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[Y1] Pathology > Diseases of the immune system > Flashcards

Diseases of the immune system Flashcards

1
Q

what are the 2 times that a disease of the immune system occurs?

A

-when the immune systtem fails to attack
-when the immune system attacks itself

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2
Q

what is it called when the immune system fails to attack?

A

immunodeficiencies

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3
Q

what is the definition of immunodeficiency?

A

when the immune system is depressed or absent and an individual is unable to mount a normal immune resonse to protect the body

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4
Q

what are the 2 origins of immunodeficiency?

A

-primary or congenital
-secondary or acquired

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5
Q

what is primary/congenital immunodeficiency?

A

-inherited genetic defects in immune cell development or function
-an inherited deficiency in a particular immune molecule

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6
Q

what is secondary/acquired immunodeficiency?

A

a loss of a previously functional immunity due to a number of reasons

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7
Q

what are the 6 reasons for secondary immunodeficiency?

A

-infection
-radiation
-splenectomy
-aging
-malnutrition
-drugs (immunosuppressant drugs after transplant)

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8
Q

Is SCID deficiency an X or Y linked deficiency?

A

X

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9
Q

what do people with SCID lack?

A

common-y chain
(necessary for the development and function of T cells

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10
Q

Name one person born with SCID and when?

A

David Vetter
born in 1971

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11
Q

how was david vetters birth “germ free”?

A

born in a reverse isolation chamber

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12
Q

what is autoimmunity?

A

occurs when the immune system mistakenly attacks “self” proteins (“auto”)

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13
Q

what causes autoimmunity?

A

-many potential causes
-the problem lies in the effective regulation

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14
Q

what was previously believed to cause autoimmunity?

A

self-reactive lymphocytes were deleted during their development

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15
Q

what 2 things can be involved in autoimmune reactions that lead to autoimmune diseases?

A

-autoreactive T cells
-autoantibodies
(both react to proteins in the body known as autoantigens)

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16
Q

What is self-tolerance?

A

the ability of the immune system not to attak the normal tissue of the body
(autoimmunity is therefore regarded as a breakdown in self-tolerance)

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17
Q

name 3 organ specific autoimmune diseases

A

Type 1 diabetes
Multiple sclerosis
Gaves’ disease
Hashimoto’s thyroiditis
Goodpasture’s syndrome

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18
Q

name 3 systematic autoimmune diseases?

A

rheumatoid arthritis
scleroderema
systemic lupus

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19
Q

what is an organ-specific autoimmune diease?

A

the immune response is directed to a target antigen that is unique to a single organ or gland

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20
Q

what does organ-specific autoimmunity cause to the organ?

A

-cellular lysis
-inflammatory response
-function of organ declines

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21
Q

what are the three types of autoimmune disease classification?

A

-Type II autoimmune disease
-Type III: immune complex disease
-Type IV: T-cell mediated disease

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22
Q

how are autoimmune diseases classified?

A

by immuno-pathogenic mechanism

23
Q

name 3 Type II autoimmune diseases

A

goodpasture’s syndrome
autoimmune haemolytic anemia
acute rheumatic fever

24
Q

name 2 Type III conditions

A

-mixed essential cryoglobulinemia
-rheumatoid arthristis

25
Q

name 2 Type IV conditions

A

-type 1 diabetes
-rheumatoid arthritis
-multiple sclerosis

26
Q

what is the role of immune complexes?

A

“mop” up soluble molecules

27
Q

what is the proper name for type 1 diabetes?

A

Insulin-dependant diabetes mellitus

28
Q

what causes the insulin defficiency in type 1 diabetes?

A

T cells mediated destruction of the cells that make insulin

29
Q

how do the beta cells get destroyed in diabetes?

A

-CD8+T cells recognise a protein from insulin-producing beta cells
-beta cells are destroyed by the cytotoxic actions of the CD8+T cells and insulin can no longer be produced

30
Q

what causes Type 2 diabetes?

A

antagonistic antibodies block stimulation by insulin

31
Q

what are 5 symptoms of diabetes?

A

-elevation of plasma glucose
-glucose in urine
-thirst
-weight loss
-excessive urination

32
Q

what are the extreme symptoms of diabetes id not treated?

A

Ketosis (due to fats as a source of energy)
-leads to convulsions and diabetic coma
Ketoacidosis occurs when blood pH reduces from pH 7.4 to 7.1

33
Q

what is the treatment for type 1 diabetes?

A

measurement of blood glucose
administration of insulin injections to maintain a normal level of glucose in the body

34
Q

what is myasthenia?

A

“serious muscle weakness”

35
Q

what causes myasthenia?

A

-Target antigen - acetylcholine receptors on motor end-plates of muscles
-Antibodies prevent the binding and thereby the actions of acetylcholine
-Inhibit muscle activation

36
Q

what are the symptoms of myasthenia gravis?

A

-abnormal weakness and fatigability of selected muscles
(can be facial muscles and muscles required for breathing)

37
Q

what are the treatments for myasthenia gravis?

A

-acetylocholine esterase inhibitors to try and build up concentrations on acetylcholine
-immunosuppressive drugs
-plasmapheresis (removal, treatment and return of blood plasma)

38
Q

what does multiple sclerosis do to the body?

A

causes inflammatory lesions along myelin sheath of nerve fibers

39
Q

what causes the inflammatory lesions in MS?

A

cerebro-spinal fluid contains activated T lymphocytes

40
Q

what is the function of myelin?

A

insulates nerve fibres which enables rapid depolarisation

41
Q

do HIC or LIC countries have higher population risk of MS?

A

HIC

42
Q

what type of autoimmune response is MS?

A

type IV

43
Q

what are 3 autoantigens for MS?

A

Myelin Basic Protein (MBP)
Proteolipid protein (PLP)
Myelin oligodedrocyte protein (MOG)

44
Q

what are 5 symptoms of MS?

A
  • Unsteady gait, shaky movements of the limbs (ataxia)
  • Rapid involuntary movements of the eyes
  • Defects in speech - pronunciation
  • Spasticity (involuntary muscle contractions that are not coordinated with other muscles)
  • episodic relapses
45
Q

what are 2 possible treatments for MS?

A
  • Immunosuppressive drugs
  • Immune-modulating treatments
46
Q

who does rheumatoid arthritis most commonly affect?

A

women between the ages of 40 and 60

47
Q

what is the main symptom of rheumatiod arthritis?

A

chronic inflammation of the joints

48
Q

what is the cause of rheumatoid arthritis?

A
  • Generation of auto-antibodies called rheumatoid factors
  • These are reactive with Fc portion of antibodies
  • Bind normal IgG in circulation and complexes are deposited in joints
  • Complement activation and chronic inflammation occurs
49
Q

what type of autoimmune reaction is rheumatoid arthritis?

A

type III

50
Q

what is the only option to clear the autoimmunity?

A

bone marrow transplant to “replace” the immune system

51
Q

what are the 3 main options for palliative therapy?

A
  1. Anti-inflammatory therapy to reduce the mount of tissue injury that occurs by inflammation eg ASPIRIN, non-steroidal anti-inflammatory drugs followed by CORTICOSTEROIDS in severe inflammation
  2. Modification of the immune response by IMMUNOMODULATORY THERAPY
  3. Compensate for the impaired physiological function (eg. Injection of insulin in type 1 diabetic patients)
52
Q

what is the general current treatment for dealing with problem antibodies?

A

Plasmapheresis - may give temporary relief for patients with Grave’s disease, myasthenia gravis, rheumatoid arthritis, and SLE (removes the autoantibodies from the circulation)

53
Q

what is the general current treatment for dealing with problem T cells?

A

-Most cause non-specific suppression of the immune system i.e. no distinction between beneficial and pathologic immunity
-Example drugs: corticosteroids, azathioprine, cyclophosphamide
(cause slow proliferation of lymphocytes)

54
Q
A

[Y1] Pathology (10 decks)

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