Question 1

Wickham striae is a term used to describe the oral mucosal lesions of:

Accepted Answer

Wickham striae describe the slender white lines seen in lichen planus. Linea alba is the white line on the buccal mucosa that extends anteroposteriorly along the occlusal plane. Frictional keratosis occurs when there is chronic cheek and tongue chewing and chewing on edentulous ridges. Erythema multiforme is an acute self-limited disease that affects the skin and mucous membranes. The skin lesions are described as iris, target, or bull's eye lesions. The mucosal lesions are superficial ulcerations.

Question 2

In which type of immune response do B-lymphocytes and antibodies play the predominant role?

Accepted Answer

B-lymphocytes produce antibodies in response to antigens, which is the primary mechanism of humoral immunity. Cell-mediated immunity involves T-lymphocytes and is focused on attacking infected cells directly. Immune complex reactions involve the formation of complexes between antigens and antibodies, which can lead to inflammation and tissue damage. Passive immunity involves receiving pre-formed antibodies from an outside source (such as through maternal transfer or injection of antibodies) rather than producing them internally.

Question 3

The breakdown of cellular adhesion between epithelial cells is called:

Accepted Answer

The breakdown of cellular adhesion between epithelial cells is called acantholysis. Acantholysis is a hallmark feature of certain autoimmune skin diseases, such as pemphigus vulgaris, in which autoantibodies target the desmosomes that hold epithelial cells together, leading to blistering and erosion of the skin and mucous membranes.

Question 4

Which lymphocyte matures without passing through the thymus and later can develop into a plasma cell that produces antibodies?

Accepted Answer

The B-lymphocyte matures without passing through the thymus and later can develop into a plasma cell that produces antibodies. The T-lymphocyte matures in the thymus before migrating to tissues. A macrophage is a large tissue-bound mononuclear phagocyte derived from monocytes circulating in the blood. The LE cell is an atypical mature neutrophil characteristic of lupus erythematosus and other autoimmune diseases.

Question 5

What is the most common precipitating factor in the development of aphthous ulcers?

Accepted Answer

Trauma, such as biting the inside of the cheek or tongue, is the most common precipitating factor in the development of aphthous ulcers. Other factors such as stress, hormonal changes, and certain foods may also play a role. Allergy and systemic disease are less common causes of aphthous ulcers, and citrus foods are not a common trigger.

Question 6

Which one of the following has not been associated with erythema multiforme?

Accepted Answer

Erythema multiforme has been associated with herpes simplex, histoplasmosis, and tuberculosis, but it has not been associated with HLA-B27.

Question 7

Certain recurrent ulcers appear on movable mucosa. They are discrete, round-to-oval ulcers that are 3 to 5 mm in diameter and exhibit a yellowish-white fibrin center surrounded by an erythematous halo. They are called:

Accepted Answer

These are characteristic features of minor aphthous ulcers, which typically occur on movable mucosa such as the tongue, lips, and cheeks. Major aphthous ulcers are larger, more painful, and take longer to heal, while herpetiform aphthous ulcers are smaller and have a cluster-like appearance. Sutton disease refers to a type of erythema multiforme characterized by target lesions on the skin.

Question 8

Which one of the following ulcers may require a biopsy to make the diagnosis?

Accepted Answer

The answer of Which one of the following ulcers may...

Question 9

An antigenic marker called HLA-B27 is present in most patients with:

Accepted Answer

HLA-B27 is present in most patients with Reiter syndrome, which is a type of reactive arthritis. It is not associated with the other conditions listed.

Question 10

A certain condition, thought to be a hypersensitivity reaction, is characterized by skin and mucous membrane lesions. The skin lesions are referred to as target, iris, or bull's eye lesions. The lip and mucosal lesions are more extensive and painful and often appear bloody and crusted. The intraoral lesions are extensive superficial ulcerations. The onset is explosive. On the basis of these clinical features, you suspect:

Accepted Answer

The target or iris lesions and the extensive superficial ulcerations on the mucous membranes are classic signs of erythema multiforme. The condition is thought to be a hypersensitivity reaction to various triggers such as viral infections, medication reactions, or autoimmune diseases.

Question 11

Which one of the following is an example of type I hypersensitivity?

Accepted Answer

Type I hypersensitivity involves the immediate release of IgE antibodies in response to an allergen, resulting in histamine release and symptoms such as asthma. Immune complexes (A), autoimmune hemolytic anemia (C), and serum sickness (D) are examples of type III hypersensitivity.

Question 12

Antihistaminic drugs are the principal method of treatment for:

Accepted Answer

Antihistaminic drugs are commonly used to treat urticaria, also known as hives, which is a skin rash characterized by itching and redness. Other treatments for urticaria may include avoiding triggers, using topical creams, and taking corticosteroids in severe cases. Antihistamines work by blocking the effects of histamine, a substance released by the body that causes allergic reactions.

Question 13

The diagnosis of lichen planus is made on the basis of:

Accepted Answer

The diagnosis of lichen planus is primarily based on clinical and histologic appearance. Clinical presentation includes appearance of characteristic papules and plaques with distinct clinical features. The diagnosis is confirmed by performing a biopsy and examining the histologic appearance of the lesion under a microscope. History and therapeutic medication may help in management of the condition but are not the primary diagnostic tools. Radiographic appearance is not typically used in the diagnosis of lichen planus.

Question 14

Which one of the following routes of drug administration can cause the most significant hypersensitivity reaction?

Accepted Answer

Parenteral administration involves injecting the drug directly into the bloodstream, which can quickly cause a systemic allergic reaction. Other routes, such as topical, patch, and oral, may cause localized or mild reactions but are unlikely to cause significant hypersensitivity reactions.

Question 15

Which of the following is a protein molecule that is produced by plasma cells and is also called an immunoglobulin?

Accepted Answer

Antibodies, also known as immunoglobulins, are protein molecules produced by plasma cells in response to an antigen. They are part of the body's immune system and help identify and neutralize foreign substances such as bacteria and viruses.

Question 16

Which of the following is a condition that involves a deficiency in number, function, or interrelationships of the involved white blood cells and their products?

Accepted Answer

Immunodeficiency refers to a lack of function or numbers of white blood cells and their products (such as antibodies), making the individual more susceptible to infections and diseases. Autoimmune diseases, like lupus or rheumatoid arthritis, involve the immune system attacking the body's own tissues. Leukocytosis is an increase in the number of white blood cells, which can be a response to infection or inflammation. Anaphylaxis is a severe allergic reaction that can cause symptoms like difficulty breathing or a drop in blood pressure.

Question 17

An example of natural passive immunity would occur when:

Accepted Answer

When antibodies from a mother pass through the placenta to the developing fetus, it is an example of natural passive immunity. This is because the immunity is acquired passively (rather than actively producing antibodies through exposure or vaccination) and is a natural process that occurs between mother and child.

Question 18

A prodromal period begins:

Accepted Answer

The prodromal period typically begins one to two days before the onset of symptoms such as ulcers, indicating the early signs of an impending outbreak.

Question 19

Which one of the following is not a component of Reiter syndrome?

Accepted Answer

Wickham striae are not a component of Reiter syndrome. Reiter syndrome is a type of reactive arthritis that typically involves the triad of arthritis, urethritis, and conjunctivitis. Geographic tongue-like lesions can also sometimes be seen in Reiter syndrome.

Question 20

Which one of the following is not a specific component of immunity?

Accepted Answer

A humoral response, a cell-mediated response, and memory are all specific components of immunity. Pavementing, however, is not a specific component of immunity but rather a cellular process in which white blood cells adhere to the walls of blood vessels.

Quiz 3: Immunity and Immunologic Oral Lesions