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MRCP Part 2 and PACES > Antibodies > Flashcards

Flashcards in Antibodies Deck (18)
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1
Q

Coeliac

A

anti ttg

anti endomysial

2
Q

Sjorgens - Abs + associations + other tests

  • xeropthalmia / xerostoma / anhidriasis / parotitis
look for scars beneath chin
DIFFS = 
sarcoid
parotid cancer
mumps

primary rare
usually secondary where another AI disease present (RA or SLE)

A

anti Ro
anti La
RF present in 90%

Shirmer test:
lacrimation - litmus hung from eyelids = 5 mins >15mm water movement.

also:
RF - 90% (70% RA)
Ds DNA

assoc:
Primary 40x risk lymphoma

3
Q

Primary sclerosing cholangitis

Bile duct and sinusoidal inflammation leading to progressive fibrosis and biliary obstruction

A

P-ANCA
ANA
and Anti-smooth muscle

ASSOC IBD
esp UC

4
Q

SLE

A

anti-ANA +VE 95% - specific
anti ds-DNA - disease activity

low c3 and low c4 (heavy depostion in lupus nephritis)
- good marker for activity as well

Associations:
anti-phospholipid
anti-Sm = SMITH not SMOOTH MUSCLE
ENA
Ro
La
5
Q

PsA

A

Seronegative arthritis!

5 Patterns
1. RA like - symmetrical small joint - HLA DR4
2- Spondyloarthropathy (asymmetrical HLA B27)
3-DIPJ - HLA b38/b39
4- Arthritis mutilans - telescoping / dacytilitis /
5-oligoarthritis - asymmetry + massive effusions

6
Q

Limited cutaneous systemic sclerosis

A
ANA = 90%
anti-centromere = 80%

sclerodactyly
morphoea - tight shiny skin plaques
en coup de sabre over scalp

7
Q

Sarcoid

A

None specific
Pathogenesis is related to a breakdown of normal immunofunction resulting in inappropriate propogation of a th2 response and intiiation of a granulomatous forming process
Some Abs are found directed against mycobacteria

hatpen reaction process

8
Q

SCLC

A

Anti-YO + Anti-Purkinje = CEREBELLAR DEGENERATION

Anti-Hu - ENCEPHALOMYOSITIS

9
Q

Myasethenia

A

Abs vs post synaptic NMJ ACH-R

10
Q

lambert eaton

A

Abs Vs presynaptic voltage gated calcium channels

11
Q

anti phospholipid

A

anti-phospholipid

ANA

12
Q

Raynauds

A

Form of scleroderma
expect to see:

ANA
anti-centromere

LOOK FOR ADDITIONAL FEATURES TO IDENTIFY IF CREST PRESENT

look for ungal abscess - sign of dermatomyositis
look for pyoderma gangrenosum - dermatomyositis

look for where inolvement rests - thickened and hardedn skin from chronic ischaemia

look for signs of digital ulceration from chronic ischaemic damage

13
Q

CREST-

dysphagia . diarrhoea, dyspepsia, dyspnoea + renal crisis

A
ANA = 90%
anti-centromere = 80%

Remember greatest cause of morbidity is progression of pulmonary fibrosis and pulmonary hypertension by CREST and drugs used to treat
NSIP - surivival 12-14 years with good response to steroids
AIP - surivival 2.5-5 years with poor steroid response
i.e.

MTX and MMF for skin thickening

cyclophosphamide useful for pulmonary stabilisation and better survival

Calcinosis
Raynauds
Esophagial and GIT dysmotility
Sclerodcatyly
Telangiectasia
14
Q

Diffuse cutaenous systemic sclerosis
greater incidence of pulmonary fibrosis
greater incidence if renal crisis

A

ANA 90%

anti SCL = 40%

15
Q

Crohns

A

Anti-Saccharomyces cerevisiae antibodies (ASCA) are associated with Crohn disease;

anti-CBir, an antibody against flagellin, also is associated with Crohn disease (but not UC) and is found in about 40%

Associated with PSC - UC stronger association

  • P-ANCA
  • ANA
  • anti-smooth muscle
16
Q

Wegners granulomatosis and polyangitis

A
ANCA-PR3 (c-ANCA)
Cavitating granulomas
hits:
epistaxis
saddle nose
pulmonary haemorrhage
Renal involvement
17
Q

Eosinophillic granulamtosis and polyangitis (CHURG STRAUSS)

A

ANCA- MPO (p-ANCA)
necrotizing vasculitis
small-to-medium-sized vessels
associated with severe asthma and eosinophilia

Asthma (wheezing, expiratory rhonchi)
Eosinophilia of more than 10% in peripheral blood
Paranasal sinusitis
Pulmonary infiltrates (may be transient)
Histological proof of vasculitis with extravascular eosinophils
Mononeuritis multiplex or polyneuropathy

18
Q

What antibodies are present in cyroglobulinaemia

A

RF - present in 90%
ANA
low C3 (immune complex precipitation)

presents:
raynauds
purpuric rash
athralgia
arthritis
bony pain
ARDS