Cardiac Immune Disorders- Barrington Flashcards

(37 cards)

1
Q

pathogenesis of rheumatic fever

A

post GAS sequellae;
molecular mimicry where auto-Ab’s against GAS M protein that looks like cardiac myosin and our own body will attack the myosin and cause cardiac damage

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2
Q

recurrent ARF leads to what

A

rheumatic heart disease

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3
Q

GAS infection can be treated with what

A

Penicillin

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4
Q

where is ARF and RHD most prominent

A

in underdeveloped countries

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5
Q
A

R: Beta hemolytic
L: gram + cocci in chains
(GAS)

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6
Q

common sites of GAS infection

A

throat and skin

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7
Q

untreated GAS can lead to what

A

ARF

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8
Q

GAS is aka

A

S. pyogenes

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9
Q

what specific cells are activated with ARF

A

B cells

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10
Q

most important sign of ARF

A

carditis

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11
Q

what is targeted in carditis

A

mitral valve

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12
Q
A

mitral valve

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13
Q
A

Aschoff nodules seen in carditis; ARF

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14
Q

another sign of ARF involving joints

A

polyarthritis

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15
Q

migrating arthritis from joint to joint

A

polyarthritis

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16
Q

another sign of ARF (jerky movements)

A

Sydenham’s chorea

17
Q

painless rash on torso (sign of ARF)

A

Erythema marginatum

18
Q

common when carditis is present

A

subcutaneous nodules (formed from Ashcoff bodies)

19
Q

hard to diagnose ARF w/ testing why

A

b/c it takes 2-5 wks after GAS infection to show up

20
Q

minor signs of ARF

A

fever, arthralgia

21
Q

labs done for ARF

A

anti-streptolysin O titer
throat swab

22
Q

to Rx ARF:

A

penicillin to GAS
bed rest; Rx sx’s

23
Q

likelihood of graft rejection is high in what graft

24
Q

how to donor match for heart since limited time frame

A

ABO and PRA (checking for reactive Ab’s)

25
post op drugs for heart transplant
cyclosporin corticosteroids azathioprine -mab
26
what has to be done to endocardium frequently after heart transplant
biopsy
27
worst grades
2 and 4 (graft rejection)
28
rejection that happens within min-hours of transplant; pre-existing Ab's
hyperacute
29
rejection that happens w/in first 1-2 months of tranplant; alloreactive T cells
acute rejection
30
rejection that is harder to control and causes vasculopathies
chronic rejection
31
pig heart transplant
xenotransplantation
32
problem w/ xenotransplantation
hyperacute rejection
33
solution to xenotransplantation
genetically modify pigs to make it where human T cells won't recognize and not attack
34
ischemia/MI reperfusion injury in a nut shell
damage to heart due to some kind of immune response (B or T cells); complement activation
35
mouse to use for best outcome for ischemia/MI reperfusion injury
RAG deficient mouse (unable to make B and T cells)
36
MoA for cyclosporine
blocks calcineurin; inhibits IL-2 (therefore stopping T cell expansion)
37
success of xenotranplantation meaning
lack of hyperacute rejection