immunological investigation of multisystem A.I diseases

Question 1

autoimmunity

Answer 1

predisposing factors
breakdown of immunological tolerance
pathological autorecognition
inflammation & tissue damage

Question 2

test purpose

Answer 2

disease
-diagnosis
- subclassification
- prognosis
-monitering
treatment
-planning
-selection
-triage
- M&E

Question 3

immunology test

Answer 3

antinuclear antibodies
antineutrophil cytoplasmic antibodies
antiphospholipid antibodies
complement
cryoglobulins

Question 4

antibody production

Answer 4

Th2-> Bcell

Question 5

Antinuclear antibody

Answer 5

SLE (95%)
drug induced Lupus
Mixed connective tissue disorder
RA
sjogren
scleroderma
chronic inflammation
old age
neoplasia
chronic active hepatitis

Question 6

ANA

Answer 6

high sensitivity
low specificity SLE
high negative value
low positive predictive value
ANA negative SLE unlikely

Question 7

types

Answer 7

homogeneous
speckled
nucleolar
peripheral

Question 8

homogeneous

Answer 8

dsDNA
-SLE (60-90%)
-some autoimmune liver disease
ssDNA
-non specific
-many inflam disorders
Histone proteins
-drug induced lupus

Question 9

Speckled

Answer 9

Ro- Sjogren
La- Sjogren
Sm- SLE
RNP- MCTD
Scl-70- Scleroderma
Jo-1- Polymyositis
Centromere

Question 10

Nucleolar

Answer 10

nucleolus specific RNA

• Scleroderma, systemic sclerosis & ovrlap syndromes
• clinical variants

Question 11

peripheral

Answer 11

dsDNA

-SLE

Question 12

cascade testing

Answer 12

screening test-> specific test

Question 13

auto Ab

Answer 13

Anti- dsDNA= nephritis, vasculitis
-Sm= nephritis, cerebral
-RNP= Arthritis, myositis, Raynauds
-Ro= photosensitivity, sjogren's
cutaneous form of lupus

Question 14

Antinuclear cytoplasmic antibodies

Answer 14

small vessel vasculitis

1) ANCA-associated
2) immune complex associated

Question 15

ANCA

Answer 15

C-ANCA
major autoantigen associated - proteinase 3 
-> GPA
P- ANCA
Major autoantigen associated-
Myeloperoxidase
-> MPA
->EGPA (eosinophilic granulomatous polyangiitis)

Question 16

ANCA

Answer 16

variably correlate with disease
should not change solely on this for treatment
not disease specific unlike most
-infection
-inflammation
- drugs
- connective tissue disorders
-inflammatory BD

Question 17

Antiphospholipid syndrome

Answer 17

Primary
secondary
- CT disorders
- Chronic infection
- Drugs ( phenytoin)
Lymphoproliferative
Features:
Vascular thrombosis
Recurrent fetal loss
Livedo reticularis- small thrombi forming in post cap venule
Thrombocytopenia

Question 18

antiphospholipid antibodies

Answer 18

Anticardiolipin antibodies
Anti- B2 glycoprotein I antibodies
Lupus anticoagulant

Question 19

Complement

Answer 19

Phagocyte chemotaxis
opsonisation
lysis of micro organisms
maintaining solubility of immune complexes

Question 20

completement assays

Answer 20

diagnosis/ monitoring disease

detection of hereditary deficiencies

Question 21

Immune complex diseaseC

Answer 21

C1,4,2

Question 22

Recurrent neisserial infection

Answer 22

C 5678

Question 23

Recurrent bacterial infection

Answer 23

C3

Question 24

Cryoglobulin

Answer 24

immunoglobuin which reversibly precipitate out of solution at temperatures <37 degrees

Question 25

types

Answer 25

monocloncal (plasma cell dyscrasias)
Polyclonal IgG
with monoclonal IgM (hepatitis)
Poly Clonal (CT disease)

Question 26

Cryoglobulins

Answer 26

livedo reticularis
raynauds
peripheral cyanosis
purpura

glomerulonephritis
neuropathy
arthralgia