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Emma's NPLEX II Dx > Immunologic > Flashcards

Flashcards in Immunologic Deck (43):
1

What gender is more likely to have juvenile rheumatoid arthritis?

Both genders have equal predisposition for systemic JRA

Girls are 3x more likely to have articular-specific JRA than boys

2

What is the most common presenting symptom in Systemic Lupus Erythematosus?

Myalgia

SLE is often referred to as the disease of 10,000 faces because its clinical presentation significantly varies

3

Aside from joint-related characteristics in Rheumatoid Arthritis (rheumatoid nodules, vasculitis, pannus formation, and baker cysts) what systemic symptoms can be seen?

1.) Pleural effusion
2.) Lymphadenopathy
3.) Interstitial Lung Fibrosis

4

In what condition do you find heliotrope discoloration of the eyelids?

Dermatomyositis

5

What autoantibody is highly indicative of diffuse scleroderma?

Anti-topoisomerase I

6

What Rheumatoid Factor titer ratio is necessary to diagnose an autoimmune condition?

Titers > 1:80

Note: RF is not specific to any condition!

7

What are the advantages of PCR over ELISA in HIV testing?

1.) PCR becomes positive earlier in the disease course (PCR measures DNA whereas ELISA measures antibodies)

2.) PCR does not require that the patient have a competant immune system (ELISA requires the host to make antibodies)

8

How is HIV viral load measured?

RT-PCR

9

Churg Strauss Syndrome (Eosinophilic Granulomatosis with polyangitis) causes what symptoms?

1.) Severe Asthma
2.) Allergic rhinitis
3.) Vasculitis symptoms (purpura and related symptoms)

10

What are the main symptoms of cryptosporidiosis in HIV?

1.) Watery Diarrhea with abdominal pain and nausea/vomiting, causing:

2.) Weight loss, anorexia, and Dehydration

11

What is Scleroderma?

An autoimmune disease that produces antibodies against the body's connective tissue thereby causing systemic fibrosis. It most commonly affects the skin, kidneys, heart, and lungs

12

Opportunistic infections generally develop when the CD4 count drops below what threshold?

200

13

ANCA autoantibodies are associated with what conditions?

Small vessel vasculitis conditions such as:

1.) Eosinophilic granulomatosis with polyangitis (formerly Churg-Strauss)
2.) Granulomatosis with polyangitis (formerly Wegener's granulomatosis)
3.) ANCA glomerulonephritis

14

What are the symptoms of CREST Syndrome? What condition is CREST associated with?

Calcinosis - deposition of calcific nodules in the skin
Raynaud's phenomenon - frequently the first symptom
Esophageal dysmotility - which may lead to GERD or dysphagia
Sclerodactyly - increased collagen deposition in the skin of the hands causing the skin to tighten
Telangiectasia - dilated capillaries

CREST is considered to be a limited systemic version of scleroderma

15

A normal CD4:CD8 ratio is? In HIV it becomes?

Normal = 2:1
HIV = 1:1 or less

16

In polymyositis, are distal or proximal muscle groups affected?

Proximal muscle groups

17

How long may it take to seroconvert?

6 months

18

How might a person with HIV contract Cryptosporidiosis?

Drinking unfiltered water

19

Retinitis in HIV is often associated with what opportunistic infection? How would you diagnose this condition?

Cytomegalovirus (CMV). The infection may lead to blindness

Diagnosed via CMV blood titers

20

In what condition is the tensilon test used?

Myasthenia gravis

The tensilon test is the administration of edrophonium (acetylcholinesterase inhibitor) used to prevent progressive muscle weakness typically experienced in myasthenia gravis

21

Heterophile antibodies designate what infection?

Epstein-Barr Virus (EBV)

22

How is AIDS classified?

If Asymptomatic (A), Symptomatic (B), Symptomatic with AIDS defining illness (C)

If CD4 count >500 (1), 200-500 (2), <200 (3)

Therefore, an asymptomatic person with a CD4 count of 600 = A1

23

What is the treatment of dermatomyositis?

Corticosteroids

24

Toxoplasmosis presents with what symptoms?

1.) Encephalitis and altered mental status
2.) Unilateral paralysis
3.) Seizures
4.) Severe Headaches
4.) Fever

25

Polyarteritis nodosa is commonly associated with what virus?

Hepatitis B virus

26

Mayasthenia Gravis usually starts with weakness in what muscle?

Eye muscle weakness

27

What medication is a risk factor for IgA deficiency?

Phenytoin

28

How do you differentiate CMV and EBV mononucleosis?

EBV-mononucleosis has heterophile antibodies present while CMV does not

29

Cryptococcus in HIV may present with what symptoms?

1.) Meningitis with headaches and intermittent fever
2.) Fatigue
3.) Altered mental status
4.) Pneumonia

30

What test is done for basic HIV screening?

anti-HIV antibodies using ELISA

If ELISA comes back positive, then Western Blot testing is done to confirm the result

However, the earliest diagnosis can be made with PCR for HIV

31

What 2 autoimmune conditions may be related to silicone implants?

Scleroderma and Sjogren's

32

What autoantibody is generally present in SLE?

anti-dsDNA antibody & anticardiolipin antibodies

33

What autoantibody is highly associative with limited systemic scleroderma (CREST)?

Anti-centromere Antibody

34

What lab test is used to detect various immunoglobulins?

ELISA

35

What are the typical lab findings in Dermatomyositis?

1.) Increased CK (d/t muscle breakdown)
2.) Positive ANA & Anti-Jo1 antibody
3.) Perimysial Inflammation & Endmysial atrophy

Perimysium = sheath that groups muscle fascicles
Endomysium = ensheaths each individual muscle fibre

36

What is the most common ANCA vasculitis?

Microscopic Polyangitis (affecting the lungs and kidneys)

37

What lab test is used to identify mumps?

IgM paramyxovirus

38

What autoimmune condition greatly increases the risk of lymphoma?

Sjogren's Syndrome

39

What auto-immune condition is twice as likely to occur in men than women?

Polyarteritis nodosa

40

What autoantibody is highly associated with polymyositis and dermatomysositis?

Anti-Jo Antibody

41

What autoantibodies are associated with scleroderma?

1.) Anti-centromere = favours the diagnosis of CREST (limited systemic scleroderma)
2.) Anti-nuclear Antibody
3.) Anti-topoisomerase I = associated with diffuse scleroderma
4.) Anti-collagen Type IV Antibody (vs Basement Membrane)

42

What lab test evaluates the presence of IgE?

RAST

43

What ANA antibodies are associated with Sjogren's Syndrome?

Anti-SSA/Ro (present in many other AI conditions)
Anti-SSB/La (more specific)