Perio Exam 2 Mock Test questions

All of the following are classic symptoms of acute inflammation, EXCEPT:

Bruising

All of the following are components of the immune system, EXCEPT:

Hemidesmosomes

Chronic inflammation is a pathological condition characterized by tissue destruction. In chronic inflammation, the inflammatory process can become so intense that it inflicts permanent damage to body tissues.

Both statements are true

In which stage of inflammation is pain a common symptom?

Acute inflammation

The primary purpose of the immune system is to:

Defend the life of the host (the individual)

Which of the following is a normal process that protects and heals the body?

Acute inflammation

Which of the following is defined as a complex series of proteins circulating in the bloodstream that facilitates the destruction of bacteria by phagocytosis or puncturing bacterial cell membranes?

Compliment system

Which of these immune cells secrete antibodies?

B‑lymphocytes

Which leukocyte is the first to arrive at the site of inflammation?

Neutrophil

Which cell is most commonly found in chronic inflammation?

Macrophage

Cytokines that play an important role in periodontitis are:

IL-1, IL-6, IL-8, and TNF

If the bacterial pathogens in early gingivitis continue to proliferate, what is the next phase of disease progression?

Advanced lesion

In which of the following phases of periodontal disease progression are all the usual clinical features of gingivitis present?

Established gingivitis phase

The immune biochemical mediators secreted by the immune cells are responsible for which of the following tissue destruction seen in periodontitis?

All of these choices

The primary purpose of the immune system when it responds to a bacterial infection of the periodontium is to:

Defend the life of the host (the individual with the bacterial infection)

When neutrophils rush to the site of infection of the periodontium, they release substances that destroy healthy gingival connective tissue. What is the advantage of connective tissue destruction in this instance?

This creates a pathway for the neutrophils to move quickly through the tissue

Which of the following is the cause of nearly all the tissue destruction seen in periodontitis?

Host Response

Which phase of periodontal disease progression is characterized by permanent tissue destruction?

Advanced Lesion

When RANKL is dominating over OPG, the result will be:

Bone resorption

A family of enzymes that degrade collagen and other connective tissue components is categorized as:

Matrix metalloproteinases (MMP)

All of the following substances are released by the host response to bacterial biofilm EXCEPT one. Which one?

Lipopolysaccharide endotoxin

Bone resorption occurs when osteoclasts are stimulated by ________________ to resorb alveolar bone.

RANKL

During which Page & Schroeder phase of pathogenesis does plasma cells predominate and activate antibodies.

Established lesion

During which Page and Schroeder phase of pathogenesis are osteoclasts stimulated?

Advanced lesion

MMPs are released only by macrophages. The most important MMP involved in periodontal disease is PGE2.

Both statements are false

1. Most of the bone destruction in periodontitis is due to this

2. Initiate tissue destruction and bone loss

3. Causes extensive collagen destruction

A.Cytokines

B. MMP

C. PGE-2

1C, 2A, 3B

Neutrophils live for long periods of time in inflammation.

False

Phagocytosis is the process best described as the ability of WBCs to:

Engulf and destroy microorganisms

The part of the complement system that coats the surface of the bacteria allowing for phagocytosis:

Opsonization

The body's response to inflammation can damage or destroy important host tissues like the PDL and alveolar bone.

True

The cytokine Interleukin-1, induces breakdown of collagen matrix in gingiva, PDL fibers and alveolar bone. It also stimulates osteoclasts.

True

The first host defense cell to arrive at an area of tissue injury is:

Neutrophil

The formation of the antigen/antibody complexes by B cells activates this system:

Complement

The movement of neutrophils to the site of invading microorganisms is called:

chemotaxis

The WBC associated with chronic inflammation is the:

Macrophage

Bacteria associated with periodontal disease are most effectively phagocytized by:

Neutrophil

Cells that destroy alveolar bone are called:

osteoclasts

Diapedisis is:

the way bacteria squeeze through the blood vessel to get into the tissues

In response to a microbial challenge, host immune cells secrete biologically active compounds called:

chemical mediators

Margination is:

The buildup of RBCs in the center and movement of WBCs to the periphery of the blood vessel walls.

The best way to stop the sequence of events that unfolds in the inflammatory and infectious process of gingivitis and periodontitis caused by the biofilm and bacteria is to (what can we do as dental hygienists):

Remove the bacteria

Which cell is the MAJOR source of PGE-2 in the periodontal tissues?

 Macrophages

The most active WBC in the periodontal pocket is the:

Neutrophil

Which immune cell is primarily responsible for forming a protective barrier between subgingival biofilm and the junctional epithelium?

Neutrophils

Excessive production of PGE‑2 in periodontal tissues leads to which of the following outcomes?

Increased osteoclast activity and bone resorption

Which event occurs FIRST during the movement of neutrophils from the bloodstream into infected periodontal tissues?

Margination

Which of the following best describes the role of complement activation in periodontal disease?

It enhances phagocytosis by coating bacterial surfaces

Which cell type becomes the predominant inflammatory cell in chronic periodontitis?

Macrophages

Which of the following is the MOST effective method for interrupting the inflammatory cascade in gingivitis and periodontitis?

Mechanical removal of biofilm

Which chemical mediator is MOST responsible for collagen breakdown and connective tissue destruction in periodontal disease?

Interleukin‑1 (IL‑1)

During diapedesis, leukocytes pass through which structure?

Endothelial cell junctions of blood vessels

Which immune component is responsible for recognizing antigens and producing specific antibodies?

B‑cells

Which of the following best describes chemotaxis in periodontal inflammation?

Directed movement of neutrophils toward bacterial products

Which cell is primarily responsible for destroying alveolar bone during periodontitis?

Osteoclast

Neutrophils form the first line of defense against subgingival biofilm.

True

Which chemical mediator is MOST associated with stimulating osteoclasts and bone resorption?

IL-1

The process of WBCs adhering to the vessel wall before exiting into tissues is called:

Pavementing

Which immune cell becomes the dominant cell type in chronic periodontal inflammation?

Macrophage

PGE‑2 is primarily produced by macrophages in periodontal tissues.

True

Which event occurs LAST during neutrophil recruitment to periodontal tissues?

Chemotaxis

The complement system enhances phagocytosis by coating bacterial surfaces. This is known as:

Opsonization

Which cell is MOST active inside the periodontal pocket?

Neutrophil

Diapedesis refers to the movement of bacteria through blood vessels.

False

Which mediator is responsible for increasing vascular permeability during inflammation?

Histamine

The BEST way to interrupt the inflammatory cascade in gingivitis is:

Mechanical removal of biofilm

Which immune cell produces antibodies?

B‑cells

Margination occurs because blood flow slows and RBCs move to the center of the vessel.

True

Which mediator is MOST responsible for connective tissue breakdown in periodontitis?

MMPs

Which cell releases enzymes that can contribute to host tissue destruction when present in excess?

Neutrophils

Chemotaxis is triggered by bacterial products and host‑derived mediators.

True

Which of the following is a hallmark of chronic inflammation in periodontal disease?

Dominance of macrophages and plasma cells

The complement membrane attack complex (MAC) functions by:

Punching holes in bacterial membranes

The junctional epithelium becomes more permeable during inflammation, allowing more WBCs to enter the sulcus.

True

 Individuals with well‑controlled diabetes have periodontal disease levels comparable to:

Individuals without diabetes

High susceptibility to infection in diabetes occurs when A1C is:

8%

Which glucose finger‑stick value indicates unacceptable treatment range?

300 mg/dL

The primary reason diabetics experience accelerated periodontal destruction is:

Hyperinflammatory host response

AGE‑RAGE interaction in diabetes leads to:

Exaggerated inflammation and impaired repair

Chronic stress elevates which hormone with immunosuppressive effects?

Cortisol

Pubertal gingivitis is primarily related to:

Changes in subgingival microbial composition

Pregnancy gingivitis is most severe during which trimester(s)?

2nd and 3rd

Increased progesterone during pregnancy causes:

Enhanced capillary permeability and edema

A pyogenic granuloma is best described as:

Noncancerous gingival overgrowth related to plaque

Menopausal gingivostomatitis presents as:

Pale, dry, shiny gingiva that bleeds easily

Bisphosphonate‑related osteonecrosis of the jaw is associated with:

Painful exposed bone that fails to heal

Metabolic syndrome contributes to periodontitis because it is a:

Low‑grade chronic inflammatory condition

HIV‑associated linear gingival erythema is characterized by:

2–3 mm red band at the free gingiva

Linear gingival erythema differs from gingivitis because it:

Does not resolve with biofilm removal

Down syndrome patients have increased periodontitis risk primarily due to:

Impaired neutrophil chemotaxis and phagocytosis

Leukemia‑associated gingivitis typically presents as:

Swollen, spongy, deep‑purple tissues

Oral mucositis from chemotherapy is caused by:

Rapid death of mucosal cells

Radiation‑induced xerostomia increases risk for:

Oral candidiasis and caries

Neutropenia is defined as neutrophil counts below:

1500 cells/µL

Individuals with uncontrolled diabetes exhibit increased periodontal destruction primarily because of:

Hyperinflammatory immune response

Which glucose value indicates increased risk of infection for a diabetic patient at an appointment?

200 mg/dL

Pregnancy‑associated gingivitis is most strongly linked to increased levels of:

Progesterone

Which oral manifestation is MOST characteristic of HIV infection?

Linear gingival erythema

Down syndrome patients have increased susceptibility to periodontitis primarily due to:

Impaired neutrophil function

Metabolic syndrome contributes to periodontitis because it is a:

Low‑grade chronic inflammatory condition

Oral mucositis in chemotherapy patients occurs because:

Rapidly dividing mucosal cells are destroyed