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Musculoskeletal > Micro- Autoimmunity > Flashcards

Micro- Autoimmunity Flashcards

1
Q

What is a defining characteristic of an autoimmune disease?

A

-autoantibodies or auto reactive T cells specific for self antigens

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2
Q

What affect does the release of sequestered agents have on the activation of T cells?

A
  • Developing T cells may not have been exposed to sequestered agents while developing in the thymus.
  • exposure to released sequestered agents may cause activation of the T cells.
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3
Q

What can cause the release of normally sequestered agents?

A

-trauma and infection agents

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4
Q

What is the concept of molecular mimicry?

A

-some pathogens express proteins withe regions that are similar to self components

(post rabies encephalitis, rheumatic fever, other MBP and peptides)

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5
Q

What is AIRE? What is it’s purpose?

A

Autoimmune regulator.

-Allowes for the exporsure of self antigent for T cells to aid in negative selection

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6
Q

What is the affect of a lack of AIRE?

A

Self antigens are not present in the thymus and autoimmun reactions can occur in peripheral organs.

-e.g. Autoimmune polyglandular syndrome

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7
Q

What is autoimmun polyglandular syndrome?

A

-Lack of AIRE leading to a wide range of autoantibodies against endocrine glands, liver and skin, blood cells and platelets

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8
Q

What is an example of a Type II non-cytotoxic hypersensitivity?

A

Myasthenia Gravis

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9
Q

What is the HLA type associated with Myasthenia gravis?

A

HLA DR3

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10
Q

What are the symptoms of MG?

A

droopy eyelids, double vision, facial muscle weakness and eventually breathing impairment

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11
Q

What is the etiology of MG? How is it diagnosed?

A
  • Autoantibodies against ACh receptors in the NMJ activated complement and result in endocytosing of the ACh receptors.
  • It is diagnosed by dosing with AChE inhibitor dosing
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12
Q

What are the two major Type III hypersensitivities?

A
  • Rhematoid Arthritis
  • Systemic Lupus Erythematosis
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13
Q

What is rheumatoid factor?

A

-an IgM antibody specific for the Fc portion of joint IgG

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14
Q

What is typically fonnd in the joint synovium in people with rheumatoid arthritis?

A

Leukocytes (CD4 and CD8, B cells, plasma cells, neutrophils, macrophages)

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15
Q

What are the two ways RA is diagnosed?

A

-Presence of Rheumatoid factor

or

-Elevated IgG and IgM in examination of the joint fluid

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16
Q

What is the treatment for RA?

A
  • NSAIDS (coz-2 inhibitors)
  • corticosteroids
  • immunosuppression
  • gold therapy
  • anti-TNF-alpha (infiximab)
17
Q

What HLA allotype is associated with SLE?

A

HLA DR3

18
Q

What antibodies are present in SLE?

A

-autoantibodies to almost every tissue antigen inclding histones, DNA, RNA, clotting factors

19
Q

What is the histologic appearence of SLE?

A

-LUMPY-BUMPY die to the deposition of immune complexes into tissues

20
Q

How is SLE diagnosed?

A

-used to be ANA, now anti-dsDNA is the specific test

21
Q

What is a type IV hypersensitivity that involves the CNS?

A

-Multiple Sclerosis

22
Q

Which HLA allotype is associated with MS?

A

HLA DR2

23
Q

What is the mechanism of MS tissue destruction?

A

TDTH cells infiltrate the CNS white matter and react specifically with myelin basic protein

24
Q

What is secreted from the sclerotic plaques in the CNS in MS?

A

oligoclonal IgG

25
Q

What is the diagnosis and treatment of MS?

A
  • Diagnosis via MRI
  • Treatment with: INF-beta, corticosteroids, and immunosupperssion
26
Q

What HLA allotype is associated with ankylosing spondylitis?

A

HLA B27

27
Q

A patient presents after infection with Klebsiella, Shigella, or Yersinia, and is complaining of spinal pain. HLA B27 is found after testing. What is the diagnosis?

A

Ankylosing Spondylitis

28
Q

What if a patient presents with a HLA B27 but is experiencing fevers, and conjunctivits?

A

Reiter’s syndrome

29
Q

What is different about the male to famle ration of Reiter’s syndrome as compared to most other autoimmune diseases?

A

-It has a higher male ratio (9:1)

30
Q

What kind of infection is Reiter’s syndrome experienced after?

A

Post STD or enteric infection:

–> Chlamydia, Yersinia, Shigella

31
Q

A sexually aged male is experiencing knee and ankle pain and is also experiencing urethritis. He has recently been treated for chlamydia. What is the diagnosis and treatment?

A

Reiter’s syndrome.

–> antibiotics, NSAIDS, Cox-2 inhibitors (coxibs)

32
Q

What is the basis of T cell vaccination?

A

-people with autoimmune disorders are vaccinated with autoimmune T cells and then an immune reaction is directed at the autoimmune clones

33
Q

What is the basis of treatment of autoimmune diseases with peptide blockade of MHC?

A

-dose with synthetic peptide that have a 1AA change that binds better to MHC and out competes the self peptides that are causing the autoimmune reaction.

34
Q

What are monoclonal antibodies?

A

Anti-CD4, Anti-TCR, anti-MHC, anti IL-2R

Musculoskeletal (9 decks)

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