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Exam 3 Autoimmune Diseases Flashcards

1
Q

Defined as protecting the body against infection from invading pathogens?

A

innate immunity

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2
Q

Defined as immune response that must be stimulated by and then adapts to the presence of microorganisms before it can effectively destroy them?

A

adaptive immunity

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3
Q

Defined as T lymphocytes defend the body against invaders that live inside of infected host cells?

A

cell-mediated

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4
Q

Defined as pre-exposed to self-antigens in thymus gland: learn to recognize/destroy foreign antigens only?

A

central tolerance

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5
Q

Defined as B lymphocytes can form millions of types of antibodies with different reactivity against specific antigens?

A

humoral

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6
Q

Defined as preventing the body from attacking itself?

A

self-tolerance

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7
Q

Defined as the ability to recognize self antigens

A

self-tolerance

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8
Q

Defined as the body’s ability to discriminate between self antigens and non-self antigens?

A

Immune tolerance

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9
Q

When self-tolerance and immune tolerance fail, what happens?

A

activated T-lymphocytes and antibodies attack your own cells

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10
Q

Another name for autoimmune diseases?

A

autoimmunity

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11
Q

Autoimmunity hypothesis?

A

T and B lymphocytes escape thymus and central tolerance mechanisms and get activated and self-react out in periphery

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12
Q

What are the two factors necessary for development of autoimmunity?

A

1) inherited susceptibility gene

2) environmental triggers

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13
Q

What are some genes that predispose someone for autoimmunity?

A

MHC genes

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14
Q

What do MHC genes do?

A

encode cytokines and are recognized by T lymphocytes for antigen processing

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15
Q

What are some common environmental triggers?

A

infection
high fever
trauma

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16
Q

Name some familial autoimmunity diseases?

A 
Thyroid disease
Lupus
RA
MS
Diabetes
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17
Q

What often triggers autoimmunity?

A

infection

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18
Q

How does infection trigger autoimmunity?

A

1) cytokines activate self-reactive T lymphocytes

2) injured tissue releases antigens that begin autoimmune reaction

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19
Q

What causes autoimmune diseases?

A

when immunologic tolerance fails

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20
Q

What happens to tissues when immunologic tolerance fails?

A

autoantibodies bind to tissues or form immune complexes

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21
Q

Autoantibodies deposit in blood vessels causing what systemic involvement?

A

vasculitis, joint damage, kidney damage

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22
Q

How do autoantibodies initiate disease?

A

alter/inhibit receptor function AND

stimulate receptors normally stimulated by a hormone

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23
Q

How to treat an organ specific autoimmune disease?

A

reduce inflammation with steroids OR

antagonists (blockers) to cytokines

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24
Q

How do steroids reduce inflammation?

A

suppress growth of lymph tissue throughout body

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25
1 bad side effect of reducing inflammation with steroids?
since they attack lymph tissue, increased susceptibility to infection
26
Immunosuppressive drugs are used to inhibit ___ responses?
T cell
27
Treatment for RA?
Aspirin and NSAIDS: reduce inflammation, pain, stiffness, encourage normal function
28
Adverse effects of aspirin?
GI ulcers, bleeding Kidney - hyperkalemia/edema (retention of Na/H20) Tinnitus Respiratory
29
What sulfa drug to treat RA (after Aspirin and NSAIDS fail) that interferes with prostaglandin synthesis?
sulfasalazine
30
sulfasalazine interferes with what?
prostaglandin synthesis
31
celebrex is a ____ inhibitor
cox-2
32
What drug increases risk for stroke?
celebrex
33
Celebrex should be monitored when used with ___?
antihypertensives (may decrease effectiveness)
34
What type of drug should be monitored when a patient is taking antihypertensives?
cox-2 inhibitor; celebrex
35
Celebrex (cox-2 inhibitor) contraindicated for what?
aspirin/NSAID allergic patients | sulfonamides
36
DMARDS stands for?
disease-modifying anti-rheumatic drugs (AKA slow acting)
37
Drug of choice for severe RA or psoriatic arthritis when NSAIDS fail)?
methotrexate (low dose) | **high dose used for chemo**
38
Methotrexate most common side effect?
mucosal ulcerations, nausea
39
If a patient is experiencing mucosal ulcerations and nausea, what medication are they on to fight severe RA?
methotrexate
40
What do immune modulators do and what class of drug are they?
inhibit pyrimidine synthesis | DMARD
41
Name another immune modulator besides methotrexate?
leflunomide
42
Name 2 proinflammatory cytokines?
interleukin-1b and TNF
43
What anticytokine drug blocks TNF alpha?
etanercept
44
Etenercept blocks what?
TNF alpha
45
What anticytokine drug blocks TNF alpha, but has long-term problems with use?
infliximab
46
Long-term use of infliximab has a problem, what is it?
body develops antibodies against the drug
47
Name the last TNF alpha blocker drug?
adalimumab
48
IL-1 receptor antagonist drug?
anakinra
49
anakinra mechamism?
blocks IL-1 and slows degradation of cartilage and bone loss
50
Name 2 antimalarials?
chloroquine | hydroxychloroquine
51
Antimalarial severe side effects/toxicity?
blue-black intraoral pigmentation
52
What drugs cause blue-black intraoral pigmentation?
antimalarials chloroquine hydroxychloroquine (although gold compounds do this too)
53
A chelating agent that slows the progression of bone destruction and RA?
Penicillamine (also an antidote to heavy metal poisoning)
54
What has a high incidence of toxicity and requires intensive monitoring?
Gold compounds
55
Gold compounds all have what in their drug names?
Aur Aurothioglucose auranofin gold sodium thiomalate (Aurolate)
56
What type of drugs are used in cases of refractory RA?
Immunosuppressive drugs (because refractory means the drugs ain't working)
57
What do we use with prednisone for a host of diseases I can't pronounce or even remember?
azathioprine
58
Name the immunosuppressive drug used for severe RA that causes alopecia (hair loss)?
cyclophosphamide
59
What is used primarily to prevent rejection of organ transplants?
cyclosporine
60
What drug can cause gingival overgrowth?
cyclosporine
61
What else can steroids affect?
peripheral leukocytes
62
What else can steroids inhibit?
phospholipase A
63
What else can steroids suppress?
allergies
64
Meds to treat Sjogren's Syndrome and to encourage salivary stimulation?
pilocarpine | cevimeline
65
Elevated BP may be due to ____?
chronic pain
66
Perform ____ on a regular basis.
blood assays
67
Stress raises what?
cortisol

Pharmacolocy 2 (15 decks)

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