Chapter 3 Flashcards Preview

Pathology Exam 1 > Chapter 3 > Flashcards

Flashcards in Chapter 3 Deck (179):
1

What is Acantholysis?

Dissolution of the intercellular bridges of the prickle cell layer of the epithelium.

2

What is 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

What is Active Immunity?

A type of immunity based on antibodies developed in response to an antigen, which includes both natural and acquired types.

4

What is Adjuvants?

The agents that can be added to a vaccine to modify the immune response.

5

What is Allergen?

An antigen that produces a hypersensitivity or allergic reaction.

6

What is Allergy?

Hypersensitivity acquired through exposure to a particular allergen that elicits an exaggerated reaction on reexposure to the same allergen.

7

What is Anaphylaxis?

A severe immediate type of hypersensitivity in which an 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

What is Antibody?

A protein molecule or immunoglobulin that is secreted by plasma cells and reacts with a specific antigen; includes five classes: IgA, IgD, IgE, IgG, and IgM.

9

What is an Antibody Titer?

The level of antibody in the blood that can be measured by a diagnostic laboratory test.

10

What is an Antigen?

Any substance able to induce a specific immune response.

11

What is 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

What is Autoantibody?

An antibody that reacts against a tissue constituent of one's own body.

13

What is Autoimmune Disease?

An immunopathologic condition characterized by tissue trauma caused by an immune response against tissue constituents of one's own body.

14

What is 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

What is Cell-Mediated Immunity?

A type of immunity in which the major role is played by T-cell Lymphocytes.

16

What is Connective tissue diseases?

A category of autoimmune diseases with connective tissue as the primary target of the pathology.

17

What is Cytokines?

The proteins produced by various cell types for the purpose of intercellular communication or signaling; Immunologic cytokines are involved as biochemical mediators in the immune response.

18

What is Delayed hypersensitivity?

A type of hypersensitivity reaction that takes time to develop after T-cell lymphocytes are previously introduced to an antigen to either directly cause damage to the tissue cells or recruit other cells that cause damage.

19

What is Dendritic Cell?

A type of white blood cell that acts as an antigen-presenting cell in the skin and mucosa.

20

What is Dysgeusia?

An alteration in taste

21

What is 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

What is 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, types I through IV.

23

What is Hyposalivation?

Decreased salivary flow that may result in xerostomia(dry mouth).

24

What is Immune Complex?

The combination of an antibody and antigen, producing a complex that can initiate a hypersensitivity or allergic reaction.

25

What is Immunization?

An induction of active immunity, such as when the pathogenic microorganism used to induce active immunity is encountered after vaccination.

26

What is Immunodeficiency?

A type of immunopathologic condition that involves a compromised or entirely absent immune system involving its white blood cells and their products.

27

What is Immunoglobulins?

The proteins that, when secreted by plasma cells, serve as antibodies designed to respond to a specific antigen.

28

What is Immunomodulator?

A substance that alters 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

What is Interferon?

A family of glycoproteins that have immunoregulatory, antineoplastic, and antiviral activity; it is one of the cytokines.

30

What is Langerhans cell?

A specialized dendritic cell found in the skin and mucosa that is involved in the immune response.

31

What is LE cell?

Mature neutrophil with a phagocytized spherical inclusion derived from another neutrophil; it is used as a marker of autoimmune disease.

32

What is Lymphocytes?

The white blood cells involved in the immune response that have three major subsets: the B-cell Lymphocyte, T-cell Lymphocyte, and natural killer cells.

33

What is Lymphoid Tissue?

Tissue composed of lymphocytes supported by a meshwork of connective tissue; includes tonsillar tissue, Lymph nodes, and Lymphatic Organs.

34

What is Lymphokines?

The subset of cytokines produced by B-cell or T-cell lymphocytes in contact with antigens that serve as biochemical mediators in an immune response.

35

What is Macrophage?

A large tissue-bound mononuclear phagocyte derived from derived from monocytes circulating on the blood, which can become mobile when stimulated by inflammation and interact with lymphocytes in an immune response as well as during inflammation.

36

What is Monokines?

The subset of cytokines primarily produced by monocytes or macrophages that serve as biochemical mediators in an immune response.

37

What is Mucositis?

The inflammation of a mucosal tissue due to a disease process.

38

What is a 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

What is 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

What is Passive Immunity?

Type on immunity that uses antibodies produced by another person to protect an individual against infectious disease, which includes both natural and acquired.

41

What is a Plasma Cell?

The cell derived from B-cell Lymphocytes that produces antibodies in response to the presence of antigen.

42

What is Pruritis?

The symptom of severe itching due to a disease process, possibly a hypersensitivity reaction or allergy.

43

What is a Rheumatoid factor?

Antibody that binds to certain antibodies found in the serum of patients with rheumatoid arthritis and connective tissue diseases such as Sjogren syndrome. Current assays test for IgM-class rheumatoid factor.

44

What is Schirmer Test?

A test that measures lacrimal gland flow by placing special filter paper strips inside the lower eyelid for 5 minutes.

45

What is Serum Sickness?

A classic example of type III hypersensitivity that involves a drug allergy to antitoxin serum from horses.

46

What is Syndrome?

A group of signs and symptoms that occur together.

47

What is Symblepharon?

Fibrous adhesion between the eyeball and conjunctiva.

48

What is a T-cell Lymphocyte?

A Lymphocyte that matures in the thymus and is mainly responsible for initiating cell-mediated immunity as well as modulating humoral immunity.

49

What is Thymus?

Organ consisting of lymphoid tissue located high in the chest, which is large in a infant and gradually shrinks in size in adulthood; site of T-cell lymphocyte maturation.

50

What is Xerostomia?

Dryness of the mucous membranes, including the oral cavity; usually caused by hyposalivation or decreased salivary flow.

51

An Acquired Immune Response has what?

Memory Capability

52

An acquired immune response defends the body against injury by what?

Recognizing substances called antigens.

53

What happens if an antigen is encountered more than once?

The Acquired Immune Response responds quicker than the inflammatory response.

54

An antigen typically includes?

a foreign substance such as protein, microorganisms or toxins.

55

What are the tissues/cells of our bodies that are considered foreign?

-Tumor Cells
-Cells infected with virus
-Organ transplant
-Tissue Graft
-Incompatible blood transfusion
-Cells of own body: Autoimmune Diseases (example: Lupus)

56

Non0recognition or decreased recognition of antigens is seen in certain immunodeficiency disease such as?

HIV or Leukemia

57

What does the body experience in an Excessive Immune Response?

Hypersensitivity to antigens
Ex. Autoimmune disease

58

What are the cellular involvements in the Immune Response?

-Lymphocytes
*B-Cell Lymphocytes
*T-Cell Lymphocytes
*Natural Killer (NK) Cells
-Macrophages
-Dendritic Cells
-Cytokines

59

What are the primary WBC involved in the immune response?

Lymphocytes

60

Which WBC constitutes 20-25% of the WBC population?

Lmyphocytes

61

What are the different types of Lymphocytes?

-B-Cell Lymphocytes
-T-Cell Lymphocytes
-Natural Killer Cell

62

What do B-cell Lymphocytes develop from?

Stem cells in bone marrow

63

Where do B-cell Lymphocytes Mature and reside?

Lymphoid Tissue

64

When B-cells are stimulated by antigens, what happens?

B-cells travel to the site of injury

65

What are the two types of B-cells?

Plasma Cells and B-memory cells

66

What do the Plasma Cells do?

Produce specific antibodies

67

What do B-memory cells do?

Retain the memory of previously encountered antigens and will clone itself in the presence of antigen.

68

What are the Plasma Cell Characteristics?

Round, Pinwheel shaped nucleus with visible cytoplasm.

69

What does the plasma cells produce and release in response to the presence of antigen?

Protein (antibody)

70

What are these proteins/Antibodies called?

Immunoglobulins

71

What are the five different types of Immunoglobulins?

1. IgA
2. IgD
3. IgE
4. IgG
5. IgM

72

What do the T-Cell Lymphocytes develop from?

Bone Marrow Stem Cells

73

Where do the T-Cell Lymphocytes Travel to mature?

Thymus

74

What are the different types of T-Cell Lymphocytes?

-Memory Cells
-T-helper cells
-T-suppressor cells
-T-Cytotoxic cells

75

What do T-helper Cells do?

Increase functioning of B-cells

76

What do T-Suppressor cells do?

Turn off functioning of B-cells

77

What do Cytotoxic cells do?

Attack virally infected cells or tumor cells

78

What are the functions of the T-Cell Lymphocytes?

-Increase the functions of B-cells: Enhancing the antibody response.
-Carry the CD8 marker
-Active in surveillance against virally infected cells.
-Directly attacks virally infected and neoplastic cells.
-Start, regulate, and coordinates the overall immune response.

79

What do Natural Killer Cells do?

Destroy foreign cells soon after their appearance without first recognizing the specific antigen.

80

Where are Natural Killer Cells located?

within the microcirculation not outlying tissue.

81

Natural Killer Cells are Active against what?

Viruses and Cancer Cells

82

What disease compromises and evades the Natural Killer Cells?

HIV

83

What are Macrophages?

Accessory cells in immune response

84

Where are the macrophages located during inflammation?

The connective tissue

85

What are the functions of macrophages?

- Phagocytosis
- Assist B-cells and T-cells
- Messenger between Inflammatory and immune response.
-Activation factor: Produce and secrete Lysosomal enzymes
-Amplify the immune response but do not have memory of the encountered antigen.

86

Do Macrophages have memory?

NO

87

What are Dendritic Cells?

Types of WBC found on the skin, on Mucosa, and in blood.

88

What are Antigen Presenting cells (APCs) (dendritic cells)?

Process antigenic material and present it to other immune system cells. The messenger between innate immunity and acquired immunity.

89

What cell is considered as the Antigen Presenting Cells (APCs)?

The Dendritic cells

90

What are Langerhans cell?

Specialized dendritic cell

91

What are Immunomodulating agents do?

Alter the immune response.

92

What are the major divisions of the immune response?

Humoral Immunity and Cell-mediated Immunity

93

Which division of immunity is considered the Antibody-mediated immunity?

Humoral Immunity

94

Which division of immunity is considered as the cellular immunity?

Cell-Mediated Immunity

95

What does humoral immunity do?

-production of antibodies
-protection against bacteria and viruses
- B cells are the primary cells

96

What is the primary cells in Humoral Immunity?

B-cells

97

What does Cell-Mediated Immunity do?

regulates both major immune responses.

98

What is the primary cells in Cell-mediated Immunity?

T-cells

99

Does the Immune system have memory?

Yes

100

Does the Inflammatory system have Memory?

No

101

After an initial response to an antigen, some lymphocytes what?

Retain memory of the antigen which means the immune response will be faster and stronger the next time an antigen enters the body.

102

The retained memory is called what?

Immunity

103

What are the different types of immunity?

Passive and Active

104

What is an example of Natural Passive Immunity?

Mother to Fetus

105

What is an example of Acquired Passive Immunity?

Injection

106

What is an example of Natural Active Immunity?

Microorganisms causes the disease

107

What is an example if Acquired Active Immunity?

Immunization, vaccination, booster

108

What is Immunopathology?

The study of immune reactions involved in disease; the study of diseases caused by the malfunctioning of the immune system.
-Hypersensitvity
-Autoimmune diseases
-Immunodeficiency

109

What is Hypersensitivity Type I?

-Reaction happens within minutes of exposure to an antigen.
-Plasma cells produce IgE which causes mast cells to release histamine, causing increased dilation and permeability of blood vessels and constriction of smooth muscle in bronchioles of lungs.
-This reaction may range from hay fever to asthma and life-threatening anaphylaxis.

110

What is Hypersensitivity Type II?

Cytotoxic type: Antibodies combines with an antigen bound to the surface of tissue cells, usually a circulating RBC.
-Activated complement components and IgG and IgM antibodies in blood participate un this type of hypersensitivity reaction which destroys the tissue that has the antigens on the surface of its cells. (Rh compatibility)

111

What happen to the blood cells in Hypersensitivity Type II?

They are destroyed

112

What is Hypersensitivity Type III?

-Immune complexes are formed between microorganisms and antibody in circulating blood.
-These complexes leave the blood and are deposited in body tissues, where they cause an acute inflammatory response.
-Tissue destruction occurs after phagocytosis by neutrophils.

113

What is another name for Hypersensitivity Type III?

Serum Sickness

114

What is the most common Type of hypersensitivity?

Type III

115

What is Hypersensitivity Type IV?

-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.

116

What is Drug Hypersensitivity?

*Drugs can act as antigens.
-Topical administration may cause a greater number of reactions than oral or IV routes. However, the IV route may cause a more widespread and severe reaction.

117

Immunologic tolerance

The body learns to distinguish self from nonself

118

Autoimmune disorder

The recognition mechanism breaks down some body cells are not tolerated and are treated as foreign antigens

119

Immunodeficiency

*An immunopathologic condition
*May be congenital or acquired

120

A deficiency in number, function, or interrelationships of the involved WBCs and their products

Immunodeficiency

121

What are the oral immunologic lesions and diseases?

Aphthous ulcers
Urticaria and angioedema
Contact mucositis and contact dermatitis
Fixed drug eruptions
Erythema multiforme
Lichen planus
Reactive arthritis (Reiter syndrome)
Langerhans cell disease

122

What is the most common oral lesions

Aphthous ulcers

123

Aphthous uclers

Painful oral ulcers with an unclear cause
Occurs in three forms
- Minor
- Major
- Herpetiform

124

Minor aphthous ulcers

*Occur on the movable mucosa
*Up to 1cm in diameter
*Erythematous halo surrounding a yellowish-white fibrin surface
*May have a prodrome of 1 to 2 days

125

Major aphthous ulcers

Larger then minor aphthous ulcers (>1cm)
May leave a scar

126

Herpetiform aphthous ulcers

Tiny (1 to 2 mm)
Resemble herpes simplex ulcers
Occur in groups

127

Aphthous ulcers treatment

* Topical corticosteroids
* Topical NSAIDs
* Lidocaine, benzocaine
* Nicotine replacement therapy

128

Urticaria (Hives)

* Appear as multiple areas of well-demarcated swelling of skin
*May include itching ( pruritus )

129

How are urticaria caused

By localized areas of vascular permeability in superficial connective tissue

130

Angioedema

Lesions caused by diffuse swelling as a result of increased permeability of deeper blood vessels
Does not itch

131

Causes of angioedema and uritcaria

* Idiopathic
* Infection
* Trauma
* Emotional stress
* systemic diseases
* ingested allergens

132

Treatment of angioedema and urticaria

Antihistamine drugs
Epinephrine

133

Allergic contact mucositis and dermatitis

Lesions result from contact of an allergen with skin or mucosa
Involves T-cells in a call-mediated immune response
Type IV hypersensitivity

134

Fixed drug eruptions

Lesions that appear in the same site each time a drug is introduced
A type of allergic reaction type III

135

Erythema multiforme

Acute, self-limited disease that affects skin and mucous membranes
Cause may be a hypersensitivity reaction
Target or bull-eye lesion

136

Stevens-Johnson syndrome

Classified as a variant of toxic epidermal necrolysis (TEN)
Extensive and painful oral lesions
Genital/eye mucosa may be involved`

137

Lichen planus

A benign, chronic disease affecting the skin and oral mucosa
Unknown cause
Wickham striae (lacelike)
Most common on buccal mucosa

138

Types of lichen planus

Reticular lichen Plans
Erosive and bellous lichen planus

139

Reticular lichen planus

Most common form

140

Erosive and bullous lichen planus

Epithelium separates from connective tissue

141

What can be associated with lichen plans?

Desquamative gingivitis
Skin lesions

142

Sjogren syndrome, systemic lupus erythematosus, pemphigus vulgaris, mucous membrane pemphigoid, bullous pemphigoid, and behcet syndrome

Autoimmune diseases with oral manifestations

143

Affects the salivary and lacrimal glands. Results in a decrease in saliva and tears, causing xerostomia and dry eyes (xerophthalmia), and keratoconjunctivitis sicca (damage to eyes)

Sjogren syndrome

144

May be associated with other autoimmune disorders and affects both major and minor salivary glands

Sjogren syndrome

145

When sjogren syndrome occurs alone

Primary

146

When sjogren syndrome occurs with other autoimmune disorders

Secondary

147

Parotid gland enlargement occurs in about 50% of patients

Sjogren syndrome

148

Oral discomfort caused by dry mouth, lips are cracked and dry, may see loss of filiform and fungiform on tongue, high risk for caries, perio disease, and oral candidiasis

Sjogren syndrome

149

20% of patients with sjogren syndrome have this disorder affecting the fingers and toes

Raynaud phenomenon

150

Initial pallor and subsequent cyanosis of skin caused by cold or stress, hyperemia when blood vessels are warmed, myalgia, arthralgia, and chronic fatigue

Sjogren syndrome and raynaud phenomenon

151

90% of these patients have a positive response to a rheumatoid factor, an antibod to igG present in serum

Sjogren syndrome

152

Diagnosis of sjogren syndrome is made when 2 of these 3 components are present

Xerostomia, keratoconjunctivitis (confirmed by eye exam), and rheumatoid arthritis

153

How is sjogren syndrome treated?

Treated symptomatically. Nonsteroidal anti inflammatory agents for arthritis, saliva substitutes, glasses and artificial tears to protect eyes, good oral hygiene, fluoride, and frequent dental appointments

154

An acute and chronic inflammatory autoimmune disease with no known cause. Affects women 8 times more frequently than men, predominantly during child bearing years. 3 times more frequent in black women than white women

Systemic lupus erythematosus

155

A syndrome with a wide range of disease activity. Usually chronic and progressive. Antibodies to DNA are present in serum and may have a genetic component

Systemic lupus erythematosus

156

Skin lesions occur in 85% or individuals. Butterfly rash on nose and cheeks.

Systemic lupus erythematosus

157

Erythematous plaques or erosions

May have white striae, resembles lichen planus but are less symmetric

158

Diagnosis of SLE

Based on multiorgan involvement and presence of antinuclear antibodies in serum

159

Treatment of SLE

Aspirin and anti inflammatory drugs. Hydroxychloroquine and corticosteroids along with immunosuppressive agents

160

A severe progressive autoimmune disease affecting the skin and mucous membranes

Pemphigus vulgaris

161

Characterized by intraepithelial blister formation resulting from acantholysis, a breakdown of cellular adhesion between epithelial cells

Pemphigus vulgaris

162

The first signs of disease occur in the oral cavity in more than 50% of cases. There may be shallow ulcers, to fragile vesicles, go bullae. Nikolsky sign

Pemphigus vulgaris

163

Microscopic appearance is pemphigus vulgaris

Acantholytic cells, loss of attachment, tzanck cells

164

Treatment of pemphigus vulgaris

High doses of corticosteroids. May include immunosuppressive drugs

165

A chronic autoimmune disease, affects oral mucosa, conjunctiva, genital mucosa, and skin. Nikolsky sign

Mucous membrane pemphigoid( benign mucous membrane pemphigoid, cicatricial pemphigoid

166

Gingival lesions have been called desquamative gingivitis but this type of gingivitis may be seen with lichen planus and pemphigus as well

Benign mucous membrane pemphigoid

167

Diagnosis of mucous membrane pemphigoid is made by

Biopsy and histologic examination. No degeneration in epithelium occurs and inflammatory infiltrate is found in connective tissue

168

Treatment of mucous membrane pemphigoid (a chronic disease with a benign course)

Topical corticosteroid for mild cases and systemic corticosteroid for severe cases. Eye lesions can lead to severe eye complications

169

Some people believe this and mucous membrane pemphigoid are variants of a single disease

Bullous pemphigoid

170

Bullous pemphigoid ages.. predisposition, treatment

Most pts older than 70
Oral lesions less comin than in cicatricial pemphigoid
Treated with systemic corticosteroids and NSAIDS

171

A chronic, recurrent autoimmune disease. Primarily oral ulcers, genital ulcers, ocular inflammation. No sex predilection. Oral ulcers are similar in appearance to aphthous ulcers

Behçet syndrome

172

Diagnosis of behçet syndrome requires 2 of these 3 types of lesions to be present

Oral genital ocular

173

What suggests behçet syndrome

A pustular lesion after needle puncture

174

Treatment of behçet syndrome

Systemic and topical corticosteroids

175

Can involve various components of the immune system. Divides into primary and secondary. Signs and symptoms depend on the degree of deficiency and type of immune response involved

Immunodeficiency

176

Primary immunodeficiencies

Severe combined immunodeficiency and leukocyte adhesion deficiency

177

Group of genetically inherited syndromes that have defects in both humoral and cell mediated immune responses

Severe combined immunodeficiency

178

Primary immunodeficiency characterized by defects n function on neutrophils

Leukocyte adhesion deficiency

179

Occurs as a result of an underlying disorder, more common than the other, may accompany malnutrition, renal diseases, and hiv infection

Secondary immunodeficiencies