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NBDE Part 1 > Pathology: Hypersensitivity and Autoimmune > Flashcards

Pathology: Hypersensitivity and Autoimmune Flashcards

1
Q

What are two major things that happen during acute inflammation?

A
  1. Vasodilation and increased permeability - edema

2. Migration of leukocytes to injured tissue - mostly PMNs

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2
Q

T/F: Exudate occurs during injury and is cell/protein rich.

A

True

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3
Q

What are the three main cell types for chronic inflammation?

A

Macrophages, lymphocytes, plasma cells

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4
Q

What are the three stages of chronic inflammation?

A
  1. Cell migration
  2. Granulation (fibroblasts, new capillaries)
  3. Tissue destruction (cytokines of leukocytes)
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5
Q

T/F: Steroids can cause a decrease in wound healing.

A

True

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6
Q

T/F: Reversible cell injury results from extensive plasma membrane damage.

A

False

Lack of O2 (hypoxia/ischemia) -> decrease in ATP, decrease in pH

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7
Q

What is ischemia?

A

Lack of blood flow to tissue

Can lead to hypoxia (lack of O2)

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8
Q

What is karyorrhexis?

A

Fragmentation of DNA during necrosis

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9
Q

What are three drugs that can cause gingival enlargement?

A
  1. Phenytoin
  2. Ca2+ channel blockers
  3. Cydosporin
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10
Q

Which type of necrosis occurs from ischemic injury, often from a heart attack?

A

Coagulative (MI, gangrene)

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11
Q

Which type of necrosis leaves a fatty substance and suppuration behind?

A

Liquefactive necrosis (brain abscess, acute pancreatitis)

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12
Q

Which necrosis is common in tuberculosis?

A

Caseous necrosis: cheesy, granulomatous material

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13
Q

T/F: Apoptosis leads to cell swelling and rupture of the membrane.

A

False

Apoptosis is cell shrinking

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14
Q

What are the four types of sensitivity reactions?

A

ACID

  1. Anaphylactic (IgE)
  2. Cytotoxic (IgG, IgM)
  3. Immune-mediated (antigen-antibody)
  4. Delayed (T cells)
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15
Q

In type 1 sensitivity, IgE causes mast cells and ________ to release ________.

A

basophils; histamine

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16
Q

MAC-mediated cell destruction is activated in which hypersensitivity reaction?

A

Type II - IgG, IgM mediated

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17
Q

Erythroblastosis fatalis (attacking wrong blood type) is an example of which hypersensitivity rxn?

A

Type II

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18
Q

Lupus is an example of which hypersensitivity rxn?

A

Type III - antigen-antibody complexes produce destruction

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19
Q

Tb test and skin dermatitis are examples of which reaction?

A

Type IV - delayed

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20
Q

Describe the mechanism of a type IV hypersensitivity rxn?

A

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

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21
Q

What types of patients will present with necrotizing perio disease?

A

HIV, immunocompromised, malnourished

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22
Q

What is the most common location of supragingival calculus?

A

Lingual of man incisors and buccal of mand molars (salivary gland proximity)

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23
Q

Which bacteria is involved with hormone induced gingivitis?

A

P. intermedia

24
Q

What is the predominant bacteria in aggressive periodontitis?

A

A.a. and P.g.

25
Q

T/F: Women are more susceptible to autoimmune disease.

A

True

26
Q

Malar rash is a symptom of which disease?

A

Lupus

27
Q

T/F: Lupus will result in a positive ANA antibody test.

A

True

28
Q

A woman in her 40s complains of chronic bilateral small joint pain. Diagnosis?

A

Rheumatoid arthritis

29
Q

T/F: RA pain will be the worst at the end of the day.

A

False

RA - morning pain

Osteoarthritis - evening pain

30
Q

T/F: Osteophytes (bone spurs) occur in patients with RA.

A

False

Osteoarthritis

31
Q

T/F: RA and SLE (lupus) are both collagen vascular diseases.

A

True

32
Q

T/F: RA patients will be positive for rheumatoid factor.

A

True

33
Q

What is the second most common rheumatic autoimmune disorder?

A

Sjorgren’s syndrome (90% women)

34
Q

What are the three hallmarks of Sjorgren’s syndrome?

A
  1. Dry mouth
  2. Dry eyes
  3. Arthritis
35
Q

What disease is characterized by noncaseating granulomas, including Schumann and asteroid bodies?

A

Sarcoidosis

Most often in black females

36
Q

What condition will mimic sarcoidosis?

A

Beryliosis

Inhalation of berylium

37
Q

Which two disease often come together and may result in patients complaining of scalp and jaw tenderness?

A

Polymyalgia rheumatica and temporal arteritis (giant cell arteritis)

38
Q

What is the clinical triad in Reiter’s syndrome (reactive arthritis)?

A

“Can’t pee, can’t see, can’t climb a tree.”

  1. Urethritis
  2. Conjunctivitis
  3. Joint arthritis
39
Q

What is the ideal treatment for temporal arteritis?

A

Steroids

40
Q

Erythema multiforme is an acute immune-mediated condition often caused by which virus?

A

Herpes Simplex Virus

41
Q

T/F: Erythema multiforme will cuase a type III hypersensitivity reaction.

A

True

42
Q

Which medication can lead to erythema multiforme?

A
  1. Sulfa drugs
  2. Penecillins
  3. Barbiturates
43
Q

A bulls eye lesion is a key indicator for which disease?

A

Erythema multiforme

44
Q

What is often the first sign of pemphigus vulgaris?

A

Oral mucosal lesions

45
Q

What causes the blistering in Pemphigus Vulgaris?

A

IgG antibody against desmosome

46
Q

What is the difference between pemphigus vulgaris and bullous pemphigoid?

A

PV: intraepidermal bulla (desmosomes)

BP: subepidermal bulla (hemidesmosomes)

47
Q

_______ is a chronic, T cell mediated inflammatory disease that has an unknown etiology.

A

Lichen planus

48
Q

Whickham’s striae are seen in which disease?

A

Lichen planus

49
Q

Excess uric acid levels will cause uric acid crystals to get stuck in joints causing ______.

A

gaut

50
Q

Deficiency in IgA will lead to higher incidence of disease in which areas?

A

Tears, saliva, mucous membranes, breast milk

51
Q

T/F: HIV can be transferred via saliva.

A

False

52
Q

HIV will produce similar symptoms to which other disease initially?

A

Mono

53
Q

HIV will affect which cells?

A

CD4 T cells

54
Q

What is the CD4 count where a patient is considered to have AIDS?

A

< 200

55
Q

What tests are done to diagnose HIV?

A
  1. ELISA

2. Western blot

56
Q

What are some opportunistic infections common in HIV patients?

A
  1. Pneumocystic pneumonia
  2. Candidiasis
  3. Histo infections
  4. Tb
  5. Tiposi sarcoma

NBDE Part 1 (31 decks)

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