immune system

Question 1

difference between primary + opportunistic pathogens?

Answer 1

primary = cause disease in non-immunocompromised
opportunistic = only infection in damaged host

Question 2

3 ways primary pathogens cause disease

Answer 2

1. intrinsic virulence
2. toxic production
3. induction of abnormal host response

Question 3

what virus causes oral hairy leukoplakia

Answer 3

epstein barr virus

Question 4

what virus causes cold sore

Answer 4

herpes simplex

Question 5

what virus causes herpangina within mouth

Answer 5

enteroviruses

Question 6

what virus are kaposis sarcoma associated with?

Answer 6

HHV 8

Question 7

which number of herpes virus is herpes simplex?

Answer 7

1 + 2

Question 8

how does HIV effect immune system?

Answer 8

CD4 decreased

Question 9

treatment for aids?

Answer 9

NRTI

HAART

Question 10

causes of hepatitis?

Answer 10

viral
drug interactions
autoimmune - uncommon

Question 11

what is acute hepatitis?

Answer 11

self limiting liver inflammation

caused by: viral, acute alcoholic hepatitis, drugs, toxins, medications

Question 12

what is chronic hepatitis?

Answer 12

clinical features of cirrhosis

caused by chronic Hep B or alcohol abuse

Question 13

signs of liver disease in clothed pt

Answer 13

jaundice:
yellow 
easy bruising 
spider naevi
liver flap - asterisks 
sialosis
dupuytrens contracture
palmar erythema 
gynaecomastia

Question 14

oral manifestation of gonorrhoea?

Answer 14

burning sensation in pharynx

Question 15

oral manifestations of syphilis?

Answer 15

primary - painless ulcer on lip
secondary - mucous patches on mucosa, ulcers, lymphadenopathy
tertiary - gumma, glossitis, syphilitic leukoplakia

Question 16

difference between bacteriostatic + bactericidal?

Answer 16

bacteriostatic = inhibit growth
bactericidal = kills

Question 17

difference between gram negative + positive bacteria?

Answer 17

• second outer membrane, don’t stain

+ thicker layer of peptidoglycan, stain

Question 18

how do beta lactic e.g. penicillin antibiotics work?

Answer 18

inhibitor of peptidoglycan (cell wall) synthesis

Question 19

how do tetracyclines + aminoglycoside antibiotics work?

Answer 19

inhibit protein synthesis from 30s ribosome site

Question 20

how do macrolides + clindamycin antibiotics work?

Answer 20

inhibit protein synthesis from 50s ribosome site

Question 21

how does metronidazol work as an antibiotic?

Answer 21

metabolised into toxic metabolites, interfere with DNA

Question 22

how do sulphonamides act as antibiotics?

Answer 22

inhibit folate synthesis

Question 23

what is vertical gene transfer?

Answer 23

spontaneous mutation, transferred during DNA replication

Question 24

what is horizontal gene transfer?

Answer 24

conjugation - sex
transformation - death
transduction - viruses

Question 25

how does aciclovir treat herpes?

Answer 25

analogue of purine nucleoside guanosine + incooprorated/interferes with replication of viral nucleic acid

Question 26

what is AZT used to treat?

Answer 26

HIV/AIDS pts that are symptomatic

Question 27

what must be considered if your pt has a prion disease?

Answer 27

can't sterilise instruments - disposable only

Question 28

2 conditions where amoxicillin is CI because of rash?

Answer 28

lymphocytic leukaemia + glandular fever

Question 29

dental antibiotic best for use during pregnancy?

Answer 29

amoxicillin try and avoid all medications in first trimester

Question 30

why must tetracycline be avoided in pregnancy + breast-feeding?

Answer 30

dental discolouration

Question 31

what 2 things is metronidazole CI with?

Answer 31

alcohol + warfarin

Question 32

symptoms of immunodefiency

Answer 32

``` SPUR s = serious infections p = persistance infections u = unusual sites r = recurrent infections ```

Question 33

6 clinical examples of primary immunodefiency?

Answer 33

1. SCID 2. X - linked agammaglobulinaemia 3. common variable immunodeficiency 4. chronic granulomatous disease 5. chronic mucocutaneous candiasis 6. Di George syndrome

Question 34

what is SCID?

Answer 34

T cells absent, B cells might be absent

Question 35

what is x-linked agammaglobulinaemia?

Answer 35

mutation in btk gene low/absent B cells + reduced immunoglobulins absent tonsils

Question 36

what is DiGeorge syndrome?

Answer 36

thymus fails to develop - no/reduced T cells

Question 37

causes of secondary immunodeficiency?

Answer 37

1. malnutrition 2. medication 3. infection 4. radiotherapy 5. splenectomy

Question 38

what oral manifestations of chronic granulomatous disease?

Answer 38

recurrent abscess + gingivitis

Question 39

what antibody mediated type I hypersensitivity?

Answer 39

IgE

Question 40

what antibodies mediate type II + III hypersensitive?

Answer 40

IgM + IgG

Question 41

what mediated type IV hypersensitivity?

Answer 41

CD4 T cells

Question 42

what happens in a type I hypersensitivity reaction?

Answer 42

IgE mediated degranulation of mast cells + basophils release of histamine, heparin, lysosomal enzymes + proteases increased capillary permeability + smooth muscle contraction

Question 43

test for type I hypersensitivity

Answer 43

skin prick test + blood test for specific IgE

Question 44

3 treatments for type I reaction?

Answer 44

1. antihistamines 2. steroids 3. bronchodilators

Question 45

what would result of patch test be in burning mouth syndrome?

Answer 45

negative - not an allergy

Question 46

how do glucocorticoids causes immunosuprresion?

Answer 46

suppression of T cells

Question 47

how do glucocorticoids cause anti-inflammatory?

Answer 47

decrease gene transcription for TNFalpha + interfere + IL1

Question 48

complications of glucocorticoids

Answer 48

adrenal supression osteoporosis increased risk of infection duodenal ulcers

Question 49

how does cyclosporin cause immunosuprresion?

Answer 49

targets T cells via inhibition of IL2

Question 50

2 types of calineurin inhibitor?

Answer 50

ciclosporin + tacrolimus

Question 51

2 types of antimetabolite immunosuppressants?

Answer 51

azathioprine + methotrexate

Question 52

how do monoclonal antibodies work and what are they used for?

Answer 52

inhibit cytokines involved in innate repsosne autoimmune disease

Question 53

how is the small intestine damaged in coeliac disease?

Answer 53

gluten activated series of immunological mechanisms 1. loss of villi 2. crypt hyperplasia 3. chronic inflammatory infiltrate

Question 54

what is good pastures?

Answer 54

autoimmune disease of kidney

Question 55

what other autoimmune disease is associated with sjorgrens disease?

Answer 55

rheumatoid arthritis

Question 56

what is ESR?

Answer 56

erythrocyte sedimentation rate sign of inflammation