D2 Fall Test 1

Front 1

For innate immunity, what are the different cell types associated with fighting bacteria? Viruses? Parasites?

Back 1

Bacteria=monocytes, macrophages, and neutrophils. Viruses=plasmacytoid dendritic cells and natural killer cells. Parasites=eosinophils, basophils, and mast cells.

Front 2

What type of cells can produce up to 1000-fold more interferons than other cell types?

Back 2

plasmacytoid dendritic cells

Front 3

PAMPs include __,__,__,and __. Host cell __ recognize PAMPs.

Back 3

LPS, lipoteichoic acid, bacterial lipoproteins, and peptidoglycan. PRRs (pattern recognition receptors)

Front 4

What are 2 effects of gene alterations in TLR4? TLR 4 interacts with __ making it interact with what type of bacteria?

Back 4

increased susceptibility to severe acute bacterial infection and a decreased susceptibility to atherosclerosis. LPS; G-

Front 5

NOD1 binds to __ while NOD2 binds to __.

Back 5

DAP; MDP

Front 6

NOD2 is restricted primarily to __ and __ and also occurs in __ cells. NOD2 mutations are associated with what disease?

Back 6

monocytes and macrophages; Paneth; Crohn's disease

Front 7

PAR 1, 3 and 4 are involved in __ and activated by __.

Back 7

platelet aggregation; thrombin

Front 8

PAR 2 is involed in the __ process and is activated by __ such as __ secreted by the bacterium __.

Back 8

inflammatory; trypsins; ginigpains; Porphyromonas gingivalis

Front 9

Lysozyme is more effective against what type of bacteria? Complement system?

Back 9

G+; G-

Front 10

PAR-2 has been implicated in the pathogenesis of what disease?

Back 10

periodontal

Front 11

Histamine is released from __ and also from __ which are triggered by the complement products _ and _ which are called __.

Back 11

platelets; mast cells; C3a and C5a; anaphylotoxins

Front 12

What are the two potentiators of inflammation and what produces them?

Back 12

leukotrienes and prostaglandins; mast cells

Front 13

Pain during inflammation is caused mainly by __ and __.

Back 13

kinin and phagocytic cells

Front 14

The first cells to arrive at a site of inflammation are __ cells. When bacteria penetrate tissue, the first phagocytic cells ancountered are __ and __.

Back 14

neutrophils; macrophages and dendritic cells

Front 15

Phagocytosis dramatically increases the __ pathway generating __ which is used to produce toxic products. __ plus H2O2 activates chloride ions to form hypochlorite. The entire process is associated with what?

Back 15

hexose monophosphate; NADPH; myeloperoxidase; Respiratory Burst

Front 16

IL-6 acts on what organ and produces what?

Back 16

liver; acute phase proteins

Front 17

Complement can be activated by which three pathways? These pathways converge at component _ and each pathway generates a __. Each pathway proceeds to a common endpoint, the __.

Back 17

Classical, alternative, and lectin; C3; C3 convertase; MAC

Front 18

_ and _ are chemotactic for phagocytes. Name the 3 anapylotoxins.

Back 18

C3a and C5a; C5a, C3a, and C4a

Front 19

Sulfonamides are analogs of __ and interfere with the synthesis of __.

Back 19

PABA; folic acid

Front 20

__ is synergist with sulfanomides and is a __ antagonist.

Back 20

Trimethoprim; folic acid

Front 21

Name 3 antiTB antimetabolites.

Back 21

isoniazid, ethambutol and pyrazinamide

Front 22

Activated INH interferes with __ synthesis and __ is lost. Activated INH binds covalently to the nicotinamide ring of the NADH cofactor, inhibiting the complex __ at 2 NADH-specific reduction sites.

Back 22

mycolic acid; acid-fast staining; FAS-II

Front 23

Ethambutol interferes with __ synthesis by inhibiting the step at which __ is passed from the membrane carrier lipid to the growing M. Tb cell wall.

Back 23

mycobacteria cell wall; arabinose

Front 24

Bacterial cell wall (peptidoglycan) synthesis inhibitors all require what for activity?

Back 24

cell growth

Front 25

What is the first beta-lactam antibiotic? What are the shortcomings of this drug?

Back 25

penicillin G; stomach acid lability, penicillinase sensitivity, allergic response, and ineffective vs. G- and enteric like bacteria

Front 26

What is the alternative to penicillin g that is stomach acid stable?

Back 26

penicillin V

Front 27

What is the first antistaphylococcal penicillin and what makes this drug better than other narrow spectrum penicillins?

Back 27

methicillin; it is penicillinase resistant

Front 28

Name 3 broader spectrum penicillins. What are the properties of broader spectrums? Which is the first beta-lactam effective against Pseudomonas aeruginose?

Back 28

ampicillin, amoxicillin and carbenicillin; they are active against G+ and G- enteric bacilli; carbenicillin

Front 29

Name the extended spectrum drug. What is it less active against?

Back 29

piperacillin; G+ cocci

Front 30

What are beta-lactamases called? They are inneffective against __ found in the __ of G- bacteria. What does amoxicillin + clavulanic acid equal?

Back 30

clavulanic acid; cephalosprins; periplasmic space; augmentin

Front 31

What is the drug of choice for HA-MRSA?

Back 31

vancomycin

Front 32

What drug inactivates the phosphatase responsible for regenerating the active form of the carrier lipid in peptidoglycan synthesis?

Back 32

bacitracin

Front 33

What are positively charged polypeptides with selective activity against G- enteric rods that damage the cytoplasmic membrane?

Back 33

Polymyxins

Front 34

What is the class of important antifungals and give 2 examples.

Back 34

polyene antibiotics; amphotericin B and nystatin

Front 35

Name 2 aminoglycoside antibiotics and name their mechanism of action. What are two neg. side effects of aminoglycosides?

Back 35

streptomycin and gentamycin; they bind to the 30s ribosomal subunit; can cause kidney and 8th CN damage

Front 36

What class of drugs are widely used in the treatment of periodontitis?

Back 36

tetracyclines

Front 37

Name 4 inhibitors that bind to the 50s ribosomal subunit. Which one is a macrolide anitbiotic?

Back 37

erythromycin, azithromycin, clindamycin, and chloramphenical; eryhtromycin

Front 38

What is a serious side ffect of clindamycin use? It is caused by overgrowth of what?

Back 38

pseudomembranous colitis; Clostridium difficile

Front 39

What is the drug restricted to serious infections not treatable with other agents because of the bone marrow depression? What is a rare occurrence associated with this drug?

Back 39

chloramphenicol; aplastic anemia

Front 40

Name 2 inhibitors of nucleic acid synthesis/transcription.

Back 40

Rifampin and ciprofloxacin

Front 41

What are the major sites of action for antifungals and name the two categories.

Back 41

ergosterol containing membranes and ergosterol synthesis; polyene antibitotics and antifungal azoles

Front 42

What 2 chracteristics would 2 agents need for potential antagonism? Synergism? Give examples.

Back 42

one agent requires growth (penicillin) while the other is bacteriostatic (tetracycline); an agent which damages the cell wall/membrane (penicillin or polymyxin) plus a cidal agent that is taken up poorly (aminoglycoside)

Front 43

For acquired resistance, where is a single gene mutation aften found?

Back 43

in a chromosomal gene

Front 44

What is the presumed reason of new PBPs?

Back 44

transformation

Front 45

__ are the most common cause of ampicillin resistance in G- bacteria.

Back 45

TEM-type beta-lactamases

Front 46

What oral drug is most given in the dental clinic? If unable to toake oral medication?

Back 46

amoxicillin; ampicillin or cefazolin

Front 47

Endospore formers are limited to what two genera of bacteria? Name them.

Back 47

G+ bacilli; clostridum which are obligate anaerobes and bacillus which are aerobes and facultative anerobes

Front 48

In fermentations, the ATP is formed by __ and their end products represent alternative fates of __.

Back 48

substrate level phosphorylation; pyruvate

Front 49

Are lower or higher energy x rays are much more likely to be absorbed?

Back 49

lower

Front 50

Unstable isotopes are referred to as __.

Back 50

radioactive

Front 51

What are the 2 units of radioactivity?

Back 51

curie and bacquerel

Front 52

What type of energy is associated with particulate radiation?

Back 52

kinetic

Front 53

What is the rate of loss of energy of a particle as it moves along its path in an aborber?

Back 53

linear energy transfer

Front 54

What is LET inversely related to?

Back 54

velocity

Front 55

In what medium is the velocity of all EMRs the same?

Back 55

air

Front 56

Energy of EMR and __ are directly related while it and __ are inversely related.

Back 56

frequency; wavelength

Front 57

Does higher or lower film speed require less radiation to make an image?

Back 57

higher

Front 58

In order to maximize image quality and minimize patient dosemost diagnostic x-ray tubes are operated between _ and _ kvp. What is the dental one?

Back 58

65 and 140; 65 is for dental

Front 59

What 3 things can lead to a lower dose?

Back 59

rectangular collimation, higher kvp, and faster film

Front 60

Xray machines must be registered within _ days of acqusition.

Back 60

10

Front 61

The useful wavelength range in dentistry is _ to _ degrees A.

Back 61

.1 to .5

Front 62

_Low/High_ energy Xrays are used in diagnostic radiology while _Low/High_ energy Xrays are used in radiation therapy.

Back 62

Low; High

Front 63

Irradiation of a cell before DNA synthesis results in a __ abberation while after DNA synthesis results in a __ aberration.

Back 63

double-arm, chromosome; single-arm chromatid

Front 64

During what phases of mitosis is the cell most affected?

Back 64

G2 and M phases

Front 65

The Law od Bergonie and Tribondeau says that cells tend to be radiosensitive if they have 3 properties:

Back 65

high division rate, long dividing future, and are of an unspecialized type

Front 66

Dental radiography delivers doses measurable in __.

Back 66

microsievert

Front 67

Drug metabolism is important for making drugs less __.

Back 67

lipophilic

Front 68

What is the most important site for drug metabolism?

Back 68

the liver

Front 69

Phase 1 enzyme reactions are __ and include these 3 processes:

Back 69

nonsynthetic; oxidation, reduction, and hydrolysis

Front 70

Phase 2 enzyme reactions are __ and are also called __ reactions.

Back 70

synthetic; conjugation

Front 71

Glucuronide conjugation is mostly in the __. The products (__) are excreted by __ action into bile or urine.

Back 71

liver; glucuronides; MDRP2

Front 72

Sulfate conjugation takes place in the __, __, and __. The products are excreted by __ action into bile, intestine, or urine. The endogenous substrate is __ while the endogenous products are __ and __.

Back 72

liver, intestine, or kidney; MDRP2; steroids; chondroitin sulfate and heparin

Front 73

Amino acid conjugation requires the drug to be converted to __. It reacts with __ groups on drug. Metbaolites have __ ending and it conjugates to __.

Back 73

Coenzyme A thioester; COOH; uric acid; glycine glutamine

Front 74

Acetylation utilizes __ as acetyl donor. It reacts with _ and _ groups on the drug. __ were first to show polymorphism.

Back 74

Acetyl-CoA; NH2 and hydrazine; N-Acetyl transferase

Front 75

In glutathione conjugation drug containing __ group is conjugated with reduced __. It is synthesized primarily in the _ and _ and transported by __ to bile or urine.

Back 75

SH; glutathione; liver and kidney; MDRP2

Front 76

In methylation __ is the methyl donor. Drugs containing _, _, and _ groups are methylated.

Back 76

S-adenosyl-methionine; NH2, SH, and OH

Front 77

80% of all nonsynthetic rxns are catalyzed by __.

Back 77

P450

Front 78

The 2 cyt P450 enzymes __ and __ catalyze half of all nonsynthetic rxns.

Back 78

CYP3A4 and CYP3A5

Front 79

True or False: In the general oxidation rxn one atom of oxygen is reduced to make water while the other atom is added to the drug.

Back 79

True

Front 80

The __ subfamily metabolizes many drugs during absorption from the GI tract where it __ the bioavailability of many orally administered drugs.

Back 80

CYP3A; decreases

Front 81

What type of enzymes are responsible for hydrolysis? These are performed in the _ and _.

Back 81

esterases; blood plasma and liver

Front 82

Two important hydrolase rxns important for dentists are __ forund in __ and __ found in many tissues of the body.

Back 82

hydrolase; blood; amidase

Front 83

Gray baby syndrome is associated with __.

Back 83

chloramphenicol

Front 84

Isoniazid which is used for the treatment of TB is metablozied by __ which has a high incidence of __.

Back 84

N-acetyltransferase; SNPs

Front 85

__ shows the largest pehnotypic variability amongst the CYPs due to genetic polymorphism. Its phenotype can be determined via the administration of __.

Back 85

CYP2D5; debrisoquine

Front 86

__ intoxication is associated with ultrarapid CYP2D6 metabolism.

Back 86

codeine

Front 87

Enzyme induction was discovered while studying _ and occurs by increased __.

Back 87

phenobarbital; protein synthesis

Front 88

A dealkylation rxn is also a __ reaction.

Back 88

oxidation

Front 89

The plateau state of mutliple dosing is attained after how many half lives and the time required to reach the state is dependent or independent of dose?

Back 89

4; independent

Front 90

The plateau concentration of multiple dosing is __ proportional to dose, __ proportional to dosage interval, and __ to half life.

Back 90

directly; indirectly; proportional

Front 91

Too much iron in the pancreas leads to __.

Back 91

bronze diabetes

Front 92

Which type of calcification is associated with atheromas and damaged heart valves?

Back 92

dystrophic calcifications

Front 93

Coagulative necrosis is classically associated with __.

Back 93

ischemic injury

Front 94

In coagulative necrosis of the liver excessive __ causes impaired __ mechanism.

Back 94

acetaminophen; glutathione peroxidase

Front 95

Caseous necrosis is associated with what type of infection?

Back 95

TB

Front 96

Breast trauma and pancreatitis are associated with what type of necrosis?

Back 96

fat necrosis

Front 97

Soap bubbles with blue hue are associated with what type of necrosis?

Back 97

fat necrosis

Front 98

Both pro- and antiapoptotic molecules come from which gene family?

Back 98

Bcl-2

Front 99

During protein accumulation alcoholic cirrhosis is associated with __, Igs in plasma cells with __, mutiple myeloma with __, inflammation with __, and Alzheimer's with __.

Back 99

mallory bodies; russell bodies; amyloid; hyaline; neurofibirillary tangles

Front 100

Endothelial cell activation results in release of _ and _ that result in vasodialtion and _,_, and _, that result in EC contraction (increased permeability).

Back 100

NO and prostaglandin PGI2; histamine, interleukin 1 and TNF

Front 101

__ are involved in rooling leukocytes.

Back 101

selectins

Front 102

__ bind cells to extracellular components and __ bind cells to basement membrane.

Back 102

integrins; cadherins

Front 103

__ are involved in transmigration through endothelial gaps (___).

Back 103

immunoglobulin-like proteins; diapedesis

Front 104

Plasma cells are derived from __ and synthesize and secrete __.

Back 104

B lymphocytes; cytokines

Front 105

Eosinophils are associated with __ rxns mediated by _ and _ infections. They respond to eosinophilic chemtactic factor released by __.

Back 105

allergic; IgE and parasitic; mast cells

Front 106

Name 3 etiologies of foreign body granulomas.

Back 106

suture, talc, and silicosis

Front 107

What type of cells are seen in immune granulomas?

Back 107

Langhans-type giant cell

Front 108

What are the major source of cytokines?

Back 108

macrophages

Front 109

Corticosteroids antagonize __ and decrease synthesis of __. They also decrease __ proliferation and slow down __.

Back 109

phospholipases; arachidonic acid; fibroblast; wound healing