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Weeks 7-11 > Immunology > Flashcards

Immunology Flashcards

1
Q

What is rheumatoid arthritis?

A

Chronic systemic autoimmune disease characterised by inflammation of the synovium of joints

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2
Q

What is the epidemiology of RA?

A

3 times more common in women

Ages 30-50

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3
Q

What are the symptoms of RA?

A

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

Fatigue, loss of appetite, weight loss, depression

Sjogren’s syndrome

Vaculitis

Inflammation around heart and lungs

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4
Q

How does RA affect the blood?

A

Hypochromatic-microcytic anaemia

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5
Q

How does RA affect the nerves?

A

Peripheral nerve entrapment from C-spine instability

Vasculitis leads to mononeuritis multiplex

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6
Q

How does RA affect the heart?

A

Pericardial effusion in almost 50% of patients

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7
Q

How does RA affect the lungs?

A

Interstitial lung disease

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8
Q

How does RA affect the eyes?

A

Keratoconjunctivitis sicca

Episcleritis

Scleritis

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9
Q

How does RA affect the skin?

A

Rheumatoid nodules

Dermal vasculitic lesions

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10
Q

What are MHC molecules?

A

Membrane glycoproteins on the cell surface that display peptide antigens to T cells

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11
Q

Which cells do MHC II cells present antigen to?

A

CD4+ T helper cells

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12
Q

Generally, what is the role of Th1 and Th2 cells?

A

Th1 - produce cell mediated immunity

Th2 - antibody responses

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13
Q

What is the genetic basis of RA?

A

HLA-DR4

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14
Q

What is the role of HLA-DR genes?

A

Reside in the MHC and participate in antigen presentation

Bind to arthritogenic peptides

Serve as target for autoreactive T cells

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15
Q

Which joints are affected in RA?

A

Hands and wrists in nearly all sufferers

Foot, ankle and knee detected easily

Hip involvement common

Loss of motion in elbow and shoulders

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16
Q

What is the role of autoreactive T cells?

A

Supress autoreactive T cells by secreting inhibitory cytokines

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17
Q

Which cytokines do Treg cells secrete?

A

IL-10

TGF-beta

18
Q

What is the role of the thymus?

A

Delete self-reactive T cells

19
Q

What happens when self-reactive T cells are detected?

A

They become Treg cells which produce IL-10 and TGF-beta to inhibit other self reactive T cells

20
Q

Which cytokines active synovial fibroblasts?

A

IL-1

TNF-alpha

21
Q

What is the role of synovial fibroblasts in RA?

A

Invade cartilage and bone and regulate monocyte differentiation into osteoclasts

22
Q

Which lab tests are used to diagnose RA?

A

Erthyrocyte Sedimation Rate

CRP

Anti-nuclear antibodies (rheumatic factor)

23
Q

Which drugs can be given to treat symptoms of RA?

A

NSAIDS

Analgesics

Corticosteroids

24
Q

Which disease modifying drugs can be given to treat RA?

A

Methotrexate

Hydroxychloroquine

25
Q

Which biologic modifiers can be used to treat RA?

A

Infliximab

Rituximab

26
Q

How many people with RA have severe disease with extensive disability?

A

5%

27
Q

What is ankylosing spondylitis?

A

Inflammatory arthritis affecting the joints of the spine

28
Q

Who gets AS?

A

Males more than females

29
Q

Which drugs are used for AS?

A

Pain killers - NSAIDs, diclofenac

Infliximab (anti-TNF)

30
Q

Which gene is AS associated with?

A

HLA-B27

31
Q

What is the pathology of AS?

A

Inflammation of facet joints then eventual fusion of vertebrae

32
Q

What usually triggers reactive arthritis?

A

Salmonella

Campylobacter

Chlamydia

33
Q

Which disease is AS linked to in 50% of sufferers?

A

Reactive arthritis

34
Q

What is the theory of B27 and AS?

A

Peptides from bacteria presented by B27

Peptide looks like host peptide in spine so autoreactive T cells target this joint

B27 misfolds inside cells and causes them to secrete cytokines

B27 at cell surface recognised by NK cells

35
Q

Which drug can keep RA and AS under control?

A

Anti-TNF

36
Q

Who gets coeliac disease?

A

Females

40-60 years

37
Q

What causes coeliac disease?

A

Autoimmune reaction to gluten

38
Q

Which immune cells are involved in acute inflammation?

A

Histamine

Prostaglandins

Cytokines

Bradykinin

39
Q

Which immune cells are involved in chronic inflammation?

A

Macrophage - Langhan’s giant ells

Lymphocytes

Plasma cells

Fibroblasts

40
Q

What causes coeliac disease?

A

Glutamine in gluten is converted to glutamic acid by TG2 in the gut which make protein have much higher affinity for MHC molecules

41
Q

What did the sweaty T-shirt experiment?

A

Women preferred odours of men who had a different immune system to them

Weeks 7-11 (22 decks)

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