Charts of Rheum 2

Question 1

Drug induced Lupus (DIL) type of immune injury?

Answer 1

Type 2 and 3

Question 2

DIL manifestation?

Answer 2

Immune complex, disease of vessels, glomeruli
Loss of blood cells
Renal and CNS involvement UNCOMMON

Question 3

Pathogenesis of Drug induced lupus?

Answer 3

Drug reaction to hydrazine, procainamid, isoniazid, D-penicillamine

Question 4

ANA/HLA associations of DIL?

Answer 4

Antihistones

HLA-DR4

Question 5

Discoid lupus (DL) pathogenesis?

Answer 5

Dysregulation of immune response/UV light

Question 6

Immune mechanism of DL?

Answer 6

Immune comples and complement deposits along skin

Question 7

Type of immune injury is DL?

Answer 7

Type 3

Question 8

Manifestation of DL?

Answer 8

Limited to skin

Rare systemic symptoms

Question 9

Diffuse scleroderma (DS) pathogenesis?

Answer 9

Excessive deposition of collagen due to immune activation

Question 10

Immune mechanism of DS?

Answer 10

CD4 cells stimulate cytokine production and fibrosis in skin ad other organs.
There is also blood vessel fibrosis

Question 11

HLA/ANA associations for DS?

Answer 11

DNA topoisomerase 1 (Scl-70)

Question 12

Type of immune injury is DS?

Answer 12

Type 4 due to Cytokine stimulation of fibrosis, endothelial activation

Question 13

Manifestations of DS?

Answer 13

Fibrosis of dermis, esophagus, lungs

Vascular injury to kidneys

Question 14

Pathogenesis of Limited Scleroderma (CREST)?

Answer 14

Similar to DS but limited to skin of fingers, forearms, and face
Also calcification of subcutaneous tissues

Question 15

Immune mechanism of CREST?

Answer 15

CD4 cells stimulate cytokine production and fibrosis in skin, organs, and blood vessels

Question 16

HLA/ANA associations of CREST?

Answer 16

Anti-centromere

Question 17

Type of immune injury is CREST?

Answer 17

Cytokine stimulation of fibrosis, type 4

Question 18

Manifestations of CREST?

Answer 18

Calcinosis
Raynaud's
Esophageal dysfunction
Sclerodactyl 
Telangiectasia

Question 19

Sjogrens syndrome pathogenesis?

Answer 19

Tissue specific response triggered by retrovirus HTLV or EBV infection

Question 20

Immune mechanism of Sjogren?

Answer 20

CD4 response to auto antigen such as cytoskeletal protein alpha fodrin

Question 21

HLA/ANA associations of Sjogren?

Answer 21

Anti-RNP (Ribonucleoprotein)

Multiple HLA-DR and DQ

Question 22

Type of immune injury for Sjogren?

Answer 22

Type 4

Question 23

Manifestation of Sjogren?

Answer 23

Cell mediated destruction of lacrimal and salivary glands with fibrosis

Question 24

Pathogenesis of Dermatomyositis?

Answer 24

Activation of CD4 cells leading to antibody formation

Question 25

Immune mechanism of Dermatomyositis?

Answer 25

Antibody and complement mediated vasculitis with secondary loss of muscle fibers

Question 26

Type of immune injury for Dermatomyositis?

Answer 26

Type 3

Question 27

Manifestation of Dermatomyositis?

Answer 27

Loss of small vessels in muscle with ischemic necrosis of muscle fibers

Question 28

Pathogenesis of Polymyositis?

Answer 28

Activation of CD8 cells

Question 29

Immune mechanism of Polymyositis?

Answer 29

Cell mediated destruction of myofibers

Question 30

Type of immune injury for Polymyositis?

Answer 30

Type 4

Question 31

Manifestation of Polymyositis?

Answer 31

Necrosis of muscle fibers

Question 32

Pathogenesis of Inclusion body myositis (IBM)?

Answer 32

Activation of CD8 cells

Question 33

Immune mechanism of IBM?

Answer 33

Unknown and immunosuppressive therapy isn’t helpful

Question 34

Type of immune injury for IBM?

Answer 34

Also unknown

Question 35

Manifestation of IBM?

Answer 35

Necrosis of muscle fibers

Secondary immune response