BL-SLE Flashcards Preview

BL/DD USMLE and Basics > BL-SLE > Flashcards

Flashcards in BL-SLE Deck (46):
1

Myasthenia gravis, Goodpasture’s syndrome, and autoimmune thyroiditis are examples of:

Organ specific autoimmunity

2

Strongest SLE genetic association:

C4 null alleles

3

Which antibody may be involved in the pathogenesis of lupus nephritis? sle

Anti-double-stranded DNA (ds DNA) antibodies

4

Autoimmunity is defined as the generation of an immune response directed against

self

5

Organ specific autoimmunity is defined as an immune response directed against a:

single autoantigen or a restricted group of autoantigens within a given organ.

autoimmune destruction of only those organs expressing the relevant autoantigens.

6

SLE is a multigenic disease with a major _____contribution

MHC

7

The pathophysiology of SLE involves both Type _____antibody-mediated mechanisms.

II and III (2/3)

8

Both the ________immune systems are involved in the misdirected recognition of self as foreign in SLE.

innate and adaptive

9

SLE flares can be triggered by environmental exposures such as.

the sun

10

The ______ is a major target organ in SLE, and the extent of damage is directly correlated with overall patient outcomes.

kidney

11

The presence of _____ in SLE patients is a manifestation of loss of tolerance to self-antigen as well as a useful diagnostic marker.

high-titer ANA

12

Treatment of SLE is directed at decreasing exposure to disease triggers (sun blocks), decreasing the inflammatory response [NSAIDs, and corticosteroids], and decreasing the ______immune responses

cellular/humoral

13

_______, belimumab is approved for the treatment of SLE.

anti-B cell therapy

14

The presence of high-titer ANA in SLE patients is a manifestation of loss of _______as well as a useful diagnostic marker.

tolerance to self-antigen

15

Treatment of SLE is directed at decreasing exposure to disease triggers (sun blocks), decreasing the _____ [NSAIDs, and corticosteroids], and decreasing the cellular/humoral immune responses

inflammatory response

16

___________is defined as an immune response against multiple autoantigens rather than to autoantigens of a given organ.

Systemic autoimmunity

17

SLE is a ________ which affects multiple organ systems including the skin, joints, serosal surfaces (pleura and pericardium), kidneys, central nervous system, lungs, and hematologic system.

chronic, systemic autoimmune disease

18

SLE Criteria for disease classification include (11)

(4 qualifies for SLE)

1. Malar rash
2. Discoid rash
3. Photosensitivity
4. Oral ulcers
5. Arthritis
6. Serositis
7. Renal involvement
8. Central nervous system involvement (seizures or psychosis),
9. Hematologic disorders
10. Immunologic disorders
11. Antinuclear antibody (ANA).

19

SLE is a disease primarily of the young women with a female to male ratio of _____, with onset after puberty reaching a peak during the childbearing years.

9:1

20

Predisposing Factors SLE
Genetics

HLA-DR3; and C4A null alleles

Interferon (IFN)-α and IFN-β

21

Predisposing Factors SLE
Environment

Sex hormones
UV exposure

22

Specific antibody-mediated disease (Type II) of SLE

Hemolytic anemia
anti-Phospholipid antibodies
Central Nervous System Manifestations

23

Immune complex mediated disease (Type III):of SLE

Lupus nephritis
Antinuclear Antibodies (ANA):

24

Antinuclear antibodies (ANAs) are unusual antibodies, detectable in the blood, that have the capability of binding to certain structures within the _____ of the cells.

nucleus

25

HLA-DR4 association

RA

26

HLA-B27 association

AS

27

HLA-DR3 association

SLE- (SLE is 3 letters)
*not the strongest
C4 null allele is better

28

Shared epitope QKRAA association

RA

29

SLE demographics

young white female

30

Problem list for SLE

Pancytopenia
Arthritis
Alopecia
Skin rash
Photosensitive- malar
Glomerulonephritis

31

________ (AB) can cause drug induced lupus

Minocycline

32

Why does SLE present with low RBC

autoimmune hemolyitic anemia (possibly)


33

major groups of autoantibodies produced in SLE

ABs are targeting tissues (path) or nuclear content (marker)

34

Anti-nuclear antibodies are a____ for SLE

marker

35

ANTIBODIES AGAINST _____ ARE PATHOLOGICAL

TISSUE

36

ANA test

a slide with cell w/ nucleus exposed

if ANA present, ABs bind the nucleus

AB that sees human AB with florescence tags added

if bound and light up, anti-nuclear antibodies are present

Repeat w/ dilution to determine + strength

37

Lupus has ______ autoantigens

multiple

(as opposed to like myasthenia gravis which is specific)

38

In serum sickness the antigen is:

Foreign

39

In lupus the antigen is:

Self

40


In SLE defective clearance of immune clearance/apoptotic cells- ______ is released and can be "seen" by immune system

DNA and RNA

41

Interferon (IFN)-α and IFN-β upregulate the expression of a variety of genes in _______.

lymphocytes

*This “IFN signature” of gene expression is more prevalent in patients with active SLE.

42

Basic problem of SLE

defective clearance of immune clearance

ineffective clearance of apoptotic cells

43

Does SLE have x-ray features?

NO

44

Environmental factors of SLE

Sun
Sex hormones

45

SLE will have a _____ immunoflorescence

Lumpy Bumpy

46

Goodpasture will have a _____ immunoflorescence

Linear