Oral Path Ch 1-5

Opportunistic infections are caused by microorganisms that typically do not cause harm to individuals with a healthy immune system. However, when a person's immune system is compromised or weakened, these microorganisms can take advantage of the opportunity to cause infection. This can occur in individuals with conditions such as HIV/AIDS, cancer, or those taking immunosuppressive medications. In such cases, the immune system is unable to effectively fight off these normally non-pathogenic microorganisms, leading to opportunistic infections.

Inspection is the process of critically appraising a patient for any signs of pathology. This involves three main components: examination, measurement, and comparison with normal. Examination refers to thoroughly observing and assessing the patient's physical appearance, behavior, and any visible abnormalities. Measurement involves quantifying specific parameters such as vital signs, body temperature, or blood pressure. Lastly, comparison with normal involves evaluating the patient's findings against established norms or standards to identify any deviations or abnormalities. Therefore, the correct answer is "all of the above" as inspection encompasses all these aspects.

Pyogenic is not a basic type of inflammation. Acute, chronic, and granulomas are all well-known types of inflammation, characterized by different durations and patterns of immune response. Acute inflammation occurs rapidly and is typically short-lived, while chronic inflammation lasts for a longer duration. Granulomas refer to a specific type of chronic inflammation characterized by the formation of granulomas, which are small areas of immune cells. However, pyogenic is not a recognized type of inflammation and therefore does not fit into the basic types of inflammation.

Chemotaxis is the process of recruiting phagocytic white blood cells. Phagocytic white blood cells, such as neutrophils and macrophages, are responsible for engulfing and destroying foreign particles, such as bacteria or other pathogens. Chemotaxis allows these cells to be attracted to the site of infection or inflammation by following a chemical gradient. Once recruited, the phagocytic cells can eliminate the foreign particles and help in the body's immune response.

Taurodontism is a condition characterized by an elongated pulp chamber and short pointed roots. This means that the pulp chamber, which contains the nerves and blood vessels of the tooth, is larger and extends further into the roots than usual. The roots themselves are shorter and more pointed in shape. Taurodontism is a developmental anomaly that can affect multiple teeth and is often associated with other dental abnormalities.

The most useful clinical feature for determining the type of cyst is its location. This is because the location of the cyst can provide important information about the underlying cause and potential complications. For example, a cyst located near a joint may suggest a ganglion cyst, while a cyst located in the breast may indicate a benign or malignant tumor. Therefore, understanding the location of the cyst can help guide further diagnostic testing and treatment decisions.

In autoimmune diseases, the immune system is activated to distinguish between self and nonself. This activation leads to the production of antibodies by activated B cells, which target self antigens. These antibodies are known as autoantibodies. The immune response in autoimmune diseases is characterized by the lack of recognition of abnormal tissue by cytotoxic T cells. Symptoms of autoimmune diseases typically manifest in type 1 hypersensitivity reactions.

Children with cyclic neutropenia may demonstrate recurrent gingivitis, frequent systemic infections, and a decrease in the ability to heal after minor trauma. However, they do not typically have ulcerations only on non-keratinized tissue.

Wounds in which edges cannot be closely opposed undergo healing by secondary intention. This means that the wound is left open and allowed to heal naturally from the bottom up, with the formation of granulation tissue and subsequent contraction. This process is typically used for larger, deeper wounds or those with significant tissue loss or contamination. It differs from primary intention, where the wound edges are brought together with sutures, and tertiary intention, where the wound is initially left open and then closed later. Scar tissue refers to the fibrous tissue that forms during the healing process, regardless of the method used.

The immune system is capable of mistaking itself for nonself, which is known as an autoimmune response. This occurs when the immune system mistakenly attacks healthy cells and tissues in the body. This can lead to various autoimmune diseases such as rheumatoid arthritis, lupus, and multiple sclerosis. Therefore, the statement that the immune system cannot mistake itself for nonself is incorrect.

Hyperplasia is the correct answer because it refers to an increase in the number of cells in an organ or tissue, which is a reversible process. It occurs in response to certain stimuli or as a compensatory mechanism. On the other hand, necrosis, ischemia, and calcification are examples of irreversible cell injuries. Necrosis is the death of cells due to injury or disease, ischemia is the lack of blood supply to tissues, and calcification is the abnormal deposition of calcium salts in tissues.

If a pigmented lesion does not appear radiographically as introgenically implanted dental amalgam, it suggests that the lesion is not related to dental work and may be a potential abnormal growth. Therefore, the correct course of action would be to remove the lesion and examine it under a microscope to determine if it is cancerous or requires further treatment.

Human papillomavirus (HPV) is the correct answer because it is a well-established etiologic agent responsible for cervical cancer and a growing number of oropharyngeal cancers. HPV is a sexually transmitted infection that can cause abnormal cell growth and lead to cancer over time. It is important to note that while Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are also associated with certain types of cancer, they are not specifically linked to cervical or oropharyngeal cancers. HIV, on the other hand, weakens the immune system and increases the risk of developing various types of cancer, but it is not the primary etiologic agent for cervical or oropharyngeal cancers.

The first step in the assessment of oral pathology is recognition. This means being able to identify and acknowledge the presence of any abnormality or disease in the oral cavity. Recognition involves observing and noting any signs or symptoms that may indicate an oral pathology, such as changes in the color, texture, or appearance of the oral tissues. It is an essential step as it allows for further investigation and appropriate management of the condition.

Bullae are defined as blisters that are larger than 5mm in size. Blisters are fluid-filled sacs that form on the skin, typically due to friction, burns, or certain medical conditions. Bullae are larger than the average blister and may be caused by more severe burns, certain autoimmune diseases, or infections. They can be painful and may take longer to heal compared to smaller blisters.

Granulation tissue is a scaffold for tissue repair that is composed of chronic inflammatory cells, fibroblasts, collagen, and endothelial cells. This tissue forms during the healing process of a wound or injury, and its main function is to fill the gap and provide support for tissue regeneration. It is characterized by its pink or red appearance and is rich in blood vessels. Granulation tissue eventually matures and remodels into scar tissue.

The correct answer is dentigerous. Dentigerous cysts are always located around the crown of an unerupted tooth. These cysts form from the accumulation of fluid between the reduced enamel epithelium and the tooth crown. They are commonly associated with impacted wisdom teeth or unerupted permanent teeth.

Macroglossia is often associated with Down syndrome. Down syndrome is a genetic disorder caused by the presence of an extra copy of chromosome 21. One of the common physical features of individuals with Down syndrome is a larger than normal tongue, known as macroglossia. This condition can lead to difficulties with speech, eating, and breathing. Macroglossia is not exclusive to Down syndrome but is frequently observed in individuals with this condition.

Radiographs, or X-rays, are not typically used as a laboratory test to reach a definitive diagnosis. While they can provide valuable information about the structure and condition of bones and certain organs, they are not typically used to detect or diagnose diseases or infections. Urinalysis, microbiologic cultures, and complete blood count are commonly used laboratory tests to help reach a definitive diagnosis.

Tissue damage as a result of ischemia is termed infarction. Ischemia refers to the inadequate blood supply to a particular tissue or organ, leading to oxygen and nutrient deprivation. This lack of blood flow can cause tissue damage and ultimately result in infarction, which is the death of tissue due to this ischemic injury. Hypertrophy refers to an increase in the size of cells, while atrophy refers to a decrease in cell size. Caseous necrosis is a form of tissue death characterized by a cheesy, granular appearance, typically seen in certain types of infections.

Recurrent internal herpes simplex virus infections are almost always located on the attached gingiva or hard palate. This is because the herpes simplex virus tends to infect the mucous membranes in the mouth, and the attached gingiva and hard palate are common sites for these infections. The tongue, buccal mucosa, and soft palate can also be affected by the virus, but they are not the primary locations for recurrent internal herpes simplex virus infections.

Postherpetic neuralgia is a common complication of herpes zoster, also known as shingles. Herpes zoster is caused by the reactivation of the varicella-zoster virus, which initially causes chickenpox. After the initial infection, the virus remains dormant in the sensory ganglia of the nervous system. When it reactivates, it can cause a painful rash and nerve damage, leading to postherpetic neuralgia. Herpes simplex is a different virus that causes cold sores and genital herpes, but it is not associated with postherpetic neuralgia. Herpangina is a viral infection that causes ulcers in the throat and mouth, but it is not related to postherpetic neuralgia.

Pathology is the study of disease processes, including infectious diseases and neoplasia (abnormal growth of cells). This field focuses on understanding the causes, mechanisms, and effects of diseases, as well as their diagnosis and treatment. By studying all of these aspects, pathologists can contribute to the prevention and management of various diseases, making "all of the above" the correct answer.

The most common supernumerary tooth is the mesiodens. Supernumerary teeth are extra teeth that can develop in addition to the normal set of teeth. The mesiodens specifically refers to an extra tooth that is located in the middle of the upper front teeth, between the two central incisors. It is the most common supernumerary tooth because it is often small and does not cause significant dental problems.

All of the infections listed (toxoplasmosis, syphilis, and rubella) can cause serious harm to a fetus if the mother is infected during pregnancy. Toxoplasmosis is caused by a parasite and can lead to severe brain and eye damage in the fetus. Syphilis is a sexually transmitted infection caused by bacteria, and if left untreated, it can cause stillbirth, premature birth, or birth defects. Rubella, also known as German measles, can cause miscarriage, stillbirth, and a range of birth defects if the mother is infected during the early stages of pregnancy. Therefore, all of these infections can pose a significant risk to the health and development of the fetus.

The thyroglossal tract is a congenital abnormality that occurs during embryonic development. It is a cystic structure that may develop anywhere along the path from the foramen cecum (a small depression at the base of the tongue) to the suprasternal notch (the hollow at the base of the neck). This tract is formed when the thyroid gland, which normally descends from the base of the tongue to its final position in the neck, fails to close completely. As a result, a cystic structure can form along this tract, causing the development of a thyroglossal cyst.

Lymphadenopathy refers to the enlargement of lymph nodes, which is not considered to be part of the acute phase response. The acute phase response is a systemic reaction to inflammation or infection, characterized by fever, increased cortisol levels in the blood, and leukocytosis. Lymphadenopathy, on the other hand, is a specific local response where the lymph nodes become enlarged due to the accumulation of immune cells to fight off infection or inflammation. While lymphadenopathy can occur as a result of an acute phase response, it is not considered a direct component of the response itself.

A patient with multiple odontogenic keratocysts should be evaluated for nevoid basal cell carcinoma syndrome. Nevoid basal cell carcinoma syndrome, also known as Gorlin syndrome, is a rare genetic disorder characterized by the development of multiple odontogenic keratocysts in the jaw. Other features of this syndrome include basal cell carcinomas, skeletal abnormalities, and various other benign tumors. Therefore, it is important to consider nevoid basal cell carcinoma syndrome in patients presenting with multiple odontogenic keratocysts to ensure appropriate management and surveillance for associated conditions.

MHC markers are proteins found on the surface of cells that help the immune system distinguish between self and non-self cells. They act as markers of self, indicating that the cell belongs to the body's own tissues and should not be attacked by the immune system. These markers are not present on cells that have been transformed by cancer or viral infection, which allows the immune system to recognize and target these abnormal cells. MHC markers are highly specific and play a crucial role in transplant rejection, as they help the immune system identify foreign tissues and mount an immune response against them.

IgM is the first antibody produced in response to an antigen. It is a pentameric antibody that is secreted by plasma cells during the primary immune response. IgM is effective in neutralizing pathogens and activating the complement system. It is a large antibody and is mainly found in the bloodstream. IgM is also the first antibody to be produced in newborns, providing them with passive immunity.

Reactions to transfusions and erythroblasts fetalis are examples of type 2 hypersensitivity reactions. In type 2 hypersensitivity, the immune system mistakenly targets and attacks specific cells or tissues in the body. In this case, the immune system attacks the red blood cells during transfusions or in the case of erythroblasts fetalis, the immune system attacks fetal red blood cells in the mother's body. This immune response can lead to various complications and symptoms depending on the specific condition.

Condensing osteitis is a condition characterized by the thickening of the bone near the apex of a tooth. Unlike the other options listed, which are all pathological conditions involving inflammation or cyst formation, condensing osteitis does not result in the formation of a radiolucent (dark) area on an X-ray. Instead, it appears as a radiopaque (light) area due to the increased density of the bone. Therefore, condensing osteitis will not appear as an apical radiolucency on an X-ray.

Cytology involves the removal of superficial tissue cells for microscopic examination. This means that a sample of cells is taken from the surface of a tissue and examined under a microscope to study their structure and function. This technique is commonly used in the diagnosis of various diseases, such as cancer, by analyzing the characteristics of the individual cells. It is important to note that cytology is not suitable for cases of candidiasis, a fungal infection, as it requires the examination of cells rather than microorganisms.

The term "epulis" refers to a lesion that is found on the gingiva. This means that the swelling or abnormal growth is specifically located on the gums. The other options, such as causing swelling, expressing pus, or being seen as radiolucency on pa, are not necessarily characteristics of an epulis. Therefore, the correct answer is that an epulis is found on the gingiva.

Activated T cells are a type of immune cells that play a crucial role in the immune response. They are responsible for recognizing and binding to antigens, which are foreign substances in the body. Once activated, T cells can differentiate into different subsets, including memory T cells, which retain the memory of an antigen and can provide long-term protection upon re-exposure. Additionally, activated T cells can release chemical signals called cytokines to direct and regulate the immune response. However, activated T cells do not directly attack infected or cancerous cells. Instead, they release cytokines that can recruit other immune cells to eliminate the infected or cancerous cells.

Patients with florid osseous dysplasia are at risk for a serious jaw infection if they have a tooth extracted. This is because the condition causes abnormal bone growth in the jaw, which can make it difficult for the extraction site to heal properly. The compromised healing process increases the likelihood of developing an infection, which can be potentially serious and lead to further complications. Therefore, it is important for patients with florid osseous dysplasia to take precautions and closely monitor their oral health to prevent such infections.

Major apthous ulcers are most common in adolescents and young adults. This is because these ulcers tend to occur more frequently during periods of hormonal changes, such as puberty and young adulthood. Additionally, the immune system in this age group may be more reactive, leading to an increased risk of developing these ulcers. It is important to note that major apthous ulcers are not contagious and they do not occur on keratinized mucosa such as the hard palate.

Hairy tongue does not indicate a serious disease process. It is a harmless condition where the papillae on the tongue become elongated and trap bacteria, debris, and pigments, giving the tongue a "hairy" appearance. It is usually caused by poor oral hygiene, certain medications, tobacco use, or excessive consumption of coffee or tea. Treatment involves maintaining good oral hygiene and avoiding contributing factors.

Talon cusp is a dental anomaly characterized by an extra cusp-like structure that extends from the cingulum area of the tooth. This condition is known as dens evaginatus, which is the correct answer option given. Dens-in-dente refers to a tooth within a tooth, dens invaginatus refers to an enamel invagination, and gemination refers to the division of a single tooth into two.

Clefts, which are the most common developmental facial abnormality, occur during embryotic life between the sixth and eleventh week.

Persistent generalized lymphadenopathy refers to the persistent enlargement of multiple lymph nodes throughout the body. This condition is commonly associated with HIV infection, as the virus can cause chronic immune activation and inflammation, leading to lymph node enlargement. Measles, HPV infection, and hand foot mouth disease are not typically associated with persistent generalized lymphadenopathy. Therefore, the correct answer is HIV infection.

The patient's acute extensive blistering erosive disease of the oral mucosa, along with the pruritic red concentric circular macules on the arms and neck, suggests a condition known as erythema multiforme. This condition is commonly triggered by a recent episode of recurrent herpes labialis, which is a viral infection caused by the herpes simplex virus. The symptoms of pain and difficulty eating further support this explanation.

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Allergy to dentrifrices is not considered an etiologic factor in the development of necrotizing sialometaplasia. Necrotizing sialometaplasia is a benign, self-limiting inflammatory condition that affects the salivary glands, typically the minor salivary glands in the palate. It is believed to be caused by local ischemia or trauma, such as pressure from dentures or recent dental work. The development of a tumor in the area and trauma to the area are known etiologic factors for necrotizing sialometaplasia. However, there is no evidence to suggest that allergy to dentrifrices plays a role in its development.

Autoimmune diseases such as RA involve a type 3 hypersensitivity reaction. In this type of reaction, immune complexes form when antibodies bind to self-antigens. These immune complexes then deposit in various tissues, leading to inflammation and tissue damage. In the case of RA, immune complexes accumulate in the joints, causing chronic inflammation and destruction of joint tissues.

Erythroblastosis fetalis is a condition that develops in utero and can result in intrinsic staining of the primary dentition. It occurs when there is a blood group incompatibility between the mother and fetus, leading to the destruction of fetal red blood cells. This can cause the release of bilirubin, which can stain the developing teeth. The other conditions listed, such as contemporaneous enamel hyperplasia, fluorosis, and Turner tooth, do not typically result in intrinsic staining of the primary dentition.

Contemporaneous enamel hypoplasia refers to a condition where there is an abnormal development of enamel on the facial surface of multiple, anterior permanent teeth in a band-like pattern. This condition is characterized by a deficiency in enamel formation during tooth development, resulting in thin or missing enamel in affected areas. It is different from enamel hyperplasia, which is an excessive growth of enamel. Fluorosis is a condition caused by excessive fluoride intake during tooth development, leading to enamel discoloration and pitting. Turner tooth refers to a single tooth that is smaller and has an abnormal shape due to trauma or infection. Erythroblastic enamel hypoplasia is a condition where enamel development is disrupted due to a systemic disease or condition, such as anemia.

Contact dermatitis is a skin condition that occurs when the skin comes into direct contact with an allergen or irritant. It does not require contact with all allergens, but rather with specific substances that an individual is allergic to. Repeated exposure to the allergen can lead to sensitization and subsequent allergic reactions. Contact dermatitis is not a lifelong immunity, as individuals can still develop the condition even after previous exposure. Treatment options for contact dermatitis include avoiding the allergen, using topical corticosteroids, and taking antihistamines. It is considered a type 4 hypersensitivity reaction, not type 1.

Fusion is a dental anomaly where two teeth are joined together, resulting in a decreased number of teeth compared to the normal count. This occurs when the tooth buds fuse during development, causing the teeth to merge into one. As a result, the individual will have one less tooth than the normal number.

Hormonal changes during pregnancy do not predispose patients to developing recurrent apthous stomatitis. This is because hormonal changes during pregnancy do not directly affect the immune system or the mucosal barrier, which are the main factors that contribute to the development of recurrent apthous stomatitis. The other options, including decreased mucosal barrier, increased antigenic exposure, and inherited immune dysregulation, can all lead to immune defects that increase the likelihood of developing recurrent apthous stomatitis.

Central papillary atrophy and angular cheilitis are both manifestations of candidiasis. Central papillary atrophy refers to the loss of papillae on the tongue, which can be a result of candidiasis. Angular cheilitis is the inflammation and cracking of the corners of the mouth, which can also be caused by candidiasis. These symptoms are commonly observed in individuals with candidiasis, a fungal infection caused by an overgrowth of Candida yeast.

Both dens invaginatus and evaginatus are dental anomalies that involve the abnormal development of tooth structures. In both cases, there is a risk of pulp exposure, which can lead to inflammation and infection of the dental pulp. If left untreated, this can progress to apical pathology, which refers to diseases or conditions affecting the root apex of the tooth. Therefore, the most important dental complication of both dens invaginatus and evaginatus is pulp exposure and subsequent apical pathology.

Serological testing is a diagnostic method that involves the detection of antibodies in the blood to determine if a person has been exposed to a specific virus. Antibodies are produced by the immune system in response to an infection, so the presence of specific antibodies indicates a viral infection. This type of testing is commonly used to diagnose viral infections such as HIV, hepatitis, and COVID-19. Detection of genetic material or components of the cell wall may be used in other diagnostic methods, but serological testing primarily focuses on the detection of antibodies.

Pemphigoid is a chronic blistering disease of the skin and mucous membranes that is characterized by erosive gingivitis, blisters of mucous membranes and other skin surfaces, and symblepharon. This condition causes the immune system to attack the connective tissue, leading to the formation of blisters. It commonly affects older adults and can cause discomfort and pain. Treatment usually involves medications to suppress the immune system and reduce inflammation.

Cytokines are signaling molecules that play a crucial role in regulating the immune response. They are responsible for carrying information to and from immune cells, attracting cells to migrate to an area by chemotaxis, and releasing histamine to kill parasites. However, enhancing cell growth and differentiation is not a function of cytokines. They primarily act as mediators of immune responses rather than promoting cell growth and differentiation.

Erythroblastosis fetalis is not an example of a primary immunodeficiency disease. It is a condition that occurs in newborns when there is an incompatibility between the blood types of the mother and the fetus. It is caused by the mother's antibodies attacking the red blood cells of the fetus. In contrast, selective IgA deficiency, hypergammaglobulinemia, and DiGeorge syndrome are all examples of primary immunodeficiency diseases where the immune system is compromised in some way.

IgE is found in the body fluids. IgE is an immunoglobulin that is involved in allergic reactions and plays a role in defending against parasitic infections. It is found in the blood and other bodily fluids, such as saliva and tears. IgE binds to allergens and triggers the release of chemicals, such as histamine, which cause allergic symptoms like itching, swelling, and inflammation.

Pyogenic granuloma is the correct answer because it is characterized by an exuberant growth of granulation tissue in response to a minor trauma. This condition commonly occurs in the oral cavity and appears as a red, friable, and rapidly growing mass. Traumatic ulcer, traumatic neuroma, and traumatic fibroma are different conditions that do not specifically involve the exuberant growth of granulation tissue.

Among healthy patients, most primary herpes simplex virus infections are asymptomatic. This means that individuals do not exhibit any noticeable symptoms or signs of infection. While herpes labialis (cold sores) is a common manifestation of the herpes simplex virus, it is not the most prevalent outcome in healthy individuals. Acute herpetic gingivostomatosis refers to an acute infection of the gums and mouth, but it is less common in healthy patients. Central papillary atrophy is a condition characterized by red patches on the tongue, but it is not directly associated with primary herpes simplex virus infections.

In active immunity, antibodies are produced by the host itself. This is in contrast to passive immunity, where antibodies are obtained from an external source, such as a mother to her infant. Active immunity provides long-lasting protection as the host's immune system actively produces antibodies in response to an infection or vaccination. Therefore, the statement "antibodies are not produced by the host" contradicts the concept of active immunity.

Aspergillosis is a fungal infection that is commonly acquired by immunocompromised patients during hospital stays, especially when there is building renovation taking place. This infection is caused by the Aspergillus fungus and can affect various organs in the body, including the lungs, sinuses, and brain. The spores of the fungus can be present in the air and can be inhaled by patients with weakened immune systems. Aspergillosis can lead to severe respiratory symptoms and can be life-threatening if not treated promptly.

The correct answer is that memory B cells left behind after the primary response are not primed. Memory B cells are a type of white blood cell that are formed during the primary immune response and are responsible for providing long-term immunity. These cells are not primed, meaning they do not require further activation or stimulation to respond to the same antigen in the future. Instead, they are already "primed" and ready to quickly produce antibodies upon re-exposure to the antigen, leading to a faster and more effective secondary immune response.

Macrophages are immune cells that play a crucial role in the body's defense against foreign antigens. They eliminate these antigens by releasing powerful chemical signals called antibodies. These antibodies help to neutralize or destroy the foreign substances, preventing further harm to the body. Macrophages are present in various tissues and organs, but they are relatively rare in the lungs, kidneys, brain, and liver.