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Mercy CLS 1: Immunology > 8) Autoimmune diseases > Flashcards

8) Autoimmune diseases Flashcards

1
Q

predispositions to autoimmune conditions

A
  • genetics
  • female
  • age
  • mental state/stress
  • infections
  • drugs
  • other autoimmune diseases
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2
Q

2 drugs that predispose pt to autoimmune disease

A

procainamide
hydralazine

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3
Q

how can trauma and infection predispose pt to autoimmune disease

A

release sequestered antigens

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4
Q

possible mechanisms of autoimmune disease

A
  • loss of suppressor T cells
  • MHC genes for molecules on cells they should not be on
  • idiotypic networks (ab against ab)
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5
Q

example of an idiotypic network

A

RF

IgM against IgG

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6
Q

examples of disease with anti-idiotypic networks

A

myasthenia gravis
DM
Grave’s

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6
Q

organ systems affected by SLE

A

joints
CNS
heart
kidneys

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6
Q

cause of death in SLE

A

kidney lesions

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7
Q

type of scleroderma with increased collagen deposits in skin

A

progressive systemic sclerosis (PSS)

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8
Q

associated with Raynaud’s phenomenon

A

PSS
CREST

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8
Q

CREST syndrome

A
  • calcinosis
  • raynaud’s
  • esophageal dysfunction
  • sclerodactyly
  • telengiectasis
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9
Q

components that attack joint spaces in RA

A

RFs
cytokines
IgG complexes
neutrophils
hyaluronidase

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10
Q

connective tissue disease with no renal involvement (5% pts may have it)

A

mixed connective tissue disorder (MCTD)

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11
Q

2 Ab involved in pernicious anemia

A

IF-blocking Ab
parietal cell Ab

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12
Q

autoimmune hepatitis involving smooth muscle Ab

A

chronic active hepatisis

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13
Q

very dry mouth, eyes, nose, trachea, bronchi, vagina, skin

large parotid glands

A

Sjogren’s syndrome

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14
Q

T-cells infiltrate muscle and cause inflammation

A

polymyositis

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15
Q

predominantly in young males

A

Goodpasture

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16
Q

glomerulonephritis
pulmonary hemorrhage
Ab to basement membrane of lungs, kidneys

A

Goodpasture

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17
Q

necrotizing granulomas in resp tract
focal glomerulonephritis

A

Wegener’s granulomatosis

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18
Q

2 autoimmune conditions involving skin blisters

A

bullous pemphigoid
pemphigus vulgaris

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19
Q

mitrochondrial Ab
bile ducts of liver slowly destroyed
liver damage

A

primary biliary cirrhosis

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20
Q

increased risk of clotting and repeated spontaneous abortions

A

anti-phospholipid syndrome

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21
Q

goiter
hypothyroidism

A

Hashimoto’s thyroiditis

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22
Q

goiter
ophthalmopathy
localized edema in legs
hyperthyroidism

A

Graves

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23
Q

2 types of anti-TSH receptor Ab

A
  • stimulates action of TSH on thyroid
  • blocks action of TSH on thyroid
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24
Q

Ab to NM junction (Ach receptor Ab)
weakness and fatigue of skeletal muscles

A

myasthenia gravis

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25
Q

causes most damage in MS

A

T-cells

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26
Q

autoab to plt

A

idiopathic/immune thrombocytopenia purpura

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27
Q

linear deposits of IgG/C3 at dermal-epidermal junction

A

bullous pemphigoid

28
Q

honeycomb pattern of IgG/C3 in skin intercellular spaces

A

pemphigus vulgaris

29
Q

ribbonlike pattern of Ab/C3 along glomerular basement membrane

A

Goodpasture
SLE

30
Q

general indirect IFA autoimmune screen

A

ANA
anti nuclear Ab

31
Q

3 Abs detected with mouse stomach-kidney substrate

A
  • AMA (anti mitochondrial)
  • ASMA (anti smooth muscle)
  • APCA (anti parietal cell)
32
Q

ANCA

A

anti neutrophil cytoplasmic ab

33
Q

ANA test substrate & 5 patterns

A

HEP-2 (human epithelials in interphase/mitosis)

  • homogeneous
  • speckled
  • centromere
  • nucleolar
  • rim/peripheral
34
Q

entire nucleus fluoresces
mitotic cells pos

A

homogeneous

35
Q

homogeneous pattern suggests…

A

ab to nDNA
reflex to anti-nDNA

36
Q

homogeneous pattern diseases

A

SLE
drug-induced SLE (Ab to histones, ssDNA)

37
Q

many uniform points of fluorescence
mitotic cells neg

A

speckled

38
Q

speckled pattern suggests….

A

Ab to an extractable nuclear antigen (ENA)
reflex to ENA test

39
Q

medium size points of fluorescence
mitotic cells pos in ladder-like pattern

A

centromere

40
Q

centromere pattern disease

A

CREST syndrome

41
Q

intense fluorescence of nucleoli
mitotic cells pos

A

nucleolar pattern

42
Q

nucleolar pattern diseases

A

PSS
SLE

43
Q

nucleus fluoresces around edge only

A

rim/peripheral pattern

44
Q

rim pattern suggests…

A

ab to nDNA

45
Q

rim pattern disease

A

SLE (most specific)

46
Q

anti-nDNA substrate

A

crithidia lucillae

47
Q

positive result in anti-nDNA test

A

fluorescence of kinetoplast of C. lucillae organism

48
Q

positive anti-nDNA test diseases

A

active SLE
nephritis

49
Q

nDNA Ab titer correlates with…

A

renal involvement

50
Q

fluorescence of kidney tubules + parietal cells

ab and disease

A

AMA

primary biliary cirrhosis

51
Q

fluorescence of stomach muscularis and vessel walls

ab and disease

A

ASMA

chronic active hepatitis

52
Q

fluorescence of parietal cells

ab and disease

A

APCA

pernicious anemia

53
Q

2 ANCA patterns

A
  • C-ANCA - fluorescence of cytoplasm
  • P-ANCA - fluorescence of perinuclear region
54
Q

ANCA substrate

A

human neutrophils

55
Q

C-ANCA disease

A

Wegener’s granulomatosis

56
Q

P-ANCA disease

A

systemic vasculitis

57
Q

explain EIA

A

solid phase + Ag + pt Ab + conjugate + enzyme + chromogenic substrate ==> color change

58
Q

enzyme tag often on conjugate for EIA

A

horseradish peroxidase

59
Q

EIA reading

A

spectrophotometric

60
Q

ENAs and disease associations

A
  • Sm (Smith) - SLE
  • RNP (ribonucleoprotein) - MCTD, SLE
  • SS-A (Ro) - Sjogren’s, scleroderma, SLE, neonatal lupus
  • SS-B (La) - Sjogren’s, scleroderma, SLE
  • Scl-70 - PSS
  • PM-1 - polymyositis, SLE
  • Jo-1 - polymyositis
61
Q

associated with DVT, arterial thrombosis, spontaneous abortion

A

anti-PL ab

(LLAC, anti-cardiolipin)

62
Q

seen in 90% of Hashimoto’s pts and 80% of Graves pts

A

thyroid peroxidase ab (TPO)

(microsomal ab)

63
Q

seen in 60-80% of Hashimoto pts

A

thyroglobulin antibody (TGAB)

64
Q

> 98% pts with Graves have…

A

thyroid stimulating Ig (TSI)

65
Q

performed instead of expensive TPI test

A

TH levels

66
Q

ideally use both ….. to dx RA

A

RF and anti-CCP

67
Q

found in 75% pts with RA, but not specific for RA

A

RF

68
Q

Ab against citrullinated peptides formed during death of grans and macros

A

anti-CCP

69
Q

more specific for RA than RF

A

anti-CCP

70
Q

ANAs are present in 40% of —– pts but significance is unknown

A

RA

Mercy CLS 1: Immunology (19 decks)

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