2.4 - Autoimmune disorders Flashcards

1
Q

central tolerance in the thymus leads to either T cell apoptosis or ____________

A

generation of Treg cells

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2
Q

what is the result of an AIRE mutation? what is the normal function of AIRE?

A
  • autoimmune polyendocrine syndrome

- controls the mechanisms that prevent the body from attacking itself

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3
Q

autoimmune polyendocrine syndrome is due to a mutation in _______

A

AIRE

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4
Q

what is the pathogenesis of autoimmune polyendocrine syndrome?

A
  • mutation in AIRE

- failure of central tolerance (

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5
Q

where does positive selection of T cells occur?

A

cortex of thymus

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6
Q

where does negative selection of T cells occur?

A

medulla of thymus

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7
Q

the cortex of the thymus is where _______ selection of T cells occurs

A

positive

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8
Q

the medulla of the thymus is where __________ selection of T cells occurs

A

negative

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9
Q

what are the manifestations of autoimmune polyendocrine syndrome?

A
  • hypoparathyroidism
  • adrenal failure
  • chronic candida infection
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10
Q

is autoimmune polyendocrine syndrome a failure of positive or negative selection?

A

negative (normally prevents body from making self reactive T cells)

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11
Q

peripheral tolerance leads to what two outcomes?

A
  • anergy

- apoptosis of T and B cells

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12
Q

what condition results from a mutation in the Fas apoptosis pathway?

A

autoimmune lymphoproliferative syndrome (ALPS)

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13
Q

ALPS is a result of a mutation in what process?

A

Fas apoptosis pathway

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14
Q

what is the pathogenesis of autoimmune lymphoproliferative syndrome (ALPS)? what is the result?

A
  • mutation in Fas apoptosis pathway

- self reactive lymphocytes cant undergo apoptosis and can generate IgG against blood cells, leading to lymphopenia

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15
Q

Treg cells block T cell activation and suppress autoimmunity by producing what cytokines?

A

IL-10 and TGFB

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16
Q

polymorphisms in what CD are associated with autoimmunity?

A

CD25

17
Q

mutations in what gene lead to IPEX syndrome?

A

FOXP3

18
Q

what is IPEX syndrome? what is cause?

A
  • Immune dysregulation
  • Polyendocrinopathy
  • Enteropathy
  • X linked
  • due to FOXP3 mutation
19
Q

what is the normal function of FOXP3?

A

“forkhead box P3”

involved in the development and function of Treg cells

20
Q

what is the pathogeneis / cause of anti-nuclear antibodies seen in SLE? how does damage ensue?

A
  • poorly cleared apoptotic debris (from UV light) activates self reactive lymphocytes, which then produce the antibodies
  • DNA antigens activate TLRs, amplifying immune response (IFNa)
21
Q

deficiencies of what complement proteins is associated with SLE?

A

C1q, C4, C2

22
Q

what are the important antiphosphlipid antibodies seen in SLE?

A
  • anticardioplipin
  • anti-B2 micrglobulin I
  • lupus anticoagulant
23
Q

what antibody can lead to a falsely elevated PTT in SLE?

A

lupus anticoagulant (anti phospholipid Ab)

24
Q

does antiphospholipid Ab syndrome lead to a hyper- or hypo- coagulable state?

A

hypercoagulable

25
Q

which drugs can cause drug-induced SLE? which antibody is seen in DIL?

A
  • procainamide, hydralazine, INH

- anti-histone

26
Q

sjogren syndrome is mediated by type ____ hypersensitivity?

A

IV

27
Q

what antibodies are seen in sjogren syndrome?

A
  • ANA

- antiribonucleoprotein (anti-SSA / Ro, anti-SSB / La)

28
Q

which antibodies are responsible for the extraglandular manifestations seen in sjogren syndrome?

A

SSA and SSB

29
Q

which sjogren syndrome autoantibody can cross the placenta in and cause neonatal lupus?

A

SSA

30
Q

what is the greatest adverse effect of neonatal lupus?

A

congenital heart block

31
Q

what are the diagnostic criteria for sjogren syndrome?

A
  • dry eyes
  • ANA plus SSA / SSB / RF
  • sialadenitis

need 2/3

32
Q

patients with sjogren syndrome are at increased risk for what type of cancer? how does it present?

A
  • B cell (marginal zone) lymphoma

- unilateral enlargement of the parotid gland (late)

33
Q

what are the components of CREST syndrome?

A
  • calcinosis / anti-centromere antibodies
  • raynaud phenomenon
  • esophageal dysmotility
  • scelerodatyly
  • telangiectasias
34
Q

diffuse scleroderma is associated with what autoantibody?

A

anti-Scl-70 (anti-DNA topoisomerase I)

35
Q

mixed CT disease is associated with what two autoantibodies?

A

ANA plus anti-U1 ribonucleoprotein

36
Q

anti-U1 ribonucleoprotein is associated with:

A

MCTD

37
Q

anti-Scl-70 (anti-DNA topoisomerase I) is associated with:

A

diffuse scleroderma