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Immunoserology > Lec 04: Autoimmune Diseases: Systemic > Flashcards

Lec 04: Autoimmune Diseases: Systemic Flashcards

1
Q

It refers to the inability of the immune system to discriminate between self and non-self.

A

Autoimmune diseases

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2
Q

Most autoantibodies possess which type of hypersensitivity

A

Type III

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3
Q

Familiarize the factors that can contribute to the formation of autoimmune diseases

A
  1. Genetic factors
  2. Presence of HLA
  3. Age
  4. Exogenous factors
  5. Unknown causation
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4
Q

Familiarize findings of an autoimmune disease

A

Elevated serum levels of gamma globulin
Autoantibodies
Decreased levels of complement proteins
Immune complexes
Lesions in tissues

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5
Q
  1. Localized lesion
  2. Non-localized lesion

A. Organ specific
B. Midspectrum
C. Systemic

A
  1. A and B
  2. C
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6
Q

Classifications of Autoimmune Diseases

A

Organ specific, midspectrum, and systemic

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7
Q

Refers to:

● Localized lesion; Antibody specific to the organ
● Cytotoxic (Type II Hypersensitivity)
● There is a formation of autoantibodies which is deposited to the specific organ which triggers immune response.

A

Organ-specific

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8
Q

Refers to:

● Non-localized lesion; Antibody non-specific to the organ
● Immune complex (Type III Hypersensitivity)
● Unlike organ specific, there is a formation of immune complex which will be deposited to the different parts of the body leading to systemic autoimmune diseases.
● Examples include SLE, RA, Ankylosing Spondylitis, and Miscellaneous

A

Systemic

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9
Q

The disorders classified under the organ specific and midspectrum

A
  1. Cardiovascular disorders
  2. Endocrine gland disorders
  3. Pancreatic disorders
  4. Gastrointestinal disorders
  5. Autoimmune hematologic disorders
  6. Neuromuscular disorders
  7. Renal disorders
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10
Q

Examples of autoimmune diseases classified uner systemic

A
  1. Systemic Lupus Erythematosus
  2. Rheumatoid Arthritis
  3. Ankylosing spondylitis
  4. Miscellaneous systemic disorders such as
    A. Progressive Systemic Sclerosis
    B. Sjogren’s Syndrome
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11
Q

Refers to non-localized; lesion is not speciific to the organ

Its mechanism is the production of immune complex which will be distributed to the different parts of the body, triggering immune response and inflammatory reactions

A

Systemic

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12
Q

Refers to:

● Disease of the connective tissues; expresses as vasculitis
● The whole body is affected

A

Systemic Lupus Erythematosus

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13
Q

Most frequent manifestation of SLE

A

Arthritis and Polyarthralgia

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14
Q

Environmental factors of SLE

A

● UV light/sunlight
● Drugs (Procainamide, Hydralazine, Isoniazid)
● Infectious Agents
● Hormonal changes

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15
Q

Genes associated with SLE susceptivility

A

HLA-A1, HLA-B8, HLA-DR3

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16
Q

Refers to the name of the rash that manifests in SLE upon exposure to UV lights

A

Erythematous rash / Butterfly rash / Malar rash

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17
Q

What causes the end-stage renal disease in SLE?

A

Glomerulonephritis

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18
Q

Aside from infection, what is the most common death of SLE patients?

A

Cardiac disease

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19
Q

In SLE, immune complexes may be possibly deposited to the heart leading to cardiac involvement, ________, ________, ________

A

Pericarditis, tachycardia, ventricular enlargement

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20
Q

Refers to the collective name for seizure, mild cognitive dysfunction, psychoses, depression

A

Neuropsychiatric manifestations

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21
Q

Formation of immune complexes is part of which type of hypersensitivity?

A

3

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22
Q

Refers to polymorphonuclear neutrophils with ingested body

A

LE cells

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23
Q

Refers to the antibody-coated nucleus of another neutrophil

A

LE body

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24
Q

Le factor reacts with what?

A

DNP and complement

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25
Q

Formed when the anti-nuclear antibodies bind to the nucleus of degraded neutrophils

26
Q

LE cells are often in _____ formation

27
Q

T or F: Patients with SLE has Hypocomplemetemia and has C1q, C2, and C3 deficiency

A

False (C1, C2, and C4)

28
Q

T or F: There is hypogammaglobulinemia in SLE because there is a depletion of suppressor T cells hence no activation of B cells to plasma cells

A

False (hypergammaglobulinemia) if nag-true ka uto-uto ka same kayo ng mga boses ko sa utak

29
Q

Hallmark of SLE but not diagnostic

A

Anti-nuclear Antibodies

30
Q

Refers to the antibodies to nucleus and nuclear components

31
Q

Match

  1. Most specific marker for SLE
  2. Measurement using Crithidia luciliae as
    substrate is confirmatory for SLE
  3. Reactive with denatured DNA that reacts with
    purine and pyrimidine bases of DNA.
  4. Associated with SLE, systemic sclerosis,
    localized scleroderma, and other connective
    tissues disease
  5. Associated with SLE in the active stage,
    lupus nephritis
  6. SLE may have glomerulonephritis leading to
    end stage renal disease.

A. Anti-dsDNA
B. Anti-ssDNA

A
  1. A
  2. A
  3. B
  4. B
  5. A
  6. A
32
Q

Refers to:

● Not specific for SLE and may also be found in patients with RA, Felty’s syndrome, Sjogren’s syndrome, systemic sclerosis, and primary biliary cirrhosis but in lower levels.
* Induced by drugs such as procainamide and hydralazine

A

Antihistone

33
Q

Familiarize the antihistones

A

● Anti-H1
● Anti-H2A
● Anti-H2B
● Anti-H3
● Anti-H4

34
Q

Which drugs can induce antihistones?

A

Procainamide and hydralazine

35
Q

Match

  1. Highly specific for patients with
    SLE
  2. May also be seen in patients with
    Mixed Connective Tissue Disease (MCTD), Rheumatoid Arthritis (RA), Scleroderma,
    Sjogren syndrome
  3. LE factor: an antibody that reacts with DNP
  4. Seen in patients with serositis, and again, not specific for SLE
  5. Seen in px with SLE dermatitis (Cutaneous) and Neonatal SLE
  6. Seen in px with SLE and Sjogren’s

A. Anti-Smith
B. Anti-DNP
C. Anti-RNP
D. Anti-SS-A/RO
E. Anti-SS-BLA

A
  1. A
  2. C
  3. B
  4. B
  5. D
  6. E
36
Q

Diagnostic of SLE

A

High ANA and high anti-dsDNA

37
Q

Refers to

  • Antibodies to nucleolar RNA (Anti-RNA)
  • Associated with SLE, Scleroderma, Sjogren’s, and Raynaud’s Phenomenon
A

Anti-nucleolar

38
Q

What is highly sensitive for CREST variant of scleroderma (CREST syndrome)?

A

 Calcinosis cutis
 Raynaud’s Phenomenon
 Esophageal dysmotility
 Sclerodactyly
 Telangiectasia

39
Q

Refers to:

● This antibody is a secondary to systemic lupus erythematosus
● Not specific for SLE
● It is classified as primary and secondary. SLE is secondary.

A

Anti-Phospholipid Antibody

40
Q

When there is anti-phospholipid antibody in SLE, which is classified as primary and secondary?

A

Primary - antiphospholipid antibody syndrome
Secondary - SLE

41
Q

The problem here is that inside the body if there is a presence of antiphospholipid antibody, it can activate platelets adhesion and activation leading to ______. This will also prolong the _____ result of the patient.

A

Thrombosis, APTT

42
Q

Antibody found in SLE that refers to:

  • Formation of immune complex
  • This can lead to hemolytic diseases, lysing the red cells.
A

Antibody to RBCs

43
Q

Refers to:

● It is also present in SLE.
● It is not specific for rheumatoid arthritis. It is also present in other autoimmune diseases like SLE.

A

Rheumatoid factor

44
Q

Refers to:

  • Chronic systemic disease:
    ○ Synovial membranes and articular structures of multiple joints.
    ○ Multiple organs such as heart and lungs
A

Rheumatoid arthritis

45
Q

T or F: The cause of Rheumatoid Arthritis is unknown but it is believed to be genetically inherited

46
Q

Match

  1. Elevated level of uric acid
  2. An autoimmune disease
  3. As the uric acid increases, it can be
    deposited in the joints,
  4. There is an immune complex formation
    that gets deposited to the different parts of the body

A. Rheumatoid Arthritis
B. Gouty arthritis

47
Q

Genes associated with RA susceptibility

A

HLA-D4, HLA-DRB1

48
Q

Familiarize the environmental and lifestyle factors of RA

A

Hormonal changes; Smoking and Obesity

49
Q

Familiarize the infectious agents that can possibly trigger antigens for RA

A

○ Proteus mirabilis
○ Mycoplasma organisms
○ Epstein-Barr Virus (EBV)
○ Rubella Virus
○ Porphyromonas gingivalis

50
Q

In SLE, pannus tissue adheres to articular cartilage, and the cells within the pannus produce _______ that can destroy cartilage

A

Proteinases

51
Q

Refer to:

  • Anti-Antibody
  • Immunoglobulins that interact specifically with the Fc portion of human or animal IgG
  • IgG, IgA, but predominantly IgM
A

Rheumatoid Factor

52
Q

T or F: RF is an antibody

A

True (its an antibody against antibody)

53
Q

Refers to the specific marker for RA

A

Anti-cyclic citrullinated proteins

54
Q

This can be detected in the sera from individuals 14 years before the first onset of symptoms of RA appear

55
Q

Refers to:

  • Form of chronic inflammation of the spine and sacroiliac joints
  • Autoimmune disease with the highest criteria for HL disease relationship
A

Ankylosing spondylitis

56
Q

Gene associated with Ankylosing Spondylitis

57
Q

Two examples of miscellaneous systemic Disorders

A

a. Progressive Systemic Sclerosis (Scleroderma)
b, Sjogren’s Syndromee

58
Q

Refers to Chronic Connective Tissue Disorder characterized by diffuse fibrosis

A

Progressive Systemic Sclerosis (Scleroderma)

59
Q

Antibodies present in Scleroderma

A

Anti-RNA and Anti-RNP

60
Q

Refers to:

  • Affects the lacrimal, salivary, and other excretory glands
  • Results in keratoconjunctivitis sicca and xerostomia
A

Sjogren’s Syndrome

61
Q

T or F: In Sjogren’s Syndrome, all ANA are present

A

False (with exceptions of Anto-centromere and Anti-smith)

62
Q

Pattern in immunofluorescence assay of Sjogren’s Syndrome

A

Speckled pattern

Immunoserology (12 decks)

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