Autoimmune Diseases

Question 1

In most cases of autoimmunity there is thought to be a_____ factor that acts on a _____ susceptible individual

Answer 1

environmental, genetically

Question 2

Name all the symptoms of lupus and how many of them are needed to make a diagnosis

Answer 2

Malar rash, discoid rash, photosensitivity, oral ulcers, arthritis, renal disorder, hematological disorder, immunological disorder (anti ds DNA, anti Smith , Antiphospholipid antibody), neurological disorder, antinuclear antibody/ 4 out of 11 needed

Question 3

systemic lupus erythematosus has what two unique antibody systems in abundance

Answer 3

anti ds DNA, anti Smith

Question 4

drug induced lupus erythematosus has what unique antibody system in abundance

Answer 4

anti histone

Question 5

Describe the pathogenesis of lupus

Answer 5

genes involved include MHC II and complement–> apoptotic bodies fail to clear out–> nucleosmal proteins and self antigens present–> T-cells and B-cells specific for the self antigens activate–> IgG autoantibody production–> immune complexes (Type III) or autoantibody (Type II) mediated tissue injury

Question 6

What is included in a full house granular deposition?

Answer 6

IgA, IgG, IgM, C3, C1q (C4)

Question 7

What kind of effect does lupus have on the heart?

Answer 7

Can lead to fibrinous pericarditis/cardiac rub, can also leave libman-sacks deposits on mitral valve and cardiac wall

Question 8

What are the class of lupus glomerulonephritis and which ones are dangerous?

Answer 8

Class I: Normal (not dangerous)
Class II: Mesangial (not dangerous)
Class III: Focal proliferative (dangerous)
Class IV: Diffuse proliferative (dangerous)
Class V: Membranous (protein in urine but not destruction)
Class VI: Diffuse sclerosing (RIP)

Question 9

What is the difference between Class III and Class IV lupus glomerulnephritis

Answer 9

Class III is 50% glomeruli affected

Question 10

For Class III and Class IV lupus glomerulnephritis, describe the location and process of degradation

Answer 10

The immune complexes are next to the endothelium lining–> fenestrae between the endothelial allow complement to enter–> immune complexes convert complement to C5a which recruits neutrophils–> decreased levels of complement in the serum due to this happening in the kidney

Question 11

Where is membranous lupus located in kidney cells?

Answer 11

Subepithelium–> effect podocytes thus letting proteins enter urine

Question 12

Whats the difference between lupus arthritis and rheumatoid arthritis?

Answer 12

Lupus arthritis does not have joint deformity

Question 13

CNS lupus is usually caused by what?

Answer 13

Angioplsty associated with antiphospholipid antibodies

Question 14

What time of day does Rheumatoid arthritis joint pain usually feel worse?

Answer 14

Morning

Question 15

What two test are used to confrim Rheumatoid arthritis?

Answer 15

Rheumatoid factor, anti CCP

Question 16

This disease usually involves the HLA-B27 genes, involves ligament attaching to bone, the sacroilliac joint, and is absent in RF and anti-CCP

Answer 16

Seronegative Spondyloarthropathies

Question 17

What disease specifically leads to the loss of lumbar lordosis?

Answer 17

Ankylosing spondylitis

Question 18

This autoimmune disease involves xerostomia and keritanoconjunctivitis sicca because it is thought that T-cells destroy salivary and lacrimal glands, has SS-A and SS-B antibodies, is associated with RA and RF, and increases the incidence of B-cell lymphoma by 40x

Answer 18

Sjogren Syndrome

Question 19

This disease involves the Scl-70 antibody and has a nucleolar ANA

Answer 19

Diffuse scleroderma

Question 20

This disease involvs the CREST symptoms and has anticentromere antibodies

Answer 20

Limited scleroderma

Question 21

A marked sign of sceleroderma is diffuse____ in the tissue

Answer 21

fibrosis and intimal thickening (no immune deposits)

Question 22

When the skin turns from white to blue to red after being exposed to cold

Answer 22

raynuad’s phenomenon

Question 23

This autoimmune disease leads to difficulty in rising from a chair or climbing stairs, and involves the infiltration of lymphocytes into muscle, heliotrope eyes

Answer 23

Inflammatory myopathy

Question 24

This disease is a combination of SLE, scleroderma, and inflammatory myopathy, involves antibodies to RNP, and causes little renal disease and responds well to steroids

Answer 24

Mixed connective tissue disease