Mehl. Autoantibodies 04-22 (1)

Question 1

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) AND Microscopic polyangiitis?

Answer 1

p-ANCA (anti-myeloperoxidase)

Question 2

p-ANCA (anti-myeloperoxidase) - in what 2 vessels?

Answer 2

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) AND Microscopic polyangiitis?

Question 3

Granulomatosis with polyangiitis (Wegener)?

Answer 3

c-ANCA; anti-proteinase 3 (PR3); dumb mnemonic I created that helps some of my students: Water Closet (Wegener C-ANCA)

Question 4

c-ANCA; anti-proteinase 3 (PR3); dumb mnemonic I created that helps some of my students: Water Closet?

Answer 4

Granulomatosis with polyangiitis (Wegener)

Question 5

Goodpasture syndrome?

Answer 5

Anti-collagen IV (anti-GBM; glomerular basement membrane); causes linear immunofluorescence on renal biopsy; don’t confuse with Alport syndrome, which is mutations in type IV collagen (not Ab)

Question 6

Anti-collagen IV (anti-GBM; glomerular basement membrane); causes linear immunofluorescence on renal biopsy; don’t confuse with Alport syndrome, which is mutations in type IV collagen (not Ab)?

Answer 6

Goodpasture syndrome

Question 7

Antiphospholipid syndrome?

Answer 7

Anti-b2-microglobulin; anti-cardiolipin; lupus anticoagulant (the latter is the name for either of the former two if the patient happens to have SLE); Abs associated with recurrent miscarriage; can cause false-positive syphilis screening (e.g., SLE patient who gets positive syphilis VDRL test).

Question 8

Anti-b2-microglobulin; anti-cardiolipin; lupus anticoagulant (the latter is the name for either of the former two if the patient happens to have SLE); Abs associated with recurrent miscarriage; can cause false-positive syphilis screening (e.g., SLE patient who gets positive syphilis VDRL test).?

Answer 8

Antiphospholipid syndrome

Question 9

Bullous pemphigoid?

Answer 9

Anti-hemidesmosome (bullous pemphigoid antigen); hemidesmosomes connect the dermis to epidermis; cause a linear immunofluorescence on skin biopsy

Question 10

Anti-hemidesmosome (bullous pemphigoid antigen); hemidesmosomes connect the dermis to epidermis; cause a linear immunofluorescence on skin biopsy?

Answer 10

Bullous pemphigoid

Question 11

Anti-desmosome (anti-desmoglein 1 and 3); desmosomes connect adjacent cells in epidermis; cause a net-like immunofluorescence on skin biopsy?

Answer 11

Pemphigus vulgaris

Question 12

Pemphigus vulgaris?

Answer 12

Anti-desmosome (anti-desmoglein 1 and 3); desmosomes connect adjacent cells in epidermis; cause a net-like immunofluorescence on skin biopsy?

Question 13

Anti-presynaptic voltage-gated calcium channel; sometimes a paraneoplastic of small cell lung cancer?

Answer 13

Lambert-Eaton

Question 14

Lambert-Eaton

Answer 14

Anti-presynaptic voltage-gated calcium channel; sometimes a paraneoplastic of small cell lung cancer

Question 15

Anti-topoisomerase I (Scl-70)?

Answer 15

Diffuse-type systemic sclerosis / scleroderma

Question 16

Diffuse-type systemic sclerosis / scleroderma?

Answer 16

Anti-topoisomerase I (Scl-70)?

Question 17

Primary biliary cirrhosis?

Answer 17

Anti-mitochondrial

Question 18

Anti-mitochondrial?

Answer 18

Primary biliary cirrhosis

Question 19

Anti-smooth muscle?

Answer 19

Autoimmune hepatitis

Question 20

Autoimmune hepatitis?

Answer 20

Anti-smooth muscle

Question 21

Anti-SS-A (anti-Ro); anti-SS-B (anti-La)?

Answer 21

Sjogren syndrome

Question 22

Sjogren syndrome?

Answer 22

Anti-SS-A (anti-Ro); anti-SS-B (anti-La)

Question 23

Anti-TSH receptor (this antibody is called thyroid- stimulating immunoglobulin, or TSI, and activates the TSH receptor)?

Answer 23

Graves disease

Question 24

Graves disease?

Answer 24

Anti-TSH receptor (this antibody is called thyroid- stimulating immunoglobulin, or TSI, and activates the TSH receptor)

Question 25

Anti-thyroperoxidase (anti-microsomal); anti- thyroglobulin?

Answer 25

Hashimoto thyroiditis

Question 26

Hashimoto thyroiditis?

Answer 26

Anti-thyroperoxidase (anti-microsomal); anti- thyroglobulin

Question 27

Anti-parietal cell; anti-intrinsic factor?

Answer 27

Pernicious anemia

Question 28

Pernicious anemia?

Answer 28

Anti-parietal cell; anti-intrinsic factor

Question 29

Anti-phospholipase A2 receptor?

Answer 29

Primary membranous glomerulonephritis

Question 30

Primary membranous glomerulonephritis?

Answer 30

Anti-phospholipase A2 receptor

Question 31

Anti-ADAMTS13 (a matrix metalloproteinase that cleaves vWF multimers)?

Answer 31

Thrombotic thrombocytopenic purpura

Question 32

Thrombotic thrombocytopenic purpura?

Answer 32

Anti-ADAMTS13 (a matrix metalloproteinase that cleaves vWF multimers)

Question 33

!!Anti-aquaporin 4 (asked on 2CK form)?

Answer 33

Neuromyelitis optica (Devic syndrome)

Question 34

!!Neuromyelitis optica (Devic syndrome)?

Answer 34

Anti-aquaporin 4 (asked on 2CK form)

Question 35

Anti-GpIIb/IIIa on platelets (platelet aggregation)?

Answer 35

Immune thrombocytopenic purpura (aka idiopathic thrombocytopenic purpura)

Question 36

Immune thrombocytopenic purpura (aka idiopathic thrombocytopenic purpura)?

Answer 36

Anti-GpIIb/IIIa on platelets (platelet aggregation)

Question 37

Anti-platelet factor 4-heparin complex (anti-PF4- heparin)?

Answer 37

Heparin-induced thrombocytopenia (HIT)

Question 38

Heparin-induced thrombocytopenia (HIT)?

Answer 38

Anti-platelet factor 4-heparin complex (anti-PF4- heparin)

Question 39

Anti-21-hydroxylase?

Answer 39

Addison disease

Question 40

Addison disease?

Answer 40

Anti-21-hydroxylase

Question 41

IgM against RBCs (CMV and Mycoplasma are HY infectious associations); will result in positive Coombs test?

Answer 41

Cold autoimmune hemolytic anemia

Question 42

Cold autoimmune hemolytic anemia

Answer 42

IgM against RBCs (CMV and Mycoplasma are HY infectious associations); will result in positive Coombs test

Question 43

IgG against RBCs (various miscellaneous drugs and infections); also associated with chronic lymphocytic leukemia; will result in positive Coombs test?

Answer 43

Warm autoimmune hemolytic anemia

Question 44

Warm autoimmune hemolytic anemia?

Answer 44

IgG against RBCs (various miscellaneous drugs and infections); also associated with chronic lymphocytic leukemia; will result in positive Coombs test?

Question 45

Anti-glutamic acid decarboxylase(anti-GAD); anti- zinc transporter 8?

Answer 45

Type I diabetes mellitus

Question 46

Type I diabetes mellitus?

Answer 46

Anti-glutamic acid decarboxylase(anti-GAD); anti- zinc transporter 8

Question 47

Anti-endomysial (aka anti-gliadin); anti-tissue transglutaminase IgA; antibody screening will yield false-negatives if patient also has IgA deficiency?

Answer 47

Celiac disease

Question 48

Celiac disease?

Answer 48

Anti-endomysial (aka anti-gliadin); anti-tissue transglutaminase IgA; antibody screening will yield false-negatives if patient also has IgA deficiency

Question 49

Anti-myosin; anti-valve-derived proteins; should be noted that these Abs are formed against S. pyogenes M protein and almost always cross-react with the mitral valve (molecular mimicry)?

Answer 49

Rheumatic heart disease

Question 50

Rheumatic heart disease?

Answer 50

Anti-myosin; anti-valve-derived proteins; should be noted that these Abs are formed against S. pyogenes M protein and almost always cross-react with the mitral valve (molecular mimicry)

Question 51

Rheumatoid factor (an IgM against the Fc region of IgG); anti-cyclic citrullinated peptide (CCP); anti-CCP is more specific than rheumatoid factor?

Answer 51

Rheumatoid arthritis

Question 52

Rheumatoid arthritis?

Answer 52

Rheumatoid factor (an IgM against the Fc region of IgG); anti-cyclic citrullinated peptide (CCP); anti-CCP is more specific than rheumatoid factor

Question 53

Anti-centromere?

Answer 53

Limited-type systemic sclerosis / scleroderma

Question 54

Limited-type systemic sclerosis / scleroderma?

Answer 54

Anti-centromere

Question 55

Anti-Jo1; can be a paraneoplastic of ovarian cancer?

Answer 55

Polymyositis / Dermatomyositis

Question 56

Polymyositis / Dermatomyositis?

Answer 56

Anti-Jo1; can be a paraneoplastic of ovarian cancer

Question 57

Anti-Hu/-Yo; ataxia in someone with small cell lung cancer and negative CNS imaging?

Answer 57

Small cell cerebellar dysfunction

Question 58

Small cell cerebellar dysfunction?

Answer 58

Anti-Hu/-Yo; ataxia in someone with small cell lung cancer and negative CNS imaging

Question 59

Anti-post-synaptic acetylcholine receptor; sometimes a paraneoplastic of thymoma?

Answer 59

Myasthenia gravis

Question 60

Myasthenia gravis?

Answer 60

Anti-post-synaptic acetylcholine receptor; sometimes a paraneoplastic of thymoma

Question 61

Anti-histone; caused by various drugs (Mom is HIPP) àMinocycline, Hydralazine, INH, Procainamide, Penicillamine?

Answer 61

Drug-induced lupus (DIL)

Question 62

Drug-induced lupus (DIL)?

Answer 62

Anti-histone; caused by various drugs (Mom is HIPP) àMinocycline, Hydralazine, INH, Procainamide, Penicillamine

Question 63

Anti-double-stranded DNA (dsDNA); anti-Smith (ribonucleoprotein); anti-hematologic cell line Abs; should be noted that dsDNA goes up in acute flares + best reflects renal prognosis; anti-Smith is more specific than anti-dsDNA; thrombocytopenia is an exceedingly HY finding in SLE due to Abs; if all cell lines are down in SLE, aplastic anemia (decr. bone marrow production) is WRONG answer; choose “increased peripheral destruction” as answer

Answer 63

Systemic lupus erythematosus (SLE)

Question 64

Systemic lupus erythematosus (SLE) - 3?

Answer 64

Anti-double-stranded DNA (dsDNA); anti-Smith (ribonucleoprotein); anti-hematologic cell line Abs;