Cardiac Immune Disorders- Barrington

Question 1

pathogenesis of rheumatic fever

Answer 1

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

Question 2

recurrent ARF leads to what

Answer 2

rheumatic heart disease

Question 3

GAS infection can be treated with what

Answer 3

Penicillin

Question 4

where is ARF and RHD most prominent

Answer 4

in underdeveloped countries

Question 5

Answer 5

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

Question 6

common sites of GAS infection

Answer 6

throat and skin

Question 7

untreated GAS can lead to what

Answer 7

ARF

Question 8

GAS is aka

Answer 8

S. pyogenes

Question 9

what specific cells are activated with ARF

Answer 9

B cells

Question 10

most important sign of ARF

Answer 10

carditis

Question 11

what is targeted in carditis

Answer 11

mitral valve

Question 12

Answer 12

mitral valve

Question 13

Answer 13

Aschoff nodules seen in carditis; ARF

Question 14

another sign of ARF involving joints

Answer 14

polyarthritis

Question 15

migrating arthritis from joint to joint

Answer 15

polyarthritis

Question 16

another sign of ARF (jerky movements)

Answer 16

Sydenham’s chorea

Question 17

painless rash on torso (sign of ARF)

Answer 17

Erythema marginatum

Question 18

common when carditis is present

Answer 18

subcutaneous nodules (formed from Ashcoff bodies)

Question 19

hard to diagnose ARF w/ testing why

Answer 19

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

Question 20

minor signs of ARF

Answer 20

fever, arthralgia

Question 21

labs done for ARF

Answer 21

anti-streptolysin O titer
throat swab

Question 22

to Rx ARF:

Answer 22

penicillin to GAS
bed rest; Rx sx’s

Question 23

likelihood of graft rejection is high in what graft

Answer 23

allograft

Question 24

how to donor match for heart since limited time frame

Answer 24

ABO and PRA (checking for reactive Ab’s)

Question 25

post op drugs for heart transplant

Answer 25

cyclosporin
corticosteroids
azathioprine
-mab

Question 26

what has to be done to endocardium frequently after heart transplant

Answer 26

biopsy

Question 27

worst grades

Answer 27

2 and 4 (graft rejection)

Question 28

rejection that happens within min-hours of transplant; pre-existing Ab’s

Answer 28

hyperacute

Question 29

rejection that happens w/in first 1-2 months of tranplant; alloreactive T cells

Answer 29

acute rejection

Question 30

rejection that is harder to control and causes vasculopathies

Answer 30

chronic rejection

Question 31

pig heart transplant

Answer 31

xenotransplantation

Question 32

problem w/ xenotransplantation

Answer 32

hyperacute rejection

Question 33

solution to xenotransplantation

Answer 33

genetically modify pigs to make it where human T cells won’t recognize and not attack

Question 34

ischemia/MI reperfusion injury in a nut shell

Answer 34

damage to heart due to some kind of immune response (B or T cells); complement activation

Question 35

mouse to use for best outcome for ischemia/MI reperfusion injury

Answer 35

RAG deficient mouse (unable to make B and T cells)

Question 36

MoA for cyclosporine

Answer 36

blocks calcineurin; inhibits IL-2 (therefore stopping T cell expansion)

Question 37

success of xenotranplantation meaning

Answer 37

lack of hyperacute rejection