Immuno Path II - Autoimmune disorders

Question 1

Failure of the Fas- Fas ligand system is a hallmark of what?

Answer 1

Autoimmunity as the T-cells are no longer able to cause autoreactive cells to undergo apoptosis.

Question 2

Failute of T-cell mediated supression eludes to what?

Answer 2

Eludes to the CD4 cells being unable to suppress possible autoimmune cells with IL-10, TGFB.

Question 3

Describe the Polyclonal lymphocyte activation in autoimmunity

Answer 3

Superantigens and other bacterial products can activate B-cells which may induce/alter immune responses causing auto-reactive cells.

Question 4

What is the M:F ratio and incidence of SLE?

Answer 4

1:9
1/700 females affected.
Typically occurring in monarch pregnancy.

Question 5

It is assumed that familial clustering and expression of HLA alleles at the D locus puts a patient at increased risk of what disease?

Answer 5

SLE

Question 6

What do anti-nuclear antibodies act against?

Answer 6

These act commonly against 
DNA
Histones
Non-Histone proteins
Nucleolar Ag.

Question 7

When levels of anti-dsDNA are high, what does this correlate to?

Answer 7

Correlates to active SLE, specifically nephritis!

Question 8

When levels of ribonucleoprotein, specifically anti-Smith are high, what disease does this typically correlate to?

Answer 8

Correlates to vasculitis!

Question 9

Homogenous (diffuse) pattern staining indicates Ab to what?

What disease is this commonly correlated to?

Answer 9

Ab to chromatin, dsDNA, histones.

Commonly implicated in drug induced SLE.

Question 10

Rim pattern staining indicates Ab to what and is a sign of what disease?

Answer 10

Indicates Ab to ds-DNA commonly associated with SLE with renal involvement and disease flairs.

Question 11

Speckled pattern staining indicates Ab to what and is a sign of what disease?

Answer 11

Indicates Ab to histones, ribonucleoproteins,

Is most common pattern asociated with anti-smith Ab of SLE but also Systemic Sclerosis, Sjorgens syndrome, and Mixed connective tissue disease.

Question 12

Nucleolar patterning indicates Ab to….?

And is related to what disease?

Answer 12

Ab to nucleolar RNA associated with systemic sclerosis.

Question 13

Centromere staining patterns that display anti-centromere Ab are indicitive of what disease?

Answer 13

CREST disease.

Question 14

What type of hypersensitivity is seen in visceral lesions related to SLE?

Answer 14

Type III mechanism especially in the kidneys

This is the Ab-Ag complexes causing damage.

Question 15

What type of hypersensitivity is seen in the blood cells related to a SLE disease?

Answer 15

Type II mechanism in which the Abs opsonize RBC and WBC and plateles.

Question 16

Acute vasculitis with fibrinoid necrosis and onion skin fashoned thickening of vessels are signs of what?

Answer 16

Chronic lupus affecting the blood vessels via type III hypersensitivity to ANA nuclear proteins.

Question 17

What is Libman-Sacks endocarditis?

Answer 17

Warty lesions occurin on any valve of the heart on either surface of the affected valves.
Caused by SLE
“Non bacterial endocarditis”

Question 18

What are the survival rates for SLE at 5 years and at 10 years?

Answer 18

90% 5 year survival rate

80% 10 year survival rate

Question 19

What is Chronic Discoid LE?

Answer 19

This is the cutaneous form causing a variety of skin lesions.
ANA detected but anti-dsDNA is rare!
Occurs in 5-10% of cases.

Question 20

D-pnicillamine, Procainamide, Hydralazine, and isonizad all increase the risk of what disorder?

Answer 20

All increase the risk of Drug induced lupus like syndrome.

Positive antihistone and anti dsDNA with multiple organ involvement, fever, rash, and althraglis.