pathology - autoimmune Flashcards
rash
joint pian
fever
female of repro and african
SLE
how si the heart invovled in lupus
leibman sacks endocarditis - nonbacterial, wart liek vegetations on both sides of valve and pericarditis (serositis)
how are the kidneys affected in SLE
nephritis- diffuse prolfierative glomerulonpehtiris
neprhotic - membranous gomerulonephtirits
tyep of hypersensitiveit e of SLE
type III @ skin, glomeruli/tubules, goints and small vessels
type II @ cytopenias
common causes of :( in SLE
cardivascular disease
infections
renal dsiease
why susceptible to infetions?
autoimmune hemolytic anaemia - warm IgG extravascular hemoysis
and cytopenais
RASH or PAIN of SLE pease
rash - malar or discoid arhtirits soft tissues/seoritis - leuritis and pericarditis hematogolicy disorders - cytopenias oral/nasopharyngeal ulcres renal dsiease raynouad pneomenon phostosensitivity positive VDRL/RPR antinuclear antibdoies immunosppressants neuslrog - seizures an spsyxhosis
lab findings in sle
antinuclear antiboids - senstive but not specific = SCREENING
antidsDNA - renal invovlement and specific - DIAGNOSIS
antiSMith - specifis - DIAGNOSIS
decreased C3 C4 and Ch50 due to immune complex formation
decreased CH50 in SLE?
deacreased c3 and c4 due to type III vrs skin, glomeruli/tubules, joitns and small vessels
antibodies foudn in drug induced lupus
anti histone
drugs that cause drug induced lupus
procainamide
hydralazine
diff in cxpx of drug induced lupus and sle
drug induced - seriosits in lugns and heart
arthralgias
fever
anti histone abs
NO ab dsDNA
NO decrease C’
rarely CNS and renal involvment (no dsRNA for renal)
where woudl ics be deposited in skin for sle
band liek deposition of IC at the dermal epidermal fuction
how to treat sle
nsaids, steroids, immunsupprestants, hydroxychloroquine
what is antiphospholipid syndrome
primary or secondary autoimmune disorder in SLE
what is antiphospholipid syndrome asociated with
SLE or RA, sjogrens ITP and HIV
dzs associated with:
a) RA
b) OA
c) SLE
ra - sjogrens
OA - pseudogout
SLE - antiphospholipid
how to diagnose antiphospholipid syndrome?
dx based on history of thromobosis in arterial and venous
spotnarous abortion
and lupus anticoagulat, anticardiolip and anti beta2 glycoprotein
if i say anticardiolipid, anti beta glycoprotein and lupus anticoagulant you think?
antiphospholipid syndrome
how to treat antiphospholipid syndrome
systemic anticoagulation
how to lupus anticoagulat and cardiolipid abs affect test results in antiphospholipid syndrome
lupus anticogulation - increased PTT outside body but acutally cause thrombosis in vivp
cardiolipin - false positive VDRL
where are thrombi foudn in antiphospholipid syndrome
venous at calf > renal, ehpatic, axiallry, subclavian, retinal, vena canca, placenta
areterial - can cause strokes
widespread noncaseating granulomas increase ACE elvels increased CD4/CD8 ratio hypercalcemia african american women between 20-39
saarrrccooiiddoossiiisss
cxpx of sarcoidosis
often asymptomatic
enlarged lms
CXR of sarcoidosis
bilateral adenopathy and coarse reticular opaticies
ct of sarcoidossi
extensive hilar and mediatstinal adenopathy
miscropic sarcoidosis
schaumann bodies - laminated ca concretions
asteroid bodies - stellate infiltrates
schaumann bodies
sarcoidosis
laimnated ca concretions
asteroid bodies
stellate infiltrates
sarcoidosis
what causes hypercalcemia in sarcoidosis
increased 1 alpha-hydroxylase from vitamin D activation in macropahges
treatmetn of sarcoidosis
steroids
complications fo sarcoidosis
restrictive lung disease
lupus pernio
erythema nodosum
bell palsy