Deck 4: Immunologic Disease

Question 1

All of the following are nonspecific defense mechanisms of the body EXCEPT:

A) Tears
B) Mucous membranes
C) T and B lymphocytes
D) Clotting system

Answer 1

T and B lymphocytes

Question 2

Humoral immunity involves the elimination of antigen-antibody complexes via the:

A) Complement system, spleen, and liver
B) Bone marrow
C) Adenoids and tonsils
D) Thymus gland and appendix

Answer 2

Complement system, spleen, and liver

Question 3

Which of the following long-lived mobile cells is able to recognize and respond to antigens?

A) Lymphocytes
B) Megakaryocytes
C) Thrombocytes
D) Erythrocytes

Answer 3

Lymphocytes

Question 4

Anaphylactic reactions are:

A) Type 1 hypersensitivity reactions that are generalized and systemic
B) Also known as atopic reactions
C) Type 2 cytotoxic reactions
D) Also known as Rhesus reactions

Question 5

Together, B and T lymphocytes represent what percentage of all white blood cells?

A) 80%
B) 50%
C) 20%-25%
D) 10%-15%

Question 6

Cytotoxic T cells directly attack cells carrying foreign antigens and are designated as:

A) CD4⁺
B) CD8⁺
C) CD12⁺
D) CD16⁺

Question 7

Allergic contact dermatitis is an example of a:

A) Type 1 hypersensitivity reaction
B) Type 2 hypersensitivity reaction
C) Type 3 hypersensitivity reaction
D) Type 4 hypersensitivity reaction

Question 8

Immune cells may communicate by direct physical contact or by releasing and responding to proteins called:

A) Cytokines
B) Antigens
C) Histamines
D) Granules

Question 9

Systemic lupus erythematosus is an example of a: A . Type 1 hypersensitivity reaction

A) Type 2 hypersensitivity reaction
B) Type 3 hypersensitivity reaction
C) Type 4 hypersensitivity reaction

Question 10

In active immunity:

A) The response is not influenced by inherited genes.
B) The response cannot occur through antigen exposure.
C) Antibodies are received through the placenta.
D) Antibodies are produced in response to an antigen.

Question 11

Which of the following is NOT one of the three main categories of immunopathology?

A) Hypersensitivity reactions
B) Autoimmune diseases
C) Infectious diseases
D) Immune deficiency diseases

Question 12

Which of the following are labels of self in the human immune system?

A) Antigens
B) Haptens
C) Germinal centers
D) Major histocompatibility complexes

Question 13

Which cell becomes a plasma cell and produces antibodies?

A) Mast cell
B) T cell
C) Polymorphonuclear neutrophil
D) B cell

Question 14

Cell-mediated hypersensitivity, also known as delayed hypersensitivity, usually develops over:

A) 6-12 hours
B) 12-24 hours
C) 24-72 hours
D) 72-120 hours

Question 15

Which immunoglobulin accounts for approximately 80% of all antibodies in serum?

A) IgA
B) IgG
C) IgM
D) IgE

Question 16

All of the following are characteristics of adaptive or acquired immunity EXCEPT:

A) Memory
B) Specific
C) Present at birth
D) Tolerance

Question 17

Which of the following is NOT a part of normal lymph node structure?

A) Medulla
B) Zona fasciculata
C) Paracortex
D) Germinal centers

Question 18

Lymphoid organs are critical to the immune system and include all of the following EXCEPT the:

A) Lymph nodes
B) Thymus
C) Parotid gland
D) Peyer's patches and the appendix

Question 19

Granulocytes are immune cells that can destroy microorganisms and include all of the following EXCEPT:

A) Neutrophils
B) Eosinophils
C) Mast cells
D) Natural killer (NK) cells

Question 20

Phagocytes:

A) Do not participate in the immune system
B) Are oxygen- and carbon dioxide-binding cells
C) Are not found in the lungs, kidneys, brain, or liver
D) Can ingest and digest microbes and other foreign particles

Question 21

Erythema multiforme most commonly occurs in:

A) Young adult females
B) Elderly females
C) Elderly males
D) Young adult males

Question 22

Which of the following is an example of an autoimmune disease with only single organ failure?

A) Graves' disease
B) Rheumatoid arthritis
C) Lupus erythematosus
D) Sjögren syndrome

Question 23

A patient taking highly active anti-retroviral therapy (HAART):

A) Is being treated for HIV infection
B) Has herpes zoster
C) Has cyclic neutropenia
D) Is undergoing preparation for transplant surgery

Question 24

Cinnamon stomatitis is an allergic reaction to cinnamon oil (cinnamon aldehyde). Lesions associated with chronic exposure most often present as:

A) Thick, white, painful plaques
B) Red areas with a bleeding base
C) Ulcerated, punched-out interdental papillae
D) Recurrent aphthous stomatitis

Question 25

Which form of recurrent aphthous stomatitis resembles herpes simplex infection?

A) Herpetiform
B) Major
C) Traumatic
D) Subacute

Question 26

Secondary immunodeficiencies are acquired and develop after birth. They may be caused by all of the following EXCEPT:

A) Corticosteroid therapy
B) Radiation
C) Antibody replacement therapy
D) Diabetes

Question 27

Which of the following is NOT an immunosuppressive medicine?

A) Prednisone
B) Cyclophosphamide
C) Erythromycin
D) Tacrolimus

Question 28

Which of the following is not considered a predisposing factor for developing recurrent aphthous ulcers?

A) Decreased mucosal barrier
B) Increased antigenic exposure
C) Inherited or acquired immunodysregulation
D) Pregnancy

Question 29

Which of the following factors is NOT characteristic of Behçet disease?

A) It is seen primarily in patients with Turkish, Japanese, or Eastern Mediterranean ancestry.
B) It is a leading cause of oral cancer.
C) Oral lesions are present in 99% of the cases.
D) It is a leading cause of blindness.

Question 30

Which of the following is the most commonly occurring type of aphthous ulcers?

A) Major
B) Minor
C) Traumatic
D) Herpetiform

Question 31

DiGeorge syndrome is a developmental defect that results in:

A) An impaired immune system
B) Decreased susceptibility to viral, protozoan, and fungal infections
C) Failure of the thyroid to develop resulting in an impaired immune system
D) Failure of the teeth to form resulting in anodontia

Question 32

Which of the following is NOT characteristic of autoimmune diseases?

A) They tend to run in families.
B) Their prevalence is decreasing.
C) They cause the immune system to attack normal tissues.
D) They involve both an immune and inflammatory response.

Question 33

All of the following are characteristics of typical minor aphthous ulcers EXCEPT:

A) They appear as shallow ulcers between 3 and 8 mm in diameter.
B) There is a yellow necrotic center.
C) They have raised or rolled borders.
D) There is an erythematous halo around the ulceration.

Question 34

Major aphthous ulcers differ from minor and herpetiform types in all of the following ways EXCEPT:

A) Major aphthous ulcers are larger and deeper and take longer to heal.
B) Major aphthous ulcers are associated with the herpes simplex virus.
C) Healing of the major aphthous ulcer is accompanied with scarring.
D) Major aphthae have rolled, irregular borders.

Question 35

What oral condition has become relatively common and is linked to oral health-care products containing essential oils, herbal additives, and whitening and anti-calculus agents?

A) Candidiasis
B) Aphthous ulcer
C) Pericoronitis
D) Plasma cell gingivitis

Question 36

Women who suffer from frequent recurrent aphthous ulcers often report remission from the lesions:

A) With diligent oral home care
B) Around puberty
C) During pregnancy
D) During menopause

Question 37

Ulcers of cyclic neutropenia differ from those of recurrent aphthous stomatitis in that they:

A) May lead to oral cancer
B) Rarely ever heal
C) Most often heal with excessive scarring
D) Occur on keratinized mucosa

Question 38

Oral lichen planus may mimic recalcitrant gingivitis. How is a definitive diagnosis established?

A) With a biopsy
B) By cytological smear of desquamated gingival tissues
C) By clinical inspection and the presence of striae
D) With development of periodontal pockets and loss of epithelial attachment

Question 39

Allergic contact mucositis has been associated with all of the following materials EXCEPT:

A) Denture acrylics
B) Latex rubber dam material
C) Wooden toothpicks
D) Toothpastes and mouth rinses

Question 40

Which of the following describes the classic lesions of erythema multiforme on the skin?

A) Vesicles and bullae
B) Target lesions
C) Ulcerations
D) Pruritic exanthem

Question 41

Which of the following is NOT characteristic of mucous membrane pemphigoid?

A) Lesions are preceded by the formation of a vesicle or bulla.
B) It is linked to infection with herpes simplex virus type 1.
C) Topical steroid treatment is recommended for mild cases.
D) The shallow, mildly tender ulcers typically heal in 7 to 10 days.

Question 42

A biopsy of pemphigus shows a split in the epithelium above the basal layer. Which of the following is affected?

A) Desmosomes
B) Hemidesmosomes
C) Laminins
D) Pytoxins

Question 43

What does cicatricial mean?

A) The disease occurs in multiple cycles.
B) Cycles of the disease alternate between vesicles and bullae.
C) The disorder is characterized by scarring.
D) The disorder resolves completely without scarring.

Question 44

In mucous membrane pemphigoid, autoantibodies are produced against what structural units that bind the epithelial cells to each other?

A) Desmosomes
B) Hemidesmosomes
C) Desmogleins
D) Pemphigleins

Question 45

Crohn's disease is also known as regional enteritis because:

A) It alternately affects and skips some portions of the GI tract.
B) There are no systemic manifestations outside of the GI tract.
C) It alternately affects and skips some areas of the oral cavity.
D) The disorder only affects the oral cavity and esophagus.

Question 46

Acute graft-versus-host disease, a condition seen in bone marrow transplant recipients, typically occurs within:

A) 100 days of the transplant
B) 4 to 5 months of the transplant
C) 7 to 9 months of the transplant
D) 12 months of the transplant

Question 47

Orofacial granulomatosis can affect any oral tissue, but most frequently involves which of the following?

A) Hard palate
B) Soft palate
C) Lips
D) Gingiva

Question 48

Signs of sarcoidosis that may be observed in the dental office include all of the following EXCEPT:

A) Lupus pernio
B) Xerophthalmia
C) Excessive watery eyes
D) Hoarseness or change in voice quality

Question 49

Urticaria is:

A) Diagnosed with a cytological smear
B) Characterized by shallow ulcerations
C) A type 1 hypersensitivity reaction related to histamine production
D) Not immunological

Question 50

The hereditary form of angioedema is associated with:

A) Development of erythema multiforme
B) Linear IgA disease
C) Excess C1 esterase production
D) Lack or defect in C1 estease

Question 51

All of the following are characteristics of angioedema EXCEPT:

A) It may be hereditary or acquired.
B) The etiology is most often viral or bacterial.
C) There is typically edema of the soft tissues rather than a wheal or flare.
D) Severe symptoms may require immediate medical attention.

Question 52

Characteristics of acute graft-versus-host disease include all of the following EXCEPT:

A) Rash similar to erythema multiforme
B) Gastrointestinal (GI) symptoms
C) Liver dysfunction
D) Myocardial infarction

Question 53

Raynaud phenomenon is considered to be one of the first signs of:

A) Melkersson-Rosenthal syndrome
B) Erythema multiforme
C) Scleroderma
D) Crohn's disease

Question 54

Cicatricial pemphigoid can sometimes lead to:

A) Premalignant epithelial dysplasia
B) Giant aphthous ulcerations
C) Symblepharon and blindness
D) Cyclic neutropenia

Question 55

About half of all systemic lupus erythematosus patients will develop:

A) Proteinuria and nephrotic syndrome
B) Myocardial infarction
C) Cyclic neutropenia with major aphthae
D) Targetoid lesions with necrotic centers

Question 56

Mild trauma to the oral mucosa that induces vesicle and bulla formation and sloughing of the tissue is referred to as:

A) Neuropathy
B) Targetoid
C) Nikolsky sign
D) Erosion

Question 57

Clinically chronic ulcerative stomatitis most closely resembles:

A) Major aphthous ulcers
B) Herpes zoster
C) DiGeorge syndrome
D) Erosive lichen planus

Question 58

What is the combination of sarcoidosis of the salivary glands, uveitis, and facial nerve paralysis called?

A) Discoid lupus syndrome
B) RAU syndrome
C) Stevens-Johnson syndrome
D) Heerfordt's syndrome

Question 59

Patients with systemic lupus erythematosus develop what type of antibodies?

A) Antidesmosome
B) Antinuclear (ANAs)
C) Anti-Jones (JNS)
D) Hemidesmosomal

Question 60

Cobblestone appearance of the buccal mucosa and nonpainful swelling of the lips are features of:

A) Systemic lupus erythematosus
B) Crohn's disease
C) Sarcoidosis
D) Sjögren syndrome

Question 61

The most common symptom of Sjögren syndrome is:

A) Acute pain in the parotid and other major salivary glands
B) Xerostomia associated with dysphagia and dysgeusia
C) Chronic pain in the parotid and other major salivary glands
D) GI bleeding and umbilical hernia

Question 62

What condition affecting the teeth is associated with severe oral dryness?

A) Rampant dental caries
B) Accelerated dental erosion and abrasion
C) Severe periodontal disease
D) Bruxism

Question 63

Clinical features of scleroderma include all of the following EXCEPT:

A) Ulcerations due to vascular changes
B) Obliteration of the periodontal ligament space
C) Inability to open mouth
D) Contraction of fingers and hands

Question 64

Sjögren's syndrome can best be described as a(n):

A) Acute, contagious infectious disease
B) Sexually transmitted disease
C) Acute inflammatory autoimmune disorder
D) Chronic inflammatory autoimmune disorder