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T-MRCP 1 Cards > BASIC SCIENCES > Flashcards

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

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2
Q

Examples of Type 1 hypersnesitivity reactions

IgE mediated

A

Anaphylaxis

Atopy (eg asthma, hayfever, eczema)

(Diagnosed by plasma tryptase)

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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

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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

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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

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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

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7
Q

type of hypersensitivity reaction Atopy (eczema, asthma, hayfever)

A

Type 1

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8
Q

what type of hypersensitivity reaction is anaphylaxis

A

Type 1

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9
Q

Type of hypersensitivity reaction Autominautoimmune haemolytic anaemia

A

Type 2

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10
Q
A
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11
Q

Type of hypersensitivity reaction ITP

A

type 2

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12
Q

Type of hypersensitivity reaction Goodpasteure syndrome

A

Type 2

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13
Q

Type of hypersensitivity reaction Pernicious anaemia

A

type 2

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14
Q

Type of hypersensitivity reaction Acute haemolytic transfusion reactions

A

Type 2

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15
Q

Type of hypersensitivity reaction rheumatic fever

A

type 2

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16
Q

Type of hypersensitivity reaction Pemphigus vulgaris/bullous pemphigoid

A

Type 2

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17
Q

Type of hypersensitivity reaction Serum sickness

A

Type 3- immune complex mediated

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18
Q

Type of hypersensitivity reaction SLE

A

Type 3 hypersensitivity reaction -immune complex mediated

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19
Q

Type of hypersensitivity reaction Post-streptococcal glomerulonephritis

A

Type 3 -immune complex mediated

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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

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21
Q

Type of hypersensitivity reaction Tuberculosis/tuberculin skin reaction

A

Type 4 (cell mediated)

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22
Q

Type of hypersensitivity reactionGraft versus host disease

A

Type 4 (cell mediated)

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23
Q

Allergic contact dermatitis

A

Type 4 (cell mediated)

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24
Q

Type of hypersensitivity reaction Scabies

A

Type 4 (cell mediated)

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25
Q

Type of hypersensitivity reaction Multiple sclerosis

A

Type 4

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26
Q

Type of hypersensitivity reaction Gullain-Barre syndrome

A

Type 4 (cell mediated)

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27
Q

Type of hypersensitivity reaction Myasthenia Gravis

A

Type 5 hypersensitivity

Antibodies that recognise and bind to ceel surface receptors. This is either stimulating them or blocking them.

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28
Q

Grave’s disease

A

Type 5 hypersensitivity reaction

Antibodies that recognise and bind to the cell surface receptors. This is either stimulating them or blocking ligand binding

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29
Q

What is the hallmark sign ofmast cell degranulation?

A

Classical wheal and flare

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30
Q

HLA association of Haemochromatosis

A

HLA-A3

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31
Q

HLA Association of Behcet’s disease HLA B51 is a split of B5

A

HLA-B5

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32
Q

21 Hydroxylase deficiency

A

HLA-B47

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33
Q

Psoriasis

A

HLA-CW6

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34
Q

HLA type in T1 DM

A

HLA-DR3 + HLA-DR4 (but more with HLA-DR4)

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35
Q

HLA type in Steroid responsive nephrotic syndrome

A

HLA-DR7

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36
Q

HLA type in Narcolepsy

A

HLA DR2

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37
Q

HLA type in Goodpasteure’s syndrome

A

HLA-DR2

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38
Q

Autoimmune hepatitis

A

HLA-DR3

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39
Q

HLA type in Primary Biliary Cirrhosis

A

HLA-DR3

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40
Q

HLA type in Dermatitis herpetiformis

A

HLA-DR3

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41
Q

HLA type in Coeliac disease (95% associated with HLA DQ2)

A

HLA-DR3

42
Q

HLA type in rheumatoid arthritis

A

HLA-DR3

43
Q

HLA type in What is Felty’s syndrome

A

Triad of rheumatoid arthritis, splenomegally and neutropenia

More strongly (thanregular rheumatoid arthritis) with (95%) HLA-DR4

44
Q

Function of CD1

A

HLA molecule that presents lipid molecules

45
Q

Function of CD2

A

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
Q

Function of CD3

A

The signalling component of the T cell receptor

47
Q

Function of CD4

A

Co-receptor for HLA type 2

Also a receptor used by HIV to enter cells

48
Q

Function of CD8

A

Co-receptor for HLA class 1;

Also found on a subset of myeloid dendritic

49
Q

In Diffuse systemic sclerosis the specifc Ab anti-RNA Polymerase III is associated with increased risk of which 3 conditions?

A

1) Rapidly progressive Diffuse skin thickening,
2) sclerodermic renal crisis,
3) Gastric antral vascular ectasia (GAVE) disease

50
Q

Which Ab may cause neonatal lupus and congenital heart block

A

anti-Ro (SSA)

51
Q

2nd most specific ab for SLE (after anti-Smith)

A

anti-DSNA

52
Q

Which Ab is most associated with neuropsychiatric manifestations of SLE

A

anti-ribosomal P

53
Q

Which Ab is most associated with lupus nephritis

A

anti-DSNA

54
Q

In diffuse systemic scleroderma anti-Scl-70 is associated with increased risk of……

A

Interstitial lung disease

(risk is increased even in limited disease if this antibody is present)

55
Q

In Diffuse systemic scleroderma the anti-U3 RNP antibody is associated with……… (COMPP)

A

Cariomyopathy

early severe Organ involvement

Myopathy

Pulmonary HTN

episodes of Pseudo-obstruction and malabsorption

56
Q

Most specific ab for SLE

A

anti-Smith ab

57
Q

In limited SSc and scleroderma sine scleroderma (ssSSc) the anti-centromere Ab is associated with…..

A

1) Pulmonary HTN
2) Oesophageal Involvement

nb Interstitial lung disease, cardiomyopathy and scleroderma renal crisis are rare

58
Q

what is overlap syndrome?

A

= 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
Q

Regarding Overlap syndrome anti U1RNP is associated with MIXED CONNECTIVE TISSUE DISEASE. what are its features….. (early and 3 late)

A

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
Q

Cut off for significant ANA antibodies

A

1:160

61
Q

Which Ab is most associated with drug induced lupus

A

anti-histone antibodies

62
Q

In overlap syndrome - Scleromyositis is associated with anti PM/Scl. What are it’s clinical features…..

A

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
Q

which Ab is most associated with subacute cutaneous Lupus (SCLE)

A

anti-Ro (SSA)

64
Q

Regarding Idiopathic inflammatory myositis specific antibodies pp307: Anti-aminoacyl-tRNA (antisynthase) is associated with which autoantibodies directed against aminoacyl-tRNA synthetases:

A

anti Jo 1 (75% of all the antisynthetases), PL-7, PL-12 etc

65
Q

systemic sclerosis 90-95% are ANA +ve. Which specific 3 Abs are associated with Limited Sclerosis

A

1) Anti-centromere, 2) anti-Th/To, 3) anti-U11/U12RNP

66
Q

which Ab is most related to disease activity in SLE

A

anti-DSNA

67
Q

Main clinical features of Antisynthetase syndrome ( a rare inflammatory disease related to dermatomyositis and polymyositis)…….. (MP FIRM)

A

Myositis,

polyarthritis,

Fever,

Interstitial lung disease,

Raynaud’s phenomenon,

Mechanic’s hands

68
Q

which Ab is associated with primary Sjogren’s syndrome

A

anti-La (SSB)

69
Q

classic Dermatomyositis is associated with which auto-antibody….

A

Anti Mi-2 (present in 18-35% of patients)

70
Q

Regarding Overlap syndrome anti U1RNP is associated with MIXED CONNECTIVE TISSUE DISEASE. what are its features….. (early and 3 late)

A

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
Q

Skin features of dermatomyositis (pp307)….

A

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
Q

most sensitive ab for SLE (if negative highly unlikely SLE is right dx)

A

ANA

73
Q

Regarding SLE AntiDSDNA I assocociated with

A

1) close relation to disease activity
2) lupus nephritis

74
Q

Which Ab is most associated with Libman-Sacks endocarditis

A

anti-beta-2 glycoprotein 1

75
Q

In Diffuse systemic scleroderma the anti-U3 RNP antibody is associated with……… (COMPP)

A

Cariomyopathy

early severe Organ involvement

Myopathy

Pulmonary HTN

episodes of Pseudo-obstruction and malabsorption

76
Q

In limited SSc and scleroderma sine scleroderma (ssSSc) the anti-centromere Ab is associated with…..

A

1) Pulmonary HTN
2) Oesophageal Involvement

nb Interstitial lung disease, cardiomyopathy and scleroderma renal crisis are rare

77
Q

what is autoimmune necrotising myopathy………..

A

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
Q

systemic sclerosis 90-95% are ANA +ve. Which specific Abs are associated with Diffuse scleroderma

A

1) anti-Scl-70 (75% of pts), 2) anti RNA polymerase III, 3) anti U3 RNP

79
Q

which autoantibody is associated with autoimmune necrotising myopathy

A

anti-SRP

80
Q

In overlap syndrome - Scleromyositis is associated with anti PM/Scl. What are it’s clinical features…..

A

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
Q

Regarding Idiopathic inflammatory myositis specific antibodies pp307: Anti-aminoacyl-tRNA (antisynthase) is associated with which autoantibodies directed against aminoacyl-tRNA synthetases:

A

anti Jo 1 (75% of all the antisynthetases), PL-7, PL-12 etc

82
Q

Which myositis specific antibody is associated with increased risk of ILD….

A

anti Jo1

83
Q

which myositis specific antibodies are associated with overlap syndromes with muscular involvement…….

A

Anti-Pm-Scl, (?U1/U2RNP), Ku, SnRNP, Ro, La

84
Q

which myositis specific antibody is associated with autoimmune myositis…..

A

anti TIF1-gamma

85
Q

Main clinical features of Antisynthetase syndrome ( a rare inflammatory disease related to dermatomyositis and polymyositis)…….. (MP FIRM)

A

Myositis,

polyarthritis,

Fever,

Interstitial lung disease,

Raynaud’s phenomenon,

Mechanic’s hands

86
Q

classic Dermatomyositis is associated with which auto-antibody….

A

Anti Mi-2 (present in 18-35% of patients)

87
Q

which myositis specific antibody is associated with inclusion body myositis…..

A

anti cN1A

88
Q

Which autoantibody is most specific for autoimmune hepatitis….

A

anti-smooth muscle antibody (anti SMA)

89
Q

Anti-liver/kidney microsome type 1 (LKM-1) auto-antibody is associated with which disease…

A

Autoimmune hepatitis

90
Q

Skin features of dermatomyositis (pp307)….

A

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
Q

Autoimmune hepatitis is characteristically associated with elevated levels of which class of immunoglobulin….

A

Ig G

92
Q

Primary Biliary Cholangitis is associated with which autoantibody?

A

anti-mitochondrial antibody (AMA)

93
Q

What is the target of the anti-mitochondrial antibody in primary biliary cholangitis…

A

pyruvate dehydrogenase complex

94
Q

What is the immunological association of ulcerative colitis?

A

pANCA antigen

95
Q

Regarding SLE AntiDSDNA I assocociated with

A

1) close relation to disease activity
2) lupus nephritis

96
Q

what is autoimmune necrotising myopathy………..

A

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
Q

What is the immunological association of Crohn’s disease?

A

ASCA (anti-saccharomyces Cerevisiae antibodies)

98
Q

which autoantibody is associated with autoimmune necrotising myopathy

A

anti-SRP

99
Q

which myositis specific antibody is associated with autoimmune myositis…..

A

anti TIF1-gamma

100
Q

Antibodies in Coeliac Disease…

A

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
Q

which myositis specific antibodies are associated with overlap syndromes with muscular involvement…….

A

Anti-Pm-Scl, (?U1/U2RNP), Ku, SnRNP, Ro, La

102
Q

Helper T cells expresse CD4 and
also expresses CD3, TCR & CD28.

They produce IL2.

How do they recognize antigen?

A

T-MRCP 1 Cards (3 decks)

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