Pathology: autoimmunity

Question 1

B7.1 & B7.2

Answer 1

co-stimulatory molecules for T cells on APC

up regulated during infection

Question 2

CD28

Answer 2

T cell

binds B7 to activate T cell

Question 3

CTLA-4

Answer 3

cytotoxic T-lymphocyte-associated protein 4
binds to B7 more strongly than CD28
prevents B7 from activating T cell

Question 4

ipilimumab

Answer 4

Ab that blocks CTLA-4

treat tumors that use CTLA-4 to avoid immune system

Question 5

PD-1

Answer 5

programmed death-1
binds B7 and prevents activation of T cell
some tumors and viruses

Question 6

pembrolizumab

Answer 6

Ab that blocks PD-1

Question 7

nivolumab

Answer 7

Ab that blocks PD-1

Question 8

anti-dsDNA

Answer 8

autoantibody in SLE

formation of immune complexes

Question 9

anti-Smith

Answer 9

autoantibody in SLE

formation of immune complexes

Question 10

Anti-RNP U1

Answer 10

autoantibody against RNA polymerase
associated with SLE and mixed connective tissue disease
formation of immune complexes

Question 11

Anti-SS-A (Ro)

Answer 11

autoantibody in Sjogren syndrome, SLE, and rheumatic diseases

Question 12

Anti-SS-B (La)

Answer 12

autoantibody in Sjogren and SLE

Question 13

Anti-Scl-70

Answer 13

autoantibody against DNA topoisomerase I

systemic sclerosis

Question 14

Anti-histones

Answer 14

autoantibody in SLE

formation of immune complexes

Question 15

Anti-centromere

Answer 15

autoantibody in limited scleroderma, systemic sclerosis, and CREST syndrome

Question 16

Anti-phospholipid

Answer 16

autoantibody in antiphospholipid syndrome and SLE

thrombotic episodes

Question 17

Anti-Jo1

Answer 17

autoantibody against histidyl tRNA ligase

inflammatory myopathies

Question 18

Anti-mitochondrial

Answer 18

autoantibody in primary biliary cirrhosis

Question 19

Anti-neutrophil cytoplasmic

Answer 19

autoantibody in various vasculitides

Question 20

Anti-eTg

Answer 20

autoantibody in herpetiformis

Question 21

ANA

Answer 21

autoantibody against nuclear components
associated with SLE
deficiency of C1q, C2 or C4 can impair clearance of apoptotic cells and nucleic acid fragments predisposes to SLE

Question 22

HLA-B27

Answer 22

predisposition for ankylosing spondylitis

Question 23

ankylosing spondylitis

Answer 23

destroys articular cartilage of sacroiliac joins and apophyseal joints between spinal tuberosities and processes: bony fusion of joints
Sym: lower back pain and spinal stiffness in middle age

Question 24

PTPN22 polymorphisms

Answer 24

tyrosine phosphatase
excessive activation of lymphocytes
associated with RA and T1DM

Question 25

Rheumatoid arthritis

Answer 25

autoimmune attack on small joints of hands and feet, especially MCP and MTP

Question 26

CD25

Answer 26

IL-2 receptor

Question 27

polymorphisms in alpha chain of IL-2 and IL-7 receptor

Answer 27

associated with Multiple Sclerosis | dysfunction of Treg cells

Question 28

multiple sclerosis

Answer 28

autoimmune attack on myelin | neurological symptoms

Question 29

anti-CCP

Answer 29

autoantibody agains cyclic citrullinated peptide | associated with RA

Question 30

anti-U3 RNP

Answer 30

autoantibody against RNA polymerase | associated with systemic sclerosis

Question 31

anti-myleoperoxidase

Answer 31

perinuclear anti-neutrophil cytoplasmic (P-ANCA) | associated with microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis (Churg Strauss)

Question 32

anti-proteinase-3

Answer 32

diffuse cytoplasmic anti-neutrophil cytoplasmic (C-ANCA) | associated with granulomatosis with polyangiitis (Wegner's)

Question 33

cyclosporine

Answer 33

calcineurin inhibitor nephrotoxicity can be confused with kidney rejection: isometric vacuolization of tubular epithelial cell cytoplasm, tubular calcifications, giant mitochondria

Question 34

tacrolimus

Answer 34

binds FK506 | calcineurin inhibitor

Question 35

MOA calcineurin inhibitors

Answer 35

bind immunophilins that then inhibit the phosphatase calcneurin calcneurin promotes secretion of TNF, IFN-gamma, IL-2, and IL-4

Question 36

mycophenolate nofetil

Answer 36

inhibits IMP dehydorgenase in guanine synthesis | inhibits lymphocyte proliferation

Question 37

azathioprine

Answer 37

purine analogue that inhibits DNA replication

Question 38

hydroxychloroquine

Answer 38

anti-inflammatory

Question 39

TNF-alpha inhibitors

Answer 39

1. infliximab 2. etanercept 3. adalimumab

Question 40

Belimumab

Answer 40

Ab to B cell activating factor

Question 41

rituximab

Answer 41

Ab inhibits CD20 on B cell

Question 42

tocilizumab

Answer 42

Ab inhibits IL-6

Question 43

alemtuzumab

Answer 43

Ab to CD52

Question 44

C4d

Answer 44

complement C4 degradation | deposited in peri-tubular capillaries in some cases of kidney transplant rejection

Question 45

BK virus

Answer 45

polyomavirus | in kidney transplant: intranuclear inclusion bodies and epithelial cell injury and lysis

Question 46

PTLD

Answer 46

post-transplant lymphoproliferative disorder can become a lymphoma associated with EBV