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Exam III REVIEW QUESTIONS Flashcards

1
Q

What is another name for Scleroderma?

A

Progressive Systemic Sclerosis (PSS)

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2
Q

What is the pathogenesis of scleroderma? Namely: is it a malignancy of fibroblasts? What do fibroblasts produce?

A

It is NOT a malignancy of fibroblasts, but its fibroblasts gone wild..They produce too much collagen

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3
Q

What are the 5 features of CREST syndrome?

A

C: Calcinosis R:Reynaud Phenominon E:Esophageal Dysfunction S:Sclerodactyly T:Telangiectasia

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4
Q

What are the two ANA’s (AutoaNtibody Association) for SLE (Systemic Lupus Erythematosus)? What percentage diagnosis can you achieve with these two ANAs?

A
  1. Anti-Double Stranded DNA (Native DNA) 2. Anti-Smith…90% diagnosis
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5
Q

What are the two ANA’s in Sjogren’s Syndrome?

A
  1. Anti SS-A 2. Anti-SS-B
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6
Q

What is the ANA for PSS (Progressive Systemic Sclerosis)? AND its abbreviation..

A

Anti-DNA-topoisomerase (Scl-70): PSS

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7
Q

What are the 2 major differences between Polymyositis and Dermatomyositis?

A
  1. Derma=microANGIOpathy vs Poly=no angiopathy 2. Derma=EYELID (heliotropic) rash vs Poly=no eyelid (heliotropic) rash
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8
Q

What is the CREST variant ANA? How is this different from the ANA of the “parent” condition of CREST (PSS)?

A

CREST: AntiCentromere vs PSS: [[MAIN ONE:Scl-70]], nucleolar antibodies, nonhistone nuclear protein (and anticentromere)

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9
Q

Which autoimmune disease is associated with visceral malignancies (lungs, colon, stomach…)?

A

Poly-Myo-Sitis/Derm-ato-Myo-Sitis

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10
Q

Which autoimmune disease has a 40x increased risk for malignant lymphoma?

A

S-Jo-gren Syndrome

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11
Q

What are the 3 factors most related to the cause of SLE?

A
  1. ESTROGEN (women) 2.GENETICS 3.RACE: Black Women
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12
Q

What are the 5 ANA Fluorescent Staining Patterns?

A
  1. Homogenous (diffuse) 2. Rim 3. Speckled 4.Nucleolar 5.Centromere
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13
Q

What is the mildest form/best prognosis of Lupus Nephritis?

A

Mes-an-gial Lupus

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14
Q

Lupus Path: Result of Lupus in Serous Membrane?

A

Serous Membrane: pleuritis

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15
Q

Lupus Path: Result of Lupus in lungs?

A

Pneumonia, fibrosis, pleural disease

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16
Q

What is the most common manifestation of Lupus?

A

Joints! 90% of pt have Poly-arth-ralgia

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17
Q

Result of lupus in kidney?

A

Glomer-ulo-neph-ritis 3/4 of pt’s

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18
Q

Result of Lupus in the heart (2)? BOARDS!

A

Pericarditis, LIBMAN-SACKS ENDOCARDITIS

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19
Q

Result of Lupus on the Brain?

A

Vasculitis leading to hemorrage and infarction…Psychoses, depression, mood change, seizures

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20
Q

Result of lupus on Spleen? UNIQUE!

A

ONION-SKIN pattern around small arteries

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21
Q

Which 2 autoimmune diseases are related to Raynaud’s phenomenon?

A

SLE, PSS

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22
Q

What are the 3 drugs that can cause Lupus like symptoms?

A
  1. PRO-CAIN-AMIDE 2.HYDRAL-AZ-INE 3. I-SON-IA-ZID
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23
Q

What is the different ANA associated with Drug induced lupus?

A

HISTONES! (double stranded and smith do not show up)

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24
Q

What are the 3 the skin manifestations of lupus?

A

butterfly rash, hair loss, oral mucosa ulcerations

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25
What are the three manifestations of lupus on the blood?
Anemia, LeukoPenia, ThromboCytoPenia
26
What is the pathophysiology of Agammaglobulinemia of Bruton? (3 steps)
1. Defect on X chromosome therefore 2. No B-Cell Tyrosine Kinase 3. No Pre-B-Cells ---> B-Cell maturation
27
What are the _4_ physical features of DiGeorges Syndrome?
1. MicroCephaly 2.Mouth (cleft lip/palate) 3.Ears (low set) 4. Face
28
Which embryological structures failed to form correctly in DiGeorges?
3rd and 4th pharyngeal POUCHES (Thymus and Parathyroids!)
29
Which immune cell type is deficient in Agammaglobulinemia of Bruton? Which immune cell type is fine?
No B cells! (Bruton= NO B-cells)...Tcells are fine so you ONLY have a problem handling BACTERIAL infections!
30
What's another name for the SWISS type Agammaglobulinemia?
SCID (Severe Combined ImmunoDeficiency)
31
What is the round part of the lollipop protein on HIV?
gp120
32
What is the stem of the lollipop protein on HIV?
gp41
33
What is the INNER capsid of the HIV?
p24 capsid
34
What is the layer in-between the capsid and the lipid by layer of HIV?
p17 matrix
35
his quote: "which HIV protein is on the outer envelope?"
gp41
36
What is the most common cause of meningitis in AIDS pts?
The FUNGUS: CRYPTOcoccus......Cryptococus=they soon go into the CRYPT :(
37
What KIND of virus is the HIV? Which 2 immune cells does it most affect?
Its a RETROVIRUS...CD4+ T cells (#1!!!) and Macrophages (and therefore DENDRITES, MICROGLIAL cells)
38
What is the most common cause of death via lung infection for an AIDS pt? 5
1. Mycobacterium Avium Complex (MAC) 2.TB to a lesser extent 3.Pneumocystis Carinii 4.Aspergillus 5.Candida
39
What are the 2 methods of HIV transmission?
1.The transfer of BODILY FLUIDS (Blood, Sperm, Vaginal Secretions...SEX namely) 2. MATERNOFETAL (across the placenta, breast milk, vaginal tract) MINOR WOUNDS (like the possibility in healthcare have a .3% chance of transmission!!)
40
Out of our three immune systems... Which system is depressed with the HIV attack on Tcells?
BOTH Cell-Mediated (T-cell's) and Complement (T-cells + B-cells) (but not humoral-just Bcells)
41
Which type(s) of transmission is more likely? Male to Male, Male to Female, or Female to Male?
Male to Male and Male to Female are 20x more common then female to male transmission in the US
42
What are the 4 neoplasms associated with AIDS?
1. Kaposi Sarcoma (angiosarcoma) 2. B-cell non-Hodgkin's Lymphoma 3. Primary Lymphoma of the Brain=(1,000 TIMES more frequent in HIV+ pt's!!!!) (4.Cervix didn't talk about much)
43
For the ELISA test, which antibodies in the pt's serum will bind to the given antigen? What happens next?
IgG's, If there are IgG's present a SECOND antibody is present that is a COLOR indicator
44
Which test, ELSIA or Western blot is presumptive? Which one is confirmatory?
Elisa=presumptive (can be used for different infections), Western blot= confirms the HIV presence
45
What is the unique step to Western Blot that Elisa does not do?
Acrylamide Gel Electrophoresis ("blotted" from gel to paper, hence the name!)
46
What is the threshold for the CD4+ Tcell count to confirm HIV+ has progressed to AIDS?
<200 CD4 T-cells/mm3
47
What are the 6 organisms that can cause diarrhea/dehydration in AIDS Pt's? BOOM!
1.Crypto-Sporidium, 2.Iso-spora, 3.Candia, 4.CMV (CytoMegaloVirus), 5.Herpes, (6.TB, 7.MAC mainly lungs, but the slide said these associate w GI)
48
What are the characteristic nodules of AIDS encephalopathy?
MicroGlial Nodules (multinucleated giant cells)
49
At which phase do Opportunistic organisms take over the AIDS pt?
Final/Crisis Phase (3rd phase)
50
At which phase does the patient carry HIV and is infectious, but is asymptomatic?
Chronic Phase (2nd phase)
51
Which phase is associated with "smoldering, low level HIV production"?
Chronic Phase (2nd Phase)
52
Clinically, which phase is the pt in with acute illness?
Acute Phase (1st phase)
53
Clinically, which phase is associated with persistent, generalized lymphadenopathy?
Chrnic phase (2nd)
54
Clinically, which phase incorporates those with other diseases superimposed on the viral infection?
Final/Crisis (3rd)
55
Which phase might the pt develop antibodies to HIV?
Acute Phase (1st)
56
What is the make up of Amyloid?
95% fibrillar proteins, 5% glycoproteins arranged into Beta-pleated sheets
57
What substance is an amorphous eosinphilic hyaline-appearing exracellular substance, that causes pressure and atrophy to adjacent cells?
Amyloid!
58
What is the stain that is used to show Amyloid presence in a tissue?
Congo Red Stain
59
Which neurological disease goes "hand in hand" with amyloidosis?
Alz-Hei-Mer's
60
The association of HIV and HHV-8 causes?
Kaposi Sarcoma
61
The association of HIV and HPV causes?
Squamous Cell Carcinoma of the CERVIX
62
What are the ENVIRONMENTAL factors for SLE?
UV light, Infection (epstein barr), silica dust

Immunology (10 decks)

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