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IMSE LEC > midterm - AUTOIMMUNITY AND TUMOR IMMUNOLOGY > Flashcards

midterm - AUTOIMMUNITY AND TUMOR IMMUNOLOGY Flashcards

1
Q

are conditions in which damage to organs or tissues results
from the presence of AUTOANTIBODY or
AUTOREACTIVE CELLS.

A

AUTOIMMUNITY

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2
Q

AUTOIMMUNITY results from the presence or the damage to organs and tissues caused by

A

autoantibody or autoreactive cells

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3
Q

the conflict in ____ causes the autoimmunity. The reason behind why we were able to get an autoantibody or autoreactive cells

A

conflict in self tolerance

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4
Q

the ability of the immune system to
recognize self-produced antigens as a non-threat while
recognizing foreign antigen as a threat.

A

self tolerance

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5
Q

2 stage or 2 parts of self tolerance

A

central and peripheral tolerance

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6
Q

where do central tolerance happens/occurs?

A

in the bone marrow, upon the maturation of b and t cells

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7
Q

a self tolerance that happens in the bone
marrow it aids in line with the thymus where the T cells and B cells are manufactured,

A

central tolerance

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8
Q

on this particular self tolerance it was able to
removed or destroyed the so-called self-reactive B cells or T cells that we have.

A

central tolerance

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9
Q

the back up of central tolerance just in case some of the self reacting lymphocytes pass through the central tolerance

A

peripheral tolerance

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10
Q

a self tolerance that happens in a secondary lymphoid organs

A

PERIPHERAL TOLERANCE

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11
Q

a self tolerance that ensure that those
self-reacting lymphocyte that has been able to
pass through against the central tolerance will be destroyed

A

peripheral tolerance

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12
Q

the cell in charge of peripheral tolerance

A

T regulatory cells

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13
Q

t regulatory cells help in suppressing immune response to self antigens maintaining the balance between __ and ___ in the secondary lymphoid organs

A

T helper 1 and T helper 2
TH1 and TH2

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14
Q

it is the primary mediators of autoimmune disorders, especially which type of it?

A

t helper cells especially the TH 1 cells

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15
Q

Definitely the role
of ___ is very critical in
maintaining this balance and eliminating
harmful autoimmune response.

A

T regulatory cells

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16
Q

a shutdown in central tolerance will cause ___ effect resulting to a problem with t regulatory cells causing autoimmune disorders

A

ladder effect

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17
Q

is thought to be caused by the loss or
breakdown of self-tolerance.

A

autoimmunity

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18
Q

Several other mechanisms are thought to contribute to
autoimmunity, this includes:

A

o Released of sequestered antigens, molecular
o mimicry, and polyclonal B-cell activation.
o Inheritance of MHC genes

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19
Q

2 classification of auto immune diseases

A

organ specific and sytemic

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20
Q

hashimoto’s thryroiditis is a type of auto immune diseases that affects the ____

A

thyroid

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21
Q

grave’s disease is a type of auto immune diseases that affects the ____

A

thyroid

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22
Q

pernicious anemia cells is a type of auto immune diseases that affects the ____

A

gastric parietal

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23
Q

addison’s disease is a type of auto immune diseases that affects the ____

A

adrenal glands

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24
Q

type 1 diabetes mellitus is a type of auto immune diseases that affects the ____

A

pancreas

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25
Q

MG or myasthenia gravis is a type of auto immune diseases that affects the ____

A

nerve muscle synapses

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26
Q

MS or multiple slcerosis is a type of auto immune diseases that affects the ____

A

myelin sheath or nerves

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27
Q

autoimmune hemolytic anemia is a type of auto immune diseases that affects the ____

A

red blood cells

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28
Q

idiopathic thrombocytopenic purpura is a type of auto immune diseases that affects the ____

A

platelets

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29
Q

goodpasture’s syndrome is a type of auto immune diseases that affects the ____

A

kidney and lungs

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30
Q

rheumatoid arthritis is a type of auto immune diseases that affects the ____

A

joints, lungs and skin

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31
Q

scleroderma is a type of auto immune diseases that affects the ____

A

skin, gut, lungs, kidney

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32
Q

sle is a type of auto immune diseases that affects the ____

A

skin, joints, kidney, brain, heart, and lungs

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33
Q

In myasthenia gravis, there’s a problem with the neuro muscle synapses which is responsible for the nerve impulses for moving muscles which is primarily the ___

A

acethylcoline

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34
Q

why do systemic auto immune disease are called systemic?

A

it affects multiple organs not only one

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35
Q

among the mentioned auto immune disease, which are the systemic?

A

goodpasteur syndrom
rheumatoid arthritis
sle

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36
Q

The peak age of onset is usually between ___ and ___ of age in SLE

A

20 and 40 years.

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37
Q

____ are much more likely affected.

A

women

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38
Q

the margin between women and men in terms of the number affected by the SLE

A

10 to 1.1

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39
Q

Systemic lupus erythematosus

The immune response is directed against a broad range of target antigens, as the typical patient has an average of three circulating autoantibodies.

what are they?

A

HLA-DR2 and HLA-DR3

class II MHC

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40
Q

SLE is Associated with Complement deficiencies.

what are the complements missing?

A

C1q, C2 and C4

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41
Q

CLINICAL SIGNS OF SLE

A

joint involvement
skin manifestation
renal complications

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42
Q

joint involvement of SLE results to

A

polyarthralgia’s or arthritis

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43
Q

most frequently reported
manifestation of SLE

A

joint involvement

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44
Q

90% with joint involvement with patients with SLE has

A

polyarthralgia’s or arthritis.

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45
Q

second most common sign or manifestation of SLE

A

skin manifestation

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46
Q

in skin manifestation of SLE

an erythematous rash may appear on any area of
the body exposed to ____.

A

ultraviolet light

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47
Q

appearance of the classic butterfly rash across
the nose and cheeks may appear in ____ % of
all SLE patients.

A

30-40%

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48
Q

the hallmark butterfly rash is responsible for the name lupus,
derived from the Latin term meaning “___”

A

wolflike

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49
Q

Renal complications may occur in SLE in a form of

A

glomerulonephritis

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50
Q

IMMUNOLOGIC FINDINGS OF SLE

A

discovery of LE cells
anti DNA antibody

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51
Q

is a neutrophil that has engulfed
the antibody-coated nucleus of another neutrophil.

A

LE cells

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52
Q

the autoantibody Anti-ds- DNA is associated wth the disease

homogenous pattern

A

SLE

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53
Q

anti- ss Dna is associated with the disease

not detected on routine screen

A

SLE with many other disease

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54
Q

anti histone is associated with the disease

homogenous pattern

A

drug induced sle, other diseases

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55
Q

anti dnp is associated with the disease

homogenous pattern

A

sle, drug induced sle

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56
Q

anti sm is associated with the disease

speckled pattern

A

diagnostic for sle

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57
Q

anti rnp is associated with the disease

speckled pattern

A

sle, mixed with connective issue disease

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58
Q

anti ss- B (ro) and
anti - SS- B (la) is associated with the disease

finely speckled pattern

A

sle, sjogren’s syndrome, others

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59
Q

anti-nuclear is associated with the disease

homogenous staining of nucleolus pattern

A

sle, systemic sclerosis

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60
Q

anti - sci - 70 is associated with the disease

atypical speckled

A

systemic sclerosis, scleroderma

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61
Q

anti - jo - 1 is associated with the disease

fine cytoplasmic specklin

A

polymyositis

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62
Q

which autoantibody of sle is not detected on routine screening?

A

anti - ss - dna

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63
Q

which autoantibody of sle has a homogenous pattern in immunofluorescene

A

anti histone
anti - dnp

64
Q

which autoantibody of sle has a speckled pattern in immunofluorescene

A

anti - sm
anti - rnp

65
Q

which autoantibody of sle has a finely speckled pattern in immunofluorescene

A

anti - ss A
anti - SS b

66
Q

which autoantibody of sle has a homogenous staining of nucleolus pattern in immunofluorescene

A

anti - nuclear

67
Q

which autoantibody of sle has a atypical speckled pattern in immunofluorescene

A

anti-sci- 70

68
Q

which autoantibody of sle has a fine cytoplasmic speckling pattern in immunofluorescene

A

anti - jo - 1

69
Q

what is the screening test for sle

A

ana or antinuclear antibody

70
Q

an example of ana test

A

fluorescent antinuclear antibody

71
Q

is the most widely used and accepted test, because it detects a wide
range of antibodies and is positive in about 95 percent of
patients with lupus.

A

Fluorescent antinuclear antibody (FANA) testing

72
Q

___ are a heterogeneous group of
antibodies that bind to phospholipid alone or are complexed
with protein.

A

Antiphospholipid antibodies

73
Q

ANTIPHOSPHOLIPID ANTIBODIES

They have been found in up to ___ percent of patients with lupus.

A

60%

74
Q

one of the several types of
antiphospholipid antibodies that will prolonged the APTT and PT

A

lupus anticoagulant

75
Q

in RHEUMATOID ARTHRITIS

describe the likeliness of women to men being affected with RHEUMATOID ARTHRITIS

A

women are 3 times as likely to be affected as men

76
Q

rheumatoid arthritis Strikes individuals between the ages of ___ and ___

A

35 and 50

77
Q

RHEUMATOID ARTHRITIS
usually affects what organs

A

joints, heart, and lungs

78
Q

which hla is rheumatoid arthritis associated into

A

hla-dr4

79
Q

IMMUNOLOGIC FINDINGS of rheumatoid arthritis

A

lesions
mass of cells called Pannus
presence of inflammatory agents
rheumatoid factor

80
Q

The earliest lesions in rheumatoid joints show an increase in cells lining the ___and an infiltration of mononuclear cells, mostly __- and ____

A

synovium , CD4+ T lymphocytes.

81
Q

in rheumatoid arthritis

Macrophages and neutrophils are attracted to the area,
and this results in the formation of an organized mass of
cells called a ____, which grows into the joint space
of an individual with Rheumatoid Arthritis and invades the
cartilage

A

pannus

82
Q

Presence of Pro-inflammatory agent for rheumatoid arthritis

A

IL-1, IL-6, IL-8,
TNF-α. (IL-15, IL-18)

83
Q

Approx. 75% of patients with RA have an antibody that has
been called ____

A

Rheumatoid factor

84
Q

Diagnosis for rheumatoid arthritis

A

Clinical Manifestations, Radiographic Findings,
and Laboratory Testing.

85
Q

Laboratory test for rheumatoid arthritis

A

Agglutination test

86
Q

what immunoglobulin is associated with the agglutination test of rheumatoid arthritis?

A

IgG

87
Q

Agglutination test: detects only the IgG isotypes and is found approx. in ___% of patients, thus, a negative result does not rule out the presence of
the Rheumatoid Arthritis,

A

75%

88
Q

conversely, if you tested positive for rheumatoid factor, it will not immediately indicate that you do have rheumatoid arthritis as RF can be found as well in other diseases such as

A

as Syphilis, SLE,
Chronic Active Hepatitis, TB, Leprosy, Infectious
Mononucleosis, Malaria, and Sjogren’s
Syndrome.

89
Q

the agglutination test for rheumatoid arthritis will uses the ___

A

sheep red blood cells coated with IgG

90
Q

Immunoassays for rheumatoid arthritis

A

o EIA (Enzyme Immunoassay)
o Nephelometric Methods
Both have greater precision and
sensitivity because they are automated.

91
Q

the 2 most common disease associated with thyroid

A

Hashimoto’s thyroiditis and Graves’ Disease

92
Q

a large iodinated glycoprotein
produced by Colloids particularly the Follicular
cells in the colloids

A

Thyroglobulin➔

93
Q

is a precursor of the thyroid
hormones, which is known as the T3
(triiodothyronine) and the T4 (thyroxine).

A

thyroglobulin

94
Q

explain how thyroid release hormones

A

from the hypothalamus, it will secret thyrotropin-releasing hormone. The thyrotropin-releasing hormone acts on the pituitary gland to induce the release of thyroid-stimulating hormone. The thyroid-stimulating hormone will binds to the receptor of the cell membrane of the thyroid gland and causing thyroglobulin to be
broken down into secretable substances, which is the T3 and the T4.

95
Q

HPT axis (HPTA) is composed of

A

Hypothalamus, pituitary and
Thyroid gland axis

96
Q

Production of ___ interferes with this process
and causes under- or overactivity of the thyroid

A

autoantibodies

97
Q

Associated with HLA (chain):

o Graves’ disease➔ ____
o Hashimoto’s thyroiditis➔ _____

A

o Graves’ disease➔ HLA-DR3
o Hashimoto’s thyroiditis➔ HLA-DR5

98
Q

Also known as chronic autoimmune thyroiditis.

A

Hashimoto’s Thyroiditis

99
Q

Hashimoto’s Thyroiditis is Most often seen in ___ women.

A

middle-aged

100
Q

in hashimoto’s thyroiditis, Women are ___0 times more likely to develop the
disease.

A

5 to 10

101
Q

Hashimoto’s thyroiditis’ patients will develop what signs and symptoms

A

enlargement of thyroid gland, hypothyroidism, dry skin, decreased sweating, puffy face with edematous eyelids, pallor with a
yellow tinge, weight gain, and dry and brittle hair.

102
Q

what would be the thyroid antibodies produced by the patients with Hashimoto’s thyroiditis?

A

anti-thyroglobulin.

103
Q

a type of thyroid disease wherein there will be an Increase levels of T and B cells (predominantly T cells),
macrophages, and plasma cells.

A

hashimoto’s thyroiditis

104
Q

auto antibody produced by the patient with grave’s disease?

A

(Anti-TSHR)

105
Q

grave’s disease’s patients will develop what signs and symptoms

A

hyperthyroidism, increase levels of T3 and T4.

nervousness, insomnia,
depression, weight loss, heat intolerance, sweating, rapid
heartbeat, palpitations, breathlessness, exophthalmos,
fatigue, cardiac dysrhythmias, and restlessness.

106
Q

what are the 3 major auto antibodies for thyroidism

A

anti-thyroglobulin, anti-TPO, and anti-TSHR.

107
Q

for anti- thyroglobulin, we can conduct a test such as

A

indirect IFA (indirect immunofluorescent assay), Passive hemagglutination, and EIA

108
Q

a test for anti-thyroglobulin that is using a tanned red blood cells

A

passive hemagglutination

109
Q

an anti-thyroglobulin test that is the most commonly used

A

passive hemagglutination

110
Q

an anti-thyroglobulin test that is less sensitive than passive hemagglutination but it can detect non-agglutinating antibody

A

Indirect immunofluorescent testing

111
Q

an anti-thyroglobulin test that uses methanol-fixed monkey cryostat tissue sections as
substrate.

A

Indirect immunofluorescent assays

112
Q

an anti-thyroglobulin test that will create a floccular
or puffy staining pattern

A

Thyroglobulin antibodies

113
Q

The antibodies to thyroglobulin can be detected in
___ % of patients with Hashimoto’s thyroiditis.

A

90%

114
Q

what are the parallel test for thyroid?

A

tsh, t4, t3, ft4 and thyroglobulin test.

115
Q

Antibody to CA2 produces a ___ appearance.

A

diffuse or ground-
glass

116
Q

test we can conduct for anti tpo (thyroid peroxidase)

A

EIA, Indirect IFA, Particle agglutination assays.

117
Q

an anti tpo/ thyroid peroxidase test that is the most
commonly used test in detecting this antibody

A

Enzyme immunoassay (EIA)

118
Q

an anti tpo/ thyroid peroxidase test that is

A
119
Q

Antibodies to __ are
directed against a 105 kD membrane enzyme that
catalyzes tyrosine iodination.

A

thyroid peroxidase (TPO)

120
Q

thyroid peroxidase or anti tpo is found in approximately___ percent
of patients with the disease.

A

90 to 95

121
Q

___ produce staining of the
cytoplasm and not the nucleus of thyroid cells.

A

Peroxidase antibodies

122
Q

These antibodies can be found in approximately
90 percent of patients with Hashimoto’s disease
and 80 percent of patients with Graves’ disease,
so the two cannot be distinguished on the basis of
this test.

A

anti thyroid peroxidase test

123
Q

what are the test we can conduct in Anti-TSHR

A

Bioassays, Binding Assays

124
Q

The ___, this would be intended for Grave’s
disease.

A

anti-TSHR

125
Q

an anti-tshr test that requires tissue culture and thus, it is
very difficult and requires a properly trained
personnel to perform this procedure.

A

bioassays

126
Q

an anti-tshr test that is based on the competition
between the radiolabeled TSH and patient
autoantibodies for binding to thyrotropin receptor.

A

binding assays

127
Q

Autoimmune diabetes mellitus, now termed

A

type IA diabetes,

128
Q

is a chronic autoimmune disease that occurs in a genetically susceptible individual as a result of environmental factors.

A

Autoimmune diabetes mellitus,

129
Q

Insufficient insulin production caused by selective
destruction of the beta cells of the pancreas.

A

Autoimmune diabetes mellitus,

130
Q

Autoimmune diabetes mellitus, is associated with what mhc hla

A

HLA-DR3 or HLA-DR4.

131
Q

type I diabetes mellitus may occur in thewhat mhc region.

A

HLA-DQ region especially in the coding of the DQβ chain.

132
Q

type I diabetes mellitus may occur in the HLA-DQ region.

Within the β chain, substitutions for the amino acid 57, ___, are associated with increasing risk for diabetes

A

aspartic acid

133
Q

type IA diabetes mellitus

Progressive inflammation of the islets of Langerhans in the
pancreas leads to __and destruction of most beta
cells.

A

fibrosis

134
Q

in hyperglycemia, almost or around how many percent are the beta cells being destroyed after the subclinical period of how many years

A

80% of the beta cells

134
Q

type I diabetes mellitus

Predominance of T-cells (CD4+ and CD8+), B cells, TH1
cells, plasma cells and macrophage➔ their activities are
responsible for the inflammatory response and eventually
killing/destroying the ___ cells.

A

beta

134
Q

this would be the islets cells antigen

A

anti- ica

135
Q

is glutamic decarboxylase

A

Anti-GAD

136
Q

Production of autoantibodies in type 1 diabetes mellitus

A

Anti-IA2, Anti-IA-2βA, Anti-Insulin, Anti-GAD and Anti-ICA

137
Q

Antibodies to islet cells have traditionally been detected by using ___ of human pancreas.

A

frozen sections

138
Q

an immunologic manifestation in which there will be an activation of t lymphocytes

A

sarcoidosis

139
Q

an immunologic manifestation in which there will be a sensitized t cells

A

disseminated encephalomyelitis

140
Q

an immunologic manifestation in which there will be an streptococcal antibodies that cross react with heart tissue

A

rheumatoid fever

141
Q

marker for nonseminomatous testicular germ cell liver

A

afp

142
Q

screening conducted in high risk populations for liver cancer such as those with liver cirrhosis and chronic hpatitis. in germ cell tumors both ___ and __ are elevated

A

afp and hCG

143
Q

higher levels of this markers imply poor prognosis in multiple myeloma

A

b2 microglobulin

144
Q

non cancerous conditions of elevated afp

A

pregnancy and nonneoplastic liver disease

145
Q

normal sources of AFP

A

fetal liver, yolk sac, ault liver

146
Q

elevated ____ can be found in cancer associated with specific wbc malignancies

A

cd markers

147
Q

non cancerous conditions we can found an elevated cd markers

A

wbc increase such as infection

148
Q

a marker we can found in a cancer associatde with familial medullary thyroid carcinoma

A

calcitonin and calcium

149
Q

normal sources of calcitonin and calcium

A

thyroid

150
Q

a markr that has a short half life

A

pth and ca

151
Q

the marker that will elevate in parathyroid carcinoma

A

pth and ca

152
Q

normal sources of pth and ca

A

parathyroid glands

153
Q

pth has a short half life, so levels are done intraoperatively to ensure complete ___

A

parathyroid tumor removal

154
Q

a marker that will elevate in thyroid cancer

A

TG

155
Q
A

IMSE LEC (15 decks)

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