Immunology

Question 1

Sjögren syndrome

Answer 1

Dry eyes and mouth, prolonged fatigue, skin rashes, dry skin, vaginal dryness

Caused by autoimmune (mostly CD4 T-Cells) invading exocrine glands and destroying them By secreting antibodies against the exocrine glands

(+) Rf, (+) Anti-Ro/La

Affects usually over age 40, more incidence with women than men, no cure.

Question 2

Myasthenia Gravis

Answer 2

Severe muscle weakness most commonly seen in women under 40 and men over 60 (can occur at any age though)

Caused by autoantibodies that target the acetylcholine receptors of NMJs and muscle specific tyrosine kinase.

Presents with eyelid droop, double vision, facial changes, peek sign, dysphasia, speech difficulty, muscle weakness

If left untreated, results in respiratory failure fetal complications (transfers the disease to the baby if the woman is pregnant)

Question 3

Treatment of myasthenia gravis

Answer 3

Corticosteroids with cholinesterase inhibitors

Can also use immunoglobulins and monoclonal (mab’s)

Question 4

Scleroderma

Answer 4

Hardening and tightening of the skin that is most common in ages 30-50 , women, and people that have genetic disposition to scleroderma.

Caused by immune system triggering cells to overproduce collagen which leads to fibroids tissue buildup

often seen with Raynaud phenomenon

Question 5

Scleroderma treatment

Answer 5

Corticosteroid, IFN-gamma biologists, stem cell transplants

Question 6

Lambert-Eaton Myasthenic syndrome

Answer 6

Severe muscle weakness that usually begins in the proximal limbs and can be associated with anti-muscarnic symptoms (dryness)
is very closely linked to small cell lung cancer

Caused by autoantibodies binding to UGCC receptors on presynaptic neurons. Prevent calcium influx which decreases acetylcholine release into NMJs

Most commonly seen in patients between 35-60
* earlier onset usually means genetically predisposed*

Question 7

LEMS treatment

Answer 7

Corticosteroids and IV antibodies

Question 8

Reactive arthritis

Answer 8

Joint inflammation caused by an infection that triggers MHC HLA B-27 antibodies that be developed. Joints affected tend to be knees and ankle.

• is a seronegative arthropathy*
• always presents with arthritis, conjunctivitis and urethritis (Reiters syndrome)*

More common in men or people exposed to UTIs around the ages of 25-40

Question 9

Seronegative sponyloarthrits

Answer 9

Inflammation of the spine caused by an innate immune attack. HLA-B27 and TNF-a are prominent in patients.
* most commonly found in the L5-S1 region*

Common in people 20-40s mainly men, exposure to inflammatory bowel syndrome, or whipped disease increases chances.

Presents with spine pain, inflammation of eye and psoriasis. No prescience of autoantibodies in the serum.

Diagnosed via MRI and CT

Question 10

Reactive arthritis treatment

Answer 10

DMARDs and topical steroids

Question 11

Seronegative spondyloarthritis treatment

Answer 11

Methotrexate or other DMARDs