Sjogren’s syndrome Flashcards
Sjogren’s syndrome is an autoimmune disease where the host immune cells begin attacking which aspect of the body?
1 - exocrine glands
2 - endocrine glands
3 - squamous epithelial cells
4 - respiratory epithelial cells
1 - exocrine glands
- secretions are made using ducts
What is the prevalence of Sjogren’s syndrome?
1 - 0.61 : 100,000
2 - 61 : 100,000
3 - 610 : 100,000
4 - 6100 : 100,000
2 - 61 : 100,000
- highest is in Europe
Does Sjogren’s syndrome affect men or women more?
- women
What is the mean age that Sjogren’s syndrome typically presents?
1 - 20
2 - 40
3 - 56
4 - 76
3 - 56
- has other peaks at 20 and 40 as well, but mean is 56
In Sjogren’s syndrome which 2 of the following groups of glands are most affected?
1 - lacrimal glands
2 - breast glands
3 - salivary glands
4 - skin glands
1 - lacrimal glands
3 - salivary glands
Although the aetiology of Sjogren’s syndrome is not known, it is suspected that immune cells respond incorrectly to antigens. Antigen presenting cells typically engulf foreign pathogens and phagocytose them. Do they then present an antigen using class I or II MHC?
- MHC-II
MHC-I is self cell antigens
Once an antigen presenting cell (APC) has engulfed and presented the antigen on its MHC-II, which cell binds with this?
1 - T helper cells
2 - B cells
3 - cytotoxic T cells
4 - other APCs
1 - T helper cells
- T cell becomes active and releases cytokines
- cytokine attract immune cells to area and inflammation follows
Which of the following has been linked to causing Sjogren’s syndrome?
1 - infection of GIT
2 - infection of the skin
3 - infection of exocrine glands
4 - infection of sinuses
3 - infection of exocrine glands
- all may be linked, but this is most common
Infection of exocrine glands has been linked as a cause of Sjogren’s syndrome. Infection can damage exocrine cells and contents of the cells can be released. Which aspects of the cell being released have been linked with Sjogren’s syndrome?
1 - DNA
2 - histones
3 - RNA
4 - all of the above
4 - all of the above
- these nuclear components are removed by immune cells
Typically, when cells die their contents, including nuclear contents are remove by host immune cells. However, in Sjogren’s syndrome, APCs present the nuclear components to T helper cells that active B cells. B cells then begin secrete what antibodies against these nuclear components?
1 - anti-nuclear antibodies
2 - rheumatoid factor antibodies
3 - anti-cytoplasm antibodies
4 - anti-CCP antibodies
1 - anti-nuclear antibodies
- ANA as the components they bind are nuclear
Once exocrine glands have been damaged and they release their nuclear components. The immune system incorrectly produces anti-nuclear antibodies (ANA). Which 2 of the ANA do they secrete?
1 - anti-Ro
2 - anti-La
3 - anti-SS-DNA
4 - anti-SS-RNA
1 - anti-Ro
2 - anti-La
- these antibodies then travel in the blood to the exocrine glands
Which 2 of the following human leukocyte antigens (HLA) are associated with Sjogren’s syndrome?
1 - HLA-B8
2 - HLA-B27
3 - HLA-DR 3
4 - HLA-A
1 - HLA-B8
3 - HLA-DR 3
In Sjogren’s syndrome ANAs, specifically anti-Ro and La are produced. These increase inflammation and damage in exocrine glands. What cell then replaces the exocrine gland cells in the healing process?
1 - fibroblasts
2 - myofibroblasts
3 - type III cartilage
4 - keratinocytes
1 - fibroblasts
- causes scarring and reduces the number of secreting exocrine cells
Sjogren’s syndrome can be primary, when it happens alone, or secondary when it occurs alongside other autoimmune conditions, such as RA. What is primary Sjogren’s syndrome called?
1 - sickle cell disease
2 - sicca syndrome
3 - fibroblastitis
4 - scleroderma
2 - sicca syndrome
In Sjogren’s syndrome the lacrimal glands of the eyes can be affected which can lead to keratoconjunctivitis, inflammation of both the cornea and conjunctiva. This can lead to all of the following EXCEPT which one?
1 - blurring of vision
2 - itching
3 - bleeding
4 - burning and redness
3 - bleeding
In Sjogren’s syndrome the salivary glands can be affected which can lead to xerostomia, dryness of the mouth. This can lead to all of the following EXCEPT which one?
1 - dry mouth
2 - ulcers
3 - cracks and fissures in the mouth
4 - changes in taste
5 - difficulty swallowing
2 - ulcers
In Sjogren’s syndrome the nose, respiratory passages and larynx can be affected. This can lead to all of the following EXCEPT which one?
1 - erythema nodosum
2 - crusting
3 - bleeding
4 - ulceration/perforation
5 - difficulty speaking
1 - erythema nodosum
In Sjogren’s syndrome the eyes, mouth, nose and respiratory tract are most commonly affected. Which of the following can also occur?
1 - vaginal dryness
2 - skin dryness
3 - swelling of glands and pain
4 - increased risk of infection due to dryness
5 - raynauds phenomena
6 - all of the above
5 - all of the above
A biopsy from where can show lymphocytic infiltration and be used to diagnose Sjogren’s syndrome?
1 - skin biopsy
2 - lacrimal biopsy
3 - buccal biopsy
4 - nail clipping
3 - buccal biopsy
Schirmer’s test can also be used to determine whether the eye produces enough tears to keep it moist. Not common practice anymore though
