MSI Pathology

Question 1

Polyuria, polydipsia, polyphagia and weight loss are symptoms of

Answer 1

Type 1 DM

Question 2

Name three examples of multi-system AI diseases

Answer 2

Lupus (SLE), Sjogren’s syndrome, and RA

Question 3

A lupine rash is a pathognomonic feature of what AI disorder?

Answer 3

Lupus (SLE)

Question 4

A multi-system autoimmune disorder that mainly affects CONNECTIVE TISSUE is

Answer 4

Lupus (SLE)

Question 5

Rashes, photosensitivity, hives, pleurisy, pericarditis, nephritis, pulmonary fibrosis, joint pain, and autoimmune cytopenias are features of which autoimmune disease?

Answer 5

Lupus (SLE)

Question 6

Common epidemiological features of Lupus?

Answer 6

More common in women of childbearing age, Asian & African descent

Question 7

Most abundant auto-antibodies in SLE?

Answer 7

anti-nuclear antibodies

Question 8

What are the two nuclear antigens that are considered PATHOGNOMONIC of SLE?

Answer 8

Double-stranded DNA (dsDNA) and Sm antigens of the U-1 small nuclear ribonucleoprotein complex

Question 9

The development of nephritis in Lupus is likely caused by _______ ________ deposition

Answer 9

immune complex

Question 10

Some patients with Lupus have a deficiency of _____________ complement components C1, C4, and C2

Answer 10

classical

Question 11

Deficiency of complement proteins __, __, and __ predisposes to SLE, presumably bc immune complexes cannot be cleared effectively.

Answer 11

C1, C2, and C4

Question 12

Major risk associated with DM1?

Answer 12

Ketoacidosis (requires insulin)

Question 13

How to distinguish between DM1/DM2 and monogenic diabetes?

Answer 13

Immunoassays for specific islet cell antigens (GAD, IA2, insulin)

NB: Remember that the disease effects are not bc of direct effects of these antibodies

Question 14

A direct ELISA that targets the antigen at the dermo-epidermal junction of the skin, resulting in linear deposition of AB, activating complement producing skin dehiscence and tense blisters on the skin (thick-walled bullae) is suggestive of which antibody-mediated disease?

Answer 14

Bullous pemphigoid

Question 15

A disease characterised by thin-walled bullae on skin AND MUCOUS MEMBRANES that rupture easily. Target is the intercellular cement protein desmoglein 3 in superficial skin layers. Autoantibodies detected by direct ELISA

Answer 15

Bullous pemphigus

Question 16

Antibodies binding to the endomysium of smooth muscle fibres have a strong association with which disease?

Answer 16

Coeliac disease

Question 17

Target antigen in Coeliac disease?

Answer 17

Tissue transglutaminase

Question 18

The absence of HLA DQ2/DQ8 makes the diagnosis of _________ disease very unlikely (high negative predictive value)

Answer 18

Coeliac disease

Question 19

Absorption of B12 requires a co-factor called _______ ________ which is secreted by the gastric parietal cells

Answer 19

Intrinsic factor

Question 20

Which condition describes AI destruction of the gastric parietal cells?

Answer 20

Pernicious anaemia

Question 21

Anaemia, neurological issue, and subfertility can result from ______ deficiency caused by pernicious anaemia

Answer 21

B12

Question 22

Loss of _______ ________ abrogates B12 absorption

Answer 22

intrinsic factor

Question 23

Which types of AI diseases are best treated with immunomodulation drugs?

Answer 23

Multi-system/non-organ-specific AI diseases

Question 24

Methotrexate, Azathioprine, and ciclosporin are ________ ____________ immunosuppressant drugs

Answer 24

small molecule

Question 25

A treatment that removes Abs from the bloodstream, therefore may be useful in Ab mediated diseases

Answer 25

Plasmapheresis

Question 26

T1DM, Pemphigus, Pemphigoid, Graves dz, Hashimoto’s, and auto-immune cytopaenias are classified as what type of auto immune diseases?

Answer 26

Organ-specific

Question 27

SLE, RA, and Sjogren’s syndrome are classified as what type of auto immune diseases?

Answer 27

Multi-system