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Path - Immunology > AIAI disease 2 > Flashcards

AIAI disease 2 Flashcards

1
Q

Explain aetiology of Graves

A

Production of IgG antibodies
Antibodies bind to TSH receptor
This stimulates production of thyroid hormones> excess thyroid hormone production

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2
Q

What is the evidence for Graves?

A

Antibodies stimulate thymocytes in vitro
Passive transfer of IgG from patients to rats produces the same symptoms
Babies born to mothers with Graves show transient hyperthyroidism

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3
Q

What type of hypersensitivity reaction is Graves?

A

Type II

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4
Q

What happens in the thyroid in Hashimoto’s ?

A

It becomes infiltrated with B and T cells > enlarged > goitre

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5
Q

What antibodies act in Hashimoto’s?

A

Anti-TPO antibodies

Anti-thyroglobulin antibodies

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6
Q

What time of hypersensitivity reaction is Hashimoto’s?

A

Type II, IV

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7
Q

What antibodies predate T1DM?

A

Anti-islet cell
anti-insulin
Anti-GAD
Anti-IA2

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8
Q

What did experiments show in mice for T1DM?

A

The non-obese diabetes mouse model showed CD( T cell infiltration of pancreas
CDH T cells bind to peptides presented by MHC Class I on beta cells of pancreas

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9
Q

Does detection of antibodies play a role in diagnosis of T1DM?

A

NO

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10
Q

What occurs in pernicious anaemia?

A

Antibodies are made against intrinsic factor

This leads to failure of absorption of vitamin B12

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11
Q

What clinical conditions does B12 deficiency lead to?

A

Subacute degeneration of spinal cord
Peripheral neuropathy
Optic neuropathy

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12
Q

What antibodies are used in diagnosis of pernicious anaemia?

A

gastric parietal cell antibodies

intrinsic factor antibodies

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13
Q

What antibodies to patients display in myasthenia gravis?

A

Anti-acetylcholine receptor antibodies

Antibodies against nicotinic acetylcholine receptor > leads to failure in depolarisation

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14
Q

What test confirms dx of myasthenia gravis?

A

TENSILON test

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15
Q

What does the tensilon test involve?

A

Administer short acting anti cholinesterase e.g. edrophonium bromide
This will cause rapid improvement in symptoms

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16
Q

What type of hypersensitivity is MG?

A

Type II

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17
Q

What antibodies are present in good pastures?

A

Anti-glomerular basement membrane antibodies

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18
Q

What is the genetic predisposition of RA?

A

HLA DR1, HLA DR4

PTPN22

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19
Q

What antibodies are present in RA?

A 
Anti-cyclic citrullinated peptide antibodies 
Rheumatoid factors (low sensitivity)
20
Q

What are environmental factors associated with RA?

A

Smoking > erosive disease, due to increased citrullination

Gum infection with porphyromonas gingivitis

21
Q

What occurs in the joint in RA?

A

Inflamed synovial tissue forms a PANNUS that overlays and invades articular cartilage

22
Q

What are the genetic predispositions in lupus?

A

Abnormalities in clearing apoptotic cells
Abnormalities in cell activation
B cell hyperactivity, loss of tolerance
Antibodies directed at IC proteins

23
Q

What is the triad in antiphospholipid syndrome?

A

recurrent thrombosis (arterial/venous)
recurrent miscarriage
thrombocytopenia

24
Q

What are the three major antibody tests in antiphospholipid syndrome?

A

Anti-cardiolipin
Lupus anticoagulant
AntiB2 glycoprotein 1 antibody

25
Q

What immune cells predominate in inflammation in systemic sclerosis ?

A

Th2, Th17

26
Q

What polymorphisms are responsible for activation of fibroblasts > fibrosis in systemic sclerosis’

A
  • T1 collagen alpha 2 chains AND Fibrillin 1

- TGF beta

27
Q

What are symptoms of limited cutaneous systemic sclerosis?

A

CREST

Calcinosis 
Raynaud's phenomenon
Esophageal dysmotility 
Sclerodactyly
Telangiectasia
28
Q

What are symptoms of Diffuse Cutaneous Systemic Sclerosis?

A 
Symptoms extend beyond forearms 
CREST + 
GI disease 
Interstitial pulmonary disease 
Kidney scleroderma, renal cyst
29
Q

What antibody is responsible for diagnosis of limited cutaneous scleroderma

A

anti-centromere antibody

30
Q

what antibodies aree responsible for diagnosis of diffuse cutaneous scleroderma

A

anti-topoisomerase, Scl70, RNA Pol I,II,III, Fibrillarin autoantiboidies

31
Q

what antibodies are responsible for Sjogrens

A

Anti-Ro, anti-La

32
Q

what are symptoms of Sjogrens

A 
dry mouth (xerostermia) 
dry eyes (keratoconjunctivitis siccA) 
dry nose and skin
33
Q

what test can you use to measure production of tears in Sjogreens

A

Schirmers

34
Q

what does IPEX stand for

A

Immune dysregulation
Polyendocrinopatyhy
Enterpathjy
X linkd

35
Q

what are clinical features in IPEX

A

eczema /dermatitis
naail dystrophy
AI skin condition (alopecia universalis, bullous pemphigoing

36
Q

What are antibodies for coeliaca

A 
IgA EMA (anti endomysial antibodies) 
IgA TGT (anti transglutaminase antibodies) 
IgG anti gliadin aantibodies
37
Q

what is the skin condition with coeliacs

A

Dermatitis herpetiformis

38
Q

what antibody disappears with exclusion diet in coeliacs

A

anti endomysial antibodie

39
Q

WHat HLA mutations are associated with coeliac

A

HLA DQ2, DQ8

DQ2.5 most common

Two Eight or not to eat?

40
Q

what kind of staining measures anti dsDNA in SLE

A

Homogeneous stain

41
Q

How good is anti-dsDNA in SLE

A

VERY GOOD - HIGHLY SPECIFIC present in 70% of SLE patients

42
Q

what are high titres of anti-dsDNA associated with

A

SEVERE SLE

incl renal / CNS involvement

43
Q

How do you confirm anti dsDNA

A

ELISA

44
Q

What is the complement profile for inactive SLE

A

Normal C3, Normal C4

45
Q

what is the complement profile for active SLE

A

Normal C3, LOW C4

46
Q

What is the complement profile for severe active SLE

A

LOW C3 and LOW C4

47
Q

what is a speckled pattern on homegeneous staining inficative of

A

antivbodies to EXTRACTABLE NUCLEAR ANTIGENS ENA 4 (so ribonucleoproteins, eg, Ro, La, Dm, U1RNP)

Path - Immunology (11 decks)

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