Immunologic Flashcards
What gender is more likely to have juvenile rheumatoid arthritis?
Both genders have equal predisposition for systemic JRA
Girls are 3x more likely to have articular-specific JRA than boys
What is the most common presenting symptom in Systemic Lupus Erythematosus?
Myalgia
SLE is often referred to as the disease of 10,000 faces because its clinical presentation significantly varies
Aside from joint-related characteristics in Rheumatoid Arthritis (rheumatoid nodules, vasculitis, pannus formation, and baker cysts) what systemic symptoms can be seen?
- ) Pleural effusion
- ) Lymphadenopathy
- ) Interstitial Lung Fibrosis
In what condition do you find heliotrope discoloration of the eyelids?
Dermatomyositis
What autoantibody is highly indicative of diffuse scleroderma?
Anti-topoisomerase I
What Rheumatoid Factor titer ratio is necessary to diagnose an autoimmune condition?
Titers > 1:80
Note: RF is not specific to any condition!
What are the advantages of PCR over ELISA in HIV testing?
- ) PCR becomes positive earlier in the disease course (PCR measures DNA whereas ELISA measures antibodies)
- ) PCR does not require that the patient have a competant immune system (ELISA requires the host to make antibodies)
How is HIV viral load measured?
RT-PCR
Churg Strauss Syndrome (Eosinophilic Granulomatosis with polyangitis) causes what symptoms?
- ) Severe Asthma
- ) Allergic rhinitis
- ) Vasculitis symptoms (purpura and related symptoms)
What are the main symptoms of cryptosporidiosis in HIV?
- ) Watery Diarrhea with abdominal pain and nausea/vomiting, causing:
- ) Weight loss, anorexia, and Dehydration
What is Scleroderma?
An autoimmune disease that produces antibodies against the body’s connective tissue thereby causing systemic fibrosis. It most commonly affects the skin, kidneys, heart, and lungs
Opportunistic infections generally develop when the CD4 count drops below what threshold?
200
ANCA autoantibodies are associated with what conditions?
Small vessel vasculitis conditions such as:
- ) Eosinophilic granulomatosis with polyangitis (formerly Churg-Strauss)
- ) Granulomatosis with polyangitis (formerly Wegener’s granulomatosis)
- ) ANCA glomerulonephritis
What are the symptoms of CREST Syndrome? What condition is CREST associated with?
Calcinosis - deposition of calcific nodules in the skin
Raynaud’s phenomenon - frequently the first symptom
Esophageal dysmotility - which may lead to GERD or dysphagia
Sclerodactyly - increased collagen deposition in the skin of the hands causing the skin to tighten
Telangiectasia - dilated capillaries
CREST is considered to be a limited systemic version of scleroderma
A normal CD4:CD8 ratio is? In HIV it becomes?
Normal = 2:1 HIV = 1:1 or less
In polymyositis, are distal or proximal muscle groups affected?
Proximal muscle groups
How long may it take to seroconvert?
6 months
How might a person with HIV contract Cryptosporidiosis?
Drinking unfiltered water
Retinitis in HIV is often associated with what opportunistic infection? How would you diagnose this condition?
Cytomegalovirus (CMV). The infection may lead to blindness
Diagnosed via CMV blood titers
In what condition is the tensilon test used?
Myasthenia gravis
The tensilon test is the administration of edrophonium (acetylcholinesterase inhibitor) used to prevent progressive muscle weakness typically experienced in myasthenia gravis
Heterophile antibodies designate what infection?
Epstein-Barr Virus (EBV)
How is AIDS classified?
If Asymptomatic (A), Symptomatic (B), Symptomatic with AIDS defining illness (C)
If CD4 count >500 (1), 200-500 (2), <200 (3)
Therefore, an asymptomatic person with a CD4 count of 600 = A1
What is the treatment of dermatomyositis?
Corticosteroids
Toxoplasmosis presents with what symptoms?
- ) Encephalitis and altered mental status
- ) Unilateral paralysis
- ) Seizures
- ) Severe Headaches
- ) Fever
Polyarteritis nodosa is commonly associated with what virus?
Hepatitis B virus
Mayasthenia Gravis usually starts with weakness in what muscle?
Eye muscle weakness
What medication is a risk factor for IgA deficiency?
Phenytoin
How do you differentiate CMV and EBV mononucleosis?
EBV-mononucleosis has heterophile antibodies present while CMV does not
Cryptococcus in HIV may present with what symptoms?
- ) Meningitis with headaches and intermittent fever
- ) Fatigue
- ) Altered mental status
- ) Pneumonia
What test is done for basic HIV screening?
anti-HIV antibodies using ELISA
If ELISA comes back positive, then Western Blot testing is done to confirm the result
However, the earliest diagnosis can be made with PCR for HIV
What 2 autoimmune conditions may be related to silicone implants?
Scleroderma and Sjogren’s
What autoantibody is generally present in SLE?
anti-dsDNA antibody & anticardiolipin antibodies
What autoantibody is highly associative with limited systemic scleroderma (CREST)?
Anti-centromere Antibody
What lab test is used to detect various immunoglobulins?
ELISA
What are the typical lab findings in Dermatomyositis?
- ) Increased CK (d/t muscle breakdown)
- ) Positive ANA & Anti-Jo1 antibody
- ) Perimysial Inflammation & Endmysial atrophy
Perimysium = sheath that groups muscle fascicles Endomysium = ensheaths each individual muscle fibre
What is the most common ANCA vasculitis?
Microscopic Polyangitis (affecting the lungs and kidneys)
What lab test is used to identify mumps?
IgM paramyxovirus
What autoimmune condition greatly increases the risk of lymphoma?
Sjogren’s Syndrome
What auto-immune condition is twice as likely to occur in men than women?
Polyarteritis nodosa
What autoantibody is highly associated with polymyositis and dermatomysositis?
Anti-Jo Antibody
What autoantibodies are associated with scleroderma?
- ) Anti-centromere = favours the diagnosis of CREST (limited systemic scleroderma)
- ) Anti-nuclear Antibody
- ) Anti-topoisomerase I = associated with diffuse scleroderma
- ) Anti-collagen Type IV Antibody (vs Basement Membrane)
What lab test evaluates the presence of IgE?
RAST
What ANA antibodies are associated with Sjogren’s Syndrome?
Anti-SSA/Ro (present in many other AI conditions)
Anti-SSB/La (more specific)
