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Periodontics I > FInal- Periodontitis as a Manifestation of Systemic Disease - High Yield > Flashcards

FInal- Periodontitis as a Manifestation of Systemic Disease - High Yield Flashcards

1
Q

T/F: Diseases and conditions can affect the periodontal tissues by affecting the periodontal supporting tissues INDEPENDENTLY of dental plaque biofilm-induced inflammation:

A

True

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2
Q

Systemic disorders that have a major impact on the loss of periodontal tissue by influencing periodontal inflammation include: (3)

A
  1. genetic disorders
  2. AIDS
  3. inflammatory diseases
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3
Q
  • Trisomy 21 or mongolism
  • characteristic physical appearance
  • mental deficiency & growth retardation
A

down syndrome

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4
Q

List some physical characteristics of Down syndrome:

A
  • mongolism
  • small nose, mouth & ears
  • slightly bent pinky
  • short stocky build
  • almond shaped eyes with skin fold covering inner corner
  • white spots on colored part of eyes
  • flat, round face
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5
Q

Give another name for Down syndrome:

A
  1. mongolism
  2. trisomy 21
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6
Q

Describe how periodontal disease is categorized in Down syndrome:

A

moderate to severe periodontitis with rapid progression

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7
Q

T/F: In Down syndrome local factors alone explained the severity of periodontal destruction

A

False- local factors along FAILED to explain the severity of the periodontal destruction

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8
Q

What aspects of down syndrome might contribute to the moderate to severe periodontal destruction with rapid progression?

A

INTRINSIC IMMUNE SYSTEM DEFECTS
- Poor PMN chemotaxis
- Poor phagocytosis
- Intracellular killing

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9
Q

List the three intrinsic immune system defects seen in Down syndrome:

A
  1. poor PMN chemotaxis
  2. Poor phagocytosis
  3. Intracellular killing
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10
Q

Leukocyte Adhesion Deficiency (LAD) is due to a mutation in:

A

Beta-2 integrin gene (ITGB2)

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11
Q

Lack of Beta-2 Integrin Gene in LAD results in: (2)

A
  1. Lack of beta-2 intern mRNA in leukocytes
  2. Low integrin (CD18 or CD15) expression on neutrophils
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12
Q
  1. Lack of beta-2 intern mRNA in leukocytes
  2. Low integrin (CD18 or CD15) expression on neutrophils

This is seen in _____ due to ____

A

LAD; mutation in beta-2 integrin gene (ITGB2)

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13
Q

Describe the neutrophil insufficiency in LAD:

A

Neutrophils are confined to blood vessels resulting in disruption of neutrophil-associated homeostasis

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14
Q

In what disease are neutrophils confined to blood vessels, resulting in?

A

LAD; disruption of neutrophil-associated homeostasis

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15
Q

Describe what is seen in the periodontium of LAD individuals:

A

History of severe recurrent infection but NO pus; leukocytosis is common

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16
Q

What is a common manifestation that comes along with the history of severe recurrent infection but NO pus in LAD patients?

A

leukocytosis

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17
Q

Papillon-Lefevre Syndrome is caused by a mutation in:

A

cathepsin C gene (CTSC)

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18
Q

Papillon-Lefevre Syndrome is caused by a mutation in cathepsin C gene (CTSC) that is located on:

A

chromosome 11q14

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19
Q

The mutation in Papillon-Lefevre Syndrome (Cathetpsin C gene (CTSC) results in:

A
  1. compromised neutrophil function
  2. decreased phagocytosis
  3. hyperkeratotic lesons
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20
Q

What type of lesions result from the mutation in the cathepsin C gene (CTSC) in Papillon-Lefvre syndrome?

A

Hyperkeratotic lesions
- palms
-soles of feet
- elbows
- knees

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21
Q

Chediak-Higashi Syndrome is due to a mutation in:

A

CHS1 gene & LYST gene

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22
Q

The mutations in CHS1 gene & LYST genes seen in Chediak-Higashi Syndrome result in:

A

Lysosomal tracking defect

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23
Q

Partial oculocutaneous albinisn is seen in Chediak-Higashi Syndrome, why do we see this?

A

due to defects in melanin granules

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24
Q

Patients with Chediak-Higashi Syndrome have recurrent pyogenic infections due to:

A
  1. circulating leukocytes exhibit DEFECTIVE lysosomes
  2. Decrease in phagoyctosis
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25
Q

The varying neurologic problems seen in Chediak-Higashi Syndrome include:

A
  1. intellectual defecti
  2. dementia
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26
Q
  • Mutation in CHS1
  • Mutation in LYST
  • Lysosomal tracking defection
  • Partial oculocutaneous albinism (defective melanin granules)
  • Recurrent pyogenic infections (defective lysosomes in circulating leukocytes & decrease in phagocytosis)
  • Varying neurologic problems (intellectual deficit & dementia)
A

Chediak-Higashi Syndrome

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27
Q

Congenital neutropenia results from a mutation in:

A

ELANE (50%)
HAX1 (10%)
33% unknown cause

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28
Q

Congenital neutropenia results in a ____ number of _____

A

decreased; neutrophils

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29
Q

What is the ANC level of one with congenital neutropenia?

A

less than 500 cell/microliter and static

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30
Q

What is clinical manfiestions of congenital neutropenia?

A
  1. defective immune response
  2. severe & recurrent infections
31
Q

Disease associated with Immunologic disorders:

A
  1. down syndrome
  2. LAD
  3. PLS
  4. Chediak-Higashi Syndrome
  5. Congenital neutropenia
32
Q
  1. down syndrome
  2. LAD
  3. PLS
  4. Chediak-Higashi Syndrome
  5. Congenital neutropenia

Fill in the mutations associated with these diseases:

A
  1. down syndrome- trisomy 21
  2. LAD- Beta-2 Integrin
  3. PLS- Cathepsin C Gene (CTSC)
  4. Chediak-Higashi Syndrome- LYST gene & CHS1
  5. Congenital neutropenia- ELANE & HAX1 & Unknown
33
Q

What type of syndrome is Ehlers-Danlos syndrome categorized as?

A

Diseases affecting the connective tissue

34
Q

List the oral manifestations of Ehler’s-Danlos syndrome:

A
  1. generalized, early-onset severe periodontitis
  2. gingival recession
  3. early loss of primary & permanent teeth
  4. GENERALIZED LACK OF ATTACHED GINGIVA
35
Q

In what connective tissue disease do we see a GENERALIZED LACK OF ATTACHED GINGIVA?

A

Ehler’s-Danlos syndrome

36
Q

What mutation causes HYPOphosphatasia?

A

Mutation in alkalaine phosphatase gene (ALPL)

37
Q

The forms of hypophosphatasisa range from:

A

mild to severe

38
Q

Describe oral manifestations seen in hypophosphatasisa:

A
  1. defective cementum
  2. alveolar bone loss
  3. premature loss of teeth
39
Q

IDDM:

A

type 1

40
Q

NIDDM:

A

type 2

41
Q

Describe the onset of the following :

Type 1 DM:

Type 2 DM:

A

Type 1 DM: Early onset but can occur at any age

Type 2 DM: Adult onset

42
Q

What is the prevalence and pathophysiology of type 1 DM?

A

5-10%; destruction of the pancreatic beta cells

43
Q

What is the prevalence and pathophysiology of type 2 DM?

A

90-95%; obesity & genetics

44
Q

List the characteristics of type 1 DM:

A
  1. absolute insulin deficiency
  2. marked tendency toward ketosis & coma
45
Q

List the characteristics of type 2 DM:

A
  1. blood level of insulin my be normal, increased, or decreased
  2. development of ketosis and coma is uncommon
46
Q

_____ is a complicating factor for diabetes and also affects ____

A

periodontitis; glycemic control

47
Q

What type of bacteria are seen in diabetic patients with perio disease?

A

gram negative

48
Q

Periodontal treatment in a diabetic patient leads to:

A
  1. improved insulin sensitivity
  2. improved glycemic control
49
Q
  • estrogen withdrawal
  • increase in IL6
  • increased bone turnover
  • net systemic bone loss
  • decrease in bone mineral density
  • weakened bone microarchitecture
  • high risk of bone fracture
A

Osteoporosis

50
Q

In osteoporosis there needs to be a homeostasis between what three factors?

A
  1. bone
  2. estrogen
  3. inflammation
51
Q

Describe the periodontitis associated with osteoporosis: (4)

A
  1. bacterial infection
  2. local inflammatory insult
  3. initial cortical bone compromise
  4. bone loss
52
Q

What are the shared risk factors between osteoporosis and periodontitis?

A
  1. AGE
  2. SMOKING
  3. VITAMIN D
  4. CALCIUM DEFICIENCY
53
Q
  1. AGE
  2. SMOKING
  3. VITAMIN D
  4. CALCIUM DEFICIENCY

These are the shared risk factors between:

A

osteoporosis & periodontitis

54
Q

T/F: Patients with arthritis (OA & RA) have a higher incidence of periodontal disease compared to healthy controls

A

True

55
Q

What is the correlation between RA and periodontitis?

A

the both invoke the same cytokines and pro-inflammatory mediators

56
Q

____ may play a key role in the pathogenesises of periodontitis-associated RA:

A

P. Gingivalis

57
Q

In RA, P. gingivalis produces _____ which is associated with the RA

A

peptidylarganine deaminase (PAD)

58
Q

Peptidylarginine deaminase (PAD) is produced by ____ and is seen in what disease?

A

P. gingivalis; RA & periodontitis

59
Q

Other systemic disorders that may contribute to the periodontal tissue loss by influencing the pathogenesis of periodontal diseases:

A
  1. smoking
  2. stress/depression
60
Q

List the oral manifestations of smoking (any type):

A
  1. 4x attachment loss
  2. leukoplakia
  3. carcinoma
  4. tooth loss
  5. gingival recession
61
Q

Smokers have ___x the attachment loss than non-smokers

A

4x

62
Q

What cancer is associated with smokers?

A

carcinoma

63
Q

List the continuum seen in smokers with periodontal disease:

A
  1. impaired immune response
  2. subgingival anaerobic infection
  3. connective tissue cytotoxicity
  4. impaired wound healing
  5. increased severity of periodontitis
64
Q

Fill in the blanks of the continuum seen in smokers with periodontal disease:

  1. impaired _____
  2. _____ infection
  3. _____ cytoxicity
  4. impaired ____
  5. increased severity of ___
A
  1. impaired immune response
  2. subgingival anaerobic infection
  3. connective tissue cytotoxicity
  4. impaired wound healing
  5. increased severity of periodontitis
65
Q

Nicotine causes:

A

vasoconstriction

66
Q

Nicotine causes vasoconstriction of the:

A

peripheral blood vessels

67
Q

Nicotine causes vasoconstriction of the peripheral blood vessels which leads to:

A

decrease in tissue oxygenation

68
Q

Tars are ____ & ___

A

cytotoxic and sticky

69
Q

Tars are cytotoxic and sticky leading to:

A

Lung disease (COPD & Cancer)

70
Q

Tars are cytotoxic and sticky causing lung disease ultimately leading to:

A

decrease in tissue oxygenation

71
Q

When do nicotine and tars smoking chart merge?

A

both causing a decrease in tissue oxygenation

72
Q

Both nicotine and tars lead to a decrease in tissue oxygenation resulting in: (3)

A
  1. SUBgingival ANAEROBIC infection
  2. connective tissue cytotoxicity
  3. impaired wound healing
73
Q
  • SUBgingival ANAEROBIC infection
  • CT cytotoxicity
  • Impaired wound healing

These are all due to:

A

smoking (nicotine & tars)

74
Q

Systemic disorders that can result in a loss of periodontal tissue independent of periodontitis:

A
  1. neoplasms
  2. other disorders that may affect periodontal tissue

Periodontics I (18 decks)

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