BASIC SCIENCES Flashcards
1
Q
What are the 5 types of hypersensitivity reactions?
clue: ACIDS
A
Type I Allergic
Type II Cytotoxic/Antibody mediated
Type III Immune complex IgG/IgM mediated
Type IV Delayed/Cell mediated
Type V Antibodies bind to cell surface receptors either stimulating or blocking them
2
Q
Examples of Type 1 hypersnesitivity reactions
IgE mediated
A
Anaphylaxis
Atopy (eg asthma, hayfever, eczema)
(Diagnosed by plasma tryptase)
3
Q
Examples of type II Hypersensitivity reactions
Mediated by IgG or IgM on cell surfaces
Clue: PAIR GAP
A
Pemphigous vulgaris/bullous pemphigoid
Autoimmune haemolytic anaemia
ITP
Rheumatic fever
Goodpasteure’s syndrome
Acute haemolytic transfusion reactions
Pernicious anaemia
4
Q
Examples of type 3 Hypersenitivity reactions
Free antigen and antibody (IgG,IgA) combine (immune complex deposition)
Clue: PESS
A
Post-streptococcal glomerulonephritis
Extrinsic allergic alveolitis (espescially the acute phase)
Serum sickness
SLE
5
Q
Examples of type 4 hypersensitivity reactions
T cell mediated (cell mediated)
Clue: T G(2)AMES
A
Tuberculosis
Graft versus host disease
Gullain-Barre syndrome
Allergic contact dermatitis
Multiple sclerosis
Extrinsic allergic alveolitis (espescially the chronic phase)
Scabies
6
Q
Type 5 hypersensitivity reactions examples
Antibodies that recognise and bind to the cell surface receptors. This is either stimulating them or blocking ligand binding
Clue: type V
A
GraVes disease
Myasthenia GraVis
7
Q
type of hypersensitivity reaction Atopy (eczema, asthma, hayfever)
A
Type 1
8
Q
what type of hypersensitivity reaction is anaphylaxis
A
Type 1
9
Q
Type of hypersensitivity reaction Autominautoimmune haemolytic anaemia
A
Type 2
10
Q
A
11
Q
Type of hypersensitivity reaction ITP
A
type 2
12
Q
Type of hypersensitivity reaction Goodpasteure syndrome
A
Type 2
13
Q
Type of hypersensitivity reaction Pernicious anaemia
A
type 2
14
Q
Type of hypersensitivity reaction Acute haemolytic transfusion reactions
A
Type 2
15
Q
Type of hypersensitivity reaction rheumatic fever
A
type 2
16
Q
Type of hypersensitivity reaction Pemphigus vulgaris/bullous pemphigoid
A
Type 2
17
Q
Type of hypersensitivity reaction Serum sickness
A
Type 3- immune complex mediated
18
Q
Type of hypersensitivity reaction SLE
A
Type 3 hypersensitivity reaction -immune complex mediated
19
Q
Type of hypersensitivity reaction Post-streptococcal glomerulonephritis
A
Type 3 -immune complex mediated
20
Q
Type of hypersensitivity reaction Extrinsic allergic alveolitis
A
Type 3 (immune complex mediated) espescially in the acute phase
Type 4 (cell mediated) espescially in the chronic phase
21
Q
Type of hypersensitivity reaction Tuberculosis/tuberculin skin reaction
A
Type 4 (cell mediated)
22
Q
Type of hypersensitivity reactionGraft versus host disease
A
Type 4 (cell mediated)
23
Q
Allergic contact dermatitis
A
Type 4 (cell mediated)
24
Q
Type of hypersensitivity reaction Scabies
A
Type 4 (cell mediated)
25
Type of hypersensitivity reaction Multiple sclerosis
Type 4
26
Type of hypersensitivity reaction Gullain-Barre syndrome
Type 4 (cell mediated)
27
Type of hypersensitivity reaction Myasthenia Gravis
Type 5 hypersensitivity
Antibodies that recognise and bind to ceel surface receptors. This is either stimulating them or blocking them.
28
Grave's disease
Type 5 hypersensitivity reaction
Antibodies that recognise and bind to the cell surface receptors. This is either stimulating them or blocking ligand binding
29
What is the hallmark sign ofmast cell degranulation?
Classical wheal and flare
30
HLA association of Haemochromatosis
HLA-A3
31
HLA Association of Behcet's disease HLA B51 is a split of B5
HLA-B5
32
21 Hydroxylase deficiency
HLA-B47
33
Psoriasis
HLA-CW6
34
HLA type in T1 DM
HLA-DR3 + HLA-DR4 (but more with HLA-DR4)
35
HLA type in Steroid responsive nephrotic syndrome
HLA-DR7
36
HLA type in Narcolepsy
HLA DR2
37
HLA type in Goodpasteure's syndrome
HLA-DR2
38
Autoimmune hepatitis
HLA-DR3
39
HLA type in Primary Biliary Cirrhosis
HLA-DR3
40
HLA type in Dermatitis herpetiformis
HLA-DR3
41
HLA type in Coeliac disease (95% associated with HLA DQ2)
HLA-DR3
42
HLA type in rheumatoid arthritis
HLA-DR3
43
HLA type in What is Felty's syndrome
Triad of rheumatoid arthritis, splenomegally and neutropenia
More strongly (thanregular rheumatoid arthritis) with (95%) HLA-DR4
44
Function of CD1
HLA molecule that presents lipid molecules
45
Function of CD2
Found on thymocytes, T cells, and some natural killer cell that act as ligand for CD58 and CD59 and is involved in signal transduction and cell adhesion molecules
46
Function of CD3
The signalling component of the T cell receptor
47
Function of CD4
Co-receptor for HLA **_type 2_**
Also a receptor used by HIV to enter cells
48
Function of CD8
Co-receptor for HLA **_class 1_**;
Also found on a subset of myeloid dendritic
49
In Diffuse systemic sclerosis the specifc **_Ab anti-RNA Polymerase III_** is associated with increased risk of which 3 conditions?
1) Rapidly progressive Diffuse skin thickening,
2) sclerodermic renal crisis,
3) Gastric antral vascular ectasia (GAVE) disease
50
Which Ab may cause neonatal lupus and congenital heart block
anti-Ro (SSA)
51
2nd most specific ab for SLE (after anti-Smith)
anti-DSNA
52
Which Ab is most associated with neuropsychiatric manifestations of SLE
anti-ribosomal P
53
Which Ab is most associated with lupus nephritis
anti-DSNA
54
In diffuse systemic scleroderma anti-Scl-70 is associated with increased risk of......
Interstitial lung disease
(risk is increased even in limited disease if this antibody is present)
55
In Diffuse systemic scleroderma the anti-U3 RNP antibody is associated with......... (COMPP)
Cariomyopathy
early severe Organ involvement
Myopathy
Pulmonary HTN
episodes of Pseudo-obstruction and malabsorption
56
Most specific ab for SLE
anti-Smith ab
57
In limited SSc and scleroderma sine scleroderma (ssSSc) the anti-centromere Ab is associated with.....
1) Pulmonary HTN
2) Oesophageal Involvement
nb Interstitial lung disease, cardiomyopathy and scleroderma renal crisis are rare
58
what is overlap syndrome?
= Mixed Connective Tissue Disease + Scleromyositis
"Overlap syndromes" refers to a diverse group of conditions that have clinical features of, and meet classification criteria for, more than 1 well-characterized rheumatic disease. They usually present subacutely with clinical manifestations that can include different organ systems.
A rheumatological disorder with features suggestive of several kinds of connective tissue disease, but not definitively diagnostic of any single syndrome
59
Regarding Overlap syndrome anti U1RNP is associated with MIXED CONNECTIVE TISSUE DISEASE. what are its features..... (early and 3 late)
Early: non-specific general malaise, athralgias, myalgias, low grade fever
Later:
1) Raynaud's phenomenon. Puffy hands
2) Severe non-erosive arthritis
3) Pulmonary HTN (without interstitial lung disease)
nb in contrast to SLE CNS involvement is rare
60
Cut off for significant ANA antibodies
1:160
61
Which Ab is most associated with drug induced lupus
anti-histone antibodies
62
In overlap syndrome - Scleromyositis is associated with anti PM/Scl. What are it's clinical features.....
1) Arthritis and myositis
2) Raynaud's disease
3) Benign course and good response to steroid
4) ILD
nb cardiac and renal involvement is rare
63
which Ab is most associated with subacute cutaneous Lupus (SCLE)
anti-Ro (SSA)
64
Regarding Idiopathic inflammatory myositis specific antibodies pp307: Anti-aminoacyl-tRNA (antisynthase) is associated with which autoantibodies directed against aminoacyl-tRNA synthetases:
anti Jo 1 (75% of all the antisynthetases), PL-7, PL-12 etc
65
systemic sclerosis 90-95% are ANA +ve. Which specific 3 Abs are associated with Limited Sclerosis
1) Anti-centromere, 2) anti-Th/To, 3) anti-U11/U12RNP
66
which Ab is most related to disease activity in SLE
anti-DSNA
67
Main clinical features of Antisynthetase syndrome ( a rare inflammatory disease related to dermatomyositis and polymyositis)........ (MP FIRM)
Myositis,
polyarthritis,
Fever,
Interstitial lung disease,
Raynaud's phenomenon,
Mechanic's hands
68
which Ab is associated with primary Sjogren's syndrome
anti-La (SSB)
69
classic Dermatomyositis is associated with which auto-antibody....
Anti Mi-2 (present in 18-35% of patients)
70
Regarding Overlap syndrome anti U1RNP is associated with MIXED CONNECTIVE TISSUE DISEASE. what are its features..... (early and 3 late)
Early: non-specific general malaise, athralgias, myalgias, low grade fever
Later:
1) Raynaud's phenomenon. Puffy hands
2) Severe non-erosive arthritis
3) Pulmonary HTN (without interstitial lung disease)
nb in contrast to SLE CNS involvement is rare
71
Skin features of dermatomyositis (pp307)....
Photosensitive
Macular rash over back and shoulder
Heliotrope rash over cheek
Gottron's papules- roughened red plaques over extensor surfaces of the fingers
Nail fold capillary dilatation
72
most sensitive ab for SLE (if negative highly unlikely SLE is right dx)
ANA
73
Regarding SLE AntiDSDNA I assocociated with
1) close relation to disease activity
2) lupus nephritis
74
Which Ab is most associated with Libman-Sacks endocarditis
anti-beta-2 glycoprotein 1
75
In Diffuse systemic scleroderma the anti-U3 RNP antibody is associated with......... (COMPP)
Cariomyopathy
early severe Organ involvement
Myopathy
Pulmonary HTN
episodes of Pseudo-obstruction and malabsorption
76
In limited SSc and scleroderma sine scleroderma (ssSSc) the anti-centromere Ab is associated with.....
1) Pulmonary HTN
2) Oesophageal Involvement
nb Interstitial lung disease, cardiomyopathy and scleroderma renal crisis are rare
77
what is autoimmune necrotising myopathy...........
Anti-SRP (signal recognition particle) antibody (Ab) related myositis is a group of necrotizing myositis with rapidly progressive, severe, proximal muscle weakness followed by atrophy of affected muscles and extremely high creatine phosphokinase (CPK) levels at presentation. The histology of muscle biopsy reveals that it has sparse inflammatory infiltrate, but significant muscle necrosis and endomysial capillary involvement
78
systemic sclerosis 90-95% are ANA +ve. Which specific Abs are associated with Diffuse scleroderma
1) anti-Scl-70 (75% of pts), 2) anti RNA polymerase III, 3) anti U3 RNP
79
which autoantibody is associated with autoimmune necrotising myopathy
anti-SRP
80
In overlap syndrome - Scleromyositis is associated with anti PM/Scl. What are it's clinical features.....
1) Arthritis and myositis
2) Raynaud's disease
3) Benign course and good response to steroid
4) ILD
nb cardiac and renal involvement is rare
81
Regarding Idiopathic inflammatory myositis specific antibodies pp307: Anti-aminoacyl-tRNA (antisynthase) is associated with which autoantibodies directed against aminoacyl-tRNA synthetases:
anti Jo 1 (75% of all the antisynthetases), PL-7, PL-12 etc
82
Which myositis specific antibody is associated with increased risk of ILD....
anti Jo1
83
which myositis specific antibodies are associated with overlap syndromes with muscular involvement.......
Anti-Pm-Scl, (?U1/U2RNP), Ku, SnRNP, Ro, La
84
which myositis specific antibody is associated with autoimmune myositis.....
anti TIF1-gamma
85
Main clinical features of Antisynthetase syndrome ( a rare inflammatory disease related to dermatomyositis and polymyositis)........ (MP FIRM)
Myositis,
polyarthritis,
Fever,
Interstitial lung disease,
Raynaud's phenomenon,
Mechanic's hands
86
classic Dermatomyositis is associated with which auto-antibody....
Anti Mi-2 (present in 18-35% of patients)
87
which myositis specific antibody is associated with inclusion body myositis.....
anti cN1A
88
Which autoantibody is most specific for autoimmune hepatitis....
anti-smooth muscle antibody (anti SMA)
89
Anti-liver/kidney microsome type 1 (LKM-1) auto-antibody is associated with which disease...
Autoimmune hepatitis
90
Skin features of dermatomyositis (pp307)....
Photosensitive
Macular rash over back and shoulder
Heliotrope rash over cheek
Gottron's papules- roughened red plaques over extensor surfaces of the fingers
Nail fold capillary dilatation
91
Autoimmune hepatitis is characteristically associated with elevated levels of which class of immunoglobulin....
Ig G
92
Primary Biliary Cholangitis is associated with which autoantibody?
anti-mitochondrial antibody (AMA)
93
What is the target of the anti-mitochondrial antibody in primary biliary cholangitis...
pyruvate dehydrogenase complex
94
What is the immunological association of ulcerative colitis?
pANCA antigen
95
Regarding SLE AntiDSDNA I assocociated with
1) close relation to disease activity
2) lupus nephritis
96
what is autoimmune necrotising myopathy...........
Anti-SRP (signal recognition particle) antibody (Ab) related myositis is a group of necrotizing myositis with rapidly progressive, severe, proximal muscle weakness followed by atrophy of affected muscles and extremely high creatine phosphokinase (CPK) levels at presentation. The histology of muscle biopsy reveals that it has sparse inflammatory infiltrate, but significant muscle necrosis and endomysial capillary involvement
97
What is the immunological association of Crohn's disease?
ASCA (anti-saccharomyces Cerevisiae antibodies)
98
which autoantibody is associated with autoimmune necrotising myopathy
anti-SRP
99
which myositis specific antibody is associated with autoimmune myositis.....
anti TIF1-gamma
100
Antibodies in Coeliac Disease...
first line for dx: Tissue transglutaminase (TTG) antibodies (Ig A)
Anti-casein antibodies are also found in some patients
nb Anti-gliadin antibody (IgA or IgG) are NOT recommended by NICE
101
which myositis specific antibodies are associated with overlap syndromes with muscular involvement.......
Anti-Pm-Scl, (?U1/U2RNP), Ku, SnRNP, Ro, La
102
Helper T cells expresse CD4 and
also expresses CD3, TCR & CD28.
They produce IL2.
How do they recognize antigen?
