Pathology: Hypersensitivity and Autoimmune Flashcards
What are two major things that happen during acute inflammation?
- Vasodilation and increased permeability - edema
2. Migration of leukocytes to injured tissue - mostly PMNs
T/F: Exudate occurs during injury and is cell/protein rich.
True
What are the three main cell types for chronic inflammation?
Macrophages, lymphocytes, plasma cells
What are the three stages of chronic inflammation?
- Cell migration
- Granulation (fibroblasts, new capillaries)
- Tissue destruction (cytokines of leukocytes)
T/F: Steroids can cause a decrease in wound healing.
True
T/F: Reversible cell injury results from extensive plasma membrane damage.
False
Lack of O2 (hypoxia/ischemia) -> decrease in ATP, decrease in pH
What is ischemia?
Lack of blood flow to tissue
Can lead to hypoxia (lack of O2)
What is karyorrhexis?
Fragmentation of DNA during necrosis
What are three drugs that can cause gingival enlargement?
- Phenytoin
- Ca2+ channel blockers
- Cydosporin
Which type of necrosis occurs from ischemic injury, often from a heart attack?
Coagulative (MI, gangrene)
Which type of necrosis leaves a fatty substance and suppuration behind?
Liquefactive necrosis (brain abscess, acute pancreatitis)
Which necrosis is common in tuberculosis?
Caseous necrosis: cheesy, granulomatous material
T/F: Apoptosis leads to cell swelling and rupture of the membrane.
False
Apoptosis is cell shrinking
What are the four types of sensitivity reactions?
ACID
- Anaphylactic (IgE)
- Cytotoxic (IgG, IgM)
- Immune-mediated (antigen-antibody)
- Delayed (T cells)
In type 1 sensitivity, IgE causes mast cells and ________ to release ________.
basophils; histamine
MAC-mediated cell destruction is activated in which hypersensitivity reaction?
Type II - IgG, IgM mediated
Erythroblastosis fatalis (attacking wrong blood type) is an example of which hypersensitivity rxn?
Type II
Lupus is an example of which hypersensitivity rxn?
Type III - antigen-antibody complexes produce destruction
Tb test and skin dermatitis are examples of which reaction?
Type IV - delayed
Describe the mechanism of a type IV hypersensitivity rxn?
Macrophage presents antigen on MHC II protein (also releases IL-1, IL-12) -> Th1 helper cell recognizes antigen and activates macrophage with gamma-interferon release
What types of patients will present with necrotizing perio disease?
HIV, immunocompromised, malnourished
What is the most common location of supragingival calculus?
Lingual of man incisors and buccal of mand molars (salivary gland proximity)
Which bacteria is involved with hormone induced gingivitis?
P. intermedia
What is the predominant bacteria in aggressive periodontitis?
A.a. and P.g.
T/F: Women are more susceptible to autoimmune disease.
True
Malar rash is a symptom of which disease?
Lupus
T/F: Lupus will result in a positive ANA antibody test.
True
A woman in her 40s complains of chronic bilateral small joint pain. Diagnosis?
Rheumatoid arthritis
T/F: RA pain will be the worst at the end of the day.
False
RA - morning pain
Osteoarthritis - evening pain
T/F: Osteophytes (bone spurs) occur in patients with RA.
False
Osteoarthritis
T/F: RA and SLE (lupus) are both collagen vascular diseases.
True
T/F: RA patients will be positive for rheumatoid factor.
True
What is the second most common rheumatic autoimmune disorder?
Sjorgren’s syndrome (90% women)
What are the three hallmarks of Sjorgren’s syndrome?
- Dry mouth
- Dry eyes
- Arthritis
What disease is characterized by noncaseating granulomas, including Schumann and asteroid bodies?
Sarcoidosis
Most often in black females
What condition will mimic sarcoidosis?
Beryliosis
Inhalation of berylium
Which two disease often come together and may result in patients complaining of scalp and jaw tenderness?
Polymyalgia rheumatica and temporal arteritis (giant cell arteritis)
What is the clinical triad in Reiter’s syndrome (reactive arthritis)?
“Can’t pee, can’t see, can’t climb a tree.”
- Urethritis
- Conjunctivitis
- Joint arthritis
What is the ideal treatment for temporal arteritis?
Steroids
Erythema multiforme is an acute immune-mediated condition often caused by which virus?
Herpes Simplex Virus
T/F: Erythema multiforme will cuase a type III hypersensitivity reaction.
True
Which medication can lead to erythema multiforme?
- Sulfa drugs
- Penecillins
- Barbiturates
A bulls eye lesion is a key indicator for which disease?
Erythema multiforme
What is often the first sign of pemphigus vulgaris?
Oral mucosal lesions
What causes the blistering in Pemphigus Vulgaris?
IgG antibody against desmosome
What is the difference between pemphigus vulgaris and bullous pemphigoid?
PV: intraepidermal bulla (desmosomes)
BP: subepidermal bulla (hemidesmosomes)
_______ is a chronic, T cell mediated inflammatory disease that has an unknown etiology.
Lichen planus
Whickham’s striae are seen in which disease?
Lichen planus
Excess uric acid levels will cause uric acid crystals to get stuck in joints causing ______.
gaut
Deficiency in IgA will lead to higher incidence of disease in which areas?
Tears, saliva, mucous membranes, breast milk
T/F: HIV can be transferred via saliva.
False
HIV will produce similar symptoms to which other disease initially?
Mono
HIV will affect which cells?
CD4 T cells
What is the CD4 count where a patient is considered to have AIDS?
< 200
What tests are done to diagnose HIV?
- ELISA
2. Western blot
What are some opportunistic infections common in HIV patients?
- Pneumocystic pneumonia
- Candidiasis
- Histo infections
- Tb
- Tiposi sarcoma
