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MD4001 Pathology > Immunology > Flashcards

Flashcards in Immunology Deck (28):
1

What cells are involved in chronic inflammation

T lymphocytes which secrete cytokines

plasma cells which produce immunoglobulin

neutrophils

eosinophils (parasites)

fibroblasts

macrophages (microglia in the brain)


characterised by large numbers of macrophages and granulation tissue

2

what cells are involved in acute inflammation

neutrophils (diagnostic)

3

what organism causes syphilis

treponema pallidum

4

what are the symptoms of syphilis

genital chancre
secondary rash
gumma (granuloma in tertiary disease)

5

what organism causes leprosy

mycobacterium leprae

6

what is the epidemiology of RA

more common in women
common between 30-50 years old

environmental factors may precipitate onset

7

describe some of the features of a rheumatoid joint

thinning of cartilage
erosion of the bone
inflamed synovium
inflamed tendon sheath
effusions
synovial thickenings

8

what are the symptoms of RA

inflamed joints that are warm, tender, swollen, red, painful and difficult to move

fatigue

loss of apetite, weight loss, flu like symptoms, depression, anaemia

vasculitis

sjogren's syndrome

heart and lung inflammation

9

what joints are affected in RA

foot ankle and knee
hip (later on)
hands and wrists almost always affects
elbow (loss of motion)
shoulders and neck stiffness

10

what organs are affected in RA

blood (anaemia)
nerves (mononeuritis multiplex)
heart (pericardial effusion)
lungs (interstitial lung disease)
eyes
skin (rheumatoid nodules)

11

what type of anaemia is almost always present in RA

hypochromatic microcytic anaemia with low serum ferritin and low or normal iron binding capacity

12

how are the nerves affected in RA

vasculitis causes mononeuritis multiplex
peripheral nerve entrapment
cervical spine instability

13

how are the eyes affected in RA

keratoconjuntivitis sicca, (dryness of the conjunctivae and cornea) episcleritis, scleritis

14

what is major histocompatibility complex

Membrane glycoproteins that display peptide antigens to T cells

MHC 2 bind peptides derived from proteins from extracellular sources that have been internalised

presents peptides to CD4 t helper cells

15

what is the function of th1 cytokines

cell mediated immunity

16

what is the function of Th2

antibody responses

17

what genes are associated with RA

specific human leukocyte antigen (HLA)

HLA-DR4
involved in antigen presentation
higher risk of severity of homozygous

binds to arthritogenic peptides

target for autoreactive T cells

18

what is autoimmunity

immune mediated destruction of self tissues

occurs via specific recognition of self antigens

activation of self reactive lymphocytes by self antigens

19

what is tolerance

the process that keeps the immune system from attacking itself

thymic deletion of autoreactive cells and T regulatory cells

20

what are cytokines

proteins made by cells that affect the behaviour of other cells (e.g. interleukins)

21

what are chemokines

chemotactic cytokines

22

how is RA diagnosed

no definitive test

medical history
physical examination
lab tets -imaging, ESR, CRP
rheumatoid factor

23

what are the aims of RA treatment

relieve pain
reduce inflammation
stop or slow joint damage
improve functioning and sense of wellbeing

24

what medications are available for RA

NSAIDS
analgesics
corticosteroids

disease modifying:
methotrexate
sulfasalazine
azathioprine
cyclosporine
hydroxychloroquine
minocycline

infliximab (anti TNF)
rituximab

25

what is ankylosing spondylitis

chronic inflammatory arthritis affecting the spine

more common in males

association with human class 1 MHC molecule HLA b27

bone grows out of both sides of the vertebrae and may join them together

26

how is AS treated

NSAIDs, indomethacin, COX-2 inhibitors

anti TNF (infliximab)

27

what is HLA-b27 linked to

reactive arthritis
caused by bacterial infection

28

what are the signs of reactive arthritis

eye inflammation
diarrhoea
lower back pain
scaly patches in genitals
flaky skin on soles
swelling in knee, heel or ball of foot