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MD4001 Pathology > Immunology > Flashcards

Immunology Flashcards

1
Q

What cells are involved in chronic inflammation

A

T lymphocytes which secrete cytokines

plasma cells which produce immunoglobulin

neutrophils

eosinophils (parasites)

fibroblasts

macrophages (microglia in the brain)

characterised by large numbers of macrophages and granulation tissue

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2
Q

what cells are involved in acute inflammation

A

neutrophils (diagnostic)

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3
Q

what organism causes syphilis

A

treponema pallidum

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4
Q

what are the symptoms of syphilis

A

genital chancre
secondary rash
gumma (granuloma in tertiary disease)

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5
Q

what organism causes leprosy

A

mycobacterium leprae

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6
Q

what is the epidemiology of RA

A

more common in women
common between 30-50 years old

environmental factors may precipitate onset

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7
Q

describe some of the features of a rheumatoid joint

A 
thinning of cartilage
erosion of the bone 
inflamed synovium
inflamed tendon sheath 
effusions
synovial thickenings
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8
Q

what are the symptoms of RA

A

inflamed joints that are warm, tender, swollen, red, painful and difficult to move

fatigue

loss of apetite, weight loss, flu like symptoms, depression, anaemia

vasculitis

sjogren’s syndrome

heart and lung inflammation

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9
Q

what joints are affected in RA

A 
foot ankle and knee
hip (later on)
hands and wrists almost always affects
elbow (loss of motion)
shoulders and neck stiffness
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10
Q

what organs are affected in RA

A 
blood (anaemia)
nerves (mononeuritis multiplex)
heart (pericardial effusion)
lungs (interstitial lung disease)
eyes 
skin (rheumatoid nodules)
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11
Q

what type of anaemia is almost always present in RA

A

hypochromatic microcytic anaemia with low serum ferritin and low or normal iron binding capacity

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12
Q

how are the nerves affected in RA

A

vasculitis causes mononeuritis multiplex
peripheral nerve entrapment
cervical spine instability

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13
Q

how are the eyes affected in RA

A

keratoconjuntivitis sicca, (dryness of the conjunctivae and cornea) episcleritis, scleritis

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14
Q

what is major histocompatibility complex

A

Membrane glycoproteins that display peptide antigens to T cells

MHC 2 bind peptides derived from proteins from extracellular sources that have been internalised

presents peptides to CD4 t helper cells

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15
Q

what is the function of th1 cytokines

A

cell mediated immunity

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16
Q

what is the function of Th2

A

antibody responses

17
Q

what genes are associated with RA

A

specific human leukocyte antigen (HLA)

HLA-DR4
involved in antigen presentation
higher risk of severity of homozygous

binds to arthritogenic peptides

target for autoreactive T cells

18
Q

what is autoimmunity

A

immune mediated destruction of self tissues

occurs via specific recognition of self antigens

activation of self reactive lymphocytes by self antigens

19
Q

what is tolerance

A

the process that keeps the immune system from attacking itself

thymic deletion of autoreactive cells and T regulatory cells

20
Q

what are cytokines

A

proteins made by cells that affect the behaviour of other cells (e.g. interleukins)

21
Q

what are chemokines

A

chemotactic cytokines

22
Q

how is RA diagnosed

A

no definitive test

medical history
physical examination
lab tets -imaging, ESR, CRP
rheumatoid factor

23
Q

what are the aims of RA treatment

A

relieve pain
reduce inflammation
stop or slow joint damage
improve functioning and sense of wellbeing

24
Q

what medications are available for RA

A

NSAIDS
analgesics
corticosteroids

disease modifying:
methotrexate 
sulfasalazine
azathioprine
cyclosporine
hydroxychloroquine
minocycline

infliximab (anti TNF)
rituximab

25
Q

what is ankylosing spondylitis

A

chronic inflammatory arthritis affecting the spine

more common in males

association with human class 1 MHC molecule HLA b27

bone grows out of both sides of the vertebrae and may join them together

26
Q

how is AS treated

A

NSAIDs, indomethacin, COX-2 inhibitors

anti TNF (infliximab)

27
Q

what is HLA-b27 linked to

A

reactive arthritis

caused by bacterial infection

28
Q

what are the signs of reactive arthritis

A 
eye inflammation 
diarrhoea
lower back pain 
scaly patches in genitals
flaky skin on soles
swelling in knee, heel or ball of foot

MD4001 Pathology (23 decks)

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