FK-5-Cellular and molecular bases of immune and non-immune host defense mechanism-DIAGNOSIS AND TREATMENT PLANNING

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Questions and Answers

A patient presents with painful, recurrent oral ulcerations that have persisted for over a month. Which immunological mechanism is most likely involved in the pathogenesis of these lesions?

  • IgE-mediated hypersensitivity
  • Antibody-dependent cell-mediated cytotoxicity
  • T-cell mediated cytotoxicity (correct)
  • Complement activation via the classical pathway

During a dental exam, you note several areas of gingival inflammation with bleeding upon probing. An increased presence of which cell type would be expected in the gingival crevicular fluid as an initial response?

  • Macrophages
  • Lymphocytes
  • Neutrophils (correct)
  • Plasma cells

A patient reports a history of anaphylactic reactions to certain medications. When planning dental treatment, which immune mechanism should be of primary concern?

  • Complement-mediated lysis
  • IgE-mediated hypersensitivity (correct)
  • Delayed-type hypersensitivity
  • IgG-mediated antibody-dependent cytotoxicity

In the progression of periodontal disease, which cytokine plays a significant role in alveolar bone resorption by stimulating osteoclast activity?

<p>Tumor necrosis factor-alpha (TNF-α) (C)</p>
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A dental implant procedure leads to peri-implantitis. Dysregulation of which host defense mechanism contributes to the progression of this condition?

<p>An imbalance between pro-inflammatory and anti-inflammatory mediators (D)</p>
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What is the primary concern regarding the immune response during dental treatment for a patient with a history of organ transplantation on immunosuppressive medications?

<p>An increased susceptibility to oral infections (D)</p>
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Which cells are primarily responsible for the adaptive immune response to periodontal pathogens through the production of antigen-specific antibodies?

<p>Plasma cells (C)</p>
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A patient presents with a localized, fluctuant swelling in the gingival tissue associated with a non-vital tooth. Which host defense mechanism is primarily attempting to contain this infection?

<p>Recruitment of neutrophils to the site of infection to phagocytose bacteria (D)</p>
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In the context of wound healing following oral surgery, which immune cells play a crucial role in debridement and the transition to tissue repair by releasing growth factors and cytokines?

<p>Macrophages (D)</p>
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A patient with a viral infection develops oral lesions with epithelial cell damage. Which immune cells are most likely mediating the destruction of these infected cells?

<p>Cytotoxic T lymphocytes (CTLs) (C)</p>
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The effectiveness of a dental vaccine for a specific oral pathogen would primarily rely on stimulating which arm of the immune system?

<p>Adaptive immunity (D)</p>
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A patient experiences a delayed allergic reaction to a component of a dental material, manifesting as contact dermatitis around the mouth. Which type of hypersensitivity reaction is most likely involved?

<p>Type IV (delayed-type) (A)</p>
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Which non-immune defense mechanism in the oral cavity acts as a physical barrier and contains antimicrobial substances like lysozyme?

<p>Oral mucosa (D)</p>
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During the formation of dental caries, initial demineralization of enamel is facilitated by acids produced by bacteria. Which host immune factor in saliva helps neutralize these acids and inhibit demineralization?

<p>Bicarbonate buffer system (C)</p>
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A patient with a compromised immune system due to chemotherapy is at an increased risk of opportunistic oral infections, like oral candidiasis (thrush). This occurs due to a deficiency in which aspect of host defense?

<p>Function of T lymphocytes and phagocytes (D)</p>
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What is the primary role of salivary Immunoglobulin A (sIgA) in oral health?

<p>Prevent the adherence of bacteria to oral surfaces (D)</p>
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When treating oral infections with antibiotics, considering the potential for antibiotic resistance is important. Which is a host-related factor that can influence the outcome of antibiotic therapy?

<p>The patient's underlying immune status (D)</p>
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During diagnosis of certain oral lesions, a biopsy is done to examine cellular infiltrate. The predominance of lymphocytes in a chronic inflammatory lesion suggests what type of immune response is involved?

<p>Adaptive immune response involving T and B lymphocytes (A)</p>
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Autoimmunity, where the immune system attacks self-antigens, can manifest in the oral cavity as conditions like Sjögren's syndrome. Which of the following is a key characteristic of autoimmune diseases?

<p>A breakdown of self-tolerance by the immune system (C)</p>
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When planning treatment for a patient with a known latex allergy, it is crucial to avoid triggering which immune response?

<p>IgE antibodies binding to latex allergens (A)</p>
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Flashcards

What is T-cell mediated cytotoxicity?

A type of cell-mediated immune response where cytotoxic T cells directly kill target cells, such as oral keratinocytes.

What are neutrophils?

White blood cells that are among the first to respond during gingivitis to combat bacterial biofilm.

What is Anaphylaxis?

A life-threatening allergic reaction mediated by IgE antibodies, which trigger the release of histamine from mast cells and basophils.

What is Tumor necrosis factor-alpha (TNF-α)?

A pro-inflammatory cytokine crucial in the pathogenesis of periodontal disease that stimulates osteoclast differentiation and activity.

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What imbalance contributes to peri-implantitis?

A dysregulation of the balance between pro-inflammatory and anti-inflammatory mediators. Leads to tissue destruction.

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What is the primary concern for transplant patients?

Due to their weakened immune system, they are more susceptible to bacterial, viral, and fungal infections.

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What are plasma cells?

Differentiated B lymphocytes that produce antigen-specific antibodies to target periodontal pathogens.

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What is Recruitment of neutrophils?

The immediate host defense to engulf and destroy bacteria during an acute bacterial infection.

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What are macrophages?

Immune cells essential for the resolution of inflammation and promotion of wound healing by phagocytosing debris and releasing growth factors.

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What are Cytotoxic T lymphocytes (CTLs)?

Immune cells that recognize and kill virus-infected cells by inducing apoptosis.

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What is adaptive immunity?

An immune response that generates antigen-specific antibodies and memory T cells, providing long-lasting protection.

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What is Type IV hypersensitivity reaction?

A hypersensitivity reaction mediated by sensitized T cells that release cytokines upon re-exposure to an allergen, as seen in contact dermatitis.

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What is the oral mucosa?

Provides a physical barrier against pathogens and secretes antimicrobial factors as part of the non-specific defense in the oral cavity.

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What is the bicarbonate buffer system?

Plays a significant role in neutralizing acids produced by oral bacteria, helping to maintain a neutral pH.

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T lymphocytes and phagocytes' function

When suppressed, it effects T lymphocytes and phagocytes, which are crucial for controlling fungal infections like Candida.

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What is slgA's function?

An antibody that binds to bacterial adhesins, preventing their attachment to the oral mucosa and teeth.

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What is the patient's underlying immune status?

Refers to the patient's immune system playing a crucial role in clearing an infection, even with antibiotic treatment.

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What is Adaptive immune response?

This involves T and B lymphocytes and are typically the predominant cells in chronic inflammatory lesions.

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What is a breakdown of self-tolerance?

A state where the immune system mistakenly targets the body's own tissues, leading to autoimmune diseases.

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What is IgE antibodies binding to latex allergens?

A type of hypersensitivity reaction where IgE antibodies produced against latex allergens bind to mast cells and basophils.

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Study Notes

  • Recurrent oral ulcerations are often linked to a T-cell mediated inflammatory response where cytotoxic T cells attack oral keratinocytes

Gingivitis

  • In early gingivitis, neutrophils migrate into gingival tissues to fight bacterial biofilm.

Anaphylaxis

  • Anaphylaxis, a life-threatening allergic reaction, is mediated by IgE antibodies causing histamine release from mast cells and basophils.

Periodontal Disease

  • Tumor necrosis factor-alpha (TNF-α) is a cytokine that stimulates osteoclast activity, crucial in alveolar bone resorption during periodontal disease.

Peri-implantitis

  • An imbalance between pro- and anti-inflammatory mediators causes a chronic inflammatory response, leading to tissue destruction.

Organ Transplantation

  • Immunosuppressive medications weaken the immune system, leading to increased susceptibility to bacterial, viral, and fungal infections in the oral cavity.

Adaptive Immune Response

  • Plasma cells, differentiated B lymphocytes, produce antigen-specific antibodies against periodontal pathogens.

Acute Bacterial Infection

  • In acute bacterial infections like dental abscesses, neutrophils are rapidly recruited to the infection site to engulf and destroy bacteria

Wound Healing

  • Macrophages are essential for resolving inflammation, promoting wound healing, phagocytosing debris, and releasing factors for fibroblast proliferation and angiogenesis.

Viral infections

  • Cytotoxic T lymphocytes (CTLs) recognize and kill virus-infected cells by inducing apoptosis that is key in controlling viral infections

Vaccines

  • Vaccines stimulate the adaptive immune system that generates antigen-specific antibodies and memory T cells that gives long-lasting protection against infections

Contact Dermatitis

  • Contact dermatitis is a Type IV or delayed-type hypersensitivity reaction mediated by sensitized T cells releasing cytokines upon re-exposure to an allergen.

Oral Mucosa

  • The oral mucosa acts as a physical barrier and contains antimicrobial substances like lysozyme for non-specific defense.

Saliva

  • The bicarbonate buffer system in saliva neutralizes acids produced by oral bacteria, maintaining a neutral pH and preventing enamel demineralization.

Opportunistic Oral Infections

  • T lymphocytes and phagocytes, suppressed by chemotherapy, are crucial for controlling fungal infections like Candida.

Salivary Immunoglobulin A (sIgA)

  • SlgA prevents bacterial adherence to oral surfaces by binding to bacterial adhesins.

Antibiotic Therapy

  • A patient's immune system is a host-related factor that plays a part in clearing an infection, even with antibiotic treatment, and a weakened system can lead to treatment failure.

Oral Lesions

  • Lymphocytes (T cells and B cells) are key players in the adaptive immune response of chronic inflammatory lesions.

Autoimmune Diseases

  • A key characteristic of autoimmune disorders is the loss of self-tolerance, leading to the immune system mistakenly targeting the body's own tissues

Latex Allergy

  • Latex allergy is a Type I hypersensitivity reaction where IgE antibodies produced against latex allergens bind to mast cells and basophils, causing histamine.

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