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Basic Pathology > Autoimmunity > Flashcards

Autoimmunity Flashcards

1
Q

autoimmunity:

-immune reactions directed at ____

A

self-antigens

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2
Q

autoimmunity:

-acute and/or chronic _____ and _____

A

inflammation;

cell injury

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3
Q

autoimmunity:

severity ranges from _____ to _____

A

minor;

lethal

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4
Q

autoimmunity:

cures

A

no cure for most

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5
Q

allergy: _____ antigen and _____ duration

A

environmental;

limited

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6
Q

allergies ____ with removal of environmental antigen

A

resolve

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7
Q

autoimmunity: _____ antigen and _____ duration

A

environmental or endogenous;

chronic

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8
Q

autoimmunity ____ with removal of environmental antigen

A

does not resolve

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9
Q

autoimmunity is largely limited to type ____ hypersenstivities

A

II - IV

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10
Q

most affected organs and tissues

A
  • bone marrow
  • lining of the joints
  • blood vessels
  • connective tissues
  • endocrine glands
  • kidneys
  • muscles
  • skin
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11
Q

steps to autoimmunity

A
  • “normal” autoimmunity
  • multigenic
  • hormonal
  • environmental triggers (infections, drug-induced, toxins)
  • breakdown of tolerance
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12
Q

there are some ____ that predispose people to autoimmune diseases

A

alleles

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13
Q

uveitis is associated with ____

A

HLA B27

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14
Q

uveitis:

  • inflammation of ____
  • etiology:
A

uvea;

idiopathic, infection, injury, or autoimmune disorders

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15
Q

breakdown of central and peripheral tolerance:

-faulty ____

A

clonal deletion (auto-reactive lymphocytes allowed to mature and enter circulation)

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16
Q

breakdown of central and peripheral tolerance:

-loss of ____

A

Treg-cells (hyper-responsive T and B-lymphocytes; prolonged immune reactions)

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17
Q

breakdown of central and peripheral tolerance:

abnormal expression of _____

A

HLA class II molecules

18
Q

antigens in autoimmunity:

sequestered antigens

A

immunoprivileged organs

19
Q

antigens in autoimmunity:

infectious disease

A
  • molecular mimicry

- original insult

20
Q

tissue-specific, antibody-mediated, autoimmune diseases (Type II)

A
  • auto-antibodies direct at auto-antigens
  • affect normal function of the target organ
  • induce tissue damage
  • auto-Ab levels increase with age in healthy adults
21
Q

rheumatic fever

A
  • Type II
  • strep infection induces cross-reactive auto-Abs
  • molecular mimicry
  • protein in wall of strep bacteria looks similar to antigens of tissues in our heart and myocardium - auto-Abs attack our heart
22
Q

pernicious anemia

A
  • Type II

- auto-Abs block transport molecule in GI tract

23
Q

myasthenia gravis

A
  • Type II
  • auto-Abs block muscle function
  • prevent ACh from binding, no muscle contraction, paralysis
24
Q

graves disease

A
  • Type II
  • auto-Abs stimulate thyroid gland to produce more thyroid hormone
  • have low levels of TSH and high levels of thyroid hormone
25
Q

ocular manifestations of myasthenia gravis

A
  • diplopia
  • ptosis
  • blurred vision
26
Q

ocular manifestations of graves disease

A
  • proptosis
  • periorbital edema
  • abnormal EOMs
  • exposure keratopathy
  • optic nerve compression
27
Q

autoimmune complex-mediated diseases (Type III)

A
  • auto-Ab:Ag immune complexes deposit throughout body
  • infectious initiation (reactive arthritis, poststreptococcal glomerulonephritis)
  • undetermined initiation (lupus, rheumatoid arthritis (also type IV))
28
Q

cell-mediated autoimmunity (Type IV)

A
  • does not involve antibodies
  • APC activates Th cell, which activates Tc cell
  • Tc cells use perforin and granzymes to attack cells
  • Th cell will increase amount of cytokines it produces, including interferon gamma, which increases macrophage activity
29
Q

cell-mediated autoimmune diseases (type IV)

A
  • rheumatoid arthritis (targets multiple cell types)
  • Crohn’s disease (targets epithelial cells of GI tract)
  • multiple sclerosis (targets oligodendrocytes in CNS)
  • type I diabetes (targets beta cells in pancreas)
30
Q

organ-specific autoimmune diseases

A
  • directed against a unique antigen in a given organ
  • type II hypersensitivity (myasthenia gravis, Hashimoto’s thyroiditis, pernicious anemia)
  • type IV hypersensitivity (Crohn’s disease, type I diabetes)
31
Q

systemic autoimmune diseases

A
  • wide range of antigens
  • widespread damage
  • general defect in immune regulation
  • examples: lupus, MS, scleroderma
  • may be types II, II, or IV, or combination
32
Q

systemic lupus erythematosus epidemiology

A
  • chronic, multisystem inflammatory disease
  • type III hypersensitivity
  • 90% of cases in women between 20-40
  • female:male 10:1
  • black:white 8:1
33
Q

pathogenesis of SLE

A
  • DNA and histones released from cells
  • phagocytized by APCs
  • activate T-cells
  • activate B-cells
  • produce antibodies against nuclear antigens
34
Q

SLE target organs

A
  • joints
  • blood vessels
  • kidneys
  • heart
  • skin
  • lungs
  • brain
35
Q

SLE auto-antibodies against:

A
  • nucleic acids
  • erythrocytes
  • lymphocytes
  • platelets
  • coagulation proteins
  • phospholipids
36
Q

11 common symptoms of SLE

A
  • facial (malar) rash
  • discoid rash
  • photosensitivity
  • oral or nasopharyngeal ulcers
  • non-erosive arthritis
  • serositis
  • renal disorders
  • neurologic disorders
  • hematologic disorders
  • immunologic disorders
  • presence of anti-nuclear antibodies (ANA)
37
Q

ocular manifestations of SLE (present in ____ of patients)

A

50%;

  • secondary Sjogren syndrome
  • uveitis (rare)
  • episcleritis/scleritis
  • neuro-ophthalmic lesions
  • retinal vasculopathy (cotton wool spots, most common)
  • bulls-eye maculopathy
38
Q

Sjogren’s syndrome epidemiology

A
  • targets salivary and lacrimal glands
  • ~4 million affected in US
  • 40-60 years of age
  • female:male 9:1
  • primary and secondary forms
39
Q

primary Sjogren’s syndrome

A

lymphocyte infiltration of salivary and lacrimal glands (cause damage and reduce function)

40
Q

secondary Sjogren’s syndrome

A

immune-complex accumulation in salivary and lacrimal glands (causes inflammation and reduced function)

41
Q

Sjogren’s syndrome pathogenesis

A
  • systemic autoimmune disease: RA and SLE
  • lymphocytic infiltrations
  • auto-antibodies play a role

Basic Pathology (21 decks)

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