Chapter 34 (Staci)

Question 1

_______ may alter the course and pathogenesis of a number of systemic diseases/conditions.

Answer 1

Periodontitis

Question 2

True or False.

There is evidence that suggesting that periodontitis causes systemic disease.

Answer 2

False

The possibility of an association between periodontal disease and systemic disease suggests that periodontal therapy may play an important role in decreasing the incidence and severity of certain systemic diseases.

Question 3

______ indicates that there is a relationship or a connection between two or more variables.

Answer 3

Association

Question 4

If variable A is certain to cause or lead to variable B this would be considered _______.

Answer 4

causation

Question 5

Periodontitis is characterized by both _____ and ______ events and may contribute to select systemic diseases.

Answer 5

infection and pro-inflammatory

Question 6

Inflammation, ________ and metastatic infection have been postulated as possible mechanisms of action for linking periodontitis to certain _____ diseases.

Answer 6

the immune response; systemic

Question 7

_______ is an infectious disease mediated by microorganisms that originate from a distant body site.

Answer 7

Metastatic infection

ex: certain organisms found in the mouth can travel to the lung and possibly cause a lung infection

Question 8

True or False.

Chewing and tooth brushing can disseminate whole bacteria and their products throughout the body to other nonadjacent organs or body parts.

Answer 8

True

Question 9

Oral bacteria from ______ lesions and the DNA of certain _______ can survive in the blood stream and adhere to other sites in the body causing systemic disorders.

Answer 9

periodontal; periodontal pathogens

Question 10

Systemic disorders such as endocarditis, lung infections, abscesses of the brain or liver, and fatty deposits in the carotid arteries can be caused by the _____________ and _______ that can survive in the bloodstream and adhere to other sites in the body.

Answer 10

DNA of periodontal pathogens; oral bacteria

Question 11

Periodontitis may _____ some aspects of certain systemic diseases to make those diseases more severe.

Answer 11

modify

Question 12

Infection of the periodontal pocket can stimulate the oral tissues to release _______ mediators which can then enter the blood stream and initiate significant systemic inflammation.

Answer 12

pro-inflammatory

Question 13

In periodontitis, bacterial _______ are processed and presented to the body’s immune system and recognized by _____.

Answer 13

antigens; lymphocytes

Question 14

________ inflammation is defined by increased circulation of pro-inflammatory mediators

Answer 14

Systemic

Question 15

Sub-gingival plaque biofilm provides a large and persistent source of periodontal pathogens that can enter into the systemic blood stream, activating the host immune response which facilitates ______ formation and exacerbation.

Answer 15

atheroma

Question 16

True or False.

The correlation between metastatic infection as well as inflammation and immune response have all been postulated as possible mechanisms of action for linking periodontitis to certain systemic diseases.

Answer 16

True

Question 17

Which of the following is NOT one of the possible biologic explanations for the correlation between ACVD and periodontitis?

A. Dyslipidemia

B. Elevated levels of fibrinogen

C. Antibody Cross Reactivity

D. Reduced Systemic Inflammation

Answer 17

D. Reduced Systemic Inflammation

Correct Answer: Heightened Systemic Inflammation

Question 18

Periodontal infections may contribute to atherosclerosis by triggering the host to produce elevated levels of serum ______, as well as low-density lipoproteins, _____, and very low-density lipoproteins.

Answer 18

cholesterol; triglycerides

Question 19

Periodontitis elevates levels of ________ which increases vascular inflammation. This is important because the coagulation and fibrinolytic systems play important roles in the thickening of the arteries and clot formation.

Answer 19

fibrinogen

Question 20

True or False

Studies have shown that patient with periodontitis have lower levels of plasma fibrinogen

Answer 20

False

they have HIGHER levels of fibrinogen

Question 21

_______ , one of the possible biologic explanations for the correlation between ACVD and periodontitis, occurs when an antibody reacts with an antigen other than the one that initially induced it’s production.

Answer 21

Cross reactivity

Question 22

Patients with periodontitis have elevated systemic antibody responses to a variety of _______ and are able to induce antibody cross reactivity.

Answer 22

periodontal microorganisms

Question 23

True or False.

*Cross-reactivity suggests that periodontal pathogens induce the body’s immune response to mistakenly target cells in blood vessels leading to vascular inflammation and atherosclerosis.

Answer 23

True

Question 24

Atherscherotic cardiovascular disease (ACVD) is a group of heart or vascular diseases including

A. angina, myocardial infarction, asthma, transient ischemic attack, and peripheral artery disease

B. angina, myocardial infarction, stroke, transient ischemic attack, and peripheral artery disease

C. angina, myocardial infarction, rheumatoid arthritis, transient ischemic attack, and peripheral artery disease

Answer 24

A. angina, myocardial infarction, stroke, transient ischemic attack, and peripheral artery disease

Question 25

_______ is characterized by a thickening of arterial walls.

Answer 25

Atherosclerosis

Question 26

________ is a fatty deposit in the inner lining of an artery; also called an arterial plaque

Answer 26

Atheroma

Question 27

________ is a special type of plasma protein, produced by the liver, macrophages, and smooth muscle cells that is present during episodes of acute inflammation or infection.

Answer 27

C-reactive protein

Question 28

Serum _______ are elevated in a patient with periodontitis compared to a patient without it.

Answer 28

C-reactive protein

Question 29

________ are fatty deposits in the inner lining of an artery

Answer 29

Atheromatous lesions

Question 30

What converts fibrinogen to fibrin? A. c-reactive protein B. thrombin C. plasma protein D. inflammation

Answer 30

B. thrombin

Question 31

______ is a protein substance that forms a network of threadlike structures and causes the blood plasma to gel.

Answer 31

fibrin

Question 32

True or false. Reduced levels of fibrinogen is a risk factor for atherosclerosis.

Answer 32

False Elevated levels of fibrinogen is a risk factor for atherosclerosis

Question 33

_______ refers to an abnormal amount of lipids.

Answer 33

Dyslipidemia

Question 34

A patient presents with mild, moderate or severe periodontitis and they have two or more ACVD risk factors. What would you do with this patient? A.inform that there may be an increased risk for CVD associated with periodontitis B. refer for medical eval is he/she has not had one in last 12 months C. recommend to seek medical eval is he/she has not had one in the last 12 months

Answer 34

B. refer for medical eval is he/she has not had one in last 12 months

Question 35

A patient presents with mild to severe periodontitis and they have one known ACVD risk factor. What would you do with this patient? A.inform that there may be an increased risk for CVD associated with periodontitis B. refer for medical eval is he/she has not had one in last 12 months C. recommend to seek medical eval is he/she has not had one in the last 12 months

Answer 35

C. recommend to seek medical eval is he/she has not had one in the last 12 months

Question 36

A patient presents with mild to severe periodontitis and and does not have any known ACVD risk factors. What would you do with this patient? A.inform that there may be an increased risk for CVD associated with periodontitis B. refer for medical eval is he/she has not had one in last 12 months C. recommend to seek medical eval is he/she has not had one in the last 12 months

Answer 36

A.inform that there may be an increased risk for CVD associated with periodontitis

Question 37

What is the a leading cause of neonatal death and long-term neurodevelopment disturbances and health problems in children?

Answer 37

preterm delivery of low-birth weight infants`

Question 38

_______ is a serious complication of pregnancy characterized by an abrupt rise in blood pressure, large amounts of the protein albumin into the urine, and swelling of the hands, feet, and face. It occurs in the last trimester of pregnancy

Answer 38

Preeclampsia

Question 39

Which of the following is NOT one of the possible biologic pathways related to adverse pregnancy outcomes? A. Direct Pathway B. Indirect Pathway #1 C. Transverse Pathway D. Indirect Pathway #2

Answer 39

C. Transverse Pathway

Question 40

Oral microbes and/or their components travel to the placental fetal unit in the ________ pathway

Answer 40

Direct Pathway

Question 41

In which biological pathway does oral bacteria induce the maternal periodontal tissues to release elevated levels of pro-inflammatory mediates. From there, the pro-inflammatory mediators spread systemically to have an impact on the placenta/fetal unit.

Answer 41

Indirect Pathway #1

Question 42

In which biological pathway does the maternal liver respond to oral bacteria by producing elevated levels pf pro-inflammatory mediators and acute phase reactant proteins that then spread to the placenta/fetal unit.

Answer 42

Indirect Pathway #2

Question 43

True or False. All preventative, diagnostic, and periodontal therapeutic procedures are safe throughout pregnancy. Additionally, elective procedures should be completed in the first trimester.

Answer 43

False. All preventative, diagnostic, and periodontal therapeutic procedures are safe throughout pregnancy. Elective procedures should be avoided in the first trimester.

Question 44

______ therapy may result in improved insulin sensitivity and subsequent improved glycemic control

Answer 44

Periodontal

Question 45

True or False. Xerostomia, burning mouth syndrome, fungal infections, slower wound healing are the associated oral conditions of diabetes mellitus.

Answer 45

True

Question 46

_______ is a medical term referring to the typical blood glucose levels in those with diabetes mellitus.

Answer 46

Glycemic control

Question 47

A fasting blood glucose level less than _______ mg/dL is normal

Answer 47

100

Question 48

A fasting glucose level between ______ mg/dL and ____ mg/dL is considered prediabetes

Answer 48

100-125

Question 49

Poor glycemic control refers to persistently elevated fasting blood glucose levels greater than or equal to _____ mg/dL.

Answer 49

126

Question 50

______ is the average blood glucose level over the past ____ to ___ months, this is the lifespan of the red blood cell.

Answer 50

HbA1C; 2 to 3

Question 51

A1C is reported as a percentage of total _____ in the blood

Answer 51

hemoglobin

Question 52

A normal HbA1C for a non-diabetic is _____

Answer 52

less than 5.6%

Question 53

A reasonable A1C goal for many adults with diabetes is BELOW ___.

Answer 53

7%

Question 54

Evidence suggests that periodontitis raises the levels of _______mediators in blood serum.

Answer 54

pro-inflammatory

Question 55

Periodontal diseases may serve as ______ of insulin resistance, thereby _____ glycemic control. Therefore, ________ may result in improved insulin sensitivity and subsequent improved glycemic control.

Answer 55

initiators; aggravating; periodontal therapy

Question 56

This type of pneumonia is contracted outside of the hospital setting by the aspiration of oropharyngeal organisms. It responds well to treatment. A. Hospital acquired B. Community acquired C. Ventilator-associated

Answer 56

B. Community acquired

Question 57

This type of pneumonia is an infection of the lungs contracted during a hospital stay or in a long-term care facility. A. Hospital acquired B. Community acquired C. Ventilator-associated

Answer 57

A. Hospital acquired

Question 58

This type of hospital-acquired pneumonia developing after intubation for mechanical ventilation. A. Hospital acquired B. Community acquired C. Ventilator-associated

Answer 58

C. Ventilator-associated

Question 59

Periodontal diseases may be related to _______ by the inhalation of fine droplets from the oral cavity and throat into the lungs.

Answer 59

respiratory diseases

Question 60

Application of ______ gel to the teeth, gingiva, and other oral mucosal surfaces has been shown to significantly decrease the risk for _____.

Answer 60

0.2 chlorhexidine; pneumonia

Question 61

_____ is a group of lung diseases, mainly emphysema and chronic bronchitis, characterized by an obstruction of airflow during exhalation

Answer 61

COPD

Question 62

______ is an autoimmune disease that causes redness, warmth, swelling, and pain of the joints.

Answer 62

Rheumatoid arthritis

Question 63

______ is a cluster of conditions such as HBP, high blood sugar, excess body fat around the wist, and abnormal cholesterol or triglyceride levels. These conditions occur together, increasing the risk of heart disease.

Answer 63

Metabolic syndrome

Question 64

______ is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.

Answer 64

Cancer