- Prions lack_______as essential component? - How does it replicate ?

- nucleic acids - Self replicate

- Gingivostomatitis is caused by______ - It occurs in______% of the cases - It is more common in________________

- HSV 1 - 15-30 % - Children under 5

Module 7 Flashcards by Anson Lam

Rhinovirus lead to (localised/disseminated/systemic) infection ?

localised

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HPV lead to (localised/disseminated/systemic) infection ?

localised

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Rotavirus lead to (localised/disseminated/systemic) infection ?

localised

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HIV lead to (localised/disseminated/systemic) infection ?

disseminated

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Measles lead to (localised/disseminated/systemic) infection ?

disseminated

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HSV lead to (localised/disseminated/systemic) infection ?

disseminated

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Nipah virus lead to (localised/disseminated/systemic) infection ?

systemic

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Prion is an infectious agent that can cause____________disease

fatal neurodegenerative

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Prions lack_______as essential component?
How does it replicate ?

nucleic acids
Self replicate

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How does prions reproduce ?

By stimulating conversion of normal cellular protein (PRPc) into misfolded dz causing proteins (PRPsc)

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Human Spongiform Encephalopathies is due to___________

PRPc becoming PRPsc

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What are the 5 histopath features of Human Spongiform Encephalopathies ?

Spongiform Vacuolation
Astrocyte proliferation
Neuronal loss
Deposition of abnormal PrP
Lack of inflammatory response

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Build up of PrPsc in neurons can lead to___________

brain damage

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HSV___is more associated w/ genital infections ?

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VZV causes____________

chicken pox

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The alphaherpesivirus family include which 3 ?

HSV1, HSV2, VZV

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What kind of virus are HSV1 &2 ?

double stranded LINEAR DNA virus

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HSV1 & 2 can be dinstinguished___________

serologically

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Which HSV can cause oral infections ?

Both 1 & 2

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HSV Latent infection is established when viral particles reach________________?

sensory of neutrons of dorsal root ganglia or trigeminal ganglia in the CNS

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T/F, Latent HSV virus can reactivate in a different location ?

F. HSV virus only reactivate in the primary site of infection. Same ganglia is reactivated

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Gingivostomatitis is caused by______
It occurs in______% of the cases
It is more common in________________

HSV 1
15-30 %
Children under 5

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HSV is spread by_______________

direction contact or contact w/ secretions

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HPV is what kind of virus

unenveloped dsDNA (6-8 kilobase pairs)

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- HPV is spread by_____________ - Orophayngeal HPV is spread by_____________

- direct contact or mucosal contact - mouth to mouth contact, oral genital contact

Upon infection w/ HPV, symptoms can take_______to dvlp

3-4 months

Which 2 HPVs are most commonly asso w/ cervical cancer ?

16 & 18

HPV infection requires exposure of__________of skin ?

Basal membrane

- Oropharyngeal HPV is frequently (symptomatic/asymptomatic) ? - Oropharyngeal cancer is commonly associated w/ HPV____

- asymptomatic - 16, 18

Epithelial tissue rest on___________

Basement Membrane

Epithelial tissue is classified by which 2 things ?

cell shape, cell arrangement

What is the main type of epithelial tissue in oral mucosa ?

Stratified Squamous epithelium

All lining mucosa are thin except ?

Labial & buccal

________replication in mucosa/skin lead to Herpes lesions ?

HSV

Studies show there is expansion of resident memory_______cells in human periodontitis ?

Th17

(oral/intestinal) epithelia is multi-layered ?

Oral

Antigen Presenting Cells are required to activate____________

Adaptive Immunity

_______is a key helper T cell activated at mucosal sites ?

Th17

- (M1/M2) macrophages promote inflammatory response - (M1/M2) macrophages promote alveolar bone resorption - (M1/M2) macrophages promote cancer progression - (M1/M2) macrophages promote disease progression

- M1 - M1 - M2 - M1

T/F, innate immune cells express Pattern Recognition Receptors while oral epithelial cells do not ?

F, they both express Pattern Recognition Receptors

Which site of antibody is involved in binding to antigen ?

Variable region

What are the 4 main sequences of viral replication and infection ?

1.Attachment & entry > 2. Production of new viral PROTEINS > 3.Replication of viral GENOME > 4.Assembly & exit of new virus to infect more cells

HSV-2 is commonly associated w/_____________

genital infection

(M1/M2) macrophage may prevent tumor dvlpment ?

Ig____is important for oral mucosal immunity ?

What are the 2 common things oral & gut mucosal immunology share ?

Both are in constant contact w/ external enviornment Both have to tolerate commensals

What does MALT stand for ?

Mucosal Associated Lymphoid Tissue

Which oral infection has 3 different stages ?

Oral syphillis

What is the 1st stage of oral syphillis called and it is commonly dvlped in which area of oral cavity ?

Chancre, lips

systemic symptoms can start to dvlp w/_____stage of oral syphillis ?

2nd

What is the 2nd stage of oral syphillis called ?

Mucous patches

_______% of affected individuals dvlp into the 3rd stage of syphillis ?

Squamous papilloma is caused by which viruses ?

HPV type 6 & 11

What does Squamous papilloma look like in oral cavity ?

Pedunculated finger-like projections that are soft & painless

- Condyloma Acuminatum (warts) is caused by which viruses ? - What does it look like clinically

- HPV type 6,11 - Sessile mass w/ blunted surface projection, painless

- Oral hairy leukoplakia is caused by___________ - What does oral hairy leukoplakia looks like ?

- Epstein-Barr virus - White mucosal plaque on lateral border of tongue

In denture stomatitis, newton's types classify the_________

severity of stomatitis

Langerhan cells can act as____________

Antigen Presenting Cells

What does oral tuberculosis look like clinically ?

Chronic ulcer and swelling, type IV sensitivity

Which one of the following statements is true with regard to oral mucosal lesions? The oral mucosa may appear more red when the overlying epithelium is thinned Release of keratin into extracellular spaces accounts for the white appearance of necrotic epithelium. Oral mucosal ulceration does not require exposure of the underlying connective tissues to the oral cavity Thickening of the keratinizing layer of stratified squamous epithelium does not affect the appearance of the oral mucosa. Restoration of the epithelial barrier in a healing ulcer is independent of the underlying vascularised connective tissues.

The oral mucosa may appear more red when the overlying epithelium is thinned

Condyloma acuminatum (warts) often occur in what sites ?

Labiel mucosa & lingual frenum

CYP3A4 enzyme is commonly found in____________

Liver & intestines

The prolonged use of broad spectrum antibiotics can inc. the risk of acquiring____________

oral candidiasis

T/F, the use of corticosteroids can inc. the risk of acquiring oral candidiasis ?

What are the clinical presentations of Acute Herpetic Gingivostomatitis ?

- Painful, enlarged & red gingiva - Ulcer - Cold sore (Herpes Labialis)

Halitosis is a medical term for__________

Bad breath

Which layer of the oral epithelium is the deepest and is responsible for cell division and regeneration? Basal layer Keratinized layer Basal Lamina Granular layer Spinous layer

Basal layer

Many of the meds that treat invasive fungal infections commonly inhibit the________enzymes, which is important when considering about drug interactions

CYP450 family

Five main descriptive features of soft tissue pathology includes: Site, Temperature, Colour, Size, Consistency Site, Odor, Colour, Size, Consistency Site, Pain, Colour, Size, Consistency Site, Morphology, Colour, Size, Consistency Site, Mobility, Colour, Size, Consistency

Site, Morphology, Colour, Size, Consistency

Where does the Epstein Barr virus hide in the body during its dormancy? B cells Macrophage Platelets Neurons Endothelial cells

B cells

What are the 3 types of soft tissue lesions that are elevated and contain bodily fluid ?

Vesicle, Bulla, Pustule

An ulcer is (elevated/depresssed) lesion

Depressed

What are the 2 types of soft tissue lesions that are flat

Macule, patch

What would a lesion be called if it is elevated, contain bodily fluids and diameter is > 5mm ?

Bulla

What would a lesion be called if it is elevated, contain bodily fluids and diameter is < 5mm ?

Vesicle

What are the 4 types of elevated lesion that does NOT contain bodily fluids

Papule, Nodule, Tumor, Plaque

What are the resident immune cells in gingiva ?

Predominantly T cells, some B cells & Innate Lymphoid Cells

Which of the following microscopic features is commonly seen in oral hairy leukoplakia? Inflammatory infiltrate in the connective tissue Subepithelial vesicle formation Ulceration with necrosis of the epithelium Hyperkeratosis with acanthosis Granulomatous inflammation

Hyperkeratosis with acanthosis

What is the secondary structure of protein for PrPsc ?

predom. B-sheets

What is the secondary structure of protein for PrPc

predom. A-helice

(PrPc/PrPsc) is partially PK resistant

PrPsc

Is HPV (warts) for life ?

Often resolved w/out tx, can take up to 1-2 yrs

- What are the 3 types of oral papillomas associated with different HPV genotypes - Which one is seen most often in children

- Squamous papilloma, verruca vulgaris, condyloma acuminatum - Verruca vulgaris

Classification of epithelial tissues is based on_________

cell shape, arrangement of cells

What are the 4 fxns of oral mucosa

protection, sensation, secretion, therm. regulation

What are the 2 main components of oral mucosa

Stratified squamous epithelium, Lamina Propria

What cells can be found in oral epithelium besides keratinocytes

Melanocytes, Langerhans Cells, Merkel Cells, Inflammatory cells

Basement membrane is located between___________

oral epithelium & lamina propria

Lining mucosa are found in________

Floor of mouth, alveolar mucosa, labial/buccal mucosa, lips, soft palate, VENTRAL surface of tongue

Masticatory mucosa are found in________

Gingiva, hard palate

Specialized mucosa are found in_________

DORSAL surface of tongue

What are the resident immune cells in oral epithelium

Mast cell, dendritic cell

Tolerogenic dendritic cells induce__________cells

regulatory t

Dendritic cells in the intestinal mucosa are mostly found in______state

immature

epithelial cells of GI system is covered by_____

secreted mucus

Tufts cells are found in_______that respond to________by secreting cytokines

GI tract, helminths

What specie causes oral syphillis

Treponema Pallidum (spirochete)

What is a chancre ?

Painless & clean-based ulceration

What is tertiary syphilis called ?

Gumma

Tertiary syphilis affect____% of infected individuals

Which disease may cause perforation to nasal cavity

Tertiary syphilis

Candidal Leukoplakia is also known as________

Chronic hyperplastic candidias

Tzanck cell can be found in______

HSV infected cell

Ballon cells can be found in_________

Oral hairy leukoplakia

Hyperkeratinosis can be found in________

Oral hairy leukoplaskia

_______is an important target of anti-fungal drugs because it is unique to fungi & human is not susceptible to it

Ergosterol

(Outer/inner) wall of fungal cell wall is more immunogenic

Inner (more pro-inflammatory)

What is sjogren sydndrome

Chronic immune dz that the immune sys. attacks its own moisture producing glands (i.e. salivary glands)

Fungal reproduction: - Asexually by_________ - Sexually by________ - Parasexually by_________

- budding - conjugation w/ Haploids - conjugation w/ DIPLOIDS

(white/opaque) cells mate in C. albicans

opaque Only

What is the medicine for the systemic tx for Oral thrush ?

Fluconazole

List 3 topical tx for oral thrush

Nystatin (1mL 4 times daily, swish around mouth after meal), Amphotericin (1 lozenge 10mg 4 times daily), Miconazole (2.5mL 4 times daily, swish around mouth after meal)

- Drug class of Nystatin:_________ - What is the mechanism of action

- Polyenes - Binding STEROLS in cell wall of fungi > leakage > cell death

- Vorizonazole is used for_____________ - dosage=___________

- Aspergillus, C. albican infections (invasive fungal infections) - 400mg loading dose (or IV 6mg/kg) TWICE daily + 200mg maintenance dose (or IV 4mg/kg) TWICE daily

- What is the mechanism of Fluconazole - dosage for oral thrush=_____________ - dosage for invasive dz=____________

- Inhibits ergosterol synthesis required for cell wall - 50-200mg once daily - 800mg loading dose (or IV 12mg/kg loading dose) ONCE daily + 400mg maintenance dose (or 6mg/kg maintenance dose once daily) ONCE daily

- List 2 examples of drugs from Triazole family - What are the three drug interactions for drugs from Triazole family

- Fluconazole, Voriconazole - Inhibits or/and substrates for enzymes CYP3A4, 2C19, 2C9 (above are CYP 450 enzymes)

Which type of epithelial tissue is found lining the urinary bladder? Transitional Cuboidal Columnar Pseudostratified Squamous

Transitional

What type of epithelium is composed of cells which all touch the basement membrane and is only one cell layer thick? Stratified columnar epithelium Stratified cuboidal epithelium Transitional epithelium Stratified squamous epithelium Pseudostratified epithelium

Pseudostratified epithelium

A major difference between the oral and intestinal mucosal systems is the absence of mucosal associated lymphoid tissues (MALT) in the oral mucosa. What does this mean for the generation of adaptive immune responses in the oral mucosa? That the immune system is unable to tolerate commensals in the oral mucosa That dendritic cells must migrate to nearby draining lymphoid tissues in the nasal passage and oropharynx in order to activate T cells That dendritic cells are unable to present antigens to T cells in the oral mucosa That adaptive immune responses must be initiated in the gut That the oral mucosa is entirely reliant on innate immune responses

That dendritic cells must migrate to nearby draining lymphoid tissues in the nasal passage and oropharynx in order to activate T cells

Genetic difference in_______gene impact susceptibility of getting dz related to prions

PRNP

Treatment of invasive fungal infection should be a______dose

Which organism undergoes white-to-opaque switch when reproducing ?

C. albicans

What does Hyperplastic candidiasis look like in oral cavity ?

Thickened white patches

C. albican can cause which 3 types of candidiasis in oral cavity ?

Pseudomembranous, Erythematous, Hyperplastic

Inner cell membrane of yeast is made up of__________

Beta-1,6, Beta-1,3 glucans & Chitin

What does pseudomembranous candidiasis look like in oral cavity

White patches (aka thrush)

Yeast plasma membrane is made up of______________

ester-linked phospholipids & sterols (cholesterol, ERGOSTREROL) + mannose attached to cell surface proteins

The (inner/outer) part of yeast cell membrane is hard for human immunity to detect ?

inner

The second stage of syphillis happen______weeks after initial exposure

4-10

The first stage of syphillis happen______days after initial exposure

3-90

Can HSV Herpes be cured ?

What kind of virus is HPV ?

double stranded CIRCULAR DNA virus

What is the importance of J chain ?

It is an important bind site for poly-ig receptor which allows intact translocation of antibody into the lumen

What is the difference between oral mucosa and gut ?

Absence of MALT or GALT in the oral mucosa

In oral cavity: patients w/ genetic defect in Th17 cells show diminished______________ & inc._____________

Diminished periodontal INFLAMMATION & bone loss Inc. prevalence of RECURRENT oral fungal INFECTIONS

What are the 3 main types of oral mucosa ?

Lining, Masticatory, Specialized

In oral mucosa, what is the underlying connective tissue ?

Lamina Propria

Epithelial tissues are tightly bound to each other by_________

desmosome

Does epithelial tissue itself have blood vessel ?

Module 7 Flashcards

(140 cards)