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T IoD immunology > Autoimmunity and vasculitis > Flashcards

Autoimmunity and vasculitis Flashcards

1
Q

what investigations are done for CTD/inflammatory joint diseases?

A
  • ANA
  • Rhf
  • Anti CCP
  • Anti cardiolipi
  • Lupus anticoagulant
  • immunoglobulins
  • SPE
  • C3/C4
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2
Q

Why is electrophoresis helpful when serum immunoglobulins are raised?

A

It helps tell if it’s a polyclonal increase or an increase due to a monoclonal immunoglobulin

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3
Q

If serum immunoglobulins are high electrophoresis can show if this is due to a monoclonal immunofixation how is this?

A

Will show immunofixation

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4
Q

what conditions cause a polyclonal increase in serum immunoglobulins?

A

Connective tissue diseases
rheumatoid arthritis
chronic infective and inflammatory conditions
chronic liver disease

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5
Q

what conditions cause an increase in monoclonal immunoglobulins?

A

Multiple myeloma

waldenstroms macroglobulinaemia

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6
Q

How is complement C3/4 measured?

A

nephelometry

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7
Q

what does low C3 and low C4 suggest?

A

A complement consumption seen in immune complex diseases

- infection, SLE, septicaemia, active renal disease

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8
Q

what does low C4 and normal C3 suggest?

A

c1 esterase inhibitor deficiency

c4 nut alleles

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9
Q

what does a positive ANA test suggest?

A

connective tissue diseases such as SLE, mixed connective tissue disease, sjogrens syndrome, systemic sclerosis

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10
Q

what drugs can increase the chance of a positive ANA?

A

hydralazine, isoniazid, procainamide

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11
Q

what further testing is done on a positive ANA result?

A

Tested further for antibodies to specific nuclear antigens which includes dsDNA and ENA

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12
Q

What are two methods for testing for dsDNA antibodies?

A
  1. ELISA

2. crithdia test

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13
Q

what antigen is recognised in c-ANCA?

A

proteinase 3

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14
Q

what antigen is recognised in p-ANCA?

A

mpo

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15
Q

What antibodies are associated with coeliacs?

A

IgA Ttg antibodies

IgA endomysial antibodies

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16
Q

what diseases is anti gastric parietal cell antibodies seen wth?

A

Atrophic gastritis

pernicious anaemia

17
Q

what dsieases is anti intrinsic factor antibodies seen with?

A

pernicious anaemia

18
Q

what antibodies are seen with primary biliary cirrhosis?

A

anti mitochondrial antibodies

anti PDH2 antibodies

19
Q

what antibody is associated with goodpasture syndrome?

A

anti glomerular basement membrane antibodies

20
Q

what antibodies are associated with sjogrens syndrome?

A

Anti SSA and Anti SSb

21
Q

what are three ways of detecting autoantibodies in blood samples?

A
  1. indirect immunofluorescence
  2. ELISA
  3. immunoblotting
22
Q

what happens in ELISA?

A

Antigens are coated on to the wells

The serum is placed into the well allowing any antibody in the serum to bind to the antigens in the well

23
Q

what takes place in immunoblotting?

A

Antigens are coated onto a membrane and antibody in the patients serum detected by enzyme linked anti human Ig

24
Q

what is anti CCP highly specific for?

A

Rheumatoid arthritis

25
Q

what are examples of large cell vasculitis?

A

giant cell arteritis

takayasu arteritis

26
Q

what are examples of medium sized vessel vasculitis?

A

Polyarteritis nodosa

Kawasaki disease

27
Q

what are examples of ANCA associated vasculitis?

A

Granulomatosis with polyaniitis
Microscopic polyangiitis
Eosinophilic granulomatosis with polyangiitis

28
Q

what are symptoms of sjogrens disease?

A

Dry eyes
Dry moth
Dry skin

29
Q

who is most likely to get SLE?

A

Between the age of 20-40 female

African/carribean origin

30
Q

what are the causes of SLE?

A
  • HLA gene link
  • UV light can act as a trigger
  • EBV acts as a trigger
31
Q

what are the immunological consequences of SLE?

A
  • development of autoantibodies circulating or depositing
  • complement activation and neutrophil infiltration causing inflammation
  • abnormal cytokine production with high levels of IL10 and interferon alpha
32
Q

what are the clinical features of SLE?

A

Heart: pericarditis/endocarditis

  • abdominal pain
  • renal disease
  • anaemia
  • arthritis
  • raynauds
  • effusion
  • butterfly face rash
  • photosensitivity
  • fever
33
Q

what is schirmers test?

A

Test of tear production contributing to diagnosing sjogrens syndrome.
Place a strip of paper under the eyelid and measure moistness

T IoD immunology (2 decks)

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