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Systems Pathology l > Autoimmune Diseases > Flashcards

Autoimmune Diseases Flashcards

1
Q

What might cause tissue damage in autoimmune diseases?

A

type ll (cytotoxic) and type lll (immune complex)

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2
Q

What can help diagnose autoimmune diseases?

A

identification of specific antibodies

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3
Q

What are the three basic requirements for pathologic autoimmunity?

A
  1. reaction
  2. primary pathogenic reaction
  3. no other disease is present
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4
Q

autoimmune diseases might develop from abnormalities in what?

A

T-lymphocyte system

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5
Q

What environmental factors can lead to loss of tolerance?

A

viruses, hormones, or drugs

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6
Q

What does Graves disease affect?

A

antibodies to the TSH receptor act as agonists and elevate thryroid hormones

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7
Q

Anitgens can do what two things?

A
  1. Alter function and 2. destroy self-tissues
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8
Q

What are 7 examples of autoimmune diseases?

A
  1. antibodies and immune complexes (Graves)
  2. systemic (systemic lupus erythematosus)
  3. autoimmunity or reactions to microbes (polyarteritis nodosa)
  4. T cells (organ specific like multiple sclerosis)
  5. systemic AD’s like rheumatoid arthritis
  6. autoimune hemolytic anemia
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9
Q

What is systemic lupus erythematosus?

A

chronic, autoimmune, multisystem, inflammatory disease.

- more common in females

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10
Q

systemic lupus erythematosus can lead to what 5 things?

A
  1. renal failure
  2. butterfly rash
  3. focal neurological deficits
  4. arthritis
  5. pericarditis or endocarditise
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11
Q

Some manifestations of SLE result from what?

A

tissue injury due to immune complex mediated vasculitis

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12
Q

SLE affects how many americans?

A

around 250, 000

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13
Q

Presence of what is a characteristic feature of SLE?

A

LE bodies

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14
Q

SLE leads to…

A

Mesangial, focal, or diffuse proliferative glomerulonephritis, or tubular and interstitial changes

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15
Q

What are the pathological characteristic lesions?

A

wire-loop lesion, hyaline thrombi, and fibrinioid degeneration

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16
Q

What is the clinical presentation of SLE?

A
  • young female
  • nonspecific fatigue
  • fever
  • arthralgia
  • weight changes
  • butterfly rash, arhtritis, and vasculitis
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17
Q

What are the MSK symptoms of SLE?

A
  • 90 % have polyarthralgia (joint pain)
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18
Q

Whats the most common organ affected by SLE?

A

kidney

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19
Q

Libman-Sacks endocarditis

A

noninfectious but may look similar to infectious endocartitis

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20
Q

Discoid lupus

A

most common variet

  • skin involvement only
  • no antinuclear antibodies
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21
Q

sub-acute cutaneous lupus

A

papular and annular lesions (trunk)

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22
Q

Drug-induced lupus

A

Procainamide, hydralazine, isoniazid

- no sex predisposition and most are over 50 yoa

23
Q

Rheumatoid arthritis

A

female: male 4:1

destruction of articular cartilage

24
Q

Etiology of Rheumatoid arthritis

A

Genetically predisposed person is exposed to virus or self-Ag which activated T cells specific for a joint antigen which secretes cytokines like TNF alpha

25
Q

What is the pre-dominant cytokine found in Rheumatoid arthritis?

A

TNF alpha

26
Q

persistent tenosynovitis can lead to what?

A

synovial cysts and ruptured tendons

27
Q

most common cardiovascular manifestation of RA?

A

artherosclerosis (leading cause of death in RA)

28
Q

most common ocular manifestation?

A

keratoconjunctivitis of Sjogren’s syndrome

29
Q

can food affect RA?

A

yes, but not according to the Arthritis foundation

- saturated fats may increase inflammation

30
Q

Goodpastures syndrome (Anti-globmerluar basement membrane disease)

A
  • attacks lungs and kidneys
  • more renal and pulmonary disease
  • some just kidneys
31
Q

Felty’s syndrome

A
  • recurrent bacterial infections and chronic refractory leg ulcers
  • splenomegaly and leukopenia
  • IgM anti-IgG autoantibodies
32
Q

What is Sjogren syndrome?

A

inflammatory disease of the lacrimal and salivary gland

  • keratoconjunctivitis (dry eyes)
  • xerostomia (dry mouth)
33
Q

systemic sclerosis

A
  • difficulty swallowing

- dyspnea and chronic caugh

34
Q

dermatomyositis

A
  1. eyelid rash
  2. proximal muscles
  3. dysphagia
35
Q

autoimmune hemolytic anemia

A

antibody or compliment dependent RBC destruction

36
Q

Good pasture syndrome

A

antibodies to basement membranes in lung and kidneys

37
Q

Myasthenia gravis

A

anti-Ach receptor antibodies

38
Q

hashimoto thyroiditis

A

most common hypothryoidism in nonendemic areas

39
Q

Graves disease

A

overactive thyroid

40
Q

Ulcerative colitis

A

inflammatory disease

  • diarrhea
  • bloody stools
41
Q

ankylosing spondylitis

A

multisystem inflammatory disorder –> SI joints and axial skeleton

  • whites: 92 %
  • Blacks: 50 %
42
Q

what causes ankylosing spondylitis?

A

the spondyloarthropathies are linked by common genetics… HLA-B27

43
Q

symptoms of ankylosing spondylitis?

A
  • intermittent back pain
  • pain and stiffness (worsens with lack of activity)
  • corticosteroids for treatment should be TEMPORARY
44
Q

treatment of ankylosing spondylitis?

A
  • TNF-alpha blocker
  • anti-interleukin -6 inhibitors
  • omega-3 fatty acids
45
Q

immune deficiencies

A

primary is inhertied and secondary is infection, immunosupression, ect.

  • Ig: bacterial
  • T-cell: viral/fungal
46
Q

Primary immunodeficies

A
  1. B cell (humoral)
  2. T cell (cellular)
  3. defects in phagocytes
  4. abnormalities in complement
    these patients are subject to recurrent bacterial infections
47
Q

some immunodeficiency disorders are caused by?

A

discrete molecular defect which causes maturations arrest in lymphocytes

48
Q

Bruton x-linked Agammaglobulinemia

A
  • pre B cells can’t differentiate–> B cells
  • no immunoglobulin
  • TREATED with intravenous pooled human Ig
49
Q

selective IgA deficiency

A
  • often asymptomatic but sometimes have respiratory/gastro intestinal infections
  • MOST COMMON of all primary immune deficiencies
50
Q

common variable immunodeficiency

A

sever hypo gama globulinemia

  • more susceptible to infections
  • malabsorption
51
Q

hyper-IgM syndrome

A
  • x-linked

- can’t make IgG, IgA, or IgE

52
Q

DiGeorge syndrome

A
  • developmental malformation of 3rd and 4th pharyngeal pouches
  • bad thymus and low T cells
  • TREATMENT –> thymus transplant
53
Q

Severe combined immunodeficiency (SCID)

A
  • group of syndromes with humoral and cell mediated immune defects
  • varied infections
  • TREATMENT - bone marrow transplantation

Systems Pathology l (7 decks)

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