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Pathology Block 10 > Immunopathology Again > Flashcards

Immunopathology Again Flashcards

1
Q

Macule

A

Flat lesion <1cm

Freckle

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2
Q

Patch

A

Macule >1cm

Birthmark

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3
Q

Papule

A

Elevated solid skin lesion <1cm

Mole, acne

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4
Q

Plaque

A

Papule >cm

Psoriasis

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5
Q

Vesicles

A

Small fluid filled blister <1cm

Shingles

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6
Q

Bulla

A

Large fluid filled blister >1cm

Bulluos
Pemphigoid

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7
Q

Pustule

A

Vesicles containing pus

Pustular psoriasis

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8
Q

Wheal

A

Transient smooth papule or plaque

Hives

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9
Q

Scale

A

Flaking off of stratum corneum

Eczema

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10
Q

Crust

A

Dry exudate

Impetigo

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11
Q

Signs and symptoms of lupus erythematosus

A
  • Facial rash (photo Sensitivity) butterfly
  • arthritis
  • renal disorders
  • Neuro disorders
  • immunological disorders
  • hemolytic anemia
  • rashes

Great imitator

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12
Q

Classic triad for SLE

A

Fever, joint pain malar rash on bridge of nose and cheeks

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13
Q

Chronic inflammatory immune disorder primarily in women of childbearing age

A

SLE

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14
Q

Another name for butterfly rash

A

Malar rush

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15
Q

Women and men in SLE

A

Women outnumber men 10:1

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16
Q

Etiology of SLE

A

Unknown. Characterized by formation of an array of antinuclear antibodies (ANA) and formation of immune complexes
-type III

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17
Q

What test do we use for SLE

A

ANA

-very sensitive but not specific

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18
Q

Immune complex of SLE

A

Deposit and cause tissue damage and cause symptoms of disease

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19
Q

4 types of LE

A
  • SLE (70%)
  • discoid lupus (10%, skin and scarring, never goes internally )
  • drug-induced lupus (10% resolves upon stopping drug)
  • combination lupus + Sjogren or RA
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20
Q

Common cause of death in SLE

A

cardiovascular disease
Renal failure
Infections

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21
Q

Never goes internally, causes chronic eruptions and scarring of the skin

A

Discoid lupus

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22
Q

Most common diagnostic criteria for SLE

A

Malar rash

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23
Q

What blood tests do we use for SLE

A

ANA- sensitive, not specific
Anti-dsDNA- specific, poor prognosis
Anti-smith-specific, not prognostic

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24
Q

What can cause a false positive syphillis test

A

False positive RPR/VDRL, FTA-ABS

SLE

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25
Q

Ocular findings of SLE

A

20%

  • dry eye
  • recurrent episcleritis
  • peripheral keratitis (infiltrates)
  • photo Sensitivity
  • uveitis
  • central retinal artery occlusion (CRAO)
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26
Q

Drugs associated with drug induced lupus

A

Quietly Induce Harmful Pathology

  • quinidine (cardiac)
  • isoniazid (TB)
  • hydralazine (cardiac)
  • procainamide (cardiac)
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27
Q

How does drug associated lupus present in blood

A

Transient ANA, no anti-Sm antibodies

All the signs and symptoms of lupus but not the blood work for it

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28
Q

Inflamed vessels walls may occlude, may occur with other connective tissue diseases

A

Vasculitis

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29
Q

Affects large and small arteries, ophthalmic and aorta often involved

A

Giant cell arteritis (formal temporal arteritis)

Granuloma and inflammation can occlude the artery

Emergency

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30
Q

Presentation of giant cell arteritis

A

Evolves to severe

HA, scalp necrosis, jaw claudication, blindness

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31
Q

What is giant cell arteritis treated with

A

Steroids, prevent blindness

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32
Q

Focal or segmental lesions of small and medium arteries

A

Poly arteritis nodosum

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33
Q

Signs and symptoms of polyarteritis nodosum

A

Joint pain
Retinal vein occlusion
Cotton wool spots

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34
Q

Excessive fibrosis throughout the body, occurring mostly in women, 30-50 years old

A

Scleroderma

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35
Q

ANA in scleroderma

A

Positive in 95% of patients

36
Q

Scleroderma if it moves internally

A

Pulmonary involvement is leading cause of death

37
Q

Two major types of scleroderma

A

Diffuse

Limited

38
Q

Diffuse scleroderma

A

Widespread skin involvement, rapid progression to viscera

39
Q

Limited scleroderma

A

Skin, fingers and face, characterized by the CREST syndrome, benign course

40
Q

Limited scleroderma with CREST syndrome

A

Diagnostic of limited scleroderma that is treatable and non lethal

  • clacinosis
  • raynaud phenomenon
  • esophageal dysmotility
  • sclerodactyly
  • telangiesctasia
41
Q

Formation of calcium deposit in any soft tissue

A

Calcinosis

42
Q

Vasospasm in digits, white-blue-red

A

Raynaud phenomenon

43
Q

Thickening and tightening of skin of fingers and toes

A

Sclerpdactylyl

44
Q

Small, dilated vessels near the skin air mucus membrane surface

A

Telangiectasia

45
Q

Another test that can test for limited scleroderma

A

Anti-centromere Ab

46
Q

Anti-Scl-70

A

Diffuse/bad scleroderma outcome.

47
Q

Anti-centromere Ab

A

Limited/benign scleroderma

48
Q

Ocular implications of scleroderma

A

May involve lacrimal glands

49
Q

Autoimmune destruction of exocrine glands (especially lactimal and salivary glands)

A

Sjogrens sysndrome

50
Q

Triad in Sjogrens

A

Dry mouth, dry eyes, and arthritis

51
Q

Who is affected nu Sjogrens

A

40-60 y/o females

52
Q

Labs for Sjogren syndrome

A

ANA and RF positive

Antiribonucleoprotein Ab: SS-A (anti-Ro) and SS-B (anti-La)

53
Q

Attacks moisture producing glands

A

Sjogrens

54
Q

A term a relates to inflammation of the joints

A

Arthritis

55
Q

Applied to 100+ rheumatic diseases

A

Arthritis

56
Q

Number one cause of arthritis

A

Osteoarthritis (OA)

57
Q

Friction disease, not autoimmune disease leading to arthritis

A

Osteoarthritis

Damage to joint, related to overuse on weight bearing joints

58
Q

Who is impacted by OA

A

10% of all Americans

59
Q

Systemic inflammatory disease of symbolical membranes/joints of hands, feet, wrists, also involves heart/lung/liver/skin/vasculature

A

RA

60
Q

Pathology of RA

A

Starts as retype IV, and then very quickly goes to type III

61
Q

Rheumatoid factors

A

Used to ID and Dx RA

  • the antibody that help forms the immune complex
  • IgM!! (Usually everything class switches to IgE, by RA does not)
  • Anti-IgG Ab
  • autoimmune
62
Q

What is unique about the IgG in RA

A

It does not activate complement

63
Q

RA immunoglobulin

A

RF is the IgM that is bound to the IgG FC portion that is attached to a cell membrane and causes complement
-anti-IgG Ab

64
Q

What HS is RA

A

Type III

Starts as 4 but very transient

65
Q

Ocular manifestations in RA (percent)

A

25%

66
Q

What are the ocular manifestations of RA

A
  • keratoconjunctivitis sicca
  • scleromalacia perforans
  • choroiditis, retinal vasculitis, RD
67
Q

What is the most common ocular manifestation of RA

A

Keratoconjunctivitis sicca (deacreased porduction and subsequent corneal damage) in 15-25% of patients

68
Q

Necrotizing scleritis with inflammation occurring in RA

A

Scleromalacia perforans

69
Q

Deep, boring pain exacerbated by palpating the eye. Vessels are purplish and dont blanch with pehnyl

A

Scleritis. Not the case for conjunctivitis

70
Q

Formerly known JRA, most common form of arthritis in children

A

Juvenile idopathic arthertis

71
Q

Who does JIA target

A

Young females and affects multiple joints

72
Q

Blood test for JIA

A

ANA positive

RF neg 50% of cases

73
Q

What patients are at a higher risk of ocular manifestations from JIA

A

Patients under the age of 6 with recent onset of disease

74
Q

JIA control

A

Can be easily controlled and can totally go away

75
Q

The number one cause of uveitis in children

A

JIA

Accounting for 80% of cases

76
Q

Arthertis without rheumatoid factor, no anti-IgG Ab

A

Seronegative spondyloartheropathies

77
Q

What is there a strong association with in seronegative spondyloartheropathies

A

HLA-B27 (MHC-1)

78
Q

Signs and symptoms of seronegative spondyloartheropathies

A
  • Inflammatory back pain- improves with exercise

- extraarticular GI symptoms, dactylitis (sausage fingers)

79
Q

seronegative spondyloparthropathies mnemonic

A

PAIR

  • psoriatic arthritis
  • ankylosing spondylitis
  • inflammatory bowel disease (IBD)
  • reactive arthritis
80
Q

Associated with skin psoriasis and nail bed pitting, dactylitis and uveitis

A

Psoriatic arthritis

81
Q

Spinal and sacroiliac ankylosis (joint fusion), lower back pain, bamboo spine, uveitis

A

Ankylosing spondylitis

82
Q

Most common extracurricular manifestation of ankylosing spondylitis

A

Uveitis

83
Q

What can people with IBD develop

A

Can have joint pain

84
Q

Post venerial and post diarrheal, present with triad of conjunctivitis, urethritis, and arthritis

A

Reactive arthritis

-cant pee, cant see, cant climb a tree

85
Q

Non-rhematologic autoimmune, inflammatory up disease with an associated of iveiuti and hypercalcium

A

Sarcoidosis

86
Q

Signs and symptoms of sarcoidosis

A

Non caseating granulomas skin lesions

  • associated with pulmonary infiltrates
  • hilar adenpathy
87
Q

When’s someone has high calcium levels what do we consider

A

Parathyroid gland problems, sarcoidosis, and lung cancer

Pathology Block 10 (8 decks)

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