A. VI Flashcards
Hypersensitivity reaction=
Pathological immune response to otherwise harmless Ag
Type I HSN
IgE mediated, mast cell activation
Type I HSN stages
Immediate (Mast cell release histamine and tryptase)
Late (Chemokine attract inflammatory cells)
Type I HSN examples
Anaphylaxis
Allergic asthma
Type II HSN
Ab mediated. Binds cell surface Ag and attracts NK
B for II
Type II HSN examples
Autoimmune hemolytic anemia Transfusion reaction Rheumatic fever MG Graves disease
Type III HSN
Immune Complex Ag-Ab complex activate complement which attracts neut -> release lysosomal enymes
C for III
Type III HSN examples
SLE
Polyarthritis nodosa
PSGN
Type IV HSN (two mechanism)
Delayed, cell mediated
- CD8+ T cell kill target cell
- CD4+ T cell recognizes Ag and release cytokines
HSN I-III are all _____ mediated
Ab
Type IV HSN examples
Contact dermatitis
PPD skin test
Graft vs host disease
Autoimmune disorders are characterized by
Immune-mediated damage of tissue
Autoimmune disorders involves loss of
Self-tolerance
Autoimmune disorders are more common in
Women of childbearing age
Etiology of Autoimmune disorders
Likely an inviormental trigger in genetically susceptible individuals
What happens in SLE?
Ab against the host damage multiple tissue
HSN II=
Cytotoxic
HSN III=
Ag-Ab complex
SLE includes what type of HSN reaction?
II+III
SLE clinical features
Fever Weight loss Butterfly rash Arthritis Pleuritis Pericarditis Cns psychosis Renal damage Endocarditis Myocarditis Anemia Trhombocytopenia Leukemia
Most common renal damage in SLE?
Diffused proliferative glomerulonephritis
What type of endocarditis is common in SLE?
Libman Sacks Endocarditis
LSE on SLE
Libman sacks endocarditis characterized by
small, sterile deposits on both sides of the mitral valve
Libman sacks endocarditis affects which valve?
Mitral
SLE symptoms by mnemonic
RASH OR PAIN
Rash Arthritis Serositis Hematologic disorders Oral ulcers Renal disease Photosensitivity Antinuclear Ab Immunologic disorders Neurologic disorders
Which syndrome is associated with 30% SLE cases?
Antiphospholipid Ab syndrome
Antiphospholipid Ab syndrome results in
Arterial and venous thrombosis
Sjorgen syndrome=
Autoimmune destruction of lacrimal and salivary glands (exocrine glands)
Sjorgen syndrome is a type __ HSN
IV
Sjorgen syndrome is _______ mediated damage with ________
Lymphocyte mediated damage with fibrosis
Sjorgen syndrome classically presents with
Dry eyes (no tears) Dry mouth (no saliva) Recurrent dental carries
Dry mouth is also called
Xerostomia
Sjorgen syndrome often associated with what other syndrome?
Rheumatoid arthritis
Sjorgen syndrome posses an increase risk for
B cell lymphoma in the parotid gland
MALT lymphoma
Sjorgen syndrome characterized by the presence of which Ab?
Anti Nuclear Ab
Antiribonucleoprotein Ab
Antiribonucleoprotein Ab present in Sjorgen syndrome
SS-A (Anti-Ro)
SS-B (Anti-La)
Scleroderma=
Autoimmune tissue damage with activation of fibroblasts and deposition of collagen (Fibrosis)
Systemic sclerosis!!
Scleroderma is devided into 2
Diffused
Localized
Diffused Scleroderma=
Skin and early visceral involvment
Which organ is usually affected by Diffused Scleroderma
Esophagus
Diffused Scleroderma is characterized by which Ab
Anti Nuclear Ab
Anti-DNA (Scl-70)
Localized Scleroderma=
Local skin and late visceral involvment
Localized Scleroderma is associated with what mnemonic syndrome
CREST
Calcinosis cutis Raynaud phenomenon Esophagus dysmotility Sclerodactyly Telangietasia
Rheumatoid arthritis=
Chronic, systemic autoimmune disease
Rheumatoid arthritis is associated with what genetics?
HLA-DR4
Hallmark of Rheumatoid arthritis
Synovitis
Synovitis leads to
Pannus= inflamed granulation tissue
Rheumatoid arthritis leads to destruction of
Cartilage
Rheumatoid arthritis leads to destruction of Cartilage and
ankylosis= fusion of joints
Clinical features of Rheumatoid arthritis
Arthritis with morning stiffness that improves with activity Fever Vasculitis Baker cyst Pleural effusion
Which fingers joints are involved in Rheumatoid arthritis?
PIP
Laboratory findings in Rheumatoid arthritis
IgM Ab against Fc region of IgG (Rheumatoid factor)
What is Rheumatoid factor
Antibody against the Fc portion of IgG