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Pathology Exam III > Immunopathology II > Flashcards

Immunopathology II Flashcards

1
Q

how does acute GVHD affect skin

A

rash exfoliation

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2
Q

how does acute GVHD affect GI

A

ulcerative gastroenteritis

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3
Q

how does acute GVHD affect liver

A

bile duct necrosis

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4
Q

what is the mechanism of acute GVHD

A

donor cytotoxin T cells or cytokines from helper T cells destroy epithelial celsl

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5
Q

when does chronic GVHD happen

A

after resolution of acute GVHD or without acute phase

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6
Q

what does the morphology of chornic GVHD miminc

A

systemic sclerosis

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7
Q

what does chronic GVHD cause

A

generalized fibrosis of GI, Skin, LIver, and broncholes of lunch

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8
Q

what critieria is required for an autoimmune diseaes

A

immunological reaction to self=Ag or native tissue
reaction is primary to pathogensis
no other etiology

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9
Q

polymorpims is what gene is often implicated in autoimmunity

A

PTPN-22

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10
Q

how do microbes influence auto-immunity

A

increase expression of APC co-stimulatory molcules, non-soecific B and T cell stimulation

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11
Q

what is the prototypical multisystem disorder

A

SPE

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12
Q

What is the ACR diagnositic creteria for SPE

A 
malar rash
discoid rash
photsensitivty
oral ulcers
arthritis
serositis
renal diorder
neurologic
hemotologic
antinuclear antibodies
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13
Q

mala rash

A

butterfly rash

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14
Q

discoid rash

A

scaely

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15
Q

serositis

A

ST elevation of EKG

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16
Q

what is the hematologic disorder seen in SPE pts

A

hemolytic anemia or leukopenia or lyophopeia or thrombocytopenia

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17
Q

what locus is associated with SPE

A

HLA-DQ

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18
Q

what are the most common clinical signs in SPE pts

A 
hematologic
arthritis
skin
fever
fatique
weight loss
renal
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19
Q

what is the hallmark of lupus

A

antinuclear antibodies

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20
Q

how do you test for ANA

A

fluorescnese

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21
Q

homogenous ANA pattern indicates

A

RA or drug induced SLE

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22
Q

rim pattern of staining indictaes

A

dsDNA, SLE active flares

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23
Q

speckled ANA pattern inidcates

A

anti-smith Ab of SLE, systemic sclerosis, sjogren’s syndrome

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24
Q

nucleolar ANA pattern inidcates what

A

SLE, systemic sclerosis, CREST

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25
Q

centromere pattern inidcates

A

systemic sclerosis, CREST

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26
Q

type II mechanism in lupus

A

against blood cells, causes frequent hematologic abnormalites

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27
Q

type III mechanism in lupus

A

visceral lesions

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28
Q

how are joints affects in lupus

A

synovitis without deformity

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29
Q

how are joints affects in lupus

A

synovitis without deformity

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30
Q

acute lupus vascular changes

A

vasculitis with fibrinoid necrosis of arteries/arterioles in any tissue

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31
Q

chronic lupus vascular changes

A

layered fibrous thickening - onion skin looking

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32
Q

lupus nephritis

A

prototype of immune complex glomerulnephritis

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33
Q

what are the 5 patterns of lupus nephritis

A

minimal changes
mesangial CN with increase in cells and matrix
membranous
diffuse GN with proliferation of endothelial, epithelial, mesagnial celsl

34
Q

membranous glomerulonephritis

A

thickening of capillary loops

35
Q

acute form of serositis

A

exudation of fibrin

36
Q

chronic form of serositis

A

proliferation of fibrous tissue, thickening membranes, adhesions

37
Q

heart problems often seen in lupus

A

frequent pericarditis
occasional mycoarditis
nonbacterial endocaridits

38
Q

vegetative endocarditis in rheumatic heart disease

A

small, warty vegetations along lines of closure of balbe leaflets

39
Q

infection endocarditis vegative endocarditis

A

large, irregular destructive masses of valve cusps, can extend to chordae

40
Q

vegetative endocarditis in nonbaterical thrombotic endocarditis

A

small, bland vegetations at the line of closure

41
Q

vegetative endocarditis in libman=sacks endocarditis

A

small-medium sized vegetrations on either/both sides of valve leaflets

42
Q

acute lung problems with lupus

A

penumotisis with alveolar damge, edema, and hemorrhage

43
Q

chronic lung problems with lupus

A

interstitial and vascular fiborsis causing pulomary fiborsis and pulmonary hypertension (restrictive lung disesase)

44
Q

common lupus CNS problems

A

seizures, focal neurologic deficit, neuropsych

45
Q

what tends to be the COD with lupus

A

renal faiure, infection, CAD

46
Q

chronic discoid LE

A

variety of skin lesions without systemic features, SLE can develop but rare

47
Q

subacute cutaneous LE

A

diffuse superifical, nonscarring photosenstive lesions
mild systemic disease
in between form of lupus

48
Q

drug induced lupus

A

mutiple organ involvment, no renal or SNS pathology

49
Q

what drugs can cause lupus

A

d-penicillamine, procaiaminde, hydralazine, isonizid

50
Q

sjogren’s syndrome

A

autoimmune destruction of exocrine glands - mostly lacrimal and salivary

51
Q

pathogenesis of sjogrens

A

CD4+T cells against glandular epithelial self-Ag initate the disorder, can be induced by viral infection

52
Q

sjogens’ morphology

A

follicle formation with germinal centers
ductal epithelial hyperplasia
acinar atrophy, fat replacement of parenchyma

53
Q

systemic sclerosis

A

autoimmune disorder characterized by chronic inflammation, destruction of small vessels and progressive tissue firosis

54
Q

invovledment of what in systemic sclerosis causes the most morbidy and mortiality

A

GI, kidney, heart, lung, muscoskeletal

55
Q

what does CREST stand for

A 
calcinosis
raynaud's phenomenon
esophageal dysfunction
sclerdactylyl
telangiectasis
56
Q

raynaud’s phenomen

A

spasm of blood vessels in response to cold or stress

57
Q

sclerodactylyn

A

thickening and tightening of skin on fingers and hands

58
Q

telangiectaias

A

dilation of capillaries causing red makes on surface of skin

59
Q

diffuse varient of systemic sclerosis

A

widespread skin involemnt at onset
early vesiceral invovlemnet
rapid progression
Ab to DNA topiosermiase I

60
Q

early skin changes in diffuse varient of systemic sclerosis

A

edmea, lyphocyte infiltrates

61
Q

late skin changes in diffuse varient of systemic sclerosis

A

claw fingers, mask faces

62
Q

esophagus changes in systemic sclerosis

A

collagenization and fibrosis of muscularis, can get reflus/barnett’s

63
Q

small bowel cances in systemic sclerosis

A

mucosal thinning, loss of villi/microvilli, malabsorption

64
Q

early stage of musculoskeletal changes in systemic sclerosis

A

nondestructive hyperplasia and inflammation of synovium

65
Q

late stage of muscular skeletal changes in systemic sclerosis

A

fibrosis of synovial and periarticular CT

66
Q

renal changes in systemic sclerosis

A

thickening of interlobular arteries by concentric proliferation of intimal cells, deposition of collagenous or mucinous material and hyaline changes

67
Q

pulomary changes in systemic sclerosis

A

alveolar fiborsis

pulomary hypertension

68
Q

COD in systemic sclerosis

A

renal, cardiac, pulmonary, GI dysfunction or failure

69
Q

rheumatoid arthritis

A

systemic autoimmune inflammatory disorder

70
Q

synovitis in rheumatoid arthrits

A

nonsuppurative, prolifeative, destructive

71
Q

pannus formation

A

granulation tissue, synovial and inflammatory cell, fibrous CT

72
Q

how does RA affect hands

A

diffuse osteopenia
marked loss of joint spaces
ulnar drift of fingers

73
Q

osteopenia

A

loss of joint space

74
Q

COD of RA

A

disease complications of amyloidosis, vasculalitis

complications of drug therapy

75
Q

juvenile idiopathic arthritis often affects

A

large joints

76
Q

systemic features of juvenile idiopathic arthristis

A

pericarditis
mycoarditis
pulmonary fibrosis
glomerulonephritis

77
Q

still’s disease varient

A

febrile illnesss with hepatosplenomegaly, rash, incraesed WBC count

78
Q

mixed connective tissue disease

A

clinical syndrome with overlapping features of SLE and Systemic sclerosis

79
Q

what ab is affect in MCTD

A

anti-U1RNP - to ribonucleoproten

80
Q

what do you treat MCTD with

A

steroids

Pathology Exam III (10 decks)

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