8 - Autoimmune Diseases

Question 1

Autoreactive B cells and autoantibodies

Answer 1

Directly cytotoxic
Activation of complement
Interfere with normal physiological function

Question 2

Autoreactive T cells

Answer 2

Directly cytotoxic

Inflammatory cytokine production

Question 3

Hashimotos thyroiditis

Answer 3

Destruction of thyroid follicles by autoimmune process
Associated with autoantibodies to thyroglobulin and to thyroid peroxidase
Leads to hypothyroidism

Question 4

Grave’s disease

Answer 4

Inappropriate stimulation of thyroid gland by anti-TSH-autoantibody
Leads to hyperthyroidism

Question 5

Failure of vitamin B12 absorption leads to what type of anaemia

Answer 5

Pernicious anaemia

Question 6

Type of non-specific tests

Answer 6

Inflammatory marker

Question 7

Type of disease specific diagnostic test

Answer 7

Autoantibody testing

HLA typing

Question 8

What does HLA stand for?

Answer 8

Human leukocyte antigen

Question 9

What are non-specific markers of systemic inflammation

Answer 9

ESR
CRP
Ferritin
Fibrinogen
Haptoglobin
Albumin
Complement

Question 10

What treatments are there for autoimmune issues?

Answer 10

Supportive
Immunosuppression
Preventative

Question 11

Anti-nuclear antibodies

Answer 11

Bind to skin cells that have been damaged by UV light.

Involved in SLE so the immune system forms antibodies against proteins and DNA in the nuclei of cells

Question 12

What is SLE?

Answer 12

Systemic lupus erythematous

Question 13

SLE: common features

Answer 13

Photosensitivity, malar rash, alopecia, mouth ulcers, arthralgia, arthritis, fatigue

Question 14

SLE: internal organ involvement and problems with them

Answer 14

Kidney: lupus nephritis
Lung: pleurisy / pleural effusion
Brain: cerebral lupus, seizures, strokes

Question 15

SLE: testing

Answer 15

Antinuclear antibodies

Question 16

SLE: treatment

Answer 16

Immunosuppression

Question 17

What is vasculitis?

Answer 17

Inflammation of small vessels

Question 18

What does ANCA stand for?

Answer 18

Anti-neutrophil cytoplasmic antibodies

Question 19

3 types of ANCA vasculitis

Answer 19

Microscopic polyangiitis (MPA)
Granulomatosis with polyangiitis (GPA)
Eosinophilic granulomatosus with polyangiitis (EGPA)

Question 20

What is a granuloma?

Answer 20

Mass of inflamed tissue

Question 21

What is polyangiitis?

Answer 21

Many vessels inflamed

Question 22

How does a granuloma cause damage? Which areas?

Answer 22

Destructive lesions

e.g. nose, sinus, trachea, lung, orbits

Question 23

Where does inflammation of small vessels cause most damage?

Answer 23

Skin
Kidney
Lung
Gut

Question 24

Which Ab are involved in Reynaud’s?

Answer 24

Anticentromere Ab

Question 25

What is primary Reynaud’s?

Answer 25

Common in young women
Runs in families
ANA negative
Fairly harmless

Question 26

What is secondary Reynaud’s?

Answer 26

ANA positive

May be associated with scleroderma

Question 27

Main features of scleroderma

Answer 27

Autoimmunity leads to ischaemia and fibrosis

Raynaud’s phenomenom, skin thickening and tightening in fingers and face

Question 28

Internal organ involvement for scleroderma

Answer 28

Fibrosis may affect lungs, gut, kidneys

Question 29

Testing for Scleroderma

Answer 29

Anti-nuclear antibodies

Question 30

Treatment for scleroderma

Answer 30

Immunosuppression