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Emma's NPLEX II Dx > Immunologic > Flashcards

Immunologic Flashcards

1
Q

What gender is more likely to have juvenile rheumatoid arthritis?

A

Both genders have equal predisposition for systemic JRA

Girls are 3x more likely to have articular-specific JRA than boys

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2
Q

What is the most common presenting symptom in Systemic Lupus Erythematosus?

A

Myalgia

SLE is often referred to as the disease of 10,000 faces because its clinical presentation significantly varies

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3
Q

Aside from joint-related characteristics in Rheumatoid Arthritis (rheumatoid nodules, vasculitis, pannus formation, and baker cysts) what systemic symptoms can be seen?

A
  1. ) Pleural effusion
  2. ) Lymphadenopathy
  3. ) Interstitial Lung Fibrosis
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4
Q

In what condition do you find heliotrope discoloration of the eyelids?

A

Dermatomyositis

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5
Q

What autoantibody is highly indicative of diffuse scleroderma?

A

Anti-topoisomerase I

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6
Q

What Rheumatoid Factor titer ratio is necessary to diagnose an autoimmune condition?

A

Titers > 1:80

Note: RF is not specific to any condition!

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7
Q

What are the advantages of PCR over ELISA in HIV testing?

A
  1. ) PCR becomes positive earlier in the disease course (PCR measures DNA whereas ELISA measures antibodies)
  2. ) PCR does not require that the patient have a competant immune system (ELISA requires the host to make antibodies)
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8
Q

How is HIV viral load measured?

A

RT-PCR

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9
Q

Churg Strauss Syndrome (Eosinophilic Granulomatosis with polyangitis) causes what symptoms?

A
  1. ) Severe Asthma
  2. ) Allergic rhinitis
  3. ) Vasculitis symptoms (purpura and related symptoms)
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10
Q

What are the main symptoms of cryptosporidiosis in HIV?

A
  1. ) Watery Diarrhea with abdominal pain and nausea/vomiting, causing:
  2. ) Weight loss, anorexia, and Dehydration
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11
Q

What is Scleroderma?

A

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

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12
Q

Opportunistic infections generally develop when the CD4 count drops below what threshold?

A

200

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13
Q

ANCA autoantibodies are associated with what conditions?

A

Small vessel vasculitis conditions such as:

  1. ) Eosinophilic granulomatosis with polyangitis (formerly Churg-Strauss)
  2. ) Granulomatosis with polyangitis (formerly Wegener’s granulomatosis)
  3. ) ANCA glomerulonephritis
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14
Q

What are the symptoms of CREST Syndrome? What condition is CREST associated with?

A

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

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15
Q

A normal CD4:CD8 ratio is? In HIV it becomes?

A 
Normal = 2:1
HIV = 1:1 or less
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16
Q

In polymyositis, are distal or proximal muscle groups affected?

A

Proximal muscle groups

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17
Q

How long may it take to seroconvert?

A

6 months

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18
Q

How might a person with HIV contract Cryptosporidiosis?

A

Drinking unfiltered water

19
Q

Retinitis in HIV is often associated with what opportunistic infection? How would you diagnose this condition?

A

Cytomegalovirus (CMV). The infection may lead to blindness

Diagnosed via CMV blood titers

20
Q

In what condition is the tensilon test used?

A

Myasthenia gravis

The tensilon test is the administration of edrophonium (acetylcholinesterase inhibitor) used to prevent progressive muscle weakness typically experienced in myasthenia gravis

21
Q

Heterophile antibodies designate what infection?

A

Epstein-Barr Virus (EBV)

22
Q

How is AIDS classified?

A

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

23
Q

What is the treatment of dermatomyositis?

A

Corticosteroids

24
Q

Toxoplasmosis presents with what symptoms?

A
  1. ) Encephalitis and altered mental status
  2. ) Unilateral paralysis
  3. ) Seizures
  4. ) Severe Headaches
  5. ) Fever
25
Q

Polyarteritis nodosa is commonly associated with what virus?

A

Hepatitis B virus

26
Q

Mayasthenia Gravis usually starts with weakness in what muscle?

A

Eye muscle weakness

27
Q

What medication is a risk factor for IgA deficiency?

A

Phenytoin

28
Q

How do you differentiate CMV and EBV mononucleosis?

A

EBV-mononucleosis has heterophile antibodies present while CMV does not

29
Q

Cryptococcus in HIV may present with what symptoms?

A
  1. ) Meningitis with headaches and intermittent fever
  2. ) Fatigue
  3. ) Altered mental status
  4. ) Pneumonia
30
Q

What test is done for basic HIV screening?

A

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

31
Q

What 2 autoimmune conditions may be related to silicone implants?

A

Scleroderma and Sjogren’s

32
Q

What autoantibody is generally present in SLE?

A

anti-dsDNA antibody & anticardiolipin antibodies

33
Q

What autoantibody is highly associative with limited systemic scleroderma (CREST)?

A

Anti-centromere Antibody

34
Q

What lab test is used to detect various immunoglobulins?

A

ELISA

35
Q

What are the typical lab findings in Dermatomyositis?

A
  1. ) Increased CK (d/t muscle breakdown)
  2. ) Positive ANA & Anti-Jo1 antibody
  3. ) Perimysial Inflammation & Endmysial atrophy
Perimysium = sheath that groups muscle fascicles
Endomysium = ensheaths each individual muscle fibre
36
Q

What is the most common ANCA vasculitis?

A

Microscopic Polyangitis (affecting the lungs and kidneys)

37
Q

What lab test is used to identify mumps?

A

IgM paramyxovirus

38
Q

What autoimmune condition greatly increases the risk of lymphoma?

A

Sjogren’s Syndrome

39
Q

What auto-immune condition is twice as likely to occur in men than women?

A

Polyarteritis nodosa

40
Q

What autoantibody is highly associated with polymyositis and dermatomysositis?

A

Anti-Jo Antibody

41
Q

What autoantibodies are associated with scleroderma?

A
  1. ) Anti-centromere = favours the diagnosis of CREST (limited systemic scleroderma)
  2. ) Anti-nuclear Antibody
  3. ) Anti-topoisomerase I = associated with diffuse scleroderma
  4. ) Anti-collagen Type IV Antibody (vs Basement Membrane)
42
Q

What lab test evaluates the presence of IgE?

A

RAST

43
Q

What ANA antibodies are associated with Sjogren’s Syndrome?

A

Anti-SSA/Ro (present in many other AI conditions)

Anti-SSB/La (more specific)

Emma's NPLEX II Dx (10 decks)

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