Immune system Flashcards by Herik Valles

Most common clinical manifestations of SLE

Hematologic
Fatigue
Arthritis, arthralgia or myalgia
Skin
Renal

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“SOAP BRAIN, MD” mnemonic for SLE criteria

Serositis
Oral ulcers
Arthritis
Photosensitivity
Blood disorders
Renal involvement
ANAs
Immuno. (andi-dsDNA, anti-Sm, antiphospholipid antibodies)
Neurological disorders
Malar or Discoid rash

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Genes that create genetic predisposition to SLE

HLA-DRA2 & HLA-DRA3

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Most widely used method for detection of ANAs

Indirect immunofluorescence

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Complement proteins deficient in SLE

C1q, C2 and C4

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Common triggers of SLE, have not been proved as a cause for the disease.

UV light and EBV

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Air particles or substances that increase the risk of developing SLE.

Cigarette smoking and silica

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Type of hypersensitivity causing systemic lesions in SLE.

Type III hypersensitivity

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Mechanism through which blood vessels are damaged in lupus.

Increased vascular permeability, complement activation and accuulation of PMNs that secrete enzymes.

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Most dangerous clinical manifestation in SLE because of its high morbidity and mortality.

Renal involvement

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Parts of the kidney where immune complexes deposit in SLE.

Glomerular basement membrane, mesangium and sometimes in the glomerulus.

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Most common glomerular disease pattern in SLE.

Class IV
Class 1 is the least common

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Types of class IV SLE kidney disease (diffuse lupus nephritis)

50% or more glomeruli with lesions:
IV-S: Lesions involving <half of glomerular tuft.
IV-G: Lesions involving >half of glomerular tuft.

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Classes with which membranous lupus nephritis (V) can occur

III and IV

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SLE nephritis in which 90% or more of the flomeruli are globally sclerosed.

VI. Advanced sclerotic lupus nephritis.

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These deposits may cause the thickening of the capillary wall of the glomerulous, forming the wire loops structures on class IV SLE nephtropaty.

Subendothelial immune complex

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Diffuse thickening of the glomerulous capillary walls.

Membranous lupus nephritis class V

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Sclerosis of more than 90% of the glomeruli in SLE.

Advanced sclerosing lupus nephritis class VI

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Findings in HE stained skin in SLE

Vacuolar degeneration of the basal layer of the epidermis.
Variable edema and perivascular inflammation in the dermis.

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SLE skin finding with IF

Deposition of Ig and complement in the dermoepidermal junction.

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Type of joint involvement in SLE

Non-erosive synovitis with little deformity

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Histopathologic finding of the spleen in SLE

Perioarteriolar fibrosis (onion skinning)
Concentric intimal and smooth muscle cell hyperplasia

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Histopathologic finding of the bone marrow in SLE

LE or hematoxylin bodies

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Histopathologic skin findings in chronic discoid lupus erythematosus

Follicular plug (carpet tack)
Liquefaction degeneration
Thick basement membrane

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Type of lupus with predominant skin involvement, initial widespread superficial and non-scarring rash and no genetic association, with extreme photosensitivity.

Subacute cutaneous lupus erythematosus

Drugs that may cause drug-induced LSE

Hydralazine, procainamide, isoniazid and D-penicillamine

Type of synovitis of RA

Non-suppurative, proliferative and inflammatory

Genes associated to RA

HLA-DR4 & HLA-DR1

Articular lesions in RA

Symmetrical polyarthritis Z deformity Tenosynovitis Carpal tunnel syndrome

Skin finding in RA

Bursitis and rheumatoid nodules

Finger discoloration finding in RA

Raynaud phenomenon

Citrullinated protein that mimics the epitope on microbes and is presented by class II HLA-DR4 molecule on RA.

Vinculin

CC produced by Th1 cells in RA that activates macrophages and resident synovial cells.

IFN-y

CC produced by Th17 cells in RA that recruits neutrophils and monocytes.

IL-17

Factor expressed by activated T cells in RA, simulates bone resorption.

RANKL

An activated macrophage producing TNF and IL 1 in RA, will stimulate synovial cells to produce________ to ______

MMP and ADAMTS to destroy cartilage

Diagnostic markers found in serum in RA

Anti-citrullinated peptide antibodies (ACPA)

Ig that form rheumatoid factor in RA

IgM and IgA, not specific.

Radiologic finding that differentiates RA from osteoarthritis

RA involves the non-weight bearing portion of the knee.

First joints affected in RA

Small joints, first in hands (metacarpo-phalangeal and proximal interphalangeal)

Necrotizing skin granulomas with central fibrinoid necrosis surrounded by activated macrophages.

Rheumatoid nodules

These organisms infect in mantained anti-TNF therapy

Opportunistic microorganisms (M. tuberculosis)

Swelling of popliteal fold in RA

Baker cyst

Cells infected and attacked by HIV

CD4+ T cells

Receptor and correceptors used by HIV

R: CD4 Correceptor: gp120, CCR5 and CXCR4

Pathway activated by HIV to increase the number of cells infected

Inflammasome pathway (more cell recruitment)

Organs where HIV infection of macrophages and DCs takes place.

lungs and brain

Predominant cell type infected with HIV.

Microglia

Most common neoplasm in patients with AIDS

Kaposi Sarcoma

Tinción que resalta hongos (hifas y esporas)

PAS y grocott (argénica de plata)

Afección de los virus en las células

Inclusiones virales

Virus que causa inclusión en saco de canicas (vesículas con núcleos contaminados), sólo se ve en epitelio escamoso

Herpes simple

Centro necrótico, rodeado de linfocitos con células gigantes multinucleadas.

Granuloma

Protozoarios sugestivos de VIH

Cryptosporidium, P. jirovecii y toxoplasma

Hongos sugesitos de VIH

Candida, Cryptococous en SNC, Coccidioides, Histoplasma

Patient with HIV presents interstitial pneumonia and cavitations. Alveolar biopsy shows alveolar exudate. Grocott stain is requested and black spots are shown.

P. jirovecii infection

Viral inclusion shown as only 1 owl eye everywhere in the body, often in HIV.

CMV

Person with HIV presents chronic diarrhea refractary to treatment. Most common coinfection?

Cryptosporidium

HIV patient with meningitis and encephalitis, grocott stain of CSF is asked.

Cryptococcous pneoformans

HIV infected patient presents encephalitis

T. gondii

For a patient to develop a Kaposi Sarcoma it must be infected with

Herpes virus 8

Escala utilizada para graduar el rechazo renal

Clasificación de Banff

Complement and coagulation activation after blood restorage in a transplant for HLA recognition and preformed antibodies.

Hyperacute rejection

Rejection within days or weeks or transplant, or after immunosuppressive treatment is suspended with possible damage to blood vessels.

Acute rejection

Renal tubulitis after transplantation, with infiltrates in the tubules.

Acute kidney transplant rejection

Explain the diagram and structures.

Acute rejection B: acute cellular rejection (tubulitis) C: vascular rejection

Immune system Flashcards

(66 cards)