RA, SLE + mAb Flashcards

1
Q

What is the main auto-antibody found in blood tests for RA?

A

Rheumatoid factor - autoantibodies to Fc portion of IgG

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2
Q

What other auto-antibodies can occur in RA?

A

anti-CCP

ACPA

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3
Q

Over-production of which cytokine leads to synovitis?

A

TNF-alpha

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4
Q

What can occur in the lungs in patients with RA?

A

Nodules

Pleural effusion, interstitial lung disease

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5
Q

What are three other non-articular manifestations of RA?

A

Pericarditis
Anaemia
Carpal tunnel syndrome
(PAC)

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6
Q

What type of hypersensitivity reaction is involved in SLE?

A

Type 3 mainly

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7
Q

What is pathophysiology of SLE?

A

Cell apoptosis - blebs carrying antigens with nuclear components, inefficient phagocytosis means they travel to lymphoid tissue, taken up by APCs and generate T and B cell response and autoantibodies.

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8
Q

What is the result of the auto-antibodies generated in SLE?

A
  • Form circulating complexes or bind to tissues directly
  • Activate complement, neutrophil influx causes inflammation
  • Cytokine production
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9
Q

What is the main auto-antibody found in SLE blood tests?

A

Antinuclear/Anti-DNA

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10
Q

What other autoantibodies can occur in SLE?

A

Anti-Sm antibodies

Antiphospholipid antibodies

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11
Q

The skin is often involved in SLE. Give 5 features.

A
Butterfly rash on face
Photosensitivity
Urticaria
Vasculitis
Purpura
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12
Q

What might you find in FBC of a patient with SLE?

A

Anaemia
Low WBC
Low platelets

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13
Q

What test would help confirm if autoimmune haemolytic anaemia was present in a patient with SLE?

A

Coombs test

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14
Q

Other than skin, what other body systems can be involved in SLE?

A
Kidneys - glomerulonephritis 
Heart - pericarditis, endocarditis
Lungs - pleural effusion
NS - fits, psychosis
Blood - anaemia, thrombocytopenia
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15
Q

What is the treatment for SLE?

A

Mycophenolate mofetil
Azathioprine
Steroids
Cyclophosphamide if severe

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16
Q

What lifestyle advice would you give to a patient with SLE?

A

Wear suncream

17
Q

What is a monoclonal antibody?

A

Monovalent antibodies which bind to the same epitope and are produced from a single B-lymphocyte clone

18
Q

How do monoclonal antibodies work in autoimmune diseases?

A
  • Bind to cell surface receptor to activate signalling within the cell
  • Bind to cell surface receptor to inhibit signalling within the cell
  • Bind and internalised into cell to deliver toxins to cancer cells
  • Block inhibitory effects on T cells
19
Q

What monoclonal antibody is used to treat breast cancer?

A

Trastuzumab - inhibits HER-2 signalling

20
Q

What monoclonal antibody is used to treat autoimmune conditions?

A

Inlfiximab

21
Q

How does infliximab work?

A

Inhibition of TNF (inflammatory cytokine)

22
Q

What is infliximab used to treat?

A

RA
Crohns
Psoriasis

23
Q

What monoclonal antibody is used too treat B cell lymphoma?

A

Rituximab - against CD20, expressed on surface of B cells.