systemic lupus erythematosus
  70. Type IV or cell-mediated type:
    • Cell-mediated type (delayed)
    • T cells that previously were introduced to an antigen cause damage to tissue cells or recruit other cells
    • Responsible for the rejection of tissue grafts and transplanted organs
    • Granulomatous diseases such as tuberculosis as well as graft and organ transplant rejection.
  71. Immunopathology
    • The study of immune reactions involved in disease; the study of diseases caused by the malfunctioning of the immune system
    • Hypersensitivity
    • Autoimmune diseases
    • Immunodeficiency
  72. Drug Hypersensitivity
    • Drugs can act as antigens
    • Topical administration may cause a greater number of reactions than oral or parenteral routes
    • However, the parenteral route may cause a more widespread and severe reaction
  73. Autoimmune Diseases
    • Immunologic tolerance
    • The body learns to distinguish self from nonself
    • Autoimmune disorder
    • The recognition mechanism breaks down; some body cells are not tolerated and are treated as foreign antigens
  74. Immunodeficiency
    • An immunopathologic condition
    • A deficiency in number, function, or interrelationships of the involved WBCs and their products
    • May be congenital or acquired
    • Infections and tumors may occur as a result of the deficiency
    • Can involve various components of the immune system
    • Immunodeficiency diseases are divided into primary and secondary immunodeficiencies
    • Signs and symptoms that occur in a person with immunodeficiency depend on the degree of deficiency and type of immune response involved
  75. Primary Immunodeficiencies
    • Severe combined immunodeficiency
    • Group of genetically inherited syndromes that have defects in both humoral and cell-mediated immune responses
    • Leukocyte adhesion deficiency: Primary immunodeficiency characterized by defects in function of neutrophils
  76. Secondary Immunodeficiencies
    • Those that occur as a result of an underlying disorder
    • Much more common than primary immunodeficiency disorders
    • Disorders that can have accompanying immunodeficiency include:
    • Malnutrition
    • Renal diseases
    • HIV infection
  77. recurrent aphthous ulcer:
    • canker sores or aphthous stomatitis
    • painful oral ulcers cause remains unclear
  78. Minor aphthous ulcer:
    • most common affect 80% with recurrent aphthous ulcer 
    • punched out, round-to-oval, can be as large 1cmImage Upload 1
  79. Major aphthous ulcer:
    • Sutton disease and periadentitis mucosa necrotica recurrens
    • deeper  and last longer than minor
    • can be larger than 1cm
    • Image Upload 2
  80. Herpetiform aphthous ulcer:
    • smallest 1 to 2mm
    • least common
    • Resemble herpes simplex ulcers
    • Painful, generally occur in groupsImage Upload 3
  81. Urticaria:
    • hives
    • multiple areas of well-demarcated edema and erythema of skin
    • itching
    • Image Upload 4
  82. Angioedema:
    diffuse edema of tissue caused by permeability of deeper blood vesselsImage Upload 5
  83. Allergic contact mucositis and allergic contact dermatitis:
    • lesions from direct contact of an allergen with the oral mucosa or skin
    • Involves T cells in a cell-mediated immune response
    • Type IV hypersensitivity
    • Image Upload 6
  84. Fixed drug eruptions:
    • lesions that appear in the same site each time a drug is introduced.
    • May be single or multiple, slightly raised, reddish patches or clusters of macules on the skin, or sometimes the mucous membranes
    • Occurrence may include pain or itching
    • A type of allergic reaction (type III)
    • This creates erythema and edema in superficial layers of the skin or mucosa
    • Treatment
    • The drug causing the reaction should be identified and discontinued
  85. Erythema multiform(EM):
    • Acute, self-limited disease that affects skin and mucous membranes
    • Cause: Not clear; may be a hypersensitivity reaction
    • Target or bull’s-eye lesion
    • Concentric erythematous rings alternating with normal skin colorImage Upload 7
  86. Stevens-Johnson syndrome:
    • Used to be considered a very severe form of erythema multiforme; now classified as a variant of toxic epidermal necrolysis (TEN)
    • Extensive and painful oral lesions
    • Genital mucosa and mucosa of eyes may be involved
    • Lips generally are encrusted and bloody
    • Rare and usually a very severe reaction to drugsImage Upload 8
  87. Lichen planus:
    • A benign, chronic disease affecting the skin and oral mucosa
    • Unknown cause
    • Lesions have characteristic Wickham striae (lacelike)
    • •The classic appearance of lichen planus affecting the oral mucosa is an arrangement or interconnecting white lines and circles.
    • Most commonly on buccal mucosa
    • Lesions may be on the tongue, lips, floor of mouth, and gingiva
    • Most common in middle age
    • Slightly more common in women
    • Treated when symptomatic
    • Topical corticosteroid medications
    • Meticulous oral hygiene
    • Discontinuation of drugs causing condition
    • Regular oral examination 
    • Biopsy of suspicious lesions is necessary because these patients may be at increased risk of development of squamous cell carcinoma
    • Image Upload 9
  88. Reticular lichen planus:
    most common
  89. Reactive Arthritis:
    Reiter Syndrome
    • Chronic classic syndrome includes arthritis, urethritis, and conjunctivitis
    • Genetic influence in most patient
    • Probably an abnormal immune response to a microbial antigen
    • May see aphthous ulcers, erythematous lesions, and geographic tongue–like lesions
    • Diagnosis is made on basis of clinical signs and symptoms, along with identification of HLA-B27 antigenic markerImage Upload 10
  90. Langerhans cell hisiocytosis (LCH):
    • Langerhans cell disease
    • group of rare disorders characterized by the presence of histiocytes-like cells and eosinophils
  91. Sjögren syndrome:
    • Chronic, systemic, autoimmune disease
    • Affects the salivary and lacrimal glands
    • Results in a decrease in saliva and tears, causing a dry mouth (xerostomia) and dry eyes (xerophthalmia).
    • May be associated with other autoimmune disorders
    • Primary Sjögren syndrome: When it occurs alone
    • Secondary Sjögren syndrome: When it occurs with other autoimmune disorders
    • Affects both major and minor salivary glands
    • Oral discomfort caused by dry mouth
    • Lips: Cracked and dry
    • May see loss of filiform and fungiform papillae on the dorsum of the tongue
    • High risk for caries, periodontal disease, and oral candidiasis
    • Diagnosis is made when two of three components are present:
    • Xerostomia
    • Measurement of salivary flow and biopsy can help
    • Keratoconjunctivitis sicca
    • Confirmed by eye examination
    • Rheumatoid arthritis
    • For most patients, the course of the disease is chronic and benign, but these patients are at risk for the development of other, more serious diseasesImage Upload 11
  92. Systemic lupus erythematosus:
    • An acute and chronic inflammatory autoimmune disease
    • No known cause
    • Affects women eight times more frequently than men, predominantly during childbearing years
    • Three times more frequent in black women than in white women
    • A syndrome with a wide range of disease activity
    • Usually chronic and progressive 
    • Periods of remission and exacerbation
    • Skin lesions occur in 85% of individuals
    • “Butterfly” rash on bridge of nose
    • There may be erythematous lesions on fingertips
    • Arthritis and arthralgia are common
    • May have a genetic component
    • Image Upload 12
  93. Pemphigus vulgaris:
    • A severe, progressive autoimmune disease affecting the skin and mucous membranes
    • Characterized by intraepithelial blister formation resulting from acantholysis, a breakdown of cellular adhesion between epithelial cells
    • No gender predilection exists.
    • A broad age range has been reported as well.
    • The first signs of disease occur in the oral cavity in more than 50% of cases
    • There may be shallow ulcers, to fragile vesicles, to bullae
    • Diagnosis is made by biopsy and microscopic examination
    • Nikolsky sign:
    • Diagnostic sign whereby the superficial epithelium separates easily from the basal layer on exertion of firm, sliding manual pressure with the fingers or a tongue blade

    Image Upload 13
  94. Bullous Pemphigoid
    • Some investigators believe bullous and mucous membrane pemphigoid are variants of a single disease
    • Chronic disease and most patients are >70 years of age
    • Oral lesions are less common than in mucous membrane pemphigoid
    • Diagnosis microscopic
    • Treatment:High doses of systemic corticosteroids and NSAIDs
  95. Benign Mucous Membrane Pemphigoid; Cicatricial Pemphigoid
    • Gingival lesions have been called desquamative gingivitis, but this condition may be seen with lichen planus and pemphigus as well
    • Will see positive Nikolsky signImage Upload 14
  96. Mucous Membrane Pemphigoid
    • A chronic autoimmune disease
    • Affects oral mucosa, conjunctiva, genital mucosa, and skin
    • Not as severe as pemphigus vulgaris
    • Diagnosis is made by biopsy and microscopic examination
  97. BehÇet syndrome:
    • Aphthous-like ulcer
    • chronic, recurrent, and multisystem autoimmune disease.
    • Primarily oral ulcers, genital ulcers, ocular inflammation
    • Patients usually 30-40 years of age
    • Image Upload 15
  98. Pernicious anemia:
    Mucosal atrophy and ulceration with loss of both filiform and fungiform lingual papillae.
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DHE120 Chapter 3 Quiz#3
DHE120 Chapter 3 Quiz#3