Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
41 Cards in this Set
- Front
- Back
|
What are the major factors in autoimmunity?
|
Age (more common during puberty and middle age), sex (more common in females) and environmental factors (infections)
|
|
|
What is the underlying cause of SLE?
|
Presence of anti-nuclear antibodies, specifically anti-dsDNA or Sm antigen. This is diagnostic of SLE
|
|
|
How can someone get a false positive on a VDRL test if they have SLE?
|
Antiphospholipid antibodies present in 50% of SLE pts bind to cardiolipin antigen
|
|
|
What does homogenous nuclear staining indicate?
|
Antibodies to chromatin, hostones, and dsDNA
|
|
|
What does nuclear rim or periphery staining indicate?
|
Antibodies to dsDNA
|
|
|
What does speckled nuclear staining indicate?
|
Antibodies to histones and ribonucleoproteins (Sm antigen and RNP)
|
|
|
What does nucleolar staining indicate?
|
Antibodies to nucleolar RNA (most often seen in systemic sclerosis)
|
|
|
What is the mechanism of tissue injury in SLE?
|
Mostly mediated via type 3 hypersensitivity (antigen/antibody complexes)
|
|
|
What is an LE body?
|
It is when a neutrophil or macrophage engulfs the denatured nucleus of an injured cell. Found in about 70% of SLE
|
|
|
What is the most clinically evident sign of SLE?
|
Maculopapular rash due to deposition of Ig at the dermo-epidermal junction
|
|
|
What are the cardiac effects of SLE?
|
Pericarditis, myocarditis, or Libman-Sacks endocarditis (valvular lesions)
|
|
|
What is the most common cause of death in SLE?
|
Class IV-diffuse proliferative glomerulonephritis (kidney failure).
|
|
|
How do you treat SLE?
|
There isn't much you can do besides immune suppresion with steroids
|
|
|
What genes are associated with RA?
|
HLA-DR4 or HLA/DR1
|
|
|
What is the clinical presentation most common in RA?
|
Symmetric polyarticular arthritis. Sometimes they have vasculitis of the extremities with Raynaud phenomenon
|
|
|
What is the mechanism of tissue damage in RA?
|
Rheumatoid factors composed of anti-IgG Fc IgM causes injury by type 3 hypersensitivity
|
|
|
What are some suspected environmental triggers for RA?
|
EBV, Mycoplasma species, and mycobacteria
|
|
|
What is the most diagnostic feature of RA?
|
Anti-citrulline antibodies present in about 96% of RA patients
|
|
|
What is the common pattern of hand deformity in RA?
|
Radial deviation of the wrist and ulnar deviation of the fingers (swan-neck deformity). Distal IP joints spared.
|
|
|
What is formed in the synovial joint spaces in RA?
|
A pannus, which is a proliferation of synovial cells and inflammatory infiltrate. It eventually fills the joint space.
|
|
|
What is the difference between primary and secondary Renaud's disease/phenomenon?
|
Primary Renaud's is a hereditary disease on its own, secondary is an effect of all the autoimmune disorders.
|
|
|
What is Renaud's phenomenon?
|
It is a vascular disorder affecting blood supply to the extremities.
|
|
|
What are the other spondyloarthropathies associated with RA?
|
Ankylosing spondylitis, Reiter syndrome, and Psoriatic arthritis. All associated with presence of HLA B27
|
|
|
What is Sjogren syndrome
|
Autoantibodies to SS-A and SS-B (RNP's) that affect the exocrine glands and cause dry eyes and dry mouth.
|
|
|
What is the relative risk of non-Hodgkin b-cell lymphoma for Sjogrens pts?
|
About 40x higher risk
|
|
|
What are the 2 types of systemic sclerosis?
|
Diffuse and limited (CREST syndrome)
|
|
|
What are the characteristics of diffuse systemic sclerosis?
|
Widespread skin involvement, early visceral involvement, and rapid progression. Death within 1-2 years
|
|
|
What does CREST stand for?
|
Calcinosis, Raynauds, esophageal dysmotility, sclerodactyly, and telangiectasia. This is the limited form of systemic sclerosis that is much less serious
|
|
|
What autoantibodies are associated with systemic sclerosis?
|
Anti-DNA topoisomerase in those with diffuse, and anti-centromere in those with CREST.
|
|
|
What are the most common visceral lesions in systemic sclerosis?
|
Esophagus/GI tract, joints, and lungs
|
|
|
Epidemiology of multiple sclerosis
|
Affects caucasians twice as much, has a big genetic factor associated with HLA, more common in northern latitudes and in higher socioeconomic groups.
|
|
|
Which virus is sometimes associated with onset of multiple sclerosis?
|
EBV, varicella, and measles. EBV antigens resemble those of myelin basic protein
|
|
|
What is the mechanism of CNS tissue destruction in MS?
|
T and B lymphocytes become activated and can more easily cross blood-brain barrier where they then destroy myelin
|
|
|
What is the name for an area of demyleinization in the CNS of an MS patient?
|
Plaque. They are usually full of inflammatory cells and antibodies as well.
|
|
|
What is the most common initial symptom of MS?
|
Some degree of sensory loss, like a feeling of numbness. Motor defecits, visual loss or diplopia, and cognitive changes are also common.
|
|
|
What is the most common form of MS initially?
|
Relapsing remitting disease, which will progress to secondary progressive disease eventually.
|
|
|
What paercentage of MS pts present with benign and primary progressive disease?
|
About 20% present with benign and 15% with primary progressive that leads to rapid decline
|
|
|
What are the most common conditions that exacerbate MS?
|
Fever (most common), infections, and emotional or physical stress
|
|
|
What effect does pregnancy have on MS symptoms?
|
Disease activity and frequency of attacks tend to decrease
|
|
|
What is the most accurate diagnostic technique for MS?
|
Electrophoresis of CSF will reveal banding pattern of Ig's called oligoclonal bands. Present in up to 90% of MS pts. They would also look for presence of myelin basic protein
|
|
|
What is the preferred treatment for MS?
|
High dose steroids for the acute attack and Interferon B for prevention of relapses.
|
