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21 Cards in this Set

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How common are rheumatoid nodules and what are they?
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.
What is rheumatoid factor?
IgM antibodies (perhaps originating from the joints) that are directed against the Fc portion of autologous IgG.
What does the thyroid look like histologically in Graves disease?
The tissue is very cellular and there is little colloid.
What is the immunologic mechanism responsible for Graves' disease?
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.
What role does genetics play in the predisposition to Graves' disease?
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)
Does Graves' disease predispose to thyroid cancer?
No
What are antithyroglobulin antibodies?
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.
What are antimicrosomal antibodies?
Antimicrosomal antibodies are autoimmune antibodies directed at the thyroid gland. They are seen in almost all patients with Hashimoto's thyroiditis.
What can be found in the thyroids of patients with Hashimoto's thyroiditis?
Germinal centers
What is immunopathogenic explanation for Hashimoto's thyroiditis?
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.
What is polyarteritis nodosa?
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.
What vessels are typically affected in polyateritis nodosa?
PAN affects small and medium-sized muscular arteries. The renal and visceral arteries are typically affected while the pulmonary arteries are often spared.
What antibodies are sometimes seen in polyateritis nodosa?
Circulating antineutrophil cytoplasmic antibodies
What is the Ghon complex?
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).
What cells make up the interstitial infiltrate seen in this case of acute transplant rejection?
Mononuclear cells - primarily CD4+ and CD8+ lymphocytes.
What is the cellular response seen in the acute rejection vasculitis in this case of acute transplant rejection?
Neutrophils are recruited to the lesions due to immunoglobulin deposition and complement fixation. There is also deposition of fibrin and thrombosis.
What is the usual organ distribution of amyloid in AL amyloidosis?
Heart, gastrointestinal tract, peripheral nerves, skin, and tongue.
What is SAA protein, where is it produced, and what stimulates its production?
"Serum amyloid-associated" protein is a protein produced by the liver when stimulated by interleukins 1 and 6.
What protein makes-up senile amyloid in the atrium of the heart?
Atrial natriuretic peptide.
At what age does senile amyloidosis usually develop?
Eighth and ninth decades.
Where does senile amyloid deposit?
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.