Pathology 16 and 17

Question 1

What is the basis of type III autoimmune disease?

Answer 1

IgG antibodies bind antigens and activate complement that is deposited on vasculature and results in anaphylatoxin mediated inflammation

Question 2

What are some types of type III autoimmune diseases?

Answer 2

1) SLE
2) Poststreptococcal glomerulonephritis
3) Polyarteritis nodosa
4) Reactive arthritis
5) Serum sickness

Question 3

In what two ways can SLE cause autoimmune mediated symptoms?

Answer 3

autoantibodies either damage tissue directly –OR- form immune complex deposits

Question 4

How is SLE diagnosed?

Answer 4

Requires 4+ criteria (at least one clinical and 1 laboratory criteria) OR biopsy-proven lupus nephritis with positive ANA or Anti-DNA Abs

Question 5

What are the 9 clinical criteria used for SLE diagnosis?

Answer 5

• 1) Acute cutaneous lupus (easy to biopsy for diagnosis)
  2) Chronic cutaneous lupus
  3) oral or nasla ulcers
  4) non-scarring alopecia
• 5) Arthritis
  6) Serositis
• 7) Renal
  8) Neuorlogic
  9) Hemolytic anemia
  10) Leukopenia
  11) Thrombocytopenia (less than 100,000/mm^3)

Question 6

What are the 6 immunologic criteria used for SLE diagnosis?

Answer 6

1. ANA
2. Anti-DNA
3. Antiphospholipid Ab
4. Anti-smith
5. Low complement (C3, C4, CH50)
6. Direct Coomb’s test

Question 7

Does the presence of ANA mean you definitely have SLE?

Answer 7

No, Approximately 20% of the normal population will have a positive ANA test; positive tests are also seen in other conditions, such as thyroid disease, certain liver conditions, and other autoimmune diseases.

Question 8

What are LE bodies?

Answer 8

ANAs need damaged cells to interact with nuclear elements. When this happens nuclei lose their chromatin and become homogenous.
Neutrophils eat up the damaged lymphocyte
This produces the LE cell

Question 9

Tobacco smoke contributes to the development of cancers where?

Answer 9

oral cavity, esophagus, pancreas, and bladder

combo with alcohol exacerbates the effect

Question 10

What is the basic cause of atherosclerosis?

Answer 10

damage to endothelium

Question 11

What are some common mediators of damaged endothelium?

Answer 11

hypertensions, cigarettes, hemodynamic stress, increased LDL production

Question 12

What does damaged endothelium lead to?

Answer 12

1) Platelet adhesion
2) Diffusion of plasma proteins into intima
3) Migration of monocytes into intima

Question 13

What does platelet adhesion lead to?

Answer 13

PDGF release resulting in proliferation of myointimal cells

Question 14

What does diffusion of plasma proteins into intima cause?

Answer 14

oxidation of LDL leading to uptake by migrating monocytes in the intima (3)

Question 15

What do migrating monocytes in intima packed with oxidized LDL form?

Answer 15

foam cells

Question 16

What do foam cells do?

Answer 16

release cytokines that increase proliferation of myointimal cells

Question 17

Overall, what does the proliferation of intimal cells cause to occur?

Answer 17

fibrosis and collagen synthesis (end game) that results in atherosclerosis

Question 18

T or F. maternal smoking increases the risk of spontaneous abortions and preterm births

Answer 18

T. Increases the risk of abortion, premature birth (decreases birth rate), and intrauterine growth retardation

Question 19

Are Polyarteritis nodosa (PAN) patients ANCA positive?

Answer 19

No

Question 20

What type of immune disease is PAN? Why?

Answer 20

type III. About 30% of patients with PAN have chronic hepatitis B and deposits containing HBsAg-HBsAb complexes in affected vessels, indicating an immune complex-mediated disease (type III)

Question 21

Injury by physical agents is divided into the following categories:

Answer 21

1) mechanical trauma
2) thermal injury
3) electrical injury
4) injury produced by ionizing radiation