Autoimmune Diseases

Question 1

Autoimmunity

Answer 1

Breakdown of self tolerance. Genetically determined

Question 2

Autoimmune diseases

Answer 2

Distinct autoimmune processes with distinct clinical entities-environmental factors acting on favourable genetic background

Question 3

Which cells have HLA type 1

Answer 3

All cells

Question 4

Which cells have HLA type 2

Answer 4

Professional APCs

Question 5

Central tolerance

Answer 5

B cell tested against self antigens and deleted if they don’t react. This results in auto-reactive B cells in the bone marrow.

Question 6

Peripheral tolerance

Answer 6

If some cells in the blood react against self antigens, regulatory processes e.g. in the lymph nodes, protect against this.

Question 7

Who is most likely to develop autoimmune diseases?

Answer 7

Females. Elderly. environmental triggers include infection, trauma, and smoking

Question 8

2 examples of Autoimmune thyroid disease

Answer 8

Hashimotos Thyroiditis

Grave’s disease

Question 9

Hashimotos Thyroiditis

Answer 9

Destruction of thyroid follicles by autoimmune process leads to hypothyroidism

Question 10

Grave’s Disease

Answer 10

Inappropriate stimulation of thyroid gland by TSH receptor-stimulates autoantibodies and leads to hyperthyroidism

Question 11

Myasthenia Gravis

Answer 11

Usually caused by a tumour in the thymus. Antibodies bind to ACh receptor at neuromuscular junction-block neurotransmitters from sending signal-no stimulation. Results in weakness and fatigue-actions gadually suppress as ACh levels decrease

Question 12

Microcytic anaemia

Answer 12

Low iron, small cells

Question 13

Macrocytic anaemia

Answer 13

Low folic acid/B12. Autoantibodies block intrinsic factor- can’t bind B12

Question 14

3 examples of non organ specific autoimmune diseases

Answer 14

SLE
ANCA vasculitis
Raynauds

Question 15

SLE

Answer 15

Photosensitive malar rash-UV induced. Arthralgia, alopecia, pleural effusion/pleuricy, cerebral lupus-seizures, strokes. Anti nuclear antibodies bind to skin cells that have been damaged by UV light i.e. undergone ‘unhealthy cell death’ Antibodies and their antigens form immune complexes that bind to complement and cause inflammation in any tissue

Question 16

Lupus nephritis

Answer 16

Kidney involvement of SLE patients. Immune complex deposition in glomeruli-inflammation-leaky glomeruli-loss of renal function-scarring-irreversible renal failure

Question 17

ANCA vasculitis

Answer 17

Anti neutrophil cytoplasmic antibodies- inflammation of small blood vessels caused by WBCs that have been stimulated by ANCA. ANCA activates neutrophils and causes them to leave the vessels.

Question 18

3 forms of ANCA vasculitis

Answer 18

Microscopic polyangitis
Granulomatosis with polyangitis (Wegener’s granulomatus)
Eosinophilic granulomatosus with polyangitis

Question 19

Granulomatosis

Answer 19

Mass of inflammed tissue

Question 20

Polyangitis

Answer 20

Inflammation of many small vessels

Question 21

Primary Raynauds

Answer 21

Common in young women. Runs in families. Harmless. ANCA -ve

Question 22

Secondary Raynauds

Answer 22

ANCA +ve. May be associated with scleroderma

Question 23

Scleroderma

Answer 23

Digital ulcers due to tightening and ischaemia. Lung fibrosis. Skin fibrosis and tightening.

Question 24

Autoinflammation

Answer 24

Immmulological disruption in the innate immunity e.g. Crohn’s disease