- Sjogren's disease is much more commonly (male/female) - It is due to impaired_________fxn

- female - secretory (dry eyes & mouth)

- Necrotizing Sialometaplasia is more common in (hard/soft) palate - What is the potential cause of Necrotizing Sialometaplasia

- hard - infarction of salivary acini

Module 15 Flashcards by Anson Lam

Which antigen is an important contributor to Autoimmune dz

HLA antigen

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What are 3 main causes of autoimmune disease

Genetics, Immune dysregulation, Enviornmental

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What are the 4 mechanisms to control self-reactive lymphocytes

deletion
receptor editing
fxntional unresponsiveness
suppression by regulatory cells

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Sjogren’s disease is much more commonly (male/female)
It is due to impaired_________fxn

female
secretory (dry eyes & mouth)

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List 4 clinical presentations of of Sjogren disease

lack of saliva
lack of tear
fatigue
joint/muscle pain

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Having sjogren’s disease inc. the risk of__________cancer by_______fold

lymphoid, 10

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What is the mechanism of lymphoma dvlpment in sjogren’s disease

Clonal expansion of B cells > Hyper-activated B cells

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Which drug treats sjogren’s disease by depleting B cells

Rituximab

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Which drug treats sjogren’s disease by targeting BAFF

Belimumab

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List 2 infectious disease that can cause xerostamia

HIV, Hep C

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Xerostomia inc. the risk of what kind of infection

Oral candidiasis

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What are 3 histopathological features that can be seen in age related reduced salivary flow

loss of acini
fibro-fatty change
oncocytosis of ducts

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The histopathological feature of epimyoepithelial island can be found in what dz

Sjogren’s dz

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Sialosis (Sialadenosis) is the__________of salivary acini

enlargement

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What disease is associated w/ duct obstruction, often due to salivary calculi & low grade ascending infection

Chronic SialaDENITIS

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Which 2 histo features can be seen in sialolithiasis (salivary stones) ?

concentric layer surrounding the stone, periductal inflammation

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Necrotizing Sialometaplasia is more common in (hard/soft) palate
What is the potential cause of Necrotizing Sialometaplasia

hard
infarction of salivary acini

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What is associated/secondary sjogren’s dz

Sjogren’s dz with other systemic involvement

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Sjogren’s dz most commonly occur at age >_____

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A score of >=_____ in Sjogren’s disease classification criteria is sufficient to diagnose sjogren’s syndrome

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What collagen type is found in bones ?

Type I ONLY

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(Ccortical/cancellous) bone is more active

cancellous

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Bones w/out________will be brittle

Collagen

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Bones w/out________will be bendy

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Osteoblast is derived from____________

mesenchymal lineage

Osteoblast can terminally differentiate into_________

osteocyte

Osteoclast derive from____________

hematopoietic stem cells

When osteoclast break down bone matrix, ________collagen fiber is released

CTX

What are the 2 mechanims used by osteoclast to resorb bone matrix

1. Secrete acid to demineralize > 2. secrete protease to break down collagen matrix

_________are the master regulators of bones

Osteocytes

RANKL & OPG factors are released by_________

osteocytes

(RANKL/OPG) factor inc. osteoclast formation & activity

RANKL

(RANKL/OPG) factor dec. osteoclast formation & activity

OPG

__________are the primary mechanosensing cells in bone.

osteocytes

Osteocytes form________network between each other

canalicular

Bone is_____% mineral

Mature compact bone is organized into_________

lamellae

What is the structural unit of compact bone

Haversian sys.

Horizontal connecting channels of compact bone are called

Volkmann's canals

Each haversian system is surround by a layer called_______

cement line

T/F, immature bone is organized into lamellae/haversian sys.

In immature bone, _______% of hydroxyapatite is deposited in the first few days, the remaining are deposited over_______

75, few months

- Periosteum is__________ - It is anchored to bone surface via_________

- dense irregular connective tissue covering outside of bone - sharpey's fibers (bundles of strong collagen type 1)

Endosteum is made of single layer of__________

endosteal cells

What is the avg half life of osteocyte

25 years

After being resorbed by osteoclast, the channels that formed are called_________

howship's lacunae

Is cartilage mineralized

What are the 3 types of cartilage

Hyaline, Elastic, Fibro

Cartilages are produced by cells ?

Chondrocytes

- Which kind of cartilage have perichondrium ? - It is NOT found attached to which 2 surfaces

- Hyaline ONLY - articular & epiphyseal surfaces

What is the most abundant type of cartilage

Hyaline

Cartilage usually contain what type of collagen

A 65 year old woman diagnosed with osteoporosis presented in the dental clinic. On history, she reveals that she is taking various medications and supplements. Which of the followings is associated with the increased risk of jaw necrosis post a surgical extraction? CoQ10 supplement Alendronate Calcitonin Hormone replacement therapy Fish oil supplement

Alendronate

40 year old Peter Langdon has been experiencing stiffness in his small joints, which is worse in the morning, accompanied by joint swelling and pain. This condition has been gradually getting worse over the past year and is affecting his joints in a symmetrical fashion. He also shows systemic symptoms such as weight loss and fatigue. Which of the following diseases are these symptoms and signs consistent with? Osteoarthritis Gout Osteomalacia Osteoporosis Rheumatoid arthritis

Rheumatoid arthritis

Mast cells are found in abundance within all epithelial layers of the oral mucosa. What are the implications of this for the immune response in the oral mucosa? Increased chance of rapidly killing commensals Increased chance of responding rapidly to pathogens Increased risk of allergies Increased risk of periodontitis Increased risk of autoimmune diseases

Increased chance of responding rapidly to pathogens

A new congenital immunodeficiency has been discovered where patients lack dendritic cells. Which of the following statements is most correct regarding the ability of these patients to mount effective immune responses? This would be a mild immunodeficiency because the patient still has neutrophils and macrophages This would be a mild immunodeficiency as the patient still has T and B lymphocytes This would have no effect because congenital immunodeficiencies do not lead to defective immune responses This would be a severe immunodeficiency because dendritic cells are needed to activate T cells This would be a severe immunodeficiency because dendritic cells produce antibodies

This would be a severe immunodeficiency because dendritic cells are needed to activate T cells

The increased risk of oral candidiasis that accompanies the use of some asthma inhalers indicates that: The inhalers increase the risk of bacterial infection The ingredients in the inhalers can suppress the immune system in the oral mucosa The inhalers are probably being used incorrectly These inhalers can be susceptible to fungal contamination The inhibition of mast cell degranulation

The ingredients in the inhalers can suppress the immune system in the oral mucosa

Which of the following contains an extracellular matrix that becomes calcified during normal growth and development? Spongy bone only Compact bone and spongy bone only Compact bone, spongy bone, hyaline cartilage and fibrocartilage Compact bone only Compact bone, spongy bone and hyaline cartilage only

Compact bone, spongy bone and hyaline cartilage only

How are anti-Ro60 antibodies proposed to contribute to immunopathology in Sjögren’s disease? Immune complexes of anti-Ro60 and Ro60 can directly activate T cells to secrete interferon-gamma Ro60 is a survival protein that increases the activation and survival of B cells Anti-Ro60 antibodies bind to epithelial cells and cause apoptosis Immune complexes of anti-Ro60 and Ro60 can enhance BAFF secretion Immune complexes of anti-Ro60 and Ro60 can activate Toll-like receptors in plasmacytoid dendritic cells

Immune complexes of anti-Ro60 and Ro60 can activate Toll-like receptors in plasmacytoid dendritic cells

Which hormone is reduced during ageing which can lead to bone loss in men? Progesterone Estrogen Testosterone Cortisol Androgen

Testosterone

Which of the following contains an extracellular matrix that is organised into lamellae? Compact bone and spongy bone only Bundle bone only Compact bone only Compact bone, spongy bone and bundle bone Spongy bone only

Compact bone, spongy bone and bundle bone

In sjogren's dz, APCs activated by virus/ other stimulator promotes____________pdtion

type 1 & type 2 IFN

Which 2 cytokines enhance BAFF secretion as well as activation of B & T cells

IFNa & IFNb

Which 4 viral infections can cause acute sialadenitis

HIV, Mumps, CMV, Coxsackie A

Acute sialadenitis are associated w/ which 4 major causes

infections, dehydration, reduced salivary flow, immunocompromised

Chronic sialadenitis usually affect which gland

submandibular

What are the 4 histo features of chronic sialadenitis

1. Acinar atrophy w/ replacement fibrosis 2. Dilatation of ductal sys. 3. Hyperplasia of ductal epithelium 4. Periductal fibrosis

Salivary stone is also known as____________

sialolithiasis

How does osteoblast form bone

forms organic matrix, osteoid then mineralize it w/ hAp

What bone organized into haversian sys.

Compact ONLY

T/F, only compact bones contain lamellae

F, tubercle of spongy bone ALSO contain lamellae but usually // to surface

What is known as the initial organic bone substance before bone completely maturess >

Osteoid

Osteocyte lacunae connects to each other & central canal via___________

canaliculi

T/F, matrix of cartilage contain proteoglycans

Does cartilage contain blood vessel, lymphatics or nerves

What are the 2 fxns of perichondrium

1. Provide blood supply 2. As a source of new chondrocytes for growth & repair

What indicates recent cell division of chondrocytes

isogenous groups

The 3 types of cartilage by difference in_________maxtrix

extracellular

T/F, hyaline cartilage can become calcified & allow dvlpment into bone

What are the 3 fxns of hyaline cartilage

1. Resist compression 2. Provide cushioning 3. Transmitting force into underlying bone

Which cartilage provides structural sprt for respiratory sys.

Hyaline

What cartilage is found in intervertebral disc

fibrocartilage

What cartilage is found in menisci of joints

fibrocartilage

The process of replacing hyaline cartilage w/ bone tissue is called_____________

endochondral ossification

Meckel's cartilage is made of_________cartilage

hyaline

What is the unique feature of TMJ joint

Articular surface covered by FIBROUS LAYER rather than hyaline cartilage

What kind of joint is TMJ

Diarthroses (synovial)

What produce synovial fluid in synvovial joint

Inner cellular layer of synovial membrane

1 in____women over age 50 suffer osteoporosis

1 in____men over age 50 suffer osteoporosis

Which hormone can be a source of estrogen

testosterone

Estrogen act on (osteoblast/osteoclast)

both

How does denosumab work to treat osteoporosis

blocking the formation of osteoclast via blocking RANKL

Osteocytes reduce sclerostin pdtion in response to________

load

Sclerostin is osteocyte specific protein that___________________

negatively regulates osteoBLAST differentiation

How does romosozumab treat osteoporosis

inc. bone formation (P1NP) & dec. bone resorption (CTX)

What is the dose romosozumab ?

monthly injection of 210mg

How does bisphosphate work to treat osteoporosis

bind to bone mineral & stay for long time, causing loss of resorptive fxn

T/F, prolonged used of glucocorticoids can inc. risk for osteoporosis

Missing a dose of Denosumab can lead to which serious effect

vertebral fracture (if dose delayed for more than 4 weeks)

Teriparatide is a synthetic form of which hormone

human parathyroid

Teriparatide work by which 3 ways ?

1. inc. renal distal tubular calcium resorption 2. inc. vitamin D 3. dec. renal proximal tubular phosphate reabsorption Overall effect, INC. bone mass

Teriparatide can be used daily for up long how long

2 years

Which drug for treating osteoporosis is a monoclonal antibody

Romosozumab

List 4 non-phamacological tx for osteoporosis

1. weight-bearing exercise 2. vitamin d thru sun 3. diet 4. avoid smoking & xs alcohol

Module 15 Flashcards

(105 cards)