3S [LEC]: Autoimmune Disorders Flashcards
(144 cards)
1
Q
Which scientist introduced the concept of horror autotoxicus or fear of self poisoning?
A
Paul Ehrlich
2
Q
Which scientist introduced the concept of self tolerance?
A
Paul Ehrlich
3
Q
T/F: Paul Ehrlich’s concept of self tolerance was eventually disproven by other scientist
A
True
4
Q
Expression of IR that happens when it is unable to distinguish “self” from “non-self”
A
Autoimmunity
5
Q
The ability of the immune system to accept self-antigens and not initiate a response against them
A
Self-tolerance
6
Q
T/F: Autoimmunity involves the production of autoantibodies, auto-reactive cells, and B-cell mediated immune response
A
False (T-cell mediated IR)
7
Q
Happens when the immune system is unresponsive to antigens
A
Tolerance
8
Q
Type of tolerance that happens in the primary lymphoid organs
A
Central tolerance
9
Q
Type of tolerance where the self-reactive cells are destroyed via apoptosis
A
Central tolerance
10
Q
Type of tolerance involving secondary lymphoid organs
A
Peripheral tolerance
11
Q
T/F: Central tolerance can result from anergy caused by the absence of a costimulatory signal from APC or binding of inhibitory receptors such as CTLA-4
A
False (this happens in peripheral tolerance)
12
Q
Happens when the T-cells that express TCR with a strong affinity for self-death
A
Negative selection
13
Q
Negative selection process
A
Clonal deletion
14
Q
Unresponsiveness
A
Clonal anergy
15
Q
T/F: Anergy is associated with central tolerance
A
False (associated with peripheral tolerance)
16
Q
Which inhibitory co-receptor is responsible in clonal anergy?
A
CTLA-4 co-receptor
17
Q
Clonal anergy may occur when antigen is presented in the absence of which co-stimulatory molecule?
A
B7 (CD80/ CD86)
18
Q
Receptor for B7
A
CD28
19
Q
Peripheral suppression is associated with which immune cell/s that secrete TGF-B?
A
CD8+ T cells or macrophage
20
Q
Immune cell that is important in peripheral tolerance and downplays immune cells
A
T regulatory cells
21
Q
T/F: Cells that is attached to an MHC molecule but has no antigen peptide loaded are destroyed by the immune system
A
True
22
Q
T regulatory mainly secretes which cytokine that primarily inhibits IL1?
A
TGF-B
23
Q
Which gene expressed in the T regulatory cells promotes tolerance to fetal antigens?
A
FoxP3 gene
24
Q
This happens when immature T cells are destroyed and generation of CD4+
A
Central tolerance
25
This is induced when mature T cells recognize self antigen leading to anergy or death
Peripheral tolerance
26
This happens when self-reactive lymphocytes are suppressed by Treg
Peripheral tolerance
27
Which type of tolerance is associated with receptor editing?
Central tolerance
28
In central tolerance, which immature immune cell strongly reacts with self antigen and is involved in receptor editing?
B cells
29
T/F: In peripheral tolerance, immature B cells that recognize self antigen in peripheral lymphoid tissues become incapable of responding to the antigen
False (mature B cells)
30
T/F: There is a single gene that would cause autoimmune disorder
False
31
This happens when B cells are stimulated to rearrange immunoglobulin genes, triggered by BCRs that may weakly recognize self-antigens
Receptor editing
32
Autoimmune disease that is very strongly linked to HLA-B27
Ankylosing spondylitis
33
Autoimmune disease that is weakly associated with HLA-B8
Grave's disease
34
Autoimmune disease that is intermediately associated with HLA-Cw6
Psoriasis vulgaris
35
Autoimmune disease that is strongly associated with HLA-DR4
Rheumatoid arthritis
36
Autoimmune disease that is weakly associated with HLA-DR3
Sjogren's syndrome
37
Autoimmune disease that is weakly associated with HLA-DR3 and intermediately associated with HLA-DR2
Systemic lupus erythematosus
38
Autoimmune disease that is strongly associated with HLA-DR3
Celiac disease
39
Autoimmune disease that is strongly associated with HLA-DR4 and intermediately associated with HLA-DR3
DM Type 1
40
Immune cells that has a higher absolute count in women, making them more prone to the development of autoimmune disorders
CD4+ T cells
41
Which autoimmune disorder is more common to male, specifically having 1.2:1 ratio of male to female ratio
Crohn's disease
42
Autoimmune disorders are ___ times more frequent in women
2.7x
43
Inhibits the second signal in T-cell activation
CTLA4
44
Age range with the highest chance of developing autoimmune disorders
60-70 years old
45
Hormone that favors a Th2 response
Estrogen
46
Hormone that favors a Th1 response
Androgens
47
Hormone that can stimulate both humoral and cell-mediated immune response
Prolactin
48
Happens when microbial antigens closely resemble the structure of self-antigen and can trigger cross-reactions
Molecular mimicry
49
In the case of S. pyogenes infection, the produced antibody can react to which virulence factor that is cross-reactive with cardiac myosin?
M protein
50
Antibodies against ___ cross react with human fibronectin and collagen
T. pallidum
51
Antibodies against ___ cross react with insulin receptors
HPV E2
52
Antibodies against ___ cross react with basic myelin protein
Measles VP2
53
Antibodies against ___ cross react with acetylcholine receptors
Poliovirus VP2
54
Happens when microbes can induce a local inflammatory response that can also lead to epitope spreading
Bystander effect
55
Expansion of immune response to unrelated antigens
Epitope spreading
56
Proteins produced by microbes and can act as potent T-cell mitogens by activating a large number of T cells with different antigen specificities
Superantigens
57
Modifications in gene expression that are not caused by changes in original DNA sequence
Epigenetics
58
Changes occurring at protein level
Post-translational modifications
59
MHC class that binds with superantigens
MHC Class II
60
Characterized by persistent activation of immunologic effector mechanisms that alter the function and integrity of individual cells and organs
Autoimmune disorders (AID)
61
T/F: Patients may have more than 1 AID
True
62
What differentiates pernicious anemia and D. latum infection?
Achlorhydria (present in pernicious anemia)
63
Specific antibodies present in SLE patients
Anti-dsDNA, Anti-Sm
64
Antibody present in SLE patients that has a homogenous on FANA
Anti-dsDNA
65
Antibody present in SLE patients that has a coarse, speckled pattern on FANA
Anti-Sm
66
Genetic association in SLE
HLA-A1, B8, DR3
67
Diagnostic for SLE, very specific but only seen in 20-40% of SLE patients
Anti-Sm
68
Hypersensitivity reaction involved in SLE
Type III
69
Most frequent manifestation of SLE
Arthritis
70
Major cause of illness and death in SLE patients
Nephritis
71
Skin lesions present in SLE patients that presents central atrophy and scarring
Discoid rash
72
Other antibody present in SLE that is associated with increased miscarriage, stillbirth, protein delivery in pregnant women with lupus
Anti-phospholipid antibodies
73
Other antibody present in SLE that produces prolonged APTT and PT
Lupus anticoagulant
74
Widely distributed antibody in SLE that is especially associated with deep-vein and arterial thrombosis and recurrent pregnancy loss
Anti-phospholipid antibody
75
Procedure done to visualize LE cells
Mashed clot test
76
Most common cause of death of SLE patients
Renal failure and infection
77
A chronic progressive disease causing inflammation in the joints and resulting in painful deformity and immobility
Rheumatoid arthritis
78
T/F: Rheumatoid arthritis also affects the heart and lungs
True
79
Strongest environmental risk factor in RA patients
Cigarette smoking
80
Occurs in morning stiffness that lasts for one hour
Rheumatoid arthritis
81
Sheet of inflammatory granulation tissue that grows into the joint space and invades cartilage in RA
Pannus
82
Genetic association of rheumatoid arthritis
HLA-DRB1, PTPN22 gene polymorphisms
83
Antibodies present in rheumatoid arthritis
Rheumatoid factor, Anti-cyclic citrullinated peptide antibody (anti-CCP)
84
Pattern by antibodies present in rheumatoid arthritis in ANA
Speckled pattern
85
Autoimmune disorder that primarily presents as dry eyes and mouth due to chronic inflammation of exocrine glands
Sjogren's syndrome
86
Diagnostic antibody in Sjogren's syndrome
Anti SS-A/ Ro
87
Pattern seen in FANA showing Anti SS/ Ro present in Sjogren's syndrome
Fine speckled pattern
88
Excessive fibrosis and vascular abnormalities that affect the skin and joints that affect eventually other internal organs
Scleroderma/ System Sclerosis
89
The presence of this antibody in scleroderma presents better survival rate
Anti-centromere antibody
90
The presence of this antibody in scleroderma presents bad prognosis
Anti-topoisomerase I
91
The presence of this antibody in scleroderma presents good prognosis
Anti-RNA polymerase III
92
Antibody present in inflammatory myopathies
Anti-Jo-1
93
Antibody present in mixed connective tissue disease
Autoantibodies to U1-RNP
94
Rare autoimmune disorder that presents as inflammation of blood vesses
Wegener's granulomatosis
95
Immune cell that is most associated with Wegener's granulomatosis that induces macrophage and forms macrophages
Th1
96
Antibody present in Wegener's granulomatosis
Anti-neutrophil cytoplasmic antibody (ANCA)
97
Hypertrophy of eye muscles with bulging of eye ball, present in Grave's disease
Exophthalmos
98
This autoimmune disorder presents enlarged rubber and irregular thyroid
Hashimoto's thyroiditis
99
This autoimmune disorder presents diffusely enlarged and firm goiter
Grave's disease
100
Antibodies present in Hashimoto's thyroiditis
Antithyroglobulin
Antithyroid peroxidase (Anti-TPO)
101
Antibodies present in Grave's disease
Antithyroglobulin
Thyroid-stimulating hormone receptor antibodies
Antithyroid peroxidase (Anti-TPO)
102
Antibodies against zinc transporter (ZnT8) are present in which autoimmune disorder?
Type I Diabetes Mellitus
103
Autoimmune disorder affecting the small intestines and other organs
Celiac disease
104
Known environmental trigger of celiac disease
Dietary gluten
105
Antibody present in celiac disease
IgA Ab against tTG (tissue transglutaminase)
106
Method of choice for initial testing of celiac disease
IgA Ab against tTG (tissue transglutaminase)
107
Used for the confirmation of celiac disease diagnosis
Endomysial antibodies
108
Enzymes increased in autoimmune hepatitis
ALT, AST
109
Virus associated with autoimmune hepatitis
Hepatitis C virus
110
Antibody present in autoimmune hepatitis type 1
SMA Ab
111
Antibody present in autoimmune hepatitis type 2
Anti-LKM-1 and Anti-LC-1
112
Most common autoimmune liver disease
Primary biliary cholangitis/ cirrhosis
113
Most common autoimmune disease
Hashimoto's thyroiditis
114
The presence of anti-mitochondrial antibodies is one of the diagnostic criteria of which autoimmune disorder?
Primary biliary cholangitis/ cirrhosis
115
An autoimmune disorder involving inflammation and destruction of CNS
Multiple sclerosis
116
Autoimmune disorder that causes the formation of plaques in the white matter of the CNS that leads to progressive destruction of the myelin sheath
Multiple sclerosis
117
Specific T helper cell that is the center of pathogenesis of multiple sclerosis
Th1
118
Specific macrophage present in the CNS
Microglial cells
119
Virus that may be associated with multiple sclerosis
Epstein Barr Virus
120
T/F: Exposure to sunlight increases the likeliness of developing multiple sclerosis
False (reduced exposure)
121
Manifests as tingling or pins and needles that run down the spine and flashes of light seen on eye movement
Multiple sclerosis
122
Genetic association of multiple sclerosis
HLA DRB1
123
Present in the electrophoresis of CSF of multiple sclerosis patient
Oligoclonal band
124
Autoimmune disease that affects the neuromuscular junction
Myasthenia gravis
125
Present of antibody mediated damage to acetylcholine receptors
Myasthenia gravis
126
Manifests as ptosis, diplopia, and snarling appearance
Myasthenia gravis
127
Which lymphoid organ is associated with myasthenia gravis?
Thymus
128
A tumor of the thymus that may contain autoreactive T cells and may be present in the case of myasthenia gravis
Thymoma
129
T/F: Thymoma is present in late onset myasthenia gravis, while thymic hyperplasia is common in early onset MG
True
130
Gold standard for the identification of acetylcholine receptor antibody present in MG
Quantitative radioimmunoassay (RIA)
131
Radiolabel used in quantitative RIA in identification of acetylcholine receptor antibody
Alpha-bungarotoxin
132
Presence of autoantibodies to the basement membrane antigen in the glomerulus of the kidney or alveoli of the lungs
Goodpasture's syndrome
133
Genetic association of Goodpasture's syndrome
HLA-DRB1-15
134
Gold standard in the detection of anti-GBM
Indirect immunofluorescence
135
T/F: ESR & CRP are other tests that may be used in the diagnosis of Goodpasture's syndrome
True
136
Presence of autoantibodies against cortical elements
Addison's disease
137
A form of arthritis that primarily affects the spine, causing inflammation of the the joints of the vertebrae that leads to severe, chronic pain and discomfort
Ankylosing spondylitis
138
Most widely used and accepted test for autoimmune disorders
Fluorescent antinuclear antibody test
139
T/F: FANA can determine ANA titer, especially if moderate to high titer
True
140
Method of detecting the presence of autoantibodies in the serum
Fluorescent antinuclear antibody test
141
Standard substrate that is commonly used in Fluorescent antinuclear antibody test
HEp-2 cells
142
Secondary antibody used in Fluorescent antinuclear antibody test
Anti-human globulin
143
Indirect immunofluorescence uses ___ that possess a kinetoplast composed mainly of dsDNA
Crithidia luciliae
144
A secondary serologic test that can determine the immunologic specificity of a positive FANA especially for speckled patterns
Ouchterlony Test
