E3 Autoimmune

Question 1

What is the protective function known as self-tolerance?

Answer 1

prevent the body from attacking itself

Question 2

dampen the actions of both helper T cells and cytotoxic cells

Answer 2

Suppressor T cells

Question 3

Suppressor T cells regulate?

Answer 3

critical for regulating immune reactions

Question 4

Human immune system does not react

to one’s own antigens

Answer 4

Immunologic tolerance

Question 5

When self-tolerance fails, activated T
cells and antibodies attack the
individual’s own cells and tissues =

Answer 5

autoimmunity

Question 6

What is Self-tolerance?

Answer 6

 ability to recognize self antigens

 acquired during fetal life

Question 7

What is immune tolerance?

Answer 7

is the body’s ability to discriminate between

self antigens and non-self antigens

Question 8

Two factors are necessary for development of

Autoimmunity

Answer 8

1. Inherited susceptibility genes
   - –Major histocompatibility complex (MHC) genes
2. Environmental triggers
   • infection
   • high fever
   • trauma

Question 9

What T cells are activated when infection is a trigger for autoimmune disease?

Answer 9

activate antigen-specific T

lymphocytes and self-reactive T lymphocytes

Question 10

Adverse gastrointestinal effects of Aspirin

Answer 10

Ulceration and bleeding

Question 11

Adverse Effects on Special senses of Aspirin

Answer 11

 Tinnitusis sign of toxicity to aspirin

 Requires decrease in dose

Question 12

Adverse Effects on Respiratory system of Aspirin

Answer 12

 Toxic levels may cause central respiratory paralysis =

respiratory acidosis

Question 13

Adverse Effects on the kidney of Aspirin

Answer 13

 Retention of sodium and water

 May cause hyperkalemia and edema in some patients

Question 14

Contraindicated in aspirin/NSAID allergic patients(cross-sensitivity)

Answer 14

celebrex (Celecoxib)

Question 15

Interleukin 1b and tumor necrosis factor

alpha are

Answer 15

proinflammatory cytokines

Question 16

Excessive production of cortisol

Answer 16

Cushing’s Disease (primary disorder)

Question 17

Insufficient production of cortisol

Answer 17

Addison’s disease (primary disorder)

Question 18

What happens in Medication-Induced Adrenal Insufficiency

Answer 18

 Secondary disorder
 taking glucocorticoid medications
(exogenous steroids) suppresses the
body’s own production of endogenous
steroids

Question 19

Associated with chronic steroid use

Answer 19

Secondary Adrenal Insufficiency

Condition usually does not produce
symptoms unless patient is significantly
stressed (or not enough circulating cortisol)

Question 20

Signs and Symptoms of Adrenal Crisis

Answer 20

 Profuse sweating
 Hypotension
 Weak pulse
 Dyspnea
 Cyanosis

Question 21

Mechanism of Action of Steroids

Answer 21

Anti-inflammatory effects

Peripheral leukocytes

 Increases in concentration in neutrophils
 decrease in lymphocytes (T and B cells), monocytes, eosinophils and
basophils

Inhibition of phospholipase A
 Decreases production of both prostaglandins and
leukotrienes from arachidonic acid

Question 22

Steroid Prep most likely to cause

adrenal suppression

Answer 22

oral steroids

Question 23

Alternate day therapy is used for patients

who must take

Answer 23

steroids for longer than 1

month

Question 24

Any medication dosage that exceeds this

amount may cause suppression

Answer 24

20-30 mg

hydrocortisone equivalent

Question 25

Adverse Events Associated with Chronic Steroid Use avoid taking these two things together...

Answer 25

avoid aspirin and NSAIDS

Question 26

Oral Side Effects of Steroids

Answer 26

 Candidiasis = most common  Poor wound healing= long-term use  Masking of oral infections= anti-inflammatory Xerostomia

Question 27

Steroids in dentistry are used for...

Answer 27

 For reduction of pain and swelling |  Treatment of inflammatory pathologies of oral mucosa

Question 28

Avoid steroids with

Answer 28

 Avoid in pregnant/lactating women Use with extreme caution in pediatric patients Geriatric patients more susceptible to hypertension and osteoporosis side effects

Question 29

Determination of the lethal dose

Answer 29

= LD50 Dose of a particular drug that kills 50% of the mice who take it.

Question 30

Determination of effectiveness =

Answer 30

Dose of a drug that causes an effect in 50% | of the total numbers of mice that received it

Question 31

The margin of safety is...

Answer 31

LD50 divided by the ED50

Question 32

A small TI represents

Answer 32

a small (or “narrow”) therapeutic window = requires monitoring

Question 33

detoxication Typically uses which enzymes?

Answer 33

cytochrome P450 liver enzyme system to create water soluble molecules to allow for elimination

Question 34

What is selective toxicity?

Answer 34

1. Attack targets that are unique to the pathogen/cancer cell that are not present in the host 2. Attack targets in the pathogen or cancer cell that are similar but not identical to those in the host 3. Attack targets in the pathogen/cancer cell that are shared by the host, but that vary in importance between the pathogen and the host -selective action: more important to pathogen than host

Question 35

P 53 surpasses tumors by?

Answer 35

– Active DNA repair proteins – Hold cell cycle at G1/S regulation point so that DNA repair proteins will fix damage, then cell allowed to continue cell cycle – Can initiate apoptosis is damage is irreparable – Induce growth arrest

Question 36

What kinetics do tumor cells express?

Answer 36

First order

Question 37

These types of cancer masses don't respond well to chemotherapy, and require?

Answer 37

Tumors Radiation or surgery

Question 38

What is the “triple cocktail” ?

Answer 38

Antiretrovirals for HIV  2 nucleoside reverse transcriptase inhibitors with a protease inhibitor

Question 39

What kinds of things do heavy mettles do to animal cells?

Answer 39

``` – Disrupt enzymatic and transport processes – Loss of energy production – Loss of ion regulation – Potential carcinogenesis ```

Question 40

most common | arsenic containing mineral

Answer 40

arsenopyrite

Question 41

Arsenic (As) Local effects

Answer 41

dermatological

Question 42

signs of Arsenic poisoning

Answer 42

Vasodilation of capillaries (arsenic binds to contractile mechanism so cannot contract) – Rosy complexion – Edema – No wrinkles

Question 43

Gi effects of arsenic

Answer 43

very unpleasant death (vomiting leads to fluid loss and CV collapse)

Question 44

What poisoning is able to diagnosed this | poisoning due to smell.

Answer 44

Garlic Breath Arsenic (As)

Question 45

What is Argyria?

Answer 45

Silver and silver containing compounds become absorbed into circulatory system and deposited into body tissues

Question 46

Gold salts are toxic to...

Answer 46

Liver and Kidneys

Question 47

Gold toxicity manifests as...

Answer 47

dermatitis, metallic taste in mouth, proteinuria, GI symptoms, aplastic anemia

Question 48

Antidote to gold poisoning...

Answer 48

dimercaprol or penicillamine

Question 49

Exposure to Mercury causes?

Answer 49

Tremors, impaired cognitive skills, and sleep disturbance in workers with chronic exposure to mercury vapor even at low concentrations in the range 0.7–42 μg/m3

Question 50

Mercury toxicity occurs at what concentrations?

Answer 50

1.1 to 44 mg/m3 resulted in chest pain, dyspnea, cough, hemoptysis, impairment of pulmonary function, and evidence of interstitial pneumonia

Question 51

With continuing exposure what develops?

Answer 51

fine tremor develops and may escalate to violent muscular spasms. Tremor initially involves the hands and later spreads to the eyelids, lips, and tongue.

Question 52

This kind of mercury causes... – Neurotoxicity with neuropsychiatric effects – Acute poisoning = pneumonitis

Answer 52

elemental mercury

Question 53

This kind of mercury causes corrosive to oral cavity and gut – Used in dental amalgam – Kidney damage

Answer 53

Inorganic mercury

Question 54

Why is lead toxic?

Answer 54

Enzyme inhibitor in the production of heme Accumulates in CNS GI, CV effects