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118 Cards in this Set

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Dissolution of the intercellular bridges of the prickle cell layer of the epithelium.
A severe type of hypersensitivity or allergic reaction in which the exaggerated immunologic reaction results from the release of histamine.
A protein molecule, also called an immunoglobulin, which is produced by plasma cells and reacts with a specific antigen.
Any substance able to induce a specific immune response.
A disease characterized by tissue injury caused by a humoral or cell-mediated immune response against constituents of the body's own tissues.
Autoimmune disease
A lymphocyte that matures without passing through the thymus.
B lymphocyte (B cell)
Immunity in which the predominant role is played by T lymphocytes.
Cell-mediated immunity
Cell product produced by the cells involved in the immune system.
Immunity in which B lymphocytes and antibodies play the predominant role.
Humoral immunity
A combination of antibody and antigen.
Immune complex
A deficiency of the immune response resulting from hypoactivity or decreased numbers of lymphoid cells.
A protein, also called an antibody, synthesized by plasma cells in response to a specific antigen.
A cell that is a characteristic of lupus erythematosus (LE) and other autoimmune diseases; it is a mature neutrophil that has phagocytized a spherical inclusion derived from another neutrophil.
LE cell
Tissue composed of lymphocytes supported by a meshwork of connective tissue.
Lymphoid tissue
A large tissue-bound mononuclear phagocyte derived from monocytes circulating in blood.
Mucosal inflammation.
A lymphocyte that is part of the body's initial innate immunity, which by unknown mechanisms is able to directly destroy cells recognized as foreign.
Natural killer cell (NK cell)
In some bullous diseases such as pemphigus vulgaris and bullous pemphigus the superficial epithelium separates easily from the basal layer on exertion of firm, sliding manual pressure.
Nikolsky's sign
A protein, immunoglobulin M (IgM) found in serum and detectable on laboratory tests; associated with _________ and other autoimmune diseases.
Rheumatoid factor
Rheumatoid arthritis
A lymphocyte that mature in the thymus before migrating to tissue; is responsible for cell-mediated immunity and may modulate the humoral immune response.
T lymphocyte (T cell)
A lymphoid organ located high in the chest, which is large in an infant and gradually shrinks in size.
Abnormal dryness of the eyes.
Patient complaint of dryness of the mouth usually caused by decreased salivary flow.
Give some examples of antigens.
Microorganisms and their toxins
Tumor cells
Cells infected by viruses
Tissue in case of organ transplant or blood transfusion
When an immune response is activated against components of self or fails to recognize foreign substances it's called?
Autoimmune disease
Which immune response defends the body against injury and involves memory?
Acquired immune response
Which immune response does not involve memory?
Innate immune response
In the response to injury process which comes first, inflammatory response or immune response?
Inflammatory is first
Immune response follows.
What are the primary WBC that are involved in the immune response?
What percentage of the WBC population do lymphocytes make up?
20 to 25%
What are the three types of WBC that are involved in the immune response?
B lymphocytes (B cells)
T lymphocytes (T cells)
Natural Killer cell (NK cells)
Which lymphocyte is involved in the innate immunity rather than the acquired immunity?
NK cells
These lymphocytes have the ability to destroy foreign substances early in their appearance since they recognize them as foreign without having to first recognize them as a specific antigen.
NK cells
Where are NK cells located?
This cells seems to be active against viruses and cancer cells and is abnormal in function in acquired immunodeficiency syndrome.
NK cells
These cells develop from the stem cells in the bone marrow and then reside and mature in the lymphoid tissue.
B cells
What are the two types of B cells?
Plasma cell
B memory cell
Which B cell retains the memory of the antigen?
B memory cell
What is the process where B memory cells duplicate themselves called?
Clonal selection
Round, pin-wheel-shaped nucleus and visible cytoplasm that produces proteins called antibodies.
Plasma cell
Antibodies are also called __________.
Immunoglobins (Igs)
What are the five different types of immunoglobins?
The level of a specific antibody in the blood is called ________.
Antibody titer
The portion of the antibody that recognized and binds to the antigen is called __________.
Antigenic determinate
What renders the antigen inactive?
The formation of an immune complex.
After these cells develop from the bone marrow stem cell, they travel to the thymus and then are processed mature cells.
T cells
T cells depend on unique cell surface molecules called ____________.
Major histocompatibility complex
What are the different types of T cells?
Memory cells
Helper cells
T-suppressor cells
T-cytotoxic cells
Which cells turn off the function of B lymphocytes?
T-suppressor cells
Which cells directly attack virally infected cells and tumor cells?
T-cytotoxic cells
Which cells increase the functioning of B lymphocytes?
T-helper cells
Where are macrophages present in the response process to injury?
Inflammatory and Immune response
These cells are active in phagocytosis and help the B and T cells during the immune response.
These cells are antigen-processing cells that activate the lymphocytes to travel from lymphoid to injured tissue.
Which cells serve as a link between the inflammatory and immune response?
These are proteins that are producted by cells and are able to influence the behavior of other cells; play a major role in activating the immune response.
Cytokines that stimulate leukocyte proliferation and other functions.
Cytokines that stimulate macrophage emigration
Macrophage chemotactic factor
Cytokines that inhibit macrophage activity
Migration inhibitory factor
Cytokines that activate macrophages to produce and secrete lysosomal enzymes.
Macrophage-activating factor
Cytokines that destroy fibroblasts.
Cytokines that have antiviral function and are involved with leukocytes, fibroblasts, and endothelial cells.
Cytokines that are involved in various functions involving leukocytes and fibroblasts.
Tumor necrosis factor
Cytokines that are involved in controlling infection.
What are the two types of immune response?
Humoral immunity or antibody-mediated

Cell-mediated immunity or cellular immunity
This form of immune response involves the production of antibodies with the B lymphocytes as the primary cells; responsible for protection against many bacteria and viruses.
Humoral immunity
This form of immune response involves lymphocytes, usually T cells, working alone or with macrophages; regulates both major responses.
Cell-mediated immunity
What are the two types of immunity?
Passive and active
This type of immunity occurs when antibodies from a mother pass through the placenta to the developing fetus.
Natural passive immunity
This type of immunity is given by injection of antibodies against a microorganism to which the person has not previously developed antibodies.
Acquired passive immunity
This type of immunity can occur when a microorganism causes the disease and protection against further attack by that microorganism is conferred to the individual if the body recovers from the disease.
Active natural immunity
This type of immunity is given to the person by injection or ingestion of altered pathogenic microorganism wich will act as an antigen but cannot produce infection; vaccine, immunization.
Active acquired immunity
The study of immune reactions involved in disease.
Type I hypersensivity reaction is also called ________ and examples of it are _______.
Anaphylactic type
Hay fever
Type II hypersensivity reaction is also called __________ and examples of it are __________.
Cytotoxic type
Autoimmune hemolytic anemia
Type III hypersensitivity reaction is also called _____________ and examples of it are _______.
Immune complex type
Autoimmune diseases
Type IV Hypersensitivity reaction is also called ______________ and examples of it are _________.
Cell-mediated type
Granulomatous disease (TB)
This type of hypersensitivity reaction occurs immediately, within minutes after exposure to a previously encounted antigen such as pollen, latex, penicillin.
Type I (anaphylactic type)
What does it cause and what is the immunoglobulin involved?
Edema, Hay fever, Asthma, Anaphylaxis
This type of reaction occurs in incompatible blood transfusions and rhesus (Rh) incompatibility; releases IgG and IgM antibodies in the blood.
Type II (cytotoxic type)
In Rh incompatibility, the mother's antibodies cross the placenta and destroy the newborn's red blood cells, resulting in ___________.
Hemolytic anemia
In this type of hypersensitivity response immune complexes are formed and deposited in various body tissues where neutrophils are attracted and once phagocytosis occurs death of neutrophils occurs and lysosomal enzymes are released and they cause destruction; this type occurs in autoimmune diseases such as sytemic lupus erythematosus.
Type III (immune complex type)
What is a classic example of Type III sensitivity?
Serum sickness
In this type of cell-mediated hypersensitivity response, T cells cause damage or recruit cells to cause damage; is also called ______________; used when diagnosing TB and is responsible for rejection of tissue grafts and transplanted organs.
Type IV (cell-mediated type)
aka delayed hypersensitivity
Which drug can cause systemic anaphylactic reaction and causes 300 deaths per year in the US?
Recognition and the nonresponsiveness of the immune system to the body's own cells and tissues is called?
Immunologic tolerance
Another name for autoimmune diseases is?
Connective tissue diseases
When T cells attack pancreatic cells it contributes to which condition or disease?
Diabetes mellitus
Type of immunopathologic condition that involves a deficiency in number, function, or interrelationships of the involved WBC and their products.
Painful ulcers for which the cause remains unclear, common in the oral cavity, occur in about 20% of the general population.
Aphthous ulcers aka canker sores or aphthous stomatitis.
1. What is the most reported factor affecting aphthous ulcers?
2. What are some associated diseases?
1. Trauma
2. Behcet syndrome, Chron's disease, Ulcerative colitis, cyclic neutropenia, Sprue, Intestinal lymphoma, PFAPA syndrome.
Most commonly occuring type of aphthous ulcers; round to oval; as large as 1 cm, yellowish-white fibrin surface surrounded by halo of erythema.
Minor aphthous ulcer
1. Where do they occur?
1. Anterior portion of the mouth (moveable mucosa or detached mucosa)
Aphthous ulcers larger than 1 cm; deeper; most likely in posterior of the mouth; several weeks to heal and leave scarring.
Major aphthous ulcers
1. aka
2. associated with which infection?
1. Sutton's disease
2. HIV
How do you diagnose minor aphthous ulcers?
Clinical appearance
Location of lesion
Patient history
How do you diagnose major aphthous ulcers?
Biopsy is often needed to differentiate between major aphthous ulcers and squamous cell carcinoma or deep fungal infections.
How do you differentiate between major aphthous ulcers and intraoral ulcers caused by herpes simplex virus?
Ulcers from Herpes Simplex Virus occur on keratinized mucosa (palate and attached gingiva)
How do you differentiate between Herpetiform aphthous ulcers and Primary herpetic gingivostomatitis?
Therapeutic diagnosis....prescribe tetracycline....Herpetiform aphthous ulcers respond to tetracycline and primary herpetic gingivostomatitis does not.
Very tiny (1 to 2 mm) aphthous ulcers found anywhere in the oral cavity and are painful and occur in groups.
Herpetiform aphthous ulcers
Type of Aphthous ulcer:
3 to 5 mm
unattached mucosa
anterior part of mouth
1 to 5 in number
no scarring
Minor aphthous ulcer
1. Tx
Topical steroids
Antiinflammatory agents
Topical anesthetics (Orabase/Zilactin)
Type of Aphthous ulcer
5 - 10 mm
Unattached mucosa
Posterior part of mouth
1 to 10 in number
Major aphthous ulcer
Systemic steroids may be necessary
Type of Aphthous ulcer
1 to 2 mm
Unattached mucosa
Anywhere in mouth
1-100 in number
No scarring
Ulcers coalesce
Herpetiform aphtous ulcer
1. Treatment
1. Topical steroids and antiinflammatory agents
Tetracycline for this type of aphthous ulcer.
Lesions that usually appear as multiple areas of well demarcated swelling of the skin, accompanied by itching.
Urticaria aka hives
1. What are some causes?
2. Dx?
3. Tx?
1. Infection, Trauma, Stress, Certain systemic diseases, Ingested allergens
2. Clinical exam and patient history
3. Antihistime
Lesions that appear as a diffuse swelling of tissue caused by permeability of deeper blood vessels; the skin covering the swelling appears normal and this lesion is usually not accompanied by itching.
What are some causes?
1. Infection, Trauma, Stress, Certain systemic diseases, Ingested allergens
2. Clinical exam and patient history
3. Antihistime
Lesion that results from the direct contact of an allergen with the skin.
Contact dermatitis

2. What is the clinical appearance?
3. What causes it?
4. Tx?

2. Erythematous with swelling and vessicles and later the area becomes encrusted and scaly, white epidermis.
3. Latex gloves and glove powders
4. Topical or systemic corticosteroids
Lesion that results from the direct contact of an allergen with the mucosa.
Contact mucositis
1. What is the clinical appearance?
2. What causes it?
3. Tx?
1. Erythematous with edematous, burning and itching, small vissicles and ulcers may appear.
2. Topical antibiotics, Antihistamines, Preservatives in anesthetics, Acrylics, Metal-based alloys, Epoxy resins, Flavoring agents
3. Topical or systemic corticosteroids.
Single or multiple slightly raised, reddish patches or clusters of macules on the skin or rarely on the mucosa; pain and itching may be associated.
Lesions that appear in the same site each time a drug is introduced.
Fixed drug eruptions
Acute, self-limited disease that affects the skin and mucosa; the skin lesion is called a target, iris, or bull's eye lesion and consists of concentric rings of erythema alternating with normal skin color.
Erythema multiforme
1. where does it occur?
2. a more sever form that may lead to blindness?
3. Dx?
4. Tx?
1. lateral borders of the tongue accompanied by encrusted bleeding lips.
2. Stevens-Johnson syndrome
3. Clinical features, biopsy, histologic examination
4. Topical or systemic corticosteroids
What are some triggering factors for erythema multiforme?
Herpes simplex,
Malignant tumors
Drugs: barbiturates & sulfonamides
A benign chronic disease affecting the skin and oral mucosa that appears as a pattern of interconnecting lines called striae; oral pattern is interconnecting white lines and circles; most likely appear on buccal mucosa, but at times tongue, lips, floor of mouth and gingiva.
Lichen planus
1. Causes
2. Types (describe each)
3. Dx
4. Tx
5. What gingival lesions does it cause?
6. Patients with lichen planus have an increased risk for?
1. Stress, drugs
2. Reticular lichen planus: most common type, Wickham's striae
Erosive and bullous lichen planus: where epithelium separates from connective tissue
3. Clinical appearance, Histologic appearance, biopsy
4. Topical corticosteroid, meticulous dental hygiene, causitive drug.
5. Desquamatous gingivitits
6. Squamous cell carcinoma
A disease formerly called histiocytosis X; consists of three entities: Letterer-Siwe disease; Hand-Schuller-Christian disease, and solitary eosinophilic granuloma.
Langerhans cell disease
An acute disseminated form of Langerhans cell disease that usually affects children younger than 3 years of age; the disease resembles a lymphoma in that it generally has a rapidly fatal course that sometimes responds to chemotherapy.
Letterer-Siwe disease
A chronic multifocal form of Langerhans cell disease; this form occurs in children younger than 5 years of age; the triad includes single-to-multiple well defined radiolucent areas in the skull (may also occur in jawbone).
Hand-Schuller-Christian disease
A solitary or chronic localized form of Langerhans cell disease; this form primarily affects older children and young adults; the skull and mandible are commonly involved; lesion may resemble periodontal disease or periapical inflammatory disease.
Solitary Eosinophilic granuloma
How is langerhans cell disease treated?
Conservative surgical excision of eosinophilic granuloma; low-dose radiation therapy.
Autoimmune disease that affects the mouth and eyes and caused xerostomia and xerophthalmia.
Sjogren syndrome
1. Associated with what syndrome?
2. Eye damage that occurs is?
3. Two types, explain.
4. Signs and symptoms
5. 50 % of patients with Sjogren syndrome also have these two autoimmune diseases?
6. These patients are at high risk for?
7. 50% also have this enlarged gland?
8. 20 % of patients have this disorder that affects fingers and toes?
1. Sicca syndrome : dry eyes, dry mouth
2. Keratoconjunctivitis sicca
3. Primary: lacrimal and salivary gland involvement without autoimmune disease.
Secondary: lacrimal and salivary gland involvement with autoimmune disease.
4. Oral discomfort, dry sticky mouth, cracked and dry lips, loss of filiform and fungiform.
5. Rhematoid arthritis or systemic lupus erythematosus
6. Caries, Periodontal disease, Oral candidiasis
7. Parotid
8. Rynaud phenomenon
What are the signs and symptoms of xerophthalmia?
Burning and itching eyes
Photophobia (abnormal visual intolerance to light)
Dry eyes
What is the treatment for Sjogren syndrome?
Antiinflammatory agents
Saliva substitutes
Artificial tears
Pilocarpine to increase salivary flow
Fluoride toothpaste
Fluoride rinses
An acute and chronic inflammatory autoimmune disease that is actually a syndrome that ranges from lesions to life-threatening disease with multiple-organ involvement; occurs in women 8x more and in black women 3x more; classic butterfly rash occurs on bridge of nose; and erythematous lesions on fingers.
Systemic Lupus Erythematosus
1.Common manifestations
2. Symptoms
3. Clinical appearance
4. Tx
1. Arthritis and Artharalgia
2. Rhematoid arthritis but without the severe deformities.
3. Erythematous plaque or erosions with white striae from the center; resembles lichen planus; petechiae and gingival bleeding may be present.
4. Aspirin, Antiinflammatory agents, hydroxychloroquine, Corticosteroids, Azathioprine, Cyclophosphamide
Severe progressive autoimmune disease that affects the skin and mucosa; causes epithelial cell separation called?
Pemphigus vulgaris
1. What are the 3 forms?
2. Clinical apperance
3. Dx
4. Tx
5. Associated with these autoimmune diseases.
Pemphigus vegetans
Pemphigus foliaceus
Pemphigus erythmatosus
2. Shallow ulcers, fragile vesicles, bullae
3. Biopsy, microscope, direct & indirect immunofluorescense
4. High doses of corticosteroids, azathioprine, methotrexate
5. Lupus erythematosus, rheumatoid arthritis, Sjogren syndrome
Chronic autoimmune disease that affects the oral mucosa, conjunctiva, genital mucosa, and skin; lesions may heal with scarring.
Mucous membrane pemphigoid
1. aka
2. clinical appearance
3. Dx
4. Tx
5. Other type of Mucous membrane pemphigoid.
1. Cicatricial pemphigoid and benign mucous membrane pemphigoid
2. Occurs on gingiva and gingival lesions are called desqamative gingivitis; appearance ranges from erythema to ulceration and involves both free and attached gingiva; bullae are thick walled not that fragile.
3. Biopsy and histologic exam
4. Topical and systemic corticosteroids
5. Bullous pemphigoid; oral lesions are less common occurs in patients over 60.
Chronic, recurrent autoimmune disease consisting primarily of oral ulcers, genital ulcers, and ocular inflammation.
Behcet syndrome
1. Clinical apperance?
2. Dx
3. Tx
1. Similar to Aphthous ulcers, few mm to several cm.
2. A pustular lesion develops after a needle puncture
3. Systemic and topical corticosteroids; Chrorambucil for ocular lesions; Immunosuppressive drugs