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MD4001 Week 9 > Immunology: The Immune Response, Auto-immunity, WBCs > Flashcards

Immunology: The Immune Response, Auto-immunity, WBCs Flashcards

1
Q

Autoimmunity?

A

Misdirected

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2
Q

What are autoimmune diseases?

A

Group of 80 or so chronic inflammatory conditions

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3
Q

Are autoimmune diseases multigenetic?

A

Yes but some exceptions

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4
Q

What are the single gene autoimmune disorders?

A

Autoimmune polyglandular syndrome type 1

Autoimmune lymphoproliferative syndrome

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5
Q

Describe autoimmune polyglandular syndrome?

A

Low expression of some self antigens in thymus

Some autoreactive T cells not deleted

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6
Q

Describe autoimmune lymphoproliferative syndrome?

A

Failure of apoptosis of some self reactive T and B cells

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7
Q

What is the difference in sex for autoimmune disorders?

A

Woman generally have a higher prevalence

Men are equal with UC and more in diabetes mellitus

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8
Q

What are the body parts that can be affected by autoimmune disease?

A

Trachea

Blood and blood vessels

Heart

Skin

Oesophagus

Liver

Kidney

Ovary

Brain

Eyes

Mouth

Spinal cord

Thyroid

Lung

Joints

Pancreas

Gut

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9
Q

What does autoimmune uveitis affect?

A

Eyes

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10
Q

What does sjogren’s syndrome affect?

A

Mouth

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11
Q

What does rheumatic fever affect?

A

Heart and others

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12
Q

What does autoimmune hepatitis affect?

A

Liver

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13
Q

What does autoimmune oophoritis affect?

A

Ovaries

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14
Q

What does rheumatoid arthritis affect?

A

Joints

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15
Q

What does MS affect?

A

Nerves

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16
Q

What does phemiphus affect?

A

Skin and mucosa

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17
Q

What does goodpasture’s affect?

A

Lung

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18
Q

What does diabetes affect?

A

Pancreas

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19
Q

What does UC affect?

A

Large intestine

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20
Q

What does autoimmune haemolytic anaemia affect?

A

Blood

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21
Q

What is tolerance?

A

The process that keeps the immune system from attacking itself

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22
Q

What are the two mechanism of tolerance?

A

Thymic deletion of autoreactive cells

T regulatory cells

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23
Q

Describe deletional tolerance?

A

Self-reactive T cells are deleted in the thymus

Occasionally self reactive T cells may escape deletion

In the periphery such escaped self-reactive T cells can cause damage

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24
Q

Describe regulatory tolerance?

A

T cell specific for self antigen becomes a regulatory T cell

Cytokines produced by T cell inhibit other self reactive T cells

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25
Q

What mechanisms are thought to involved in the breakdown of tolerance?

A

Failure to delete autoreactive lymphocytes

Central or peripheral tolerance failure

Molecular mimicry

Abnormal presentation of self antigens

Aberrant expression of HLA class II molecules

Release of sequestered self antigens

Overproduction of self antigens

Cyptic T cell epitopes

Epitope spreading

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26
Q

What are epitope?

A

the part of an antigen molecule to which an antibody attaches itself.

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27
Q

What mechanism of tolerance breakdown does rheumatic fever have?

A

Molecular mimicry

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28
Q

Describe the mechanism of rheumatic fever?

A

Group A streptococcus infection

Antibodies generated strep carbohydrate GlcNAc

These antibodies cross react on cardiac myosin

T cells are also produced

Heart valve damage but also brain/ neuronal damage is possible

29
Q

Symptoms of systemic lupus erythematosus (SLE)

A

Butterfly rash

Raised red patches on skin

Light sensitivity

Mouth ulcers

Heart/lung lining inflammation

Seizures/ nerve problems

Proteinuria

Antinuclear antibodies

30
Q

Treatment of SLE?

A

Systemic corticosteroids

Steroid creams

Antimalarials

Monoclonal antibodies

31
Q

Symptoms of Sjogren’s syndrome?

A

dry eyes.

a dry mouth.

dry skin.

tiredness.

vaginal dryness.

muscle or joint pain.

swelling between the jaw and ears (swollen salivary glands)

rashes (especially after being in the sun)

32
Q

Treatment of Sjogren’s syndrome?

A

Eye drops

Antifungals

NSAIDs

Hydroxychloroquine
`
Methotrexate

33
Q

What is Grave’s disease?

A

Overstimulation of thyroid

Antibodies generated against TSHr eceptor which mimics TSh

34
Q

Symptoms of Grave’s disease?

A

Bulging eyes (only in Graves’ disease)

Thickening and reddening of the skin, especially on the shins and upper feet (only in Graves’ disease)

Irritability or nervousness.

Tiredness or muscle weakness.

Heat sensitivity.

Trouble sleeping.

Shaky hands.

Rapid and irregular heartbeat

35
Q

Treatment of Grave’s disease?

A

Methimazole

Thyroidectomy

Radioactive iodine

36
Q

What is Hashimoto’s thyroiditis?

A

Autoimmune hypothyroidism

Antibodies to thyroglobulin and thyroid peroxidase

37
Q

Symptoms of Hashimoto’s thyroiditis?

A

Fatigue

Feeling cold

TSH increase

Eight gain

Enlarged thyroid

38
Q

Treatment of HT?

A

Replacement therapy

Levothyroxine

39
Q

What is myasthenia gravis?

A

Antibodies to acetylcholine receptors

Long-term neuromuscular problems

40
Q

Symptoms of MG?

A

Double vision

Drooping eyelids

Skeletal muscle weakness especially after exercise

41
Q

What is the treatment of MG?

A

Thymectomy

Immunosuppressive drugs

Plasmapheresis

42
Q

What is autoimmune pernicious anaemia?

A

Antibodies generated to intrinsic factor and parietal cells

Deficiency in B12 results as no binding to intrinsic factor and absorption

43
Q

How do treat pernicious anaemia?

A

B12 injections

44
Q

What is haemolytic anaemia?

A

Antibodies binding to RBC

Lysis, clumping, clearance by spleen

Induced by drug or agent modifying rbc cell surface, neo-antigen created

45
Q

What are the symptoms of haemolytic anaemia?

A

Chills

Tachycardia

Pale

Fatigue

Dark urine

Jaundice

46
Q

What is the treatment of haemolytic anaemia?

A

Avoid activating drugs

Plasmapheresis

Splenectomy

47
Q

What causes MS?

A

CD4 and CD8 T cells that recognise and attack CNS

Damage to myelin sheath surrounding nerves

48
Q

What is the treatment of MS?

A

Steroids

Muscle relaxant for spasm

Stem cell treatment

49
Q

Symptoms of MS?

A

fatigue. vision problems. numbness and tingling. muscle spasms, stiffness and weakness. mobility problems. pain. problems with thinking, learning and planning. depression and anxiety

50
Q

What is rheumatoid arthritis?

A

Inflammation of the lining or synovium of the joints

51
Q

What does RA lead to?

A

Long term joint damage which would result in chronic pain, loss of function and disability

52
Q

Epidemiology of RA?

A

3 times more common in woman than in men

Usually 30-50 years of age

53
Q

What joints are affected by RA?

A

Foot, ankle and knee

Hip

Hands and wrists

Elbow

Shoulders

54
Q

What are the organs affected by RA?

A

Blood

Nerves

Heart

Lungs

Eyes

Skin

55
Q

How does RA affect blood?

A

Hypochromatic-microcytic anaemia with low serum ferritin and low or normal iron-binding capacity almost universal in patients with active RA

56
Q

How does RA affect nerves?

A

Cervical spine instability

Peripheral nerve entrapment

Vasculitis

All cause mononeuritis multiplex

57
Q

How does RA affect the heart?

A

Pericardial effusion present in 50% of patients

58
Q

How does RA affect the lung?

A

Interstitial lung disease common

59
Q

How does RA affect the eyes?

A

Keratoconjunctivitis sicca

Episcleritis

Scleritis

60
Q

How does RA affect the skin?

A

Rheumatoid nodules

Dermal vasculitic lesions

61
Q

What is the genetic relation with RA and the immune system?

A

Specific human leukocyte antigen HLA-DR genes have been found to be associated with RA

Reside in MHC and participate in antigen presentation

Higher risk of severity of disease, increased by homozygosity

62
Q

What are the potential roles of HLA-DR genes?

A

Binds to arthritogenic peptides

Serves as a target for autoreactive T cells

Closely linked to other genes in the MHC

63
Q

How do you diagnose RA?

A

No definite test

Medical history

Physical examination

Lab tests

64
Q

What lab tests are indicative of RA?

A

Imaging studies- Erythrocyte sedimentation rate

Blood tests- CRP

Rheumatoid factor- antinuclear antibodies

65
Q

Treatment of RA?

A

Tailored to individual

Focuses on;

Relieving pain
Reducing inflammation
Stopping or slowing joint damage
Improving functioning and sense of well-being

66
Q

Medications for RA?

A

NSAIDs

Analgesics

Corticosteroids

Methotrexate
Sulfasalazine
Cyclosporine
Minocycline

Infliximab
Combination DMARD therapy

67
Q

What are the symptoms of coeliac disease?

A

Diarrhoea

Abdominal pain

Bloating

Osteoporosis

Anaemia

Bowel cancer

68
Q

What causes coeliac disease?

A

Autoimmune reaction to gluten

Small intestines become inflamed

69
Q

Describe the molecular level of coeliac disease?

A

Alpa-glidin molecule

A lot of glutamine inside structure

TG2 protein turns these glutamine to glutamic acid

These peptides tend to bind better with class II autoreactive T cells

MD4001 Week 9 (8 decks)

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