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Clinical Pathology > Core Immunology - Autoimmune Diseases (9) > Flashcards

Core Immunology - Autoimmune Diseases (9) Flashcards

1
Q

Autoimmunity

A

Theoretical concept, inherit to immune system, genetically determined

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2
Q

Autoimmune disease

A

Breakdown of self-tolerance, environmental factors acting on favourable genetic background

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3
Q

MHC class

A

Class 2 shape T cell repertoire, predispose to autoimmunity, antigen presenting cells MHC class 2 present antigens to CD4 and T cells

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4
Q

Which MHC class do all cells have?

A

1 - present antigens to CD8 and T cells

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5
Q

Where’s most common genetic susceptibility?

A

HLA region

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6
Q

Autoimmunity arise due to

A

Failures of central/peripheral tolerance, B/T cells require receptor so can react against any infection, any possible combination, some will react to self proteins

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7
Q

Risk factors

A

Women, elderly, sequestered antigens, infection, trauma-tissue damage, smoking

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8
Q

How does autoimmunity cause disease?

A
  • Autoreactive B cells and autoantibodies (cytotoxic, activation of complement, interfere with normal physiological function)
  • Autoreactive T cells (directly cytotoxic and inflammatory cytokine production)
  • Infections active immune and autoimmune response
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9
Q

Changes in amount/nature of autoantigens

A
  • Citrullination of proteins (RA)
  • Tissue transglutamase alters gluten bind to HLA-DQ (coeliac)
  • Failure to clear apoptotic debris increases availability of sequestered antigens inside cell (SLE)
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10
Q

T cells > inflammation

A

Releasing inflammatory cytokines/helping B cells make autoantibodies

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11
Q

Organ specific

A

Affect a single organ, overlap with other organ specific diseases

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12
Q

Example of organ specific

A

Thyroid disease

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13
Q

Systemic

A

Affect several organs, autoantigens found in most cells, overlap with non-organ specific diseases

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14
Q

Examples of systemic

A

Connective tissue diseases

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15
Q

Hashimotos thyroiditis

A

Destruction of thyroid follicles, autoantibodies to thyroglobulin and thyroid peroxidase

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16
Q

Hashimotos thyroiditis leads to …thyroidism

A

Hypothyroidism

17
Q

Grave’s disease

A

Inappropriate stimulation of thyroid gland by anti-TSH-autoantibody

18
Q

Grave’s disease leads to leads to …thyroidism

A

Hyperthyroidism

19
Q

Myasthenia gravis symptoms

A

Difficulty keeping eyes open, speaking, swallowing, hardly smiles, muscular weakness with atrophy

20
Q

Myasthenia gravis mechanism

A

Antibody sticks to receptor for acetylcholine at synapse - stopping it

21
Q

Folic acid/B12 deficiency

A

Pernicious anaemia, B12 binds IF, tingling in feet, increase fatigue, vitiligo

22
Q

SLE symptoms

A

Photosensitive malar/butterfly rash (sunlight damages DNA), multiple mouth ulcers, arthralgia, alopecia, fatigue, arthritis, chest pleuracy, pleural effusion, cerebral lupus, seizures and strokes

23
Q

Anti-nuclear antibodies

A

In SLE immune system forms antibodies against proteins and DNA in nuclei of cells, bind to skin cells that have been damaged by UV, ANA form immune complexes that bind to the complement and cause inflammation

24
Q

Connective tissue diseases

A

SLE, scleroderma, polymyositis, Sjogrens syndrome

25
Q

Vasculitis

A

Inflammation of small vessels

26
Q

Symptoms of vasculitis

A

Patchy non-blanching rash, sinus problems, ear pain

27
Q

Antibody Anti-Neutrophil Cytoplasmic Antibodies (ANCA)

A

Inflammation of vessel wall caused by WBC stimulated by ANCA, digest neutrophils by covering them in enzymes

28
Q

3 forms of ANCA vasculitis

A
  1. Microscopic polyangitis (MPA)
  2. Granulomatis with polyangitis (GPA)
  3. Eosinophilic granulomatous with polyangitis (EGPA)
29
Q

Granuloma

A

Mass of inflammed tissue - destructive lesions in nose, sinuses, trachea, lung, orbits

30
Q

Polyangitis

A

Inflammation of many vessels - skin, kidney, lung, gut

31
Q

Wegener’s Granulomatosis

A

Granulomatosis with polyangitis

32
Q

Raynaud’s phenomenon symptoms

A

Painful, white, numb fingers (red and throbbing when warm up)

33
Q

Primary Raynaud’s phenomenon

A

Common young women, runs in families, ANA negative, harmless

34
Q

Secondary Raynaud’s phenomenon

A

ANA positive (anti-centromere/anti-scl-70 antibodies), associated with scleroderma and SLE

35
Q

Scleroderma

A

Skin fibrosis and tightening, digital ulcers due to tightening and ischaemia, lung fibrosis - gut/kidneys

Clinical Pathology (60 decks)

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