Autoimmune diseases

Question 1

What are the two types of autoimmune diseases.

Answer 1

1- organ specific

2-non-organ specific.

Question 2

define autoimmunity

Answer 2

where the immune system attacks own tissue.

Question 3

Autoimmune diseases are due to the effects of

Answer 3

1-Genes- genetically predispose you to a condition
2-Environment
3-Immune regulation- if it breakdown results in autoimmunity.

Question 4

In which region of the human genome is most common susceptibility for autoimmune conditions.

Answer 4

HLA.

Question 5

What is the role of MHC 1

Answer 5

detect foreign activity in all cells.

Question 6

What is the role of MHC 2

Answer 6

Professional cells take up antigens from tissue and present to T cells.

Question 7

Where are B cells produced

Answer 7

bone marrow

Question 8

Where are T cell produced

Answer 8

thymus.

Question 9

What is central tolerance

Answer 9

B cells and T cells acquire receptors and are tested against self antigens to see which ones react.

Question 10

Where does central tolerance take place.

Answer 10

bone marrow and thymus

Question 11

What is peripheral tolerance.

Answer 11

removing B and T cells from the peripheral blood which are not tolerant to self antigens.
T regulatory cells- help in this process.

Question 12

Which T cells are involved in peripheral tolerance

Answer 12

T regulatory cells.

Question 13

Causes of autoimmunity expect genetics

Answer 13

• sex due to hormones (women greater than men)
• Age-autoimmunity more common in elderly.
• Sequestered antigens- antigens of body parts not in contact with immune system.
• Environment.

Question 14

How do auto reactive B cells cause autoimmunity

Answer 14

directly cytotoxic, activation of complement, interfere with normal physiological function

Question 15

How do auto reactive T cells cause autoimmunity

Answer 15

directly cytotoixc, inflammatory cytokine production or activate B cells.

Question 16

Other than genetic factors which lifestyle factor helps trigger rheumatoid arthritis.

Answer 16

smoking.

Question 17

2 major types of autoimmune thyroid disease.

Answer 17

Hashimoto’s thyroiditis

Grave’s disease.

Question 18

How does hashimotos cause thyroiditis and is it hyper to hypothyroidism

Answer 18

Antibodies destroy the thyroid follicles

This causes hypothyroidism.

Question 19

How does grave’s cause autoimmune thyroid condition and is it hyper or hypothyroidism.

Answer 19

antibodies stimulate the thyroid

autoantibody mimics TSH

Question 20

Symptoms of hyperthyroidism

Answer 20

weight loss, excessive sweating, hot even in cold weather, anxiety, lack of sleep, diahorrhea, puffy face, sparse eyebrows especially in the lateral 1/3

Question 21

symptoms of hypothyroidism

Answer 21

tierd, difficult concentrating., decline in memory, constipation, weight gain, cold in hot weather.

Question 22

What is myasthenia gravis

Answer 22

Autoantibody, which binds to Ach receptor in the synapse of the neuromuscular junction and inhibits functioning.
Often due to a tumour on the thymus so once removed symptoms resolve.

Question 23

What is pernicious anaemia.

Answer 23

unable to absorb b12 often due to autoantibodies binding intrinsic factor and therefore B12 cannot bind you intrinsic factor it cannot be absorbed.
Treatment is B12 injections
Macrocytic anaemia.

Question 24

What is the name given to non organ specific connective tissue diseases

Answer 24

connective tissue diseases.

Question 25

How is systemic lupus caused?

Answer 25

Antinuclear antibodies. nuclei are usually sequestered antigen. defect in apoptosis results in nuclei being exposed and autoantibodies forming.

Question 26

symptoms and signs of SLE

Answer 26

``` Photosensitive Malar Rash- leaves nasal avail fold. Multiple mouth ulcers Arthralgia- pain in joints. Alopecia sharp chest pain (pleural effusion) ```

Question 27

How does exposure to sun affect SLE and normal people differently

Answer 27

Sunlight causes cell death- undergo apoptosis and nuclei antigens come to the cell surface, in normal person no effect just get sunburnt in SLE person due to ANA rash is caused

Question 28

What organs can SLE involve that makes it a multi organ condition

Answer 28

Kidney: lupus nephritis Immune complexes deposit, causing complement activation and inflammation, the glomerulus leaks causing renal function loss, scarring and irreversible renal failure. Lung: Pleurisy / Pleural Effusion Brain: Cerebral Lupus, seizures, strokes etc.

Question 29

What is the test for SLE diagnosis

Answer 29

Antinuclear antibodies

Question 30

What is the treatment for SLE

Answer 30

immunosuppression

Question 31

What type of antibodies are found in vasculitis

Answer 31

Anti-neutrophil cytoplasmic antibodies (falsely activate neutrophils)

Question 32

How do Anti-neutrophil cytoplasmic antibodies cause vasculitis.

Answer 32

Neutrophils are falsely activated and leave blood into tissue to fight no infection Inflammation is around the blood vessel this is why you don’t get blood flow and purpaae.

Question 33

3 types of vasculitis

Answer 33

* Microscopic Polyangiitis (MPA) * Granulomatosis with Polyangiitis (GPA) * Eosinophilic Granulomatosus with Polyangiitis (EGPA)

Question 34

define polyanagitis

Answer 34

inflammation of blood vessels anywhere.

Question 35

define granuloma

Answer 35

mass of inflamed tissue.

Question 36

Granulomatosis with Polyangiitis can cause destructive lesions on

Answer 36

* Nose * Sinuses * Trachea * Lung * Orbits

Question 37

Signs and symptoms of vasculitis.

Answer 37

all have polyangitis | some have granulomas- destructive masses of chronic inflammatory tissue often in upper airway or lung but can cavitate.

Question 38

How do you diagnose vasculitis

Answer 38

• Anti-Neutrophil Cytoplasmic Antibodies (ANCA)

Question 39

What is the treatment for vasculitis

Answer 39

immunosuppression

Question 40

What causes scleroderma

Answer 40

• Anti-Nuclear Antibodies

Question 41

Primary phenomenon in scleroderma

Answer 41

Raynaurds- fingers go white. | more common in women and runs through families.

Question 42

What is scleroderma

Answer 42

Autoimmunity leads to ischaemia and fibrosis

Question 43

Signs and symptoms of scleroderma

Answer 43

* Digital ulcers due to tightening and ischaemia * Lung fibrosis- honey comb appearance on CT * Skin fibrosis and tightening.

Question 44

what organs can be involved in scleroderma

Answer 44

• Fibrosis may also affect lungs, gut, kidneys

Question 45

What is the treatment for scleroderma

Answer 45

immunosuppression