Immune Mediated Diseases Flashcards

1
Q

Acquired causes of immunodeficiency

A

Failure of passive transfer
Chronic infections e.g. FIV
Inflammatory or neoplastic disease
Drugs
Malnutrition
Toxins
Stress

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2
Q

Major haemolymphatic immune mediated diseases (3)

A

Immune mediated haemolytic anaemia/IMHA
Immune mediated thrombocytopaenia/IMTP
Immune mediated neutropenia (rare)

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3
Q

Major endocrine immune mediated diseases (2)

A

Hypothyroidism
Hypoadrenocorticism

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4
Q

Major cutaneous immune mediated diseases (3)

A

Canine dermatomyositis
Discoid lupus erythematosus
Pemphigus-pemphigoid complex

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5
Q

Major NMSK immune mediated diseases (3)

A

Polyarthritis (erosive and non-erosive)
Myasthenia gravis
Polymyositis/polyneuritis

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6
Q

Major CNS immune mediated diseases (2)

A

Meningitis of unknown origin/MUO
Granulomatous meningoencephalitis/GME

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7
Q

Major gastrointestinal immune mediated diseases (2)

A

Inflammatory bowel disease/chronic enteropathy
Pancreatitis

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8
Q

Major renal immune mediated diseases

A

Glomerulonephropathies (there are many)

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9
Q

Major immune mediated disease with multi-systemic involvement (1)

A

Systemic lupus erythematosus/SLE

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10
Q

Hypersensitivity reaction involved in IMHA/IMTP

A

Type 2 (antibody mediated)

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11
Q

Is immune mediated disease more common in cats or dogs?

A

Cats

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12
Q

Infectious causes of secondary IMHA (5)

A

Mycoplasma haemofelis
Babesia canis
FIP
FeLV
Chronic bacterial infection

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13
Q

What disease is administration of TMPS (antibiotic) and methimazole (hyperthyroid medication) a trigger for?

A

Secondary IMHA

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14
Q

Neoplastic cause of secondary IMHA

A

Splenic haemangiosarcoma

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15
Q

What disease can be caused by a snake bite or bee trigger?

A

Secondary IMHA

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16
Q

Clinical signs of IMHA

A

Hepatomegaly
Jaundice
Anaemia

17
Q

What is a marker of IMHA in a blood smear?

A

Spherocytes (also present after a blood transfusion)
Small, densely staining RBCs that lack central pallor

18
Q

How do you distinguish rouleaux formation from agglutination?

A

Auto-agglutination test

19
Q

Haematology findings in IMHA

A

Low PCV (<20%)
Moderate to marked anaemia (regenerative response depends on magnitude, if presented early may be pre-regenerative)

20
Q

Is there a left shift in IMHA?

A

Yes

21
Q

Role of Coombe’s test in IMHA and which test tube should be used?

A

Identifies antibody on the surface of red blood cells, useful if no autoagglutination/spherocytes/regenerative anaemia
EDTA

22
Q

What is commonly seen on urinalysis in IMHA?

A

Signs consistent with bilirubinuria or haemoglobinuria

23
Q

Why should a urine sediment analysis and culture be done for animals with suspected/confirmed IMHA?

A

In case UTI is a trigger

24
Q

What are two important diagnostic steps to rule out trigger factors in IMHA?

A

Diagnostic imaging (thoracic and abdominal radiography/ultrasound)
Infectious diseases screening (travel history?)

25
Q

Two major focus points in treatment of IMHA

A

Treat underlying disease (ensure no infectious causes before immunosuppression)
Immunosuppression (glucocorticoids, azathioprine, mycophenolate mofetil, cyclosporin, leflunomide)

26
Q

What is the main risk of death in IMHA and how should you prevent it?

A

Thromboembolic disease

27
Q

Signalment in IMHA

A

Young to middle aged dogs
Inherited predisposition in cocker spaniels, springer spaniels and poodles

28
Q

Signalment in primary IMTP

A

Middle aged female dogs
Cocker spaniels, Old English sheepdogs, GSDs and poodles

29
Q

Pathophysiology of secondary IMTP

A

Antibodies target non-self antigens absorbed onto surface of platelets or immune complexes bound to platelets

30
Q

Clinical signs of IMTP

A

Petechiae
Ecchymoses
Haematomas
Epistaxis
Gingival bleeding
Malaena/haematochezia from GIT bleeding
Retinal haemorrhage/hyphaema/anterior uveitis

31
Q

Laboratory findings in IMTP

A

Low platelet count (automated or manual, check for clumping)

Biochemistry profiles and coagulation tests often normal
Concurrent anaemia/other cell line reductions could indicate bone marrow disease

32
Q

What infectious disease is shown here that is causing secondary IMTP?

A

Leishamiasis

33
Q

What infectious disease is shown here that is causing secondary IMTP?

A

Babesia

34
Q

On a blood smear, below which value of platelets in one view would you suspect IMTP?

A

5

35
Q

Acute treatment of IMTP

A

Transfusion to improve oxygen delivery if clinical signs indicate

36
Q

Long term treatment of IMTP

A

Immunosuppression with prednisolone initially
Ideally move onto azathioprine, cyclosporine or mycophenolate mofetil

37
Q

Causes of death in IMTP

A

Severe life threatening haemorrhage (could be in GI tract so look for malaena)
Small but catastrophic breed (CNS/lung)

38
Q

First coagulation parameter affected by warfarin

A

Prolonged prothrombin time (PT)