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D&E Pathology > Immunology of Endocrine Disorders > Flashcards

Immunology of Endocrine Disorders Flashcards

1
Q

What are Non-organ specific autoimmune diseases?

A

Affect multiple organ diseases
Assocaited with autoimmune responses to widely distributed self-molecules
Intracellular molecules for Transcription/translation

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2
Q

What are organ specific autoimmune diseases?

A

Resticted to one organ or endocrine glands

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3
Q

Antigens against what receptor are associated with thyroid disease?

A

TSH receptor

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4
Q

Antigens against what are associated with glycaemic disease?

A

Insulin receptors

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5
Q

Antigens against what are associated with myasthenia gravis?

A

Acetylcholine receptor

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6
Q

Self antigens against what enzymes are associated with diabetes?

A

Glutamate decarboxylase

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7
Q

Self antigens against what enzymes are associated with thyroiditis/hypothyroidism?

A

Thyroid peroxidase

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8
Q

Self antigens against what enzymes are associated with Addison’s disease?

A

21-hydroxylase

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9
Q

When is peak onset for autoimmune diseases?

A

15-65

Except T1D

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10
Q

What is immunological tolerance?

A

Unresponsiveness to an antigen that is introduced by previous exposure to said antigen

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11
Q

What are tolerogens?

A

Antigens which induce tolerance

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12
Q

What is central tolerance?

A

Immature self-reactive lymphocytes
Thymus eliminates T-cells with high affinity to self antigens
Bone marrow - B cell tolerance

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13
Q

What is peripheral tolerance?

A

Mature lymphocytes that recognise self antigens in peripheral tissues become incapable of activation by re-exposure, or die

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14
Q

What are the mechanisms of peripheral tolerance?

A

Anergy (functional unresponsiveness)
T regulatory suppression
Deletion (cell death)

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15
Q

What are the mechanisms of central tolerance?

A

Apoptosis
Change in receptors
Development of T-regulatory lymphocytes

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16
Q

What factors can cause cells to overcome peripheral tolerance?

A

Inappropriate access of self-antigens
Inappropriate/increased local expression of co-stimulatory molecules
Alterations in the ways which self-molecules are presented

17
Q

When is overcoming peripheral tolerance more likely?

A

Inflammation or tissue damage

Increased proteolytic enzymes increasing the concentrations of peptides

18
Q

Which microbial antigen is associated with T1D?

A

Coxsackie B4 nuclear protein

Mumps

19
Q

What is molecular mimicry?

A

Structural similarities between self proteins and microbial antigens causing an autoimmune response

20
Q

What is epitope spreading?

A

Immune response broadens and local tissue damage accelerates

21
Q

The B27 HLA association is associated with which diseases?

A

Ankylosing spondylitis

Reiter disease

22
Q

Which HLA association is associated with T1D?

A

DR4

23
Q

Which environmental factors are associated with causing autoimmune diseases?

A

Hormones
Infections
Drugs
UV radiation

24
Q

How are autoimmune diseases treated?

A

Suppression of the damaging immune response

Replacement of the function of the organ

25
Q

How is Type 1 diabetes classified?

A

Ketoacidosis
Inadequate insulin secretion
Lymphocytic infiltration of islets
Autoimmune, genetic, viral

26
Q

How is Type 2 diabetes classified?

A 
More common
Middle age
Non-ketotic coma
Normal/increased insulin
Reduced cell surface receptors
27
Q

What are the causes of T1D?

A

Autoimmune destruction
Genetic factors
Viral infection

28
Q

What is the mechanism of Graves’ thyroiditis?

A

IgG which binds to thyroid epithelial cells and mimics TSH

29
Q

What is the cause of Exophthalmos in graves’?

A

Infiltration of the orbital tissues by fat, mucopolysaccharides and lymphocytes
Autoantibody reacting with these tissues

30
Q

Why does Hashimoto thyroiditis present early with transient hyperthyroidism?

A

Damage to thyroid follicles causing a release of thyroglobulin

31
Q

Which autoantibodies are seen in Hashimoto’s thyroiditis?

A

Antibodies reacting with:
Thyroid peroxidase
Thyroglobulin

32
Q

What is APS-1?

A 
Autoimmune Polyendocrine Syndrome Type 1
AIRE gene mutation
Polyendocrinopathy 
Candidiasis
Ectodermal dystrophy
33
Q

How does APS-1 present?

A 
Atleast 2 of:
Chronic candidiasis
Hypoparathyroidism
Addison's disease
\+
Enamel hypoplasia 
Diarrhoea or constipation
Primary ovarian insufficiency
34
Q

What is APS-2?

A 
Type 1 diabetes
Autoimmune thyroid disease 
Addison's disease
More common in women
Young adult onset
Celiac disease
35
Q

What is IPEX?

A

X-linked Immunodysregulation, polyendocrinopathy, enteropathy
Early onset T1D
Autoimmune enteropathy - diarrhoea and malabsorption
Dermatitis
Eosinophilia
Elevated IgE

D&E Pathology (18 decks)

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