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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
What mechanisms are thought to involved in the breakdown of tolerance?
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
26
What are epitope?
the part of an antigen molecule to which an antibody attaches itself.
27
What mechanism of tolerance breakdown does rheumatic fever have?
Molecular mimicry
28
Describe the mechanism of rheumatic fever?
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
Symptoms of systemic lupus erythematosus (SLE)
Butterfly rash Raised red patches on skin Light sensitivity Mouth ulcers Heart/lung lining inflammation Seizures/ nerve problems Proteinuria Antinuclear antibodies
30
Treatment of SLE?
Systemic corticosteroids Steroid creams Antimalarials Monoclonal antibodies
31
Symptoms of Sjogren's syndrome?
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
Treatment of Sjogren's syndrome?
Eye drops Antifungals NSAIDs Hydroxychloroquine ` Methotrexate
33
What is Grave's disease?
Overstimulation of thyroid Antibodies generated against TSHr eceptor which mimics TSh
34
Symptoms of Grave's disease?
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
Treatment of Grave's disease?
Methimazole Thyroidectomy Radioactive iodine
36
What is Hashimoto's thyroiditis?
Autoimmune hypothyroidism Antibodies to thyroglobulin and thyroid peroxidase
37
Symptoms of Hashimoto's thyroiditis?
Fatigue Feeling cold TSH increase Eight gain Enlarged thyroid
38
Treatment of HT?
Replacement therapy Levothyroxine
39
What is myasthenia gravis?
Antibodies to acetylcholine receptors Long-term neuromuscular problems
40
Symptoms of MG?
Double vision Drooping eyelids Skeletal muscle weakness especially after exercise
41
What is the treatment of MG?
Thymectomy Immunosuppressive drugs Plasmapheresis
42
What is autoimmune pernicious anaemia?
Antibodies generated to intrinsic factor and parietal cells Deficiency in B12 results as no binding to intrinsic factor and absorption
43
How do treat pernicious anaemia?
B12 injections
44
What is haemolytic anaemia?
Antibodies binding to RBC Lysis, clumping, clearance by spleen Induced by drug or agent modifying rbc cell surface, neo-antigen created
45
What are the symptoms of haemolytic anaemia?
Chills Tachycardia Pale Fatigue Dark urine Jaundice
46
What is the treatment of haemolytic anaemia?
Avoid activating drugs Plasmapheresis Splenectomy
47
What causes MS?
CD4 and CD8 T cells that recognise and attack CNS Damage to myelin sheath surrounding nerves
48
What is the treatment of MS?
Steroids Muscle relaxant for spasm Stem cell treatment
49
Symptoms of MS?
fatigue. vision problems. numbness and tingling. muscle spasms, stiffness and weakness. mobility problems. pain. problems with thinking, learning and planning. depression and anxiety
50
What is rheumatoid arthritis?
Inflammation of the lining or synovium of the joints
51
What does RA lead to?
Long term joint damage which would result in chronic pain, loss of function and disability
52
Epidemiology of RA?
3 times more common in woman than in men Usually 30-50 years of age
53
What joints are affected by RA?
Foot, ankle and knee Hip Hands and wrists Elbow Shoulders
54
What are the organs affected by RA?
Blood Nerves Heart Lungs Eyes Skin
55
How does RA affect blood?
Hypochromatic-microcytic anaemia with low serum ferritin and low or normal iron-binding capacity almost universal in patients with active RA
56
How does RA affect nerves?
Cervical spine instability Peripheral nerve entrapment Vasculitis All cause mononeuritis multiplex
57
How does RA affect the heart?
Pericardial effusion present in 50% of patients
58
How does RA affect the lung?
Interstitial lung disease common
59
How does RA affect the eyes?
Keratoconjunctivitis sicca Episcleritis Scleritis
60
How does RA affect the skin?
Rheumatoid nodules Dermal vasculitic lesions
61
What is the genetic relation with RA and the immune system?
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
What are the potential roles of HLA-DR genes?
Binds to arthritogenic peptides Serves as a target for autoreactive T cells Closely linked to other genes in the MHC
63
How do you diagnose RA?
No definite test Medical history Physical examination Lab tests
64
What lab tests are indicative of RA?
Imaging studies- Erythrocyte sedimentation rate Blood tests- CRP Rheumatoid factor- antinuclear antibodies
65
Treatment of RA?
Tailored to individual Focuses on; Relieving pain Reducing inflammation Stopping or slowing joint damage Improving functioning and sense of well-being
66
Medications for RA?
NSAIDs Analgesics Corticosteroids Methotrexate Sulfasalazine Cyclosporine Minocycline Infliximab Combination DMARD therapy
67
What are the symptoms of coeliac disease?
Diarrhoea Abdominal pain Bloating Osteoporosis Anaemia Bowel cancer
68
What causes coeliac disease?
Autoimmune reaction to gluten Small intestines become inflamed
69
Describe the molecular level of coeliac disease?
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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