Exam 1 Flashcards

1
Q

How does cells response to injury ?

A
  • Atrophy: decrease in size
  • Hypertrophy: Increase in size
  • Hyperplasia: Increase in #’s
  • Metaplasia: Replacement in cell type thats more durable
  • Dysplasia: abnormal dividing of cells
  • Neoplasia: No longer function/appear like normal
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2
Q

What are the Diagnostic Process?

A

Subjective
Objective
Assessment
Plan

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3
Q

What is the subjective phase?

A
  • Gather information from the PT and history.
    Example:
  • Discomfort: pain, dull ache/numbness/tingling
  • Function: Difficulty swallowing/opening chewing
  • Textural Changes: Dry/rough/swelling
  • Location: Where
  • Periodocity : association: constant/intermittent
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4
Q

What is the objective phase ?

A
  • observerable and measureable by palpation/visusal/ percussion

Example:

  • Soft tissue changes: color/ consistency/ size
  • Hard tissue changes: Size and shape
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5
Q

What are the characteristics to describe lesions?

A
  • Location
  • Size and shape
  • Color
  • Description
  • Duration/history
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6
Q

What is pathology?

A

The study of the nature of disease.
Which includes: etiology
Pathogenesis
Phathophysiology
Prognosis

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7
Q

What is disease?

A

Injury that results in structural or functional changes

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8
Q

Assessment phase is ?

A

It develops a DIFFERENTIAL diagnosis
Determine a DEFINITIVE diagnosis

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9
Q

What are the biopsy PROCEDURES?

A

Incisional - take a part of lesion for diagnosis

Excisional- take the entire lesion, for diagnosis and treatment

Needle- insert needle and aspirate some cells done with deeper tissue like organs

Cytological smear- takes sloughed or scraped surface epithelium

Brush biopsy- takes just the epithelium

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10
Q

Planning phase

A
  • Treatment provided based on diagnosis
  • Treatment strategies: no treatment
    Surgical removal
    Pharmacological agents
    Behavioral modification
    Psychiatric therapy
    Referral to specialist or others
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11
Q

What is injury ?

A

Alteration causing tissue damage

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12
Q

What are the protection measures for injury?

A
  • Physical barrier
  • Antibacterial activity of enzymes
  • flushing action of saliva
  • stomach acid
  • cilla and mucous defends airway
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13
Q

What are the different types of inflammatory response ?

A
  • Acute and chronic
  • local and systemic
  • nonspecific response
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14
Q

What are the clinical signs of inflammation?

A
  • redness
  • swelling
  • heat
  • loss of function
  • pain
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15
Q

What are the microscopic events of inflammation?

A
  • Injury
  • Constriction of microcirculation
  • Dilation of microcirculation
  • Increase in permeability of the microcirculation
  • Transudate
  • increase blood viscosity
  • Decreased blodd flow through the microcirculation
  • Margination
  • Emigration
  • WBC ingest foreign and dead material
  • Exudate formation
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16
Q

What is exudate?

A

Fluid, protein, and dead or injuried cells.

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17
Q

What are the 4 types of exudate?

A
  • Serous
  • Purulent
  • Mucinous
  • Fibrinous
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18
Q

What is serous exudate?

A
  • it is plasma and proteins
  • It is associated with mild injury
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19
Q
  • What is purulent exudate ?
A
  • It is WBCs, tissue, debris
  • associated with acute inflammation
  • found in abcess and fistulas
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20
Q

What is chemical mediators?

A

Amplify inflammatory response

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20
Q

What are some systemic manifestations of inflammation?

A
  • Fever
  • Leukocystis (increase in WBC count)
  • Lymphadenopathy
  • Elevated C-reactive protein
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21
Q

What are the types of chemical mediators?

A
  1. Histamine- Mast cells
  2. Serotonin- act like histamine released from platelets
  3. kinin System- Bradykinin acts like histamine, causes pain
  4. Fibrinolytic system- plasmin activates clotting and kinin system
  5. Prostaglandis and leukotrienes- Dilation, pain and produces mmps ( breaks down collagen)
  6. Cytokines- 1,6,8 TNA (continue movement of WBC)
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22
Q

what is actue inflammation made up of?

A
  • neutrophils (effective against bacteria and fungi)
  • Eosinophis (hypersensitivity)
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23
Q

What is chronic inflammation made up of?

A
  • Macrophages
  • Lymphocytes
  • Fibroblasts
  • Endothelial cells
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24
Q

What is the process of healing and repair?

A
  1. Clot formation
  2. Macrophages
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25
Q

What are the different types of healing?

A
  • Primary
  • Secondary
  • Tertiary
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26
Q

What are the factors that affecting healing?

A
  1. Systemic factors
  2. Local factors
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27
Q

What are the systemic factors that affect healing?

A
  1. Age
  2. Nutritional status
  3. Immune status
  4. Smoking
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28
Q

What are the local factors that affect healing?

A
  1. Secondary infection
  2. Tissue necrosis
  3. Poor Blood supply
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29
Q

What is Fibrous repair ?

A

Repair with scaring
eg. Keloid

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30
Q

What does the immune system do?

A
  • Defends against specific target: Antigen - nonself protein ( bacteria viruses, parasites)
  • macrophages present antigen to lymphocyte then it travels to injury seeking them out.
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31
Q

What are the two lymphocyte?

A

B and T cells

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32
Q

What are lymphocytes?

A

principle cells of immune system

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33
Q

Where are lymphocytes located?

A
  • lymph nodes
  • Spleen
  • Bone marrow
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34
Q

What are B-cells?

A

Effective against bacteria and viruses

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35
Q

What are the two types of B-cells?

A
  • Plasma- make antibodies only live a few days
  • Memory cells- React quickly if antigen appears again
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36
Q

How long does it take to build up enough antibodies to neutralize antigen?

A

2-3 weeks

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37
Q

What are the 5 types of Immunoglobulins?

A
  • IgG
  • IgA
  • IgM
  • IgE and IgD

GAMED

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38
Q

IgG

A
  • 75%
  • Can cross placenta
  • Long term immunity
  • In tissue and in circulation
  • Small molecule
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39
Q

IgA

A
  • 15%
  • In saliva, tears, GI tract, Breastmilk, repiratory tract.
  • Protects from inhaled and ingested antigens
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40
Q

IgM

A
  • 10%
  • Form quickly after antigen challenge
  • quick and short term protection
  • large molecule
  • replaced by IgG
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41
Q

IgD and IgE

A
  • less than 1%
  • Dont circulate, IgD serves as receptor.
  • IgE binds to recept on mast cells during allergic reactions
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42
Q

What is immune complex ?

A
  • Antigens and antibody
  • renders antigen inactive
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43
Q

What cant immune complex interact with?

A

infected host cells- T-cells

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44
Q

What are T-Cells?

A
  • recognize and attack specific antigen
  • modulate B-cell antibody production
  • produces t memory cells
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45
Q

What is cell mediate response?

A
  • delayed immunity
  • react only to antigens presented to them
  • Take longer than B-cell reaction
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46
Q

What is humoral response?

A

reacting with freely circulating antigens

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47
Q

What is Immunopathology

A

An inappropriate immune response to an infection

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48
Q

What is hypersensitivity

A

Exagerated response to allergens cause tissue destruction.

  • can be considered harmless antigens
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49
Q

What are the three types of immunopathology ?

A
  • Hypersensitivity (allergic reactions)
  • Autoimmune diseases
  • Immunodeficiency (quality/quantity deficiency of WBC)
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50
Q

What are the 4 types of hypersensitivty reaction?

A
  • I. Immediate
  • II. Antibody mediated
  • III. Immune complex mediated
  • IV. Delayed
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51
Q

What is immediate (anaphylactic) hypersenitivity ?

A
  • Occurs in minutes
  • Production if IgE antibodies
  • Histamine is releases- dilation of vessels constriction of bronchioles
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52
Q

What are examples of immediate hypersensitivity ?

A

Hayfever
Asthma
Anaphylaxis
Urticaria (hives)
Angiodema (swelling under skin)
Pruritus (itching)

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53
Q
A

Immediate Hypersensitivity
Urticaria (Hives)

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54
Q

What is Antibody Mediated (cytotoxic) Hypersensitivity?

A
  • “mistaken identity”
  • Response against harmless cells
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55
Q

What are examples of Antibody mediated response?

A

Blood Transfusions
Hemolytic disease of newborn
Certain drug reactions

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56
Q

What is Immune Complex mediated Response ?

A
  • Antigen and antibody
  • Deposited everywhere through circulation
  • incite inflammatory response common deposit sites: Kidneys, joints, heart
57
Q

What are examples of immune complex mediated response?

A
  • fixed drug truptions
  • lupus
  • rheumatoid arthritis
58
Q

What is Delayed response?

A
  • T-cell mediated: Respond to presented antigen
  • Takes 24-72 hrs

Phase 2
- Sensitization: antigen penetrates skin, memory cells produce and become localized.
- Elicitation: Memory T-cells are stimulated which triggers inflammatory response

59
Q

What is auto immune disease?

A
  • immune system cells as antigens
  • influenced by genetic factors
  • Some induced by microbes- streptococcal infections, epstein bar virus
60
Q

What is immunodeficiency?

A

Failure of immune system to protect body from infection b/c of absense of insufficiency of stuff.

61
Q

What can be immunodeficiency?

A
  • Congenital/aquired
  • systemic disease (diabetes)
  • Medication/drugs/treatment (Steriods,chemo)
  • aquired by infection (HIV)
62
Q

What is primary immunodeficiency?

A
  • Genetic/ congential abnormallity: results in defective functioning of part of the immune/inflammatory response.
63
Q

What are examples of primary immunodeficiency?

A

Brutons disease- b-cells dont mature.
Tx: antibody injection

Digeorge syndrome- 3rd and 4th pharyngeal pouches did not develop
- T-cells= absent/diminished
Tx: Bone marrow transplant

64
Q

What is the secondary immunodeficiency?

A
  • Aquired after birth, no genetics
  • oppurtunistic infection*
65
Q

What are examples of secondary immunodeficiency?

A
  • Diabetes
  • Cancer
  • Malnutrition
  • Immunosupressive drugs
  • TB
  • HIV
66
Q

What are immunologic pathogenisis ?

A

Disease development involving an immune response

67
Q

What is Aphthuos ulcers?

Disease with immunologic pathogenisis

A
  • Trauma precipates outbreak
  • Cell mediates immunity (T-Cells)
68
Q

Disease with immunologic pathogenisis

A

Aphthous Ulcer Major

69
Q

Disease with immunologic pathogenisis

A

Aphthous Ulcer Minor

70
Q

Disease with immunologic pathogenisis

A

Aphthous Ulcer Herpetiform

71
Q

What are the disease with immunologic pathogenisis?

A
  • Recurrent Aphthous Ulcer
  • Erythema Multiforme
  • Lichen Planus
  • Reiters Syndrome
  • Langerhans cell disease
  • Sjogrens syndrome
  • Lupus Erythematosus
  • Pemphigus Vulgaris
  • mucous membrane pemphigoid
  • bullous pemphiogoid
  • bechet syndrome
72
Q

What is Erythema Multiforme

Disease with immunologic pathogenisis

A
  • Immune complex mediated: Type III immunity.
  • Target lesions or bulls eye
  • Involves skin and mucous membrane
  • vesiculoboullus disease
73
Q

What are symptoms and precipitating factors of Erythema multiforme?

Disease with immunologic pathogenisis

A

Symptoms:
Low grade fever, malaise
headache

Percipitating factors:
Viral/fungal/bacterial infections
Stress
Allergy to drugs

74
Q

What is the treatment for erythema multiforme?

Disease with immunologic pathogenisis

A

Corticosteroids

75
Q

Disease with immunologic pathogenisis

A

Erythema multiforme

76
Q

What is lichen planus?

Disease with immunologic pathogenisis

A
  • Chronic affect skin and oral mucosa
  • basal layer degenerates seperation from CT
  • MORE COMMON IN** MIDDLE **WOMEN
77
Q

What are the two forms of Lichen planus?

Disease with immunologic pathogenisis

A

Reticular- wickhams striae
Erosive- bulla, erosions, desquamative gingivitis

78
Q

Disease with immunologic pathogenisis

A

Lichen Planus

79
Q

What is Rieters Syndrome

Disease with immunologic pathogenisis

A
  • Abnormal immune response after GI infection
  • SEEN in **MALES ** with certain genetic markers
80
Q

What are the symptoms of Rieters Syndrome?

Disease with immunologic pathogenisis

A

Arthritis
Conjugctivitis
Urethritis

81
Q

What is the treatment for Rieters Syndrome ?

Disease with immunologic pathogenisis

A

Spontaneous Remission
NSAIDS

82
Q

Disease with immunologic pathogenisis

A

Rieters syndrome

83
Q

What is Langerhans Cell Disease/hystiocytosis

Disease with immunologic pathogenisis

A
  • Tumor forming disease, langer cell proliferation
  • **SEEN in CHILDREN and Young adults **
84
Q

What are the three catergories for langerhans cell disease ?

Disease with immunologic pathogenisis

A
  1. Letterer siwe-fatal
  2. Hand-Schuller-christian: Bone loss, sore mouth
  3. Eosiniphillic Granuloma
85
Q

Disease with immunologic pathogenisis

A

Langerhans cell disease

86
Q

What are common autoimmune symptoms?

A
  • Raynaud phenomenon- Fingers turn white and then blue from lacks of blood
  • Rheumatoid Factor- Ig G antibodies attack IgM antibodies
87
Q

What is Sjogren Syndrome

Disease with immunologic pathogenisis

A
  • Dry eyes and mouth
  • Helps with increase tooth decay
88
Q

Disease with immunologic pathogenisis

A

Sjogrens Syndrome

89
Q

Disease with immunologic pathogenisis

A

Systemic Lupus Erythematosis

90
Q

What is Pemphigus Vulgaris

Disease with immunologic pathogenisis

A
  • Severe and progressive autoimmune condition
  • Affects skin mucous membranes
91
Q

Disease with immunologic pathogenisis

A

Pemphigus Vulgaris

92
Q

Cicatricial Pemphigoid

Disease with immunologic pathogenisis

A

When epithelieum seperates from CT @ basement membrane

93
Q

Disease with immunologic pathogenisis

A

Cicatricial pemphigoid

94
Q

Bullous Pemphigoid

Disease with immunologic pathogenisis

A
  • Autoantiboidies circulate and do not correlate with disease activity
  • less common oral lesions= less common
95
Q

Disease with immunologic pathogenisis

A

Bullous Pemphigoid

96
Q

Bechets Syndrome

Disease with immunologic pathogenisis

A
  • Chronic, recurrent
  • Creates oral ulcers, genital ulcers, ocular inflammation
  • Antibodies form agains oral mucosa
  • Diagnosis is made when two- three is present
97
Q

Disease with immunologic pathogenisis

A

Bechets Syndrome

98
Q

With infectious diseases what are are emerging diseases?

A

-Have not occured in human before or occured in only isolated places
- occured in the passed but recently recognized

99
Q

With infectious disease what are re-emerging diseases?

A

Once harmful, then not and becoming harmful again

100
Q

What are bacterial infections?

A

diseases that can affect your skin, lungs, brain, blood and other parts of your body

101
Q

What is group A strepococci ?

A

Enzymes released eat through tissue

102
Q

What is impetigo?

A

A pyogenic skin infection

103
Q

What is the cause of impetigo?

A

Normal inhabitants of the skin

104
Q

What is the treatment for impetigo?

A

Topical/systemic antibiotics

105
Q

Bacterial infection

A

Impetigo

106
Q

Strep Throat

Bacterial infection

A
  • Exudate of PMNS near tonsils
  • Can lead to scarlet or rheumatic fever
107
Q

Bacterial infection

A

Strep throat

108
Q

Scralet Fever

Bacterial infection

A
  • bacteria in additon to pharyngitis can cause red rash on skin
  • Toxins can damage blood vessels
  • Can evolve into rheumatic fever
109
Q

Bacterial infection

A

Scarlet Fever

110
Q

Rheumatic fever

Bacterial infection

A
  • After 2-3 weeks of strepococcal pyrogenes turns into rheumatic fever
111
Q

What does Rheumatic fever
affects?

Bacterial infection

A
  • Tissue inflamed
  • Mitral valve scarring- scarring cause bacteria to collect
112
Q

What is MRSA?

Bacterial infection

A

2 Types: Hospital associated
Community associated
* Can cause life threating infection

Prevention: wash hands

113
Q

Bacterial infection

A

MRSA

114
Q

What is Actinomycosis

Bacterial infection

A

normal bacteria in mouth access to CT through wounds from draining abcess in fibrous tissue.

115
Q

What is the treatment for actinomycosis ?

Infectious disease

A

debridement of granulation tissue drainage

116
Q

What is Syphilis?

Infectious disease

A

Treponema pallidum (spirochete)

117
Q

What are the three stages of syphilis?

Infectious disease

A

Primary
Secondary
Tertiary

118
Q

What is Primary syphillis?

Infectious disease

A
  • Afters after
  • 2-3 weeks
  • Highly infectious
  • ulceration at site of entry
  • Spreading occurs at this stage
119
Q

Infectious disease

A

Primary Syphillis

120
Q

What is Secondary Syphillis

Infectious disease

A
  • Occurs 4-10 weeks
  • Erythematous papules and nodules
121
Q

Infectious disease

A

Secondary Syphillis

122
Q

What is tertiary Syphillis?

Infectious disease

A
  • Entered latency after secondary stage
  • may last yrs to life time
  • Produce irreversible cardiovascular and CNS damage
  • Gumma occurs (eats away bone)
123
Q

Infectious disease

A

Tertiary Syphillis

124
Q

What is congenital syphilis?

A
  • When Syphils is passed from mother to baby.
125
Q

What can be the result of Congenital syphillis?

Infectious disease

A

Still birth
spontaneous abortion
Developmental defects

126
Q

What are the effects of congential syphilis?

Infectious disease

A

Enamel hyperplasia
Deafness
Short maxilla
high palate
saddle nose

127
Q

What is the treatment for congential syphilis ?

Infectious disease

A

Antibiotic Penicillin

128
Q

What are the symptoms of gonorrhea?

A

Sore throat
Diffuse erythema
Pustules on tonsils

128
Q

What is Gonorrhea?

Infectious disease

A
  • Sexual transmitted disease caused by bacteria
129
Q
A

Gonorrhea

130
Q

What is Sinusitis ?

A
  • When sinuses cant drain into nasal cavity
  • Can be acute or chronic
  • Most common health complaint
131
Q

What are the characteristics of Fungal infections?

A
  • similar to plants no chlorophyll
  • Cant make own food
  • parasites
  • must live on skin and mucosa
132
Q

What is a deep fungal infections?

A
  • chronic infections of the lungs
  • caused by inhalation of spores
  • all can have oral lesions
133
Q

What are the Endemic areas of infection?

A
  1. Histoplasmosis and blastomycosis
  2. Coccidiomycosis
134
Q

What is Candidiasis

A
  • moniliasis or thrush
  • opportunistic infection when factors exist like diabeters or HIV
135
Q
A

Acute Pseudomembranous (Thrush)

136
Q
A

Atrophic (Erthematous)

137
Q
A

chronic hyperplastic candidiasis

138
Q
A

angular cheilitis

139
Q
A

median rhomboid glossitis

140
Q
A