Week 5 tuesday Flashcards Preview

IHO > Week 5 tuesday > Flashcards

Flashcards in Week 5 tuesday Deck (38):
1

2 factors lead to autoimmune:

1. Inheritance of susceptible gene
2. Environmental triggers

2

Infection can cause autoimmune by:

1. Upregulate expression of costimulators on APC
2. Molecular mimicry
3. Cause polyclonal activation

3

Mechanism of SLE:

1. System lesion from antibodies on dsDNA and smith antigens form immune complex (type 3)
2. Antibodies against RBC, WBC and platelet. Opsonize and lead to cytopenia (type 2)

Neutrophil extracellulr trap in response to inflammation. release nuclear antigens

4

Problems with anti-phospholipid antibodies in SLE

Hypercoagulation, leading to clot and ischemia

5

Clinical skin features of SLE

1. Erythema in light exposed areas
2. immune complex on dermoepidermal junction

6

Clinical kidney features in SLE

Nephritis due to immune complex deposition in glomeruli

7

Clinical joint features in SLE

NON erosive and NON deforming small joint involvement

8

Clinical hematologic system in SLE

Pericarditis, endocarditis, atherosclerosis

9

SOAP BRAIN MD

SEROSITIS
ORAL ULCERS
ARTHRITIS
PHOTOSENSITIVITY
BLOOD CELLS
RENAL, RAYNAUDS
ANA
IMMUNOLOGIC
NEUROPSYCH
MALAR RASH
DISCOID RASH

10

Mechanism of RA

Systemic inflammatory disorder against joints, producing NONSUPPORATIVE proliferative and inflammatory synovities that leads to DESTRUCTION of articular cartilage and ankylosis

Major genetic susceptibility

11

Best test for RA

NOT rheumatoid factor
Test the ACCP = antibody cyclic citrullinated proteins

12

Pathologic findings seen in RA joints

T and B cells form a PANNUS (mass of inflamed synovium) that grows over joint cartialge and leads to inflammation and destruction.

13

RA nodule pathology

Area of central fibrinoid necrosis surrounded by a PALISADE OF MACROPHAGES and scattered chronic inflammatory cells

14

Clinical presentation of Sjogren syndrome

DRY eyes and DRY mouth
Mostly in middle ages woman

15

Pathology of sjogren syndrome and antibodies found

Autoimmune demediated destruction of LACRIMAL and SALIVARY glands

Often a secondary syndrome from other autoimmune. RA most common

Antibodies to ribonucleoproteins SS-A and SS-B are measured with LIP BIOPSY

16

Neoplasm associated with Sjogren syndrome

LYMPHOMA (typically marginal zone)

17

CREST syndrome

Can develop from limited scleroerma

Calcinosis
Raynauds phenomenom
Esophageal dysmotility
Sclerodactylyl
Telangiectasia

18

Diffuse vs Limited scleroderma

Diffuse: WIDESPREAD skin involvement at onset, RAPID progression to visceral

Limited: Skin involvement CONFINED to fingers, forearms and face. Follow by LATE visceral involvement. Can lead to CREST

19

Systemic sclerosis pathology

Unknown
Widespread damage to small blood vessels and progressive interstitial perivascular firbrosis of skin and organs. Patho findings are secondary to ischemic damage and fibrosis to organs

MAY have antibodies to SCL-70 (DNA TOPO 1 )
CREST may have anticentromere antibody

20

Most common cause of death from Systemic sclerosis

Respiratory failure from interstitial fibrosis

21

Clinical presentation of dermatomyositis vs myositis

dermatomyositis: muscle weakness and skin rash (discolor eye lids, red patches on knuckles, elbows and knees)

Myositis: Same, but WITHOUT skin involvement

22

Lab findings and treatment for dermatomyositis and myositis

Elevated creatine kinase
Treat with immunosuppressives

23

Antibody for Mixed connective tissue disease

Overlap of features with distinctive ANTI-U1-RNP antibody

24

CATU / centromere antibodies found in:

CREST syndrome

25

SS-A AND SS-B antibodies support:

Sjogren syndrome

26

Jo 1 antibodies support

POLYMYOSITIS

27

Scl 70 antibodies supports:

scleroderma

28

Sm antibodies and dsDNA antibodies support

LUPUS

29

primary vs secondary immunodefiency

primary: congenital or genetic
secondary: cancer, infection chemo, etc

Primary mainly found in INFANTS 6mo-2yr

30

X-linked agammaglobulinemia (brutons)

failure of bcell precursors

X LINKED GENE FOR cytoplasmic tyrosine kinase

recurrent bacterial infections. Males > females

31

variable immunodefiency

failures of bcells to differentiate. both sexes equally. later onset of symptoms

32

Digeorge syndrome

failure of 3 and 4 pouch to develop = no thymus.
Loss of tcells
congenital heart and vessel problems
facial abnormalities

33

Gene problem with digeorge syndrome

Sporadic deletion of chromosome 22q11

34

CD40 ligand xlinked recessive mutation

Hyper IgM syndrome. Can not swtich to other Ig. Only IgM found

35

Defect in gamma chain of cytokine receptor

SCID
autosomoal recessive
Defiency in enzyme adenosine deaminase
Treat with hemato cell transplant

36

Loss of spleen and risk of infections?

Encapsulated bacteria, esp streptocossus pneumoniae

recieve vaccinations for s pneumoniae, h influenzae and n meningtidis

37

Lead inhibits:

aminolevulinate dehydratase (ALA)

Ferrochelatase

Both reduce heme production as a result

38

Lead poisoning urine results

elevated protoporphyrin and ALA

elevated erythrocyte protoporphyrin found early in both kids and adults