Basic Pathology > Autoimmunity > Flashcards

Autoimmunity Flashcards

(41 cards)

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1
Q

autoimmunity:

-immune reactions directed at ____

A

self-antigens

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2
Q

autoimmunity:

-acute and/or chronic _____ and _____

A

inflammation;

cell injury

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3
Q

autoimmunity:

severity ranges from _____ to _____

A

minor;

lethal

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4
Q

autoimmunity:

cures

A

no cure for most

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5
Q

allergy: _____ antigen and _____ duration

A

environmental;

limited

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6
Q

allergies ____ with removal of environmental antigen

A

resolve

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7
Q

autoimmunity: _____ antigen and _____ duration

A

environmental or endogenous;

chronic

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8
Q

autoimmunity ____ with removal of environmental antigen

A

does not resolve

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9
Q

autoimmunity is largely limited to type ____ hypersenstivities

A

II - IV

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10
Q

most affected organs and tissues

A
  • bone marrow
  • lining of the joints
  • blood vessels
  • connective tissues
  • endocrine glands
  • kidneys
  • muscles
  • skin
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11
Q

steps to autoimmunity

A
  • “normal” autoimmunity
  • multigenic
  • hormonal
  • environmental triggers (infections, drug-induced, toxins)
  • breakdown of tolerance
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12
Q

there are some ____ that predispose people to autoimmune diseases

A

alleles

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13
Q

uveitis is associated with ____

A

HLA B27

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14
Q

uveitis:

  • inflammation of ____
  • etiology:
A

uvea;

idiopathic, infection, injury, or autoimmune disorders

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15
Q

breakdown of central and peripheral tolerance:

-faulty ____

A

clonal deletion (auto-reactive lymphocytes allowed to mature and enter circulation)

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16
Q

breakdown of central and peripheral tolerance:

-loss of ____

A

Treg-cells (hyper-responsive T and B-lymphocytes; prolonged immune reactions)

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17
Q

breakdown of central and peripheral tolerance:

abnormal expression of _____

Study These Flashcards
A

HLA class II molecules

18
Q

antigens in autoimmunity:

sequestered antigens

Study These Flashcards
A

immunoprivileged organs

19
Q

antigens in autoimmunity:

infectious disease

Study These Flashcards
A
  • molecular mimicry

- original insult

20
Q

tissue-specific, antibody-mediated, autoimmune diseases (Type II)

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A
  • auto-antibodies direct at auto-antigens
  • affect normal function of the target organ
  • induce tissue damage
  • auto-Ab levels increase with age in healthy adults
21
Q

rheumatic fever

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A
  • Type II
  • strep infection induces cross-reactive auto-Abs
  • molecular mimicry
  • protein in wall of strep bacteria looks similar to antigens of tissues in our heart and myocardium - auto-Abs attack our heart
22
Q

pernicious anemia

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A
  • Type II

- auto-Abs block transport molecule in GI tract

23
Q

myasthenia gravis

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A
  • Type II
  • auto-Abs block muscle function
  • prevent ACh from binding, no muscle contraction, paralysis
24
Q

graves disease

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A
  • Type II
  • auto-Abs stimulate thyroid gland to produce more thyroid hormone
  • have low levels of TSH and high levels of thyroid hormone
25
ocular manifestations of myasthenia gravis
- diplopia - ptosis - blurred vision
26
ocular manifestations of graves disease
- proptosis - periorbital edema - abnormal EOMs - exposure keratopathy - optic nerve compression
27
autoimmune complex-mediated diseases (Type III)
- auto-Ab:Ag immune complexes deposit throughout body - infectious initiation (reactive arthritis, poststreptococcal glomerulonephritis) - undetermined initiation (lupus, rheumatoid arthritis (also type IV))
28
cell-mediated autoimmunity (Type IV)
- does not involve antibodies - APC activates Th cell, which activates Tc cell - Tc cells use perforin and granzymes to attack cells - Th cell will increase amount of cytokines it produces, including interferon gamma, which increases macrophage activity
29
cell-mediated autoimmune diseases (type IV)
- rheumatoid arthritis (targets multiple cell types) - Crohn's disease (targets epithelial cells of GI tract) - multiple sclerosis (targets oligodendrocytes in CNS) - type I diabetes (targets beta cells in pancreas)
30
organ-specific autoimmune diseases
- directed against a unique antigen in a given organ - type II hypersensitivity (myasthenia gravis, Hashimoto's thyroiditis, pernicious anemia) - type IV hypersensitivity (Crohn's disease, type I diabetes)
31
systemic autoimmune diseases
- wide range of antigens - widespread damage - general defect in immune regulation - examples: lupus, MS, scleroderma - may be types II, II, or IV, or combination
32
systemic lupus erythematosus epidemiology
- chronic, multisystem inflammatory disease - type III hypersensitivity - 90% of cases in women between 20-40 - female:male 10:1 - black:white 8:1
33
pathogenesis of SLE
- DNA and histones released from cells - phagocytized by APCs - activate T-cells - activate B-cells - produce antibodies against nuclear antigens
34
SLE target organs
- joints - blood vessels - kidneys - heart - skin - lungs - brain
35
SLE auto-antibodies against:
- nucleic acids - erythrocytes - lymphocytes - platelets - coagulation proteins - phospholipids
36
11 common symptoms of SLE
- facial (malar) rash - discoid rash - photosensitivity - oral or nasopharyngeal ulcers - non-erosive arthritis - serositis - renal disorders - neurologic disorders - hematologic disorders - immunologic disorders - presence of anti-nuclear antibodies (ANA)
37
ocular manifestations of SLE (present in ____ of patients)
50%; - secondary Sjogren syndrome - uveitis (rare) - episcleritis/scleritis - neuro-ophthalmic lesions - retinal vasculopathy (cotton wool spots, most common) - bulls-eye maculopathy
38
Sjogren's syndrome epidemiology
- targets salivary and lacrimal glands - ~4 million affected in US - 40-60 years of age - female:male 9:1 - primary and secondary forms
39
primary Sjogren's syndrome
lymphocyte infiltration of salivary and lacrimal glands (cause damage and reduce function)
40
secondary Sjogren's syndrome
immune-complex accumulation in salivary and lacrimal glands (causes inflammation and reduced function)
41
Sjogren's syndrome pathogenesis
- systemic autoimmune disease: RA and SLE - lymphocytic infiltrations - auto-antibodies play a role
Basic Pathology
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