Immunology 9 and Review - Autoimmune, meningitis Flashcards Preview

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Flashcards in Immunology 9 and Review - Autoimmune, meningitis Deck (17):
1

Specific or systemic autoimmunity

Depends on the original auto-antigen targeted. If it is only found in one place (ie thyroid) it will be specific. If it is found more widely (ie widespread or large areas) or if immune complexes found in blood it can be systemic

2

Immunological escalation

Autoimmunity starts specific to one auto-antigen but it can then start targeting other similar or associated auto-antigens. Can be hard to identify what Ag was first

3

A few examples of organ specific autoimmune diseases

Type 1 diabetes (Tdth cells target pancreas ß cells); Addison’s disease (autoAB target adrenal Ag); ITP (autoAB vs platelets)

4

AutoAB to cell surface receptors - examples

Grave’s disease (autoAB bind to TSH receptors, and actually stimulate Thyroid to produce TH - also stimulates hypertrophy and hyperplasia); myasthenia gravis (autoAB to Ach receptor, block Ach, so muscle is inactive)

5

A few examples of systemic autoimmune diseases

Ankylosing spondylitis (Immune complexes and Tdth target vertebrae); MS (Tdth and Tc cells attack brain/white matter); Rheumatoid arthritis (AutoAB, Tdth vs connective tissue, IgG); Psoriasis (Tdth and Th17 target skin)

6

Do autoimmune diseases run in families? What is the possible factor?

They sort of do. We think it is the MHCs. They act as a barcode and are associated with elevated risk.

7

Ankylosing spondylitis mechanism

Marker is the HLA-B27 gene. Much higher risk of developing the condition.

8

Autoimmune diseases and types of hypersensitivity

Type 1: nothing. Type 2: active in rejection of transfusion, AI hemolytic anemia, Goodpasture’s syndrome. Type 3: Systemic lupus erythematosus. Type 4: Tissue graft rejection, MS (?), Rheumatoid arthritis, Diabetes

9

Treatment of autoimmune diseases

Usually a biologic (large protein, typically monoclonal AB). Can block Th1 cytokines (ie TNFa) or block co-stimulation (ie B7-CD28). Suffixes -mab is AB, -cept is soluble receptor for co-stimulator. Expensive!

10

Consequence of biologics?

If you block TNFa, you Tdth cells can’t react as well to contain some infections ie in granuloma (TB, etc). Some may also cause autoimmune diseases to boot.

11

impetigo

characterized by honey brown crust on skin. treat with topical antibiotics (not steroids)

12

prick test

drops of an allergen on skin, then prick skin so it gets through barrier (for large molecules) and can react. Type 1 reaction

13

patch test

patches on back with solutions in the patches. Just on surface, these are small molecules and can diffuse into skin no problem.

14

Asplenic concerns

More prone to encapsulated bacteria (S pneumoniae, N meningitidis) hemopholis influenzae)

15

Vaccines from Jessica case

polysaccharide vaccines. Not bad, but the conjugated vaccines are better, then get polysaccharide booster

16

What antimicrobials were started on Jessica upon admission?

Vancomycin (gram -ve) and ceftriaxone (gram +ve). Get coverage quick for sepsis.

17

meningitis symptom patient gets lumbar puncture. What results could be there for bacteria?

Gram -ve cocci = N meningitidis. Gram +ve cocci = S pneumoniae