Ip Lab - Immuno

Front 1

How common are rheumatoid nodules and what are they?

Back 1

They occur 25% of the time. Rheumatoid nodules occur on pressure points (elbows, occiput, lumbosacral area, foot) and are composed of a central area of fibrinoid necrosis surrounded by a rim of epithelioid macrophages, lymphocytes, and plasma cells. The morphology of the rheumatoid nodule is similar to the tissue reaction seen in the joints.

Front 2

What is rheumatoid factor?

Back 2

IgM antibodies (perhaps originating from the joints) that are directed against the Fc portion of autologous IgG.

Front 3

What does the thyroid look like histologically in Graves disease?

Back 3

The tissue is very cellular and there is little colloid.

Front 4

What is the immunologic mechanism responsible for Graves' disease?

Back 4

Autoantibodies directed towards the TSH receptor of the thyroid cause stimulation of the thyroid leading to increased secretion of thyroid hormones and growth of the thyroid gland.

Front 5

What role does genetics play in the predisposition to Graves' disease?

Back 5

1. Graves' disease is more common in females than males
2. It has been linked to HLA-B8 and DR3 in whites but different haplotypes in Asians
3. It has a familial predisposition
4. It is more common in patients with other forms of autoimmune thyroid problems (e.g., Hashimoto's thyroiditis)

Front 6

Does Graves' disease predispose to thyroid cancer?

Back 6

No

Front 7

What are antithyroglobulin antibodies?

Back 7

Antithyroglobulin antibodies are autoimmune antibodies directed against thyroglobulin. Over half of all patients with Hashimoto's thyroiditis have positive titers, although they are also found in other types of thyroiditis.

Front 8

What are antimicrosomal antibodies?

Back 8

Antimicrosomal antibodies are autoimmune antibodies directed at the thyroid gland. They are seen in almost all patients with Hashimoto's thyroiditis.

Front 9

What can be found in the thyroids of patients with Hashimoto's thyroiditis?

Back 9

Germinal centers

Front 10

What is immunopathogenic explanation for Hashimoto's thyroiditis?

Back 10

It is currently thought that the disease is caused by abnormal suppressor T-lymphocyte function which results in a localized cell-mediated immune response directed toward the thyroid parenchymal cells.

Front 11

What is polyarteritis nodosa?

Back 11

Polyarteritis nodosa (or periarteritis nodosa) is a serious blood vessel disease. Small and medium-sized arteries become swollen and damaged when they are attacked by rogue immune cells.

Front 12

What vessels are typically affected in polyateritis nodosa?

Back 12

PAN affects small and medium-sized muscular arteries. The renal and visceral arteries are typically affected while the pulmonary arteries are often spared.

Front 13

What antibodies are sometimes seen in polyateritis nodosa?

Back 13

Circulating antineutrophil cytoplasmic antibodies

Front 14

What is the Ghon complex?

Back 14

In primary pulmonary TB you get (1) parenchymal subpleural lesions, often just above or just below the interlobar fissure, and (2) enlarged caseous lymph nodes draining the parenchymal focus (usually the hilar lymph nodes).

Front 15

What cells make up the interstitial infiltrate seen in this case of acute transplant rejection?

Back 15

Mononuclear cells - primarily CD4+ and CD8+ lymphocytes.

Front 16

What is the cellular response seen in the acute rejection vasculitis in this case of acute transplant rejection?

Back 16

Neutrophils are recruited to the lesions due to immunoglobulin deposition and complement fixation. There is also deposition of fibrin and thrombosis.

Front 17

What is the usual organ distribution of amyloid in AL amyloidosis?

Back 17

Heart, gastrointestinal tract, peripheral nerves, skin, and tongue.

Front 18

What is SAA protein, where is it produced, and what stimulates its production?

Back 18

"Serum amyloid-associated" protein is a protein produced by the liver when stimulated by interleukins 1 and 6.

Front 19

What protein makes-up senile amyloid in the atrium of the heart?

Back 19

Atrial natriuretic peptide.

Front 20

At what age does senile amyloidosis usually develop?

Back 20

Eighth and ninth decades.

Front 21

Where does senile amyloid deposit?

Back 21

Senile amyloid deposits also occur in the lungs, pancreas, and spleen. Senile cerebral amyloidosis occurs due to deposition of A beta 2 protein in cerebral blood vessels and in senile plaques of Alzheimer's disease patients.