Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HistoPath > Histopathlogy 5: Connective Tissue Disorders > Flashcards

Histopathlogy 5: Connective Tissue Disorders Flashcards

1
Q

List 3 auto-antibodies seen in SLE ?

A
  • Anti-dsDNA
  • Anti-Smith (most specific but not very sensitive - only 30% with SLE have)
  • Anti-histone (drug related)

NB ANA (Anti-nuclear antibody) is just a screening test which tells you that the patient has antibodies that bind to nuclear antigens (it does NOT tell you which antigens it binds to)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of hypersensitivity reaction is seen in SLE ?

A

Type 3 hypersensitivity reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the HLA association with SLE ?

A

HLA DR3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name the heart condition that can be caused by SLE ?

A
  • Libman-sack endocarditis
  • This is a NON-INFECTIVE form of endocarditis (inflammatory form of endocarditis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List the signs and symptoms of SLE using the mnemonic SOAP BRAIN MD

A

Serositis (inflam of serous tissue - surround organs)
Oral ulcers
Arthritis
Photosensitivity

Blood disorders- AIHA, ITP
Renal involvement - Type 2 RPGN
ANA +ve
Immune- anti-dsDNA, anti-smith
Neuro symptoms

Malar rash
Discoid rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which auto antibodies are seen in Diffuse scleroderma ?

A

Anti-scl70 - this is the antibody to DNA topoisomerase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which autoantibodies are seen in limited scleroderma (CREST) ?

A

Anti-centromere (ANCA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which HLA is associated with scleroderma ?

A

HLA DR5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List the signs and symptoms of limited scleroderma (CREST) ?

A
  • Calcinosis
  • Raynauds phenomenon
  • Esophageal dysmotility
  • Sclerodactily
  • Telangiectasia

No involvement of the trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Aetiology of scleroderma effect in skin

A
  • EXCESS deposition of collagen
  • resulting in reduced skin elasticity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which autoantibodies are seen in Polymyositis and dermatomyositis ?

A

anti- Jo1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Patient has proximal muscle weakness. Their bloods show increased CK and abnormal EMG. No rash is seen.

Most likely diagnosis?

A

Polymyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Patient has proximal muscle weakness. Their bloods show increased CK and abnormal EMG. A heliotrope rash is seen on the eyelids. There are Gottron papules on the knuckles

Most likely diagnosis?

A

Dermatomyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Japanese lady with absence of pulse and Claudication (pain in muscles).

The Rheumatologist says that its a large vessel arthritis.

Most likely diagnosis ?

A

Takayasu’s arteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Elderly man presents with a temporal headache, jaw claudication and scalp tenderness.

Most likely diagnosis?

A

Temporal arteritis

(Large vessel vasculitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A man presents with abdo pain and signs of renal impairment. Angiogram shows “rosary beads” because of multiple aneurysms.

Most likely diagnosis?
Associated with which disease?

A 
Polyartheritis nodosa (medium vessel arteritis)
Hepatitis B
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A heavy smoker with ulceration of the toes and fingers has an angiogram which shows a “corkscrew appearance”.

Most likely diagnosis?

A

Buerger’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List the triad of features seen in Polyangitis with granulomatosis ?

A

Saddle nose
Pulmonary haemorrhage
Glomerulonephritis (Crescentic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which ANCA is associated with Granulomatosis with polyangiitis (Wegener’s Granulomatosis) ?

A

C-ANCA

directed against proteinase 3

20
Q

List 3 characteristic features of Eosinophilic granulomatosis with polyangitis (Churg-Strauss syndrome) ?

A
  • Asthma
  • Eosinophilia
  • P-ANCA vasculitis

NB this is small vessel disease

21
Q

List 3 features of Microscopic polyangitis?

A

Pulmonary haemorrhage (haemoptysis)
Glomerulonephritis (Pauci immune RPGN)
P-ANCA small vessel vasculitis

22
Q

Which type of amyloidosis is seen in multiple myeloma ?

A

AL amyloidosis (primary)

With free light chains, monoclonal Ig and Bence jones proteins in the urine

23
Q

List some causes of AA amyloidosis? (4)

A
  • Rheumatoid arthritis
  • Chronic TB infection
  • IBD
  • Hodgkin’s lymphoma
24
Q

Name one familial amyloidosis ?

A

Familial Mediterranean fever

25
Q

Congo red staining shows ……………. under polarised light if there is Amyloidosis

A

apple green birefringence

26
Q

An Afro Caribbean patient presents with SOB and cough. Examination shows erythema nodosum, lymphadenopathy and hepatosplenomegaly. X-ray shows bilateral hilar lymphadenopathy
Histology shows: non-caseating granulomas

Most likely diagnosis?

A

Sarcoidosis

27
Q

Which electrolyte is often elevated in Sarcoidosis?

A

Ca2+

28
Q
A
29
Q

How to measure anti-dsDNA in SLE

A
  • incubate the patient’s serum with Crithidia Luciliae (protozoan)
  • This organism has a big mitochondrion with dsDNA (kinetoplast)
  • Also measure with ELISA
30
Q

Skin histology for SLE

A
  • lymphocytic infiltration (black dots)
  • vacuolisation (dissolution of the cells)
  • extravasation of the RBCs
31
Q

How do glomerulus capillaries look in SLE?

A
  • thickened (wire-loop capillaries)
  • capillaries are thick due to immune complex deposition in the basement membrane (capillaries are surrounded by basement membranes)
32
Q

Limited vs diffuse Systemic Sclerosis (scleroderma) in terms of where on the body affected

A
  • Diffuse= involves the truncal skin
  • Limited= does NOT involve the trunk (only affects distal to the elbows and knees)
33
Q

immunofluorescence finding in scleroderma

A

nucleolar pattern

34
Q

Effect of trichome staining on muscle and collagen

A
  • Red staining- muscle
  • Blue staining- collagen

NB can use this in scleroderma (see XS collagen)

35
Q

Histological finding in scleroderma

A

onion skin appearance - due to intimal layer of artery proliferating and obliterating the lumen

36
Q

Why do ANA test?

A

Screen for mixed connective tissue disease

Then need to follow-up to look for specific antibodies

37
Q

Sign on knuckle in dermatomyositis

A

Gottron’s papules (erythematous purple rash over the knuckles)

38
Q

Sites affected in sarcoidosis

A
  • Joints (arthralgia)
  • Skin (e.g. lupus pernio, erythema nodosum)
  • Lungs (bilateral hilar lymphadenopathy, fibrosis, lymphocytosis (increased CD4+ cells in the bronchoalveolar lavage)
  • Lymphadenopathy
  • Heart (any layer: pericardium, myocardium, endocardium)
  • Eyes (uveitis, keratoconjunctivitis)
  • Neuro (meningitis, cranial nerve lesions)
  • Liver (e.g. hepatitis, cirrhosis, cholestasis)
  • Parotids (bilateral enlargement)

pathological hallmark of Sarcoidosis is a non-caseating granulomatous inflammation

39
Q

Enzyme and electolyte raised in sarcoidosis

A
  • Raised serum ACE levels (due to abnormality in the lungs where ACE is made)
  • HyperCa
40
Q

2 visible features of vasculitis

A
  • palpable purpuric rash
  • Nail fold infarcts
41
Q

Definitive Dx of temporal arteritis

A
  • temporal artery biopsy
  • show narrowing of the lumen and lymphocytic infiltration of the tunica media
42
Q

Tx of Giant Cell Arteritis (Temporal Arteritis)

A

high dose prednisolone

43
Q

Example of Medium Vessel vasculitis

A

Polyarteritis Nodosa

  • Necrotising arteritis
  • most commonly affecting the renal vessels or mesenteric vessels
  • May present with gut ischaemia or renal impairment
  • Creates a rosary beads appearance on the angiogram because of the presence of multiple aneurysms
44
Q

rosary beads appearance on the angiogram due to which vasculitis?

A

Polyarteritis Nodosa

45
Q

Polyarteritis Nodosa associated with which infection?

A

Hep B

46
Q

Example of Small Vessel vasculitis

A

Granulomatosis with polyangiitis (Wegener’s Granulomatosis)

  • ENT- nosebleeds, sinusitis, saddle nose
  • Lungs- haemoptysis, SOB
  • Kidneys- haematuria
47
Q

p-ANCA seen in which small vessel vasculitis?

A

Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome)

3 hallmarks:

  • Asthma
  • Eosinophilia
  • Vasculitis

HistoPath (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions