Oral Pathology for the Dental Hygienist, 7th Edition Ibsen: chapter 2

Chapter 02: Inflammation and Repair Ibsen: Oral Pathology for the Dental Hygienist, 7th Edition MULTIPLE CHOICE 1. A decrease in the size and function of a cell, a tissue, an organ, or the body is referred to as a. emigration. b. atrophy. c. hyperplasia. d. phagocytosis. ANS: B Atrophy is defined as a decrease in the size and function of a cell, a tissue, an organ, or the whole body. Emigration is the passage of white blood cells through the endothelium and wall of the microcirculation into the injured tissue. Hyperplasia is the enlargement of a tissue or organ resulting from an increase in the number of normal cells. Phagocytosis is the process of ingestion and digestion of particulate material by cells. REF: Reactive Tissue Response, page 43 OBJ: 8 2. The first response of the body to injury is a. anaphylaxis. b. erythema. c. fever. d. inflammation. ANS: D The inflammatory response is the first reaction to injury, and it involves a series of microscopic events. Anaphylaxis is a severe type of hypersensitivity or allergic reaction in which there is an exaggerated immunologic reaction resulting from the release of vasoactive substances such as histamine. Erythema is redness of the skin or mucosa and is a local sign of inflammation. Fever is the elevation of the normal body temperature and is a systemic sign of inflammation. REF: Inflammation, page 34 OBJ: 1 3. Which type of inflammation occurs when the injury is minimal and brief and its source is removed from the tissue? a. Acute b. Chronic c. Local d. Systemic ANS: A Acute inflammation occurs when the injury is minimal and brief. Chronic inflammation occurs when the inflammatory response lasts for longer periods, even indefinitely. Local is a term used to describe a specific area of inflammation. Systemic factors such as fever, leukocytosis, and lymphadenopathy occur when the injury is extensive. REF: Inflammation, page 34 OBJ: 2 4. Which cell is the first to arrive at the site of injury and is the primary cell type involved in acute inflammation? a. Macrophage b. Neutrophil c. Plasma cell d. Mast cell ANS: B The neutrophil is the first cell to arrive at the site of injury and is the primary cell type involved in acute inflammation. The macrophage is the second cell type to participate in the inflammatory response. The plasma cell is involved in chronic inflammation. The mast cell participates in both the inflammatory and immune responses. REF: White Blood Cells in the Inflammatory Response, page 38 OBJ: 4 5. Which symptom is not a classic local sign of inflammation? a. Redness b. Swelling c. Leukocytosis d. Loss of normal tissue function ANS: C Leukocytosis is an increase in the number of white blood cells and is a sign of systemic inflammation. Redness is a local clinical change at the site of injury and is one of the classic local signs of inflammation. Swelling is a local clinical change observed at the site of injury and is one of the classic localNsigRns oIf inGflamBm.aCtionM. Loss of normal tissue function at the site of injury is a classic local sign of inflammation. REF: Leukocytosis, page 41 OBJ: 5 6. Healing of an injury with little tissue loss, such as a surgical incision, is referred to as healing by which type of intention? a. Tertiary b. Keloid c. Secondary d. Primary ANS: D Healing by primary intention occurs when there is very little loss of tissue. The clean edges of the surgical incision are joined with sutures, and very little granulation tissue forms. Healing by tertiary intention occurs when an infection develops at the site of a surgical incision that is healing by primary intention. Healing by secondary intention may ensue. Keloid formation is excessive scar tissue development that can occur in healing by secondary intention when there is a significant loss of tissue. Healing by secondary intention occurs when the injury involves significant loss of tissue and the edges of the injury cannot be joined during healing. A large clot forms, resulting in an increase in granulation tissue. REF: Healing by Primary Intention, page 45 OBJ: 11 7. The wearing away of tooth structure during mastication is termed a. attrition. b. erosion. c. abrasion. d. abfraction. ANS: A Attrition is defined as the wearing away of tooth structure during mastication. Erosion is the loss of tooth structure from chemical action. Abrasion is a pathologic wearing of tooth structure resulting from a repetitive mechanical habit. Abfraction is the result of biomechanical forces on the teeth. REF: Attrition, page 46 OBJ: 14 8. The loss of tooth structure seen in bulimia is caused by a. anorexia. b. erosion. c. attrition. d. bruxism. ANS: B Generalized erosion, especially on the lingual surfaces of maxillary anterior teeth, is caused by frequent vomiting in patients with bulimia. Patients with anorexia nervosa do not vomit after eating. Attrition is the wearing away of tooth structure during mastication. Bruxism occurs when there is nonfunctional grinding or clenching of the teeth. REF: Erosion, page 48 OBJ: 14 9. A patient comes to the office for an emergency visit complaining of a toothache in the left posterior mandible. On clinical examination you notice a gray-to-white patch on the left posterior buccal mucosa. On questioning, the patient tells you that this area is also painful. After reviewing the patient’s medical history, you question the patient regarding his recent use of a. hydrogen peroxide. b. aspirin. c. antibiotics. d. mouthwash. ANS: B This is a classic case of aspirin burn caused by the misuse of aspirin. The patient placed aspirin near the tooth that was aching; thus necrosis of the mucosa occurred, resulting in the painful white patch on the buccal mucosa. A chemical burn from the use of hydrogen peroxide would be more diffuse, probably bilateral, and not a white plaque. Antibiotics would be taken systemically and