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Pathophysiology > Autoimmune > Flashcards

Autoimmune Flashcards

1
Q

Autoimmune diseases

A
  • breakdown of tolerance
  • genetic factors are important
  • original insult
  • some autoimmune diseases are organ-specific (type II) and others systemic in distribution (type III)
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2
Q

Breakdown of tolerance

A

“tolerance” is developed as part of becoming immunocompetent

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3
Q

genetic factors important in autoimmune disease

A

affected members may not develop the same autoimmune disease; some people may have more than one autoimmune disease (tendencies are what’s inherited)

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4
Q

Original insult in autoimmune

A
  • may be identifiable - often drug, virus, or bacteria

- often preexisting infections that leave no trace

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5
Q

Theories of autoimmune disease development

A
  1. Normal self-antigens are altered by a drug, pathogen, or other mutation and are no longer seen as “self” (no longer look like your own)
  2. antibodies against foreign antigens cross-react with a similar self-antigen
  3. Clonal deletion theory
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6
Q

Clonal deletion theory

A

suggests that self-reactive lymphoid cells are eliminated during immunological development

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7
Q

SLE stands for?

A

Systemic Lupus Erythematousus

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8
Q

Epidemiology for SLE

A
  • 1 in 2,500 people
  • 10x more women than men
  • familial (ID twins have 30% concordance rate)
  • 5 year survival rate = 93-95%
  • mortality is low, but impose on quality of life is high
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9
Q

Type III SLE

A

Has a wide range of symptoms including:

  • arthritis (90%) - complexes stuck in synovial membranes
  • vasculitis and rash (75%) - stuck in blood vessels of skin
  • kidney disease (40-50%) - stuck in glomerulus
  • blood abnormalities (50%)
  • cardiovascular disease (30-50%) - unknown mechanism but there’s correlation
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10
Q

SLE info

A

large variety of autoantibodies are produced including ones against DNA and RNA ( = ANA’s: anti-nuclear antibodies)

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11
Q

Treatment of SLE

A
  • glucocorticoids/ corticosteroids - strong anti-inflammatory
  • antimalarials - no known reason
  • monoclonal antibody (anti-body against autoantibodies)
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12
Q

Downside of long-term corticosteroid treatment of SLE

A
  • increased susceptibility to infections
  • atherosclerosis -> stroke, Coronary Artery Disease (heart attack)
  • obesity -> hypertension, diabetes type 2
  • Cushing’s disease (hypercorticoidism: over tim. adrenal gland)
  • others
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13
Q

Immunodeficiency diseases

A
  • primary (congenital)
  • secondary (acquired): as a result of infections, metabolic diseases, cancer or treatment
  • may involve primarily B cells or different types of T cells or it may be generalized
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14
Q

All immunodeficiencies are characterized by ___________

A

lymphopenia (lymphocytes not making antibodies)

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15
Q

Primary Immunodeficiency

A
  • SCID (severe combined immunodeficiency)
  • lack both T and B cells
  • thymus is hypoplastic (never gets big) and lymph nodes are small
  • used to die early in infancy
  • new treatments are bone marrow transplant and gene therapy trial (14/16 worked)
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16
Q

AIDS stands for?

A

Acquired immunodeficiency syndrome

17
Q

syndrome

A

a group of symptoms that occur together

18
Q

about AIDS

A
  • HIV (human immunodeficiency virus)
  • HIV as an affinity for T cells and monocytes
  • macrophages can therefore also be infected, as well as fixed tissue phagocytes)
  • HIV is cytotoxic - a depletion of these cells is typical of AIDS
  • initial infection simulates B cells to produce antibodies, allowing most infected people to enter a latent stage
  • latent = hidden (Aka asymptomatic)
19
Q

AIDS process

A
  • eventually both cell-mediated T cell and humoral B cell immunity both become depressed
  • individuals can not defend themselves from infection and may die from a minor disease that overwhelms their immune system (chicken pox most common killer in children)
  • some patients also develop tumors of different kinds (lymphomas, Kaposi’s sarcoma)
  • HIV virus may act as an oncogene
20
Q

Four groups of HIV-infected persons

A
  1. Acute illness
  2. Asymptomatic infection
  3. Generalized lymphadenopathy
  4. other diseases superimposed
21
Q

Acute illness

A
  • occurs in 50%, 3-6 weeks post-exposure
  • nonspecific symptoms which last 2 to 3 weeks, then spontaneously disappear
  • during this period, some patients develop antibodies
22
Q

Asymptomatic infection

A
  • variable duration (few months - few years)

- no symptoms, but carries the virus and is infectious

23
Q

Generalized Lymphadenopahty

A
  • in patients who were initially asymptomatic, or develop early on and persist
  • lymphadenopathy - abnormal, usually enlarged LN
24
Q

Other diseases superimposed

A
  • opportunistic infections = organisms that only cause infections when the immune system is suppressed
  • gastrointestinal disorders
  • central nervous system involvement
  • neoplasia (lack of immunosurveillance)

Pathophysiology (11 decks)

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