Autoimmunity

Question 1

Type II mediator

Answer 1

Antibodies

Question 2

Type III mediator

Answer 2

antibodies

Question 3

Type IV mediator

Answer 3

T cells

Question 4

Type II self-targets

Answer 4

cell surface & EC matrix

Question 5

Type III self-targets

Answer 5

immune complexes in tissues

Question 6

This antibody does not mediate any autoimmune diseases

Answer 6

IgE

Question 7

Autoimmune hemolytic anemia autoantigen

Answer 7

RBC surface antigen

Question 8

Autoimmune hemolytic anemia antibodies involved

Answer 8

IgG and IgM

Question 9

2 mechanisms of RBC destruction in autoimmune hemolytic anemia

Answer 9

Classical complement pathway; opsonization leading to FcR-mediated phagocytosis

Question 10

Autoimmune hemolytic anemia type

Answer 10

II

Question 11

What test is used to detect auto-immune antibodies in AHA

Answer 11

Direct Coomb’s

Question 12

Autoimmune thrombocytopenic purpura defect

Answer 12

IgG prohibits vWF cleavage

Question 13

Autoimmune thrombocytopenic purpura symptoms

Answer 13

Thrombocytopenia; bruising; neurological symptoms; microangioplastic hemolytic anemia

Question 14

Autoimmune thrombocytopenic purpura treatment

Answer 14

Plasmapheresis with healthy plasma donor

Question 15

Autoimmune thrombocytopenic purpura diagnosis

Answer 15

Observing microangioplastic hemolysis, low platelets, presence of schistocytes

Question 16

Goodpasture’s syndrome defect

Answer 16

Autoantibody targets BM type IV collagen throughout the body, causing inflammation and especially problems in KIDNEY

Question 17

Goodpasture’s treatment

Answer 17

Plasmaphoresis and anti-inflammatories

Question 18

Schleroderma autoimmune type

Answer 18

II

Question 19

Schlerodomera mech

Answer 19

Inflammatory destruction of endothelium and replacement with fibrous material

Question 20

Schlerodomera symptoms

Answer 20

Skin thickening; hard, ivory-colored skin

Question 21

Schlerodomera Dx

Answer 21

anti-nuclear Abs present; anti-topoisomerase Abs; anti-centromere Abs

Question 22

Acute rheumatic fever autoimmune type

Answer 22

II

Question 23

Acute rheumatic fever cause

Answer 23

Antibodies produced during bacterial infection (strep pyogenes), because some bacterial cell wall components are very similar to heart tissue proteins (‘molecular mimicry’)

Question 24

Pemphigus vulgaris cause

Answer 24

IgG targets desmoglein 1 and 3 -> no keratinocyte adhesion in epidermis

Question 25

Pemphigus vulgaris signs

Answer 25

painful chronic blistering

Question 26

Pemphigus vulgaris Dx

Answer 26

Punch biopsy lesion and IF stain for IgG4

Question 27

Pemphigus vulgaris treatment

Answer 27

Corticosteroids and anti-inflammatories; rituximab (CD20-specific mAB)

Question 28

What is rituximab

Answer 28

CD-20 specific mAb and B cell surface marker

Question 29

Grave's disease cause

Answer 29

Antibodies act as TSH receptor agonist

Question 30

Grave's disease symptoms

Answer 30

Bulging eyes, eye stare, heat intolerance, weight loss, nervousness, warm skin

Question 31

Grave's disease mediating antibody

Answer 31

IgG

Question 32

Myasthenia gravis treatments

Answer 32

Anti-inflammatories; pyridogstigmine (ACE inhibitor)

Question 33

Subacute bacterial endocarditis cause

Answer 33

Inflammation due to antibodies binding to bacteria that colonized damaged heart valves - particularly probable if previously had heart damage (rheumatic fever etc)

Question 34

Patients are most likely to produce cryoglobulins as sequelae to this disorder type as well as this infection

Answer 34

Hep C; B cell disorders, e.g., multiple myeloma

Question 35

Mixed essential cryoglobulinemia presents with this triad of symptoms

Answer 35

"Meltzer's" - purpura, arthralgia, myalgia

Question 36

Subacute bacterial endocarditis is this type of autoimune

Answer 36

III

Question 37

Mixed essential cryogobulinemia is this type of autoimune

Answer 37

III

Question 38

Systemic lupus is this type of autoimune

Answer 38

III

Question 39

Type 1 diabetes is this type of autoimune

Answer 39

IV

Question 40

Rheumatoid arthritis is this type of autoimune

Answer 40

IV

Question 41

MS is this type of autoimune

Answer 41

IV

Question 42

RA antibodies produced

Answer 42

IgG, IgM, IgA directed at the Fc region of antibodies

Question 43

anti-TNF antibody drug used in RA

Answer 43

infliximab

Question 44

infliximab

Answer 44

anti-TNF antibody drug used in RA

Question 45

Rituximab MOA

Answer 45

Anti-CD20 antibody that targets B cells for destruction by NK cells

Question 46

Sjogren's syndrome symptoms

Answer 46

dry eyes, mouth, skin, nose, vagina

Question 47

Sjogren's syndrome mechanism

Answer 47

Autoreactive T cells attack exocrine glands

Question 48

Sjogren's Dx

Answer 48

Schirmer test (tears); ANA and rheumatoid factor tests

Question 49

MS mediator

Answer 49

Th1

Question 50

MS Tx

Answer 50

Immunosuppression; IFN-B1

Question 51

MS Dx test

Answer 51

oligoclonal bands of IgG in cerebrospinal fluid

Question 52

Immunologyically privileged sites

Answer 52

Eyes, testes, placenta/fetus

Question 53

Guillain Barre syndrome mechanism

Answer 53

demyelination from IgG self-targeting gangliosides in nerves

Question 54

Guillain Barre syndrome symptoms

Answer 54

Bilateral lower limb weakness that ascends rapidly to upper limbs and face; dyspnea & dysphagia

Question 55

Wegener's granulomatosis

Answer 55

Autoantibody targets neutrophils, leading to activation and binding to endothelium, then degranulation that causes vasculitis

Question 56

Wegener's granulomatosis symptoms and onset

Answer 56

1st sign usually rhinitis; also conjunctivitis, lung ilfiltrates, rapidly progressing glomerulonephritis

Question 57

Sjogren's type

Answer 57

IV