Immunopathology Again Flashcards
(87 cards)
1
Q
Macule
A
Flat lesion <1cm
Freckle
2
Q
Patch
A
Macule >1cm
Birthmark
3
Q
Papule
A
Elevated solid skin lesion <1cm
Mole, acne
4
Q
Plaque
A
Papule >cm
Psoriasis
5
Q
Vesicles
A
Small fluid filled blister <1cm
Shingles
6
Q
Bulla
A
Large fluid filled blister >1cm
Bulluos
Pemphigoid
7
Q
Pustule
A
Vesicles containing pus
Pustular psoriasis
8
Q
Wheal
A
Transient smooth papule or plaque
Hives
9
Q
Scale
A
Flaking off of stratum corneum
Eczema
10
Q
Crust
A
Dry exudate
Impetigo
11
Q
Signs and symptoms of lupus erythematosus
A
- Facial rash (photo Sensitivity) butterfly
- arthritis
- renal disorders
- Neuro disorders
- immunological disorders
- hemolytic anemia
- rashes
Great imitator
12
Q
Classic triad for SLE
A
Fever, joint pain malar rash on bridge of nose and cheeks
13
Q
Chronic inflammatory immune disorder primarily in women of childbearing age
A
SLE
14
Q
Another name for butterfly rash
A
Malar rush
15
Q
Women and men in SLE
A
Women outnumber men 10:1
16
Q
Etiology of SLE
A
Unknown. Characterized by formation of an array of antinuclear antibodies (ANA) and formation of immune complexes
-type III
17
Q
What test do we use for SLE
A
ANA
-very sensitive but not specific
18
Q
Immune complex of SLE
A
Deposit and cause tissue damage and cause symptoms of disease
19
Q
4 types of LE
A
- SLE (70%)
- discoid lupus (10%, skin and scarring, never goes internally )
- drug-induced lupus (10% resolves upon stopping drug)
- combination lupus + Sjogren or RA
20
Q
Common cause of death in SLE
A
cardiovascular disease
Renal failure
Infections
21
Q
Never goes internally, causes chronic eruptions and scarring of the skin
A
Discoid lupus
22
Q
Most common diagnostic criteria for SLE
A
Malar rash
23
Q
What blood tests do we use for SLE
A
ANA- sensitive, not specific
Anti-dsDNA- specific, poor prognosis
Anti-smith-specific, not prognostic
24
Q
What can cause a false positive syphillis test
A
False positive RPR/VDRL, FTA-ABS
SLE
25
Ocular findings of SLE
20%
- dry eye
- recurrent episcleritis
- peripheral keratitis (infiltrates)
- photo Sensitivity
- uveitis
- central retinal artery occlusion (CRAO)
26
Drugs associated with drug induced lupus
Quietly Induce Harmful Pathology
- quinidine (cardiac)
- isoniazid (TB)
- hydralazine (cardiac)
- procainamide (cardiac)
27
How does drug associated lupus present in blood
Transient ANA, no anti-Sm antibodies
All the signs and symptoms of lupus but not the blood work for it
28
Inflamed vessels walls may occlude, may occur with other connective tissue diseases
Vasculitis
29
Affects large and small arteries, ophthalmic and aorta often involved
Giant cell arteritis (formal temporal arteritis)
Granuloma and inflammation can occlude the artery
Emergency
30
Presentation of giant cell arteritis
Evolves to severe
| HA, scalp necrosis, jaw claudication, blindness
31
What is giant cell arteritis treated with
Steroids, prevent blindness
32
Focal or segmental lesions of small and medium arteries
Poly arteritis nodosum
33
Signs and symptoms of polyarteritis nodosum
Joint pain
Retinal vein occlusion
Cotton wool spots
34
Excessive fibrosis throughout the body, occurring mostly in women, 30-50 years old
Scleroderma
35
ANA in scleroderma
Positive in 95% of patients
36
Scleroderma if it moves internally
Pulmonary involvement is leading cause of death
37
Two major types of scleroderma
Diffuse
| Limited
38
Diffuse scleroderma
Widespread skin involvement, rapid progression to viscera
39
Limited scleroderma
Skin, fingers and face, characterized by the CREST syndrome, benign course
40
Limited scleroderma with CREST syndrome
Diagnostic of limited scleroderma that is treatable and non lethal
- clacinosis
- raynaud phenomenon
- esophageal dysmotility
- sclerodactyly
- telangiesctasia
41
Formation of calcium deposit in any soft tissue
Calcinosis
42
Vasospasm in digits, white-blue-red
Raynaud phenomenon
43
Thickening and tightening of skin of fingers and toes
Sclerpdactylyl
44
Small, dilated vessels near the skin air mucus membrane surface
Telangiectasia
45
Another test that can test for limited scleroderma
Anti-centromere Ab
46
Anti-Scl-70
Diffuse/bad scleroderma outcome.
47
Anti-centromere Ab
Limited/benign scleroderma
48
Ocular implications of scleroderma
May involve lacrimal glands
49
Autoimmune destruction of exocrine glands (especially lactimal and salivary glands)
Sjogrens sysndrome
50
Triad in Sjogrens
Dry mouth, dry eyes, and arthritis
51
Who is affected nu Sjogrens
40-60 y/o females
52
Labs for Sjogren syndrome
ANA and RF positive
| Antiribonucleoprotein Ab: SS-A (anti-Ro) and SS-B (anti-La)
53
Attacks moisture producing glands
Sjogrens
54
A term a relates to inflammation of the joints
Arthritis
55
Applied to 100+ rheumatic diseases
Arthritis
56
Number one cause of arthritis
Osteoarthritis (OA)
57
Friction disease, not autoimmune disease leading to arthritis
Osteoarthritis
| Damage to joint, related to overuse on weight bearing joints
58
Who is impacted by OA
10% of all Americans
59
Systemic inflammatory disease of symbolical membranes/joints of hands, feet, wrists, also involves heart/lung/liver/skin/vasculature
RA
60
Pathology of RA
Starts as retype IV, and then very quickly goes to type III
61
Rheumatoid factors
Used to ID and Dx RA
- the antibody that help forms the immune complex
- IgM!! (Usually everything class switches to IgE, by RA does not)
- Anti-IgG Ab
- autoimmune
62
What is unique about the IgG in RA
It does not activate complement
63
RA immunoglobulin
RF is the IgM that is bound to the IgG FC portion that is attached to a cell membrane and causes complement
-anti-IgG Ab
64
What HS is RA
Type III
| Starts as 4 but very transient
65
Ocular manifestations in RA (percent)
25%
66
What are the ocular manifestations of RA
- keratoconjunctivitis sicca
- scleromalacia perforans
- choroiditis, retinal vasculitis, RD
67
What is the most common ocular manifestation of RA
Keratoconjunctivitis sicca (deacreased porduction and subsequent corneal damage) in 15-25% of patients
68
Necrotizing scleritis with inflammation occurring in RA
Scleromalacia perforans
69
Deep, boring pain exacerbated by palpating the eye. Vessels are purplish and dont blanch with pehnyl
Scleritis. Not the case for conjunctivitis
70
Formerly known JRA, most common form of arthritis in children
Juvenile idopathic arthertis
71
Who does JIA target
Young females and affects multiple joints
72
Blood test for JIA
ANA positive
| RF neg 50% of cases
73
What patients are at a higher risk of ocular manifestations from JIA
Patients under the age of 6 with recent onset of disease
74
JIA control
Can be easily controlled and can totally go away
75
The number one cause of uveitis in children
JIA
| Accounting for 80% of cases
76
Arthertis without rheumatoid factor, no anti-IgG Ab
Seronegative spondyloartheropathies
77
What is there a strong association with in seronegative spondyloartheropathies
HLA-B27 (MHC-1)
78
Signs and symptoms of seronegative spondyloartheropathies
- Inflammatory back pain- improves with exercise
| - extraarticular GI symptoms, dactylitis (sausage fingers)
79
seronegative spondyloparthropathies mnemonic
PAIR
- psoriatic arthritis
- ankylosing spondylitis
- inflammatory bowel disease (IBD)
- reactive arthritis
80
Associated with skin psoriasis and nail bed pitting, dactylitis and uveitis
Psoriatic arthritis
81
Spinal and sacroiliac ankylosis (joint fusion), lower back pain, bamboo spine, uveitis
Ankylosing spondylitis
82
Most common extracurricular manifestation of ankylosing spondylitis
Uveitis
83
What can people with IBD develop
Can have joint pain
84
Post venerial and post diarrheal, present with triad of conjunctivitis, urethritis, and arthritis
Reactive arthritis
| -cant pee, cant see, cant climb a tree
85
Non-rhematologic autoimmune, inflammatory up disease with an associated of iveiuti and hypercalcium
Sarcoidosis
86
Signs and symptoms of sarcoidosis
Non caseating granulomas skin lesions
- associated with pulmonary infiltrates
- hilar adenpathy
87
When's someone has high calcium levels what do we consider
Parathyroid gland problems, sarcoidosis, and lung cancer
