1 - Inflam, Immuno Flashcards
Brief description
- acute inflamm
- chronic inflamm
Acute: Neutrophils
-same 3 steps: vasodilation, incr permeability, immigration of PMNs
Chronic: cLuMP cells = lymphocytes, macrophages, plasma cells
-tissue destruction
Granulomatous inflammation
Macrophages
Walls things off
Examples: TB, histo, sutures/keloid scars, sarcoid
Factors affecting wound healing
- local (2)
- systemic (3)
L: decr blood supply, local infection
S: DM, immunocompromised, incr glucocorticoid production (stress)
Cellular dz
- what to think of
- types of necrosis (4)
Hypoxia
Coagulative = heart attack LiqueFactive = lungs, fungal Caseous = TB Fat = death to fat
HS reactions
-type 1
Anaphylactic IgE Allergens 2nd exposure -> cross-linking of IgE -> Ca2+ enters cell -> degranulation -> release of histamine 5-30 min
HS reactions
-type 2
Cytotoxic IgM, IgG Toxic to antigen and self: -Rh dz (aka erythroblastosis fetalis -> miscarriage) -Rheumatic fever (heart valves)
HS reactions
-type 3
Immune complex-mediated
Ag/Ab complex
Autoimmune condns
-SLE, RA, etc
HS reactions
-type 4
Delayed/cell-mediated
T-lymphs
2-3 days
TB skin test, contact derm, corneal transplant rejection, phlyctenulosis (staph secondary to bleph)
Systemic lupus erythematosus (SLE)
- who
- what
- testing
- ocular
- tx
30yo F
T3 HS -> anti-DNA antibody
Multiple systems: skin, kidneys, joints, heart
-butterfly/malar rash, discoid lupus, photosensitivity, arthritis, renal/neuro disorder, hemolytic anemia
(+) ANA
Dry eye - most common
Disc edema, papilledema - most severe
Recurrent episcleritis, peripheral keratitis/infiltrates, photophobia
Plaquenil, cyclosporin, methotrexate, azothioprine
Rheumatoid arthritis
- who
- what
- testing
- ocular
- tx
45yo F
T3 HS against cartilage
Small joints, worse in the morning
(+) RF
25% have ocular manifestation(s)
Dry eye
Scleromalacia perforans
Peripheral K ulceration, peripheral keratitis
Plaquenil, cyclosporin, methotrexate, azothioprine
Juvenile idiopathic arthritis (JIA)
- who
- what
- testing
- ocular
1 uveitis in children (80%)
8yo F
Can affect multiple joints
-if so, less likely to affect eyes than single joint
(-)RF (+)ANA
- classic clinical picture: female, asymptomatic, chronic, bilateral, non-granulomatous, anterior uveitis
- often with low-grade fever
Sjogrens
- who
- what
- testing
- malignancy assoc with
50yo F
Primary: dry eye, dry mouth
Secondary: dry eye, dry mouth, autoimmune dz (usually RA)
Presence of auto-antibodies: ANA, RF, SS-A, SS-B
B-cell lymphoma
-esp with Primary, 7 years
Sacroidosis
- who
- what
- testing
- ocular
- tx
African American F
Idiopathic
Non-caseatic granulomatous
High ACE (60%) Chest x-ray = MOST SPECIFIC
Chronic bilateral anterior granulomatous uveitis - most common
ON dz (disc edema, papilledema) - most severe
Vasculitis (candle wax), vitritis (cotton-ball opacities), dacryoadenitis, CN7 palsy (not Bell’s bc Bell’s is idiopathic)
Steroids
Ankylosing spondylitis
- who
- what
- testing
- ocular
20yo M
Chronic inflammatory dz of spine, large joints
Lower back pain that improves with exercise, responds to NSAIDs
Head app to sit forward
(+) HLA-B27, sacroiliac x-ray
Acute anterior unilateral (or alternating) non-granulomatous uveitis
- most common known cause
- “worst uveitis I’ve ever seen”
Reactive arthritis/Reiter’s syndrome
- who
- what
- testing
Young males
Triad: can’t see, can’t pee, can’t climb a tree
- conjunctivitis and/or anterior uveitis
- urethritis
- arthritis
(+) HLA-B27
