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Pathology Summer 2020 > Autoimmunity > Flashcards

Autoimmunity Flashcards

1
Q

Autoimmunity

A

Immune reactions directed at self-antigens.

No cure for most.

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2
Q

Allergic vs autoimmune hypersensitivity depends on

A

Antigen and duration of response

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3
Q

Autoimmunity. What antigen and what duration?

A

Environmental antigen and chronic duration.
Lately limited to type II, III, and IV hypersensitivities.
Does not resolve with removal of environmental agent.

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4
Q

Does autoimmunity resolve with removal of environmental agent?

A

NO

Allergies, however, will resolve if you remove the ag.

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5
Q

Allergy. What antigen and duration?

A

Environmental antigen and limited duration. Allergies resolve with removal of environmental antigen.

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6
Q

How many autoimmune diseases known?

A

Over 80

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7
Q

What % of autoimmune patients are women

A

75%

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8
Q

Single gene or multigenic?

A

multi. Makes it harder to pinpoint what causes someone to develop an autoimmune disease.

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9
Q

Most affected organs and tissues

A 
Bone marrow
Lining of joints 
Blood vessels
Connective tissues
Endocrine glands
Kidneys 
Muscles 
Skin
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10
Q

3 main things that can cause autoimmunity

A
  1. Multigenic.
  2. Hormonal
  3. Environmental triggers
    - Infections
    - drug induced
    - toxins

All of these cause a breakdown of central or peripheral tolerance, resulting in an autoimmune disease.

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11
Q

What is a gene and what is an allele?

A 
Gene= make
Allele= model

There are MHCI and MHCII associated alleles that can increase risk of certain diseases.

Non HLA alleles include co-stimulatory molecules and cytokines.

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12
Q

MHCI associated allele

A

HLA B27. Can be a risk for acute anterior uveitis.

If not due to infection or injury and seems idiopathic, check to see if patient has this allele.

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13
Q

What 3 things could cause the breakdown of central and peripheral tolerance?

A

Faulty clonal deletion. Auto-reactive lymphocytes mature.

Loss of T reg cells. Results in hyper responsive T and B lymphocytes with prolonged immune response.

Abnormal expression of MHCII molecules.

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14
Q

Immunoprivileged organs

A

Eyes, BBB, testes. Prevents immune cells from entering organs.

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15
Q

What antigens can be used to cause an autoimmune disease

A

Sequestered Ag’s in immunopriviledged organs. AKA the lymphocytes have not had central tolerance to these antigens.

Infectious disease. Molecular mimicry. Requires original insult- exposure to pathogen before cross reactivity.

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16
Q

Type II auto antibodies directed at auto-antigens

A 
Anti: 
DNA
IgG (Rheumatoid factor) 
phospholipids (cardiolipin- component of bacterial and mitochondrial membrane) 
erythrocyte
lymphocyte
17
Q

4 autoimmune diseases type II

A

Acute rheumatic fever. due to strep.

Pernicious anemia. Loose ability to transport via B12 from gut to blood stream. Auto abs block transport molecule in Gi tract.

Myasthenia gravis. Auto Abs block muscle function.

Graves disease. Auto Abs stimulate thyroid gland.

18
Q

Rheumatic fever

A

Strep pyogenes bacteria has M protein that is similar to proteins on valve in heart. Body will attack heart. Molecular mimicry.

19
Q

Ocular manifestations of myasthenia gravis

A

Diplopia, ptosis, blurred vision

20
Q

Ocular manifestations of graves disease

A

Proptosis (Thyroid Hormone acts on levator) which can cause exposure keratopathy.
Periorbital edema, abnormal EOMs, and optic nerve compression.

21
Q

Type III infectious initiation (2)

A

reactive arthritis

Poststreptococcal glomerulonephritis

22
Q

Type III undetermined initiation (2)

A

SLE, rheumatoid arthritis

23
Q

Rhematoid arthritis shows which 2 types of hypersensitivities

A

Type III and IV

24
Q

Uveitis could be due to which 2 autoimmune diseases

A

SLE, Reactive arthritis

25
Q

PUK could be due to which 2 autoimmune diseases

A

Rheumatoid, polyarteritis nodosa (knots in artery)

26
Q

K-sic could be secondary to which autoimmune disease

A

Sjogrens

27
Q

Type IV autoimmune diseases

A

Chrons
Type I diabetes
MS
Rheumatoid Arthritis

28
Q

How do systemic autoimmune diseases present?

A

Wide range of antigens and widespread damage
Ex: SLE, MS, scleroderma.
Could be types II, III, or IV

29
Q

Who is more likely to be diagnosed with SLE

A

African american women that are genetically predisposed.

Auto antibodies against many cells and tissues in body.

30
Q

How to be diagnosed with SLE

A

Must have greater than or equal to 4 symptoms to be diagnosed (out of 11)

31
Q

Ocular manifestations of SLE

A

Episcleritis/scleritis
Neuro-ophthalmic lesions
Retinal vasculopathy (cotton wool spots due to complexes settling–> Hypoxic cells–> swelling)
Bulls eye maculopathy (sign of long term plaquenil use)

32
Q

Primary and secondary forms of Sjogrens

A

Primary: Lymphocyte infiltration of salivary and lacrimal gland.

Secondary: Immune complex accumulation in salivary and lacrimal glands.

Pathology Summer 2020 (19 decks)

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