Autoimmune Diseases Flashcards Preview

Clinical Pathology > Autoimmune Diseases > Flashcards

Flashcards in Autoimmune Diseases Deck (24):
1

Autoimmunity

Breakdown of self tolerance. Genetically determined

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Autoimmune diseases

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

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Which cells have HLA type 1

All cells

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Which cells have HLA type 2

Professional APCs

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Central tolerance

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

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Peripheral tolerance

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

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Who is most likely to develop autoimmune diseases?

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

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2 examples of Autoimmune thyroid disease

Hashimotos Thyroiditis
Grave's disease

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Hashimotos Thyroiditis

Destruction of thyroid follicles by autoimmune process leads to hypothyroidism

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Grave's Disease

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

11

Myasthenia Gravis

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

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Microcytic anaemia

Low iron, small cells

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Macrocytic anaemia

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

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3 examples of non organ specific autoimmune diseases

SLE
ANCA vasculitis
Raynauds

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SLE

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

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Lupus nephritis

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

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ANCA vasculitis

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.

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3 forms of ANCA vasculitis

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

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Granulomatosis

Mass of inflammed tissue

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Polyangitis

Inflammation of many small vessels

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Primary Raynauds

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

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Secondary Raynauds

ANCA +ve. May be associated with scleroderma

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Scleroderma

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

24

Autoinflammation

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