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Pathology > TB & Autoimmune Path > Flashcards

TB & Autoimmune Path Flashcards

1
Q

A potentially serious infectious bacterial disease that mainly affects the lungs. Chronic and granulomatous (masses of immune cells that form at sites of infection or inflammation)

A

Tuberculosis

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2
Q

What causes tuberculosis (TB)?

A

Mycobacterium tuberculosis

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3
Q

Tuberculosis causes a type __ hypersensitivity reaction

A

IV

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4
Q

The 2 unique cells in granulomas are ___ and ___, both derived from macrophages

A

Epithelioid cells

Langhans giant cells

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5
Q

When granulomas become necrotic they show ____ necrosis

A

Casseous (a crumbly, dull white appearance that resembles cheese)

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6
Q

____ is caused by inhalation of aerosolized tubercle bacilli and occurs in the lung with development of a granuloma (Ghon focus). Occurs in a previously uninfected person.

A

Primary tuberculosis

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7
Q

____ tuberculosis occurs in a previously infected person

A

Secondary (reactivation)

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8
Q

Secondary tuberculosis is localized to what part of the lung?

A

Apex

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9
Q

The initial testing for tuberculosis suspicion is ____

A

Chest X-Ray (CXR)

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10
Q

The screening test for high risk groups for tuberculosis is?

A

PPD test (Purified Protein Derivative)

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11
Q

High risk groups for tuberculosis are?

A
  • homeless
  • alcoholics
  • health care workers
  • recent immigrants
  • prisoners
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12
Q

In the PPD test, a person in category 1 (close contacts, steroid users, HIV+ patients) is positive if the skin ‘bleb’ is __ to __mm

A

5-9mm

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13
Q

In the PPD test, a person in category 2 is positive if the skin ‘bleb’ is 10-14mm. Who is in category 2?

A

High risk groups

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14
Q

In the PPD test, a person in category 3 (low risk groups) is positive if the skin ‘bleb’ is >__mm

A

15

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15
Q

The presence of many small granulomas in any organ

A

Miliary (if in lungs = miliary tuberculosis)

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16
Q

Refers to a lack of immune responsiveness to one’s own tissue antigens

A

Self tolerance

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17
Q

Refers to deletion of self-reactive T and B lymphocytes during their maturation in central lymphoid organs (thymus for T cells, bone marrow for B cells)

A

Central tolerance

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18
Q

Mature lymphocytes that recognize self-antigens in peripheral tissues become functionally inactive or are suppressed by regulatory T lymphocytes (or die by apoptosis)

A

Peripheral tolerance

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19
Q

___ autoimmune diseases are non-organ specific

A

Systemic

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20
Q

Relating to disease caused by antibodies or lymphocytes produced against substances naturally present in the body

A

Autoimmune

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21
Q

Addison’s disease affects the ____ gland

A

Adrenal

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22
Q

What test is an important screening test for systemic autoimmune diseases?

A

Antinuclear antibody test (ANA) - performed w/a fluorescence microscopy method

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23
Q

The immune complexes of this disease tend to deposit in kidney glomeruli and in small arteries and arterioles in different tissues resulting in necrotizing vasculitis

A

Systemic Lupus Erythematosus (SLE)

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24
Q

SLE (lupus) has a female to male ratio of ____

A

9:1

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25
Q

Major causes of death is SLE? (2)

A

Renal failure and CNS involvement

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26
Q

40-60% of SLE patients have this anti-nuclear antibody

A

Anti-dsDNA (ds=double stranded)

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27
Q

__ to __% of SLE patients have Anti-Smith antibodies

A

20-30%

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28
Q

> 95% of patients with drug-induced lupus have this anti-nuclear antibody

A

Anti-histone

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29
Q

What is a classic sign of SLE?

A

Butterfly rash on the face

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30
Q

Treatment for SLE?

A

Steroids and other immunosuppressive drugs

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31
Q

With treatment, __ to __% have 10yr and 5yr survival rates respectively

A

80-90%

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32
Q

An autoimmune lymphocytic inflammatory destruction of the lacrimal and salivary glands resulting in dry eyes and mouth

A

Sjogren syndrome (SS)

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33
Q

Between __ and __% of patients with sjogren syndrome show another autoimmune disease such as RA or SLE

A

25-60%

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34
Q

90% of cases of sjogren syndrome occur in females between __ and __ years of age

A

35-45yo

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35
Q

There is a 40-fold increased risk of developing non-Hodgkin B cell lymphoma w/this autoimmune disease

A

Sjogren syndrome (SS)

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36
Q

Diagnostic test for SS?

A

Schirmer test (Paper held to eye)

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37
Q

Treatment for SS?

A

Pilocarpine (^acetylcholine which ^ oral and ocular secretions)

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38
Q

This autoimmune disease causes excess deposition of collagen in multiple organs and tissues. The skin is most often affected

A

Systemic Sclerosis (Scleroderma)

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39
Q

The limited symptoms of scleroderma are referred to as ____ (acronym)

A

CREST

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40
Q

CREST stands for what?

A 
Calcinosis
Raynaud's phenomenon
Esophageal dysfunction
Sclerodactyly
Telangiectasias
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41
Q

Sclerodactyly

A

Thickening and tightening of the skin on the fingers and hands

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42
Q

Calcium deposits in the skin

A

Calcinosis

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43
Q

Dilation of capillaries causing red marks on surface of skin

A

Telangiectasias

44
Q

Spasm of blood vessels in response to cold or stress

A

Raynaud’s phenomenon

45
Q

Acid reflux and decrease in motility of esophagus

A

Esophageal dysfunction

46
Q

Anti-Scl 70 against DNA Topoisomerase 1 seen in 70% of patients with diffuse ____ who are likely to develop more aggressive disease

A

Scleroderma

47
Q

Anti-centromere antibody present in __% of patients with limited scleroderma (benign)

A

90%

48
Q

Pathogenesis of this disease is fibroblast activation w/excessive fibrosis

A

Scleroderma

49
Q

These two autoimmune diseases are an antibody-mediated tissue injury. Most patients have Jo-1 antibodies (against RNA Synthetase)

A

Dermatomyositis, polymyositis

50
Q

T/F: patients w/dermatomyositis or polymyositis would have difficulty getting up from a chair or climbing steps.

A

True

51
Q

____ shows an associated skin rash often affecting the upper eyelids and causing periorbital edema

A

Dermatomyositis

52
Q

Dermatomyositis might show ___ papules on knuckles

A

Gottron’s

53
Q

A systemic chronic inflammatory autoimmune disease that mainly involves joints, producing chronic synovitis

A

Rheumatoid Arthritis (RA)

54
Q

Rheumatoid factor is present in the blood in __% of RA patients

A

80%

55
Q

RA patients have an increased risk of cardiovascular disease including ________

A

Coronary artery atherosclerosis

56
Q

It is proposed that this disease is initiated by activation of CD4+ helper cells responding to arthritogenic agent or to a self-antigen

A

RA

57
Q

Abnormal stiffening and immobility of a joint due to fusion of the bones

A

Ankylosis

58
Q

Treatment for RA?

A

NSAIDS

Anti-rheumatic drugs

59
Q

The presence of clinical and pathologic features of systemic lupus Erythematosus (SLE), systemic sclerosis (scleroderma), and polymyositis in combination

A

Mixed Connective Tissue Disease (CTD)

60
Q

Pulmonary involvement occurs in up to __% of Mixed CTD patients

A

85%

61
Q

In Mixed CTD, there are ^ titers of antibodies to an antigen called ______

A

U1RNP

62
Q

Treatment for mixed CTD?

A

Steroids

63
Q

Causes of congenital disease? (4)

A
  • drugs and chemicals
  • ionizing radiation (x-ray)
  • maternal infections
  • genetic (chromosomal abnormalities)
64
Q

A congenital absence of proximal portion of a limb (due to Thalidomide)

A

Phocomelia

65
Q

Two or more digits fuse together

A

Syndactyly

66
Q

Spina bifida occulta occurs in about __% of people

A

20%

67
Q

Protrusion of the meninges

A

Meningocele

68
Q

Extension of the CNS tissue through a defect in the vertebral column. Most common in the lumbosacral region. Infection is a common complication

A

Myelomeningocele

69
Q

Absence of calvarium (upper skull portion containing the brain) and brain. As a group these are the most common CNS congenital defects and most common congenital defects overall

A

Anencephaly

70
Q

In anencephaly, the neural tube closes between __ and __ days gestation

A

22 and 28

71
Q

In maternal screening, ____ protein has increased, an early detection of neural tube defects

A

Alpha-feto

72
Q

The earliest stage of a developing organ?

A

Primordium

73
Q

Partial, but incomplete development of an organ. The organ is of small size

A

Aplasia

74
Q

An abnormally formed organ, may be of different sizes. This would be called _____

A

Dysplasia

75
Q

No sign of organ development

A

Agenesis

76
Q

Failure of the esophagus to develop continuously into the stomach

A

Esophageal atresia

77
Q

Clinical sign for esophageal atresia?

A

Infant w/excessive drooling. Swallows normally, but liquid regurgitates through nose and mouth

78
Q

A group of microorganisms that either infect the fetus in utero by crossing the placenta, or at the time of birth.

A

TORCH Syndrome

79
Q

What do the letters of TORCH stand for?

A 
Toxoplasmosis/toxoplasma gondii 
Other vertically transmitted infections
Rubella
Cytomegalovirus
Herpes Simplex Virus-2
80
Q

This congenital disease is due to an extra X chromosome. The person will be tall w/long arms and legs, small testis and penis, female pubic hair profile, gynecomastia (man boobs), high pitched voice, reduced facial and body hair

A

Klinefelter syndrome

81
Q

In Klinefelter syndrome, associated disorders such as breast cancer and Lupus (SLE) are __x more common as compared to unaffected males

A

20x

82
Q

This congenital disease results from absence (57%) or abnormality (43%) of the second X chromosome

A

Turner syndrome

83
Q

The females in Turner syndrome w/an ABSENT second X chromosome are most severely affected and are stillborn in an estimated __% of cases

A

99% !

84
Q

Name the congenital disease: short stature, infantile genitalia, widely spaced nipples, micrognathia and prominent ears, widened (web) neck, amenorrhea (no menstrual period), congenital renal and aortic abnormalities

A

Turner syndrome

85
Q

In this congenital disease, 3 copies of chromosome 21 are present

A

Down’s syndrome

86
Q

Down’s syndrome occurs 1 in __ births overall

A

700

87
Q

Features of this congenital disease: flat facial profile, horizontal Palmer crease on hands, intellectual retardation, tend to develop clinical Alzheimer’s after age 40, cardiac abnormalities, increased susceptibility to infections and childhood leukemia

A

Down’s syndrome

88
Q

This congenital disease is an autosomal dominant disorder of connective tissues. The basic defect affects Fibrillin 1, which is a scaffold for elastic fibers

A

Marfan’s syndrome

89
Q

In Marfan’s syndrome, __% of cases are familial

A

75%

90
Q

This congenital disease results in long extremities and fingers, depressed or protruding sternum and spinal deformities such as kyphosis and scoliosis. Affects the cardiovascular system and eyes as well

A

Marfan’s syndrome

91
Q

This congenital disease results from defects in type I and type III collagen. 10 clinical variants are known. Other features include hyperelastic skin and hypermobile joints

A

Ehlers Danlos Syndrome (EDS)

92
Q

EDS type __ is the most severe and may cause rupture of the colon or large arteries

A

IV

93
Q

This viral infection is a herpes virus. It causes infectious mononucleosis and infects two types of cells - Oropharyngeal epithelial cells & B lymphocytes.

A

Epstein Barr Virus (EBV)

94
Q

This viral infection causes extreme fatigue. Lymphocytes are increased in the peripheral blood and some of them show reactive changes

A

Infectious mononucleosis (Mono)

95
Q

A skin rash or eruption

A

Exanthem

96
Q

A mucosal rash or eruption on the oral mucosa

A

Enanthem

97
Q

Common name for the viral infection, Rubeola?

A

Measles

98
Q

This viral infection is caused by Morbillivirus-a single stranded RNA virus. It infects the respiratory tract before spreading via the blood and lymph. Results in Koplik’s spots followed by a rash behind the ear spreading to the body

A

Measles

99
Q

Measles symptoms are the 3 C’s:

A

Cough
Coryza (stuffy nose)
Conjunctivitis

100
Q

German measles are also called ____

A

Rubella

101
Q

This viral infection infects cells of upper respiratory tract and spreads via blood and lymph. Sx include fever, fine maculopapular rash and enlarged lymph nodes. In pregnancy causes severe congenital defects. Diagnosis confirmed by serological testing for IgM

A

Rubella (German measles)

102
Q

A small, unenveloped, single-stranded DNA virus. Also known as Erythema Infectiosum. Rash begins on cheeks and spreads to arms, thighs, trunk, buttocks. Sx: mild fever, slapped cheek appearance. Sunlight aggravates rash

A

Parvovirus B19

103
Q

At the time of infection this virus causes chickenpox, and later on can cause shingles

A

Varicella-Zoster Virus

104
Q

T/F: Give aspirin to a child with chickenpox to help w/the symptoms

A

False! DO NOT (liver and brain damage)

105
Q

Over 100 types of this viral infection are recognized based on DNA sequence differences. It is a non-enveloped DNA virus w/an affinity for epithelial cells of the skin and mucous membranes

A

Human Papilloma Virus (HPV)

106
Q

Common name for condyloma acuminatum

A

Genital warts

107
Q

The most common sexually transmitted disease in the US

A

HPV

Pathology (9 decks)

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