Systemic Health

Question 1

Problems with focal infection

Answer 1

Extracting teeth didn’t necessarily cure disease

People with good oral health and no infection still developed systemic diseases

People with no teeth still developed systemic diseases

Question 2

The acute phase reaction cascade is a mechanism by which

Answer 2

Periodontitis could potentially influence systemic diseases

Question 3

When will CRP levels go up

Answer 3

Infection
Fever
Any kind of infection or inflammation will increase CRP

Question 4

Triggering factors —>_____—>______—>Secondary systemic reaction

Answer 4

Local reaction

Mediators

Question 5

Triggering factors

Answer 5

Infection
Necrosis
Surgery
Neoplasia 
Radiation

Question 6

Local reaction

Answer 6

Macrophages
Fibroblasts
Endothelial and other cells

Question 7

Secondary systemic reaction

Answer 7

• Fever and leucocytosis
• Complement activation
• Serum glucocorticoids increased
• Altered synthesis of acute phase proteins

Question 8

Mediators

Answer 8

TNF-a
IL-1
IL-6
IFN-y

Question 9

Complement components

Answer 9

Opsonization
Lysis
Chemotaxis (CTX)

Question 10

Protease inhibitor

Answer 10

A1-macroglobulin

Question 11

C-reactive protein

Answer 11

Opsonization

Question 12

Fibrinogen

Answer 12

Coagulation factor

CTX

Question 13

Plasminogen

Answer 13

Degrades blood clots

Question 14

What defines a risk

Answer 14

Consistency of association
Strength of association
Correct time sequence
Specificity of associations

Question 15

Specificity of associations

Answer 15

If a given factor is related to other diseases, its association with the disease is less likely to be interpreted as casual

Question 16

Degree of exposure

Answer 16

The risk of developing the disease should be related to the degree of exposure to the factor

Question 17

Biological plausibility

Answer 17

The association must make sense in light of known biological mechanisms and pathway

Question 18

Atherosclerotic vascular diseae occurs where

Answer 18

Large to medium sized muscular and large elastic arteries

Question 19

Atherosclerotic vascular disease arteries are occluded with

Answer 19

Fibrolite day lesions termed atheromas

Question 20

Atherosclerotic vascular disease complications

Answer 20

Coronary thrombosis

Acute myocardial infarction

Question 21

Pathways that could explain link between periodontist and cardiovascular disease

Answer 21

Effect of periodontal bacteria on platelets

Invasion of endothelial cells and macrophages by periodontal bacteria

Endocrine like effects of pro-inflammatory mediators

Question 22

Only bacteria that was found in placenta

Answer 22

Only oral bacteria

Question 23

Systemic ________ are up regulated for endocrine like effects in vascular tissue. _____ and _____ are elevated in periodotnally diseased subjects

Answer 23

Pro-inflammatory mediators

CRP
Fibrinogen

Question 24

Periodontal inflammation and infection leads to

Answer 24

Bacteria endotoxin and cytokines released into systemic circulation

Increased endothelial adhesion molecules

Recruiters T cell

Arethoma developemnt

Plaque rupture

MI

Question 25

activation of peripheral monocytes and release of IL1 TNF and IL6 tells the liver

Answer 25

To releases acute phase response (CRP Fibrinongen) Increase coagulation Thrombosis MI

Question 26

P. Gingivalis can

Answer 26

Induce platelet aggregation

Question 27

Systemic pro-inflammatory mediators CRP and Fibringoen are

Answer 27

Elevated in subjects with periodontitis

Question 28

Placental tissues release ____ causing ______ in response to activation of _____

Answer 28

PGE2 Myometrial contraction IL-1 TNF IL6

Question 29

Type I diabetes

Answer 29

Insulin depending Destruction of pancreatic beta Cells Hypo production of insulin Before age 30

Question 30

Type 2 Diabetes

Answer 30

Non-insulin dependent Target tissues dont respond to insulin Usually occurs later in life

Question 31

Poorly controlled diabetics of both types tend to have

Answer 31

More periodontal attachment loss than non-diabetics