MoD symposia Flashcards
How does autoimmunity arise?
Autoimmunity may arise due failures of central or peripheral tolerance
Pathogenesis of Hashimotos thyroiditis?
Destruction of thyroid follicles by autoimmune process
Associated with autoantibodies to thyroglobulin and to thyroid peroxidase
Leads to hypothyrodism
Pathogenesis of Grave’s disease?
Inappropriate stimulation of thyroid gland by anti-TSH-autoantibody
Leads to hyperthyrodism
Pathogenesis of pernicious anaemia?
Failure of vit B12 absorption due to antibodies against intrinsic factor
Which autoantibodies are often found in rheumatoid arthritis?
Rheumatoid factor (70%) and Anti–citrullinated protein antibody, ACPA (95%)
What is the pathogenesis of Systemic Lupus Erythematosus?
In SLE the immune system forms antibodies against proteins and DNA in the nuclei of cells
What is the pathogenesis of Lupus nephritis?
In SLE autoantibodies direct themselves against nuclear elements. These Immune complexes deposit in the glomerulus and cause inflammation
This causes the glomeruli to leak resulting in a loss of renal function and scarring
What is ANCA vasculitis and what are its three forms? (used to be known as Wegener’s granulomatosis)
Anti-Neutrophil Cytoplasmic Antibodies Vasculitis
Microscopic Polyangiitis (MPA)
Granulomatosis with Polyangiitis (GPA)
Eosinophilic Granulomatosus with Polyangiitis (EGPA)
What is Raynauds phenomenon?
fingers going white in the cold, then blue, then red and throbbing when they warm up again
What is the difference between Primary Raynaud’s and Secondary Raynaud’s? What test should be done to determine this?
Primary Raynaud’s: Anti-Nuclear Antigen (ANA) negative, Common in young women, Runs in families, Fairly harmless
Secondary Raynaud’s: ANA positive
May be associated with scleroderma (also SLE and other diseases)
What is Scleroderma and how do you test for it?
Autoimmunity leads to ischaemia and fibrosis
Raynaud’s phenomenon, skin thickening and tightening in fingers and face. Fibrosis may also affect lungs, gut, kidneys
Anti-Nuclear Antibodies (looking for anti-centromere or anti-Scl-70 antibodies)
What is an ulcer?
It is a local defect, or excavation of the surface of an organ or tissue that is produced by sloughing of inflammatory necrotic tissue
What score is used to diagnose the likelihood of a DVT or PE?
the two-level Wells score
What is a paradoxical embolism?
thrombo-embolism originating in the deep calf veins passing through a patent foramen ovale and entering the systemic circulation
What is Phenylketonuria (PKU)?
Phenylketonuria is an inborn error of metabolism involving impaired metabolism of the amino acid phenylalanine. Present from birth it can cause severe mental retardation untreated
