Autoimmunity

Question 1

[3] The autoimmune response may be influenced by:

Answer 1

1. Self tolerance
2. Genetics
3. Other endogenous and environmental factors

Question 2

[2] Self tolerance

Answer 2

1. Central
2. Peripheral

Question 3

This occurs in the thymus and bone marrow,
where T and B cells mature. Any CELLS that STRONGLY REACT to self antigens are ELIMINATED through a process called negative selection.

[self tolerance]

Answer 3

Central tolerance

Question 4

This is a BACKUP SYSTEM for any self-reactive
cells that ESCAPE CENTRAL TOLERANCE. In the lymph nodes and spleen, these cells are made inactive or deleted.

[self tolerance]

Answer 4

Peripheral tolerance

Question 5

[2] Genetics

Answer 5

1. Major Histocompatibility Complex (MHC) Genes
2. Non - MHC genes

Question 6

For example, the HLA-B27 allele dramatically increases the risk of developing ankylosing spondylitis.

[peripheral tolerance]

Answer 6

Major Histocompatibility Complex (MHC) Genes

Question 7

These genes often regulate critical immune functions, such as T-cell and B-cell signaling and activation, and the maintenance of T regulatory cells. Examples include genes like PTPN22, IL2RA, and CTLA4.

[peripheral tolerance]

Answer 7

Non - MHC Genes

Question 8

[3] Hormonal Influence

Answer 8

1. Estrogens
2. Androgens
3. Prolactin

Question 9

TEND TO PROMOTE Type 2 helper T-cell (Th2) response, which LEADS TO GREATER B-cell activation and antibody production.

[hormonal influence]

Answer 9

Estrogens

Question 10

This HEIGHTENED ANTIBODY activity is believed to increase the risk of autoimmune disease.

[hormonal influence]

Answer 10

Estrogens

Question 11

On the other hand, FAVOR A Type 1 helper T-cell (Th1) response, ACTIVATING cytotoxic T cells.

[hormonal influence]

Answer 11

Androgens

Question 12

A hormone associated with PREGNANCY and LACTATION, can stimulate both humoral and cell-mediated immune responses.

[hormonal influence]

Answer 12

Prolactin

Question 13

This is when a microbe’s antigens closely resemble self-antigens.

[microbial influence]

Answer 13

Molecular mimicry

Question 14

The immune response to the foreign microbe can MISTAKENLY CROSS-REACT with the similar self antigens, LEADING to an autoimmune attack.

[microbial infection]

Answer 14

Molecular mimicry

Question 15

This mechanism DOESN’T REQUIRE structural similarity between antigens.

[microbial infection]

Answer 15

Bystander affect

Question 16

A microbial infection CAUSES a LOCAL INFLAMMATORY response, recruiting immune cells and activating T cells.

[microbial infections]

Answer 16

Bystander effect

Question 17

This expansion of the immune response is also known as “epitope spreading.”

[microbial infections]

Answer 17

Bystander effect

Question 18

Proteins that CAN ACTIVATE NUMBER OF T CELLS AT ONCE, regardless of their specific antigen.

[microbial infection]

Answer 18

Superantigens

Question 19

If some of these T cells happen to be specific for self-antigens, a widespread autoimmune response can be triggered.

[microbial infection]

Answer 19

Superantigens

Question 20

Refers to changes in GENE EXPRESSION that DON’T INVOLVE ALTERATIONS to the DNA sequence itself.

[epigenetics and gene expression]

Answer 20

Epigenetics

Question 21

These CHANGES CAN BE TRIGGERED by environmental factors like TOXINS, DIET, or AGING.

[epigenetics and gene expression]

Answer 21

Epigenetics

Question 22

Epigenetic modifications, such as __________ or ____________, can cause genes to be over- or under expressed.

Answer 22

DNA methylation
Histone changes

Question 23

In the immune system, this can LEAD TO A BREAKDOWN of SELF TOLERANCE and result in autoimmune diseases.

[epigenetics and gene expression]

Answer 23

Epigenetics

Question 24

Environmental factors can also cause post translational modifications to proteins.

[epigenetics and gene expression]

Answer 24

Modification of Self Antigens

Question 25

The immune system may no longer recognize it as "self" and instead launch an immune response against it. [epigenetics and gene expression]

Answer 25

Modification of Self - Antigens

Question 26

[2] Types of Autoimmunity

Answer 26

1. Systemic autoimmune diseases 2. Organ - specific autoimmune diseases

Question 27

[5] Organ - specific autoimmune diseases

Answer 27

1. Hematologic disorders 2. Endocrine disorders 3. Neuromuscular disorders 4. Renal disorders 5. Gastrointestinal disorders

Question 28

[2] Hematologic disorders AI*

Answer 28

1. Autoimmune Hemolytic Anemia 2. Immune Thrombocytopenia Purpura

Question 29

[3] Endocrine disorders GHI*

Answer 29

1. Grave's disease 2. Hashimoto's Thyroiditis 3. Insulin - dependent Diabetes Mellitus

Question 30

[2] Neuromuscular disorders MM*

Answer 30

1. Myasthenia Gravis 2. Multiple Sclerosis

Question 31

[1] Renal disorders

Answer 31

Goodpasture's syndrome

Question 32

[2] Gastrointestinal disorders PP*

Answer 32

1. Pernicious anemia 2. Primary Bilary Cirrhosis

Question 33

[2] Systemic Autoimmune Diseases RSG*

Answer 33

1. Rheumatoid Arthritis (RA) 2. Systemic Lupus Erythematosus (SLE) 3. Granulomatosis with polyangiitis

Question 34

It is a SYSTEMIC RHEUMATIC DISORDER that is characterized by the presence of CIRCULATING IMMUNE COMPLEXES.

Answer 34

Systemic Lupus Erythematosus (SLE)

Question 35

It is most commonly seen in women and persons of African.

Answer 35

Systemic Lupus Erythematosus

Question 36

[2] Causes: [sle]

Answer 36

1. Idiopathic 2. Drug - induced

Question 37

[5] Symptoms of SLE

Answer 37

1. Rash (butterfly) or other skin abnormalities 2. Myocarditis 3. Lymphadenopathy 4. Glomerulonephritis 5. Serositis

Question 38

[2] Diagnosis or SLE

Answer 38

1. ANA Testing 2. The LE Cell Test

Question 39

[2] ANA Testing of SLE

Answer 39

1. The Fluorescent Antinuclear Antibody Test (FANA) 2. ANA Testing by Immunohistochemistry

Question 40

The entire nucleus of the cell stains UNIFORMLY. [FANA]

Answer 40

Homogenous

Question 41

Antibodies to dsDNA, histones, and DNP. [FANA]

Answer 41

Homogenous

Question 42

Found in patients with Systemic Lupus Erythematosus (SLE)and drug-induced lupus, among other autoimmune diseases. [FANA]

Answer 42

Homogenous

Question 43

Staining is stronger and MORE INTENSES around the outer edge of the nucleus, forming an OUTLINE. [FANA]

Answer 43

Peripheral or Rim

Question 44

Primarily caused by antibodies to dsDNA. [FANA]

Answer 44

Peripheral

Question 45

This pattern is HIGLY SPECIFIC for SLE. [FANA]

Answer 45

Peripheral

Question 46

The nucleus is filled with DISCRETE, fluorescent specks. The nucleolus and dividing cell chromatin are UNSTAINED. [FANA]

Answer 46

Speckled

Question 47

Antibodies to extractable nuclear antigens (ENAs). [FANA]

Answer 47

Speckled

Question 48

Can be seen in patients with SLE, Sjögren'ssyndrome, and SYSTEMIC ERRORS. [FANA]

Answer 48

Speckled

Question 49

PROMINENT STAINING of the nucleoli (small structures within the nucleus). [FANA]

Answer 49

Nucleolar

Question 50

Primarily antibodies to RNA and RNP. [FANA]

Answer 50

Nucleolar

Question 51

Mainly found in patients with SCLERODERMA, but also other connective tissue diseases. [FANA]

Answer 51

Nucleolar

Question 52

Numerous distinct speckles are present in the nucleus, typically 46 per cell, representing the chromosomes. [FANA]

Answer 52

Centromere

Question 53

Antibodies to centromere proteins. [FANA]

Answer 53

Centromere

Question 54

Primarily found in patients with CREST syndrome. [FANA]

Answer 54

Centromere

Question 55

Most specific for SLE. [antinuclear antibody interpretation]

Answer 55

Anti ds - DNA

Question 56

Histone is a nucleoprotein that is a MAJOR CONSTITUENT OF CHROMATIN. [antinuclear antibody interpretation]

Answer 56

Anti - histone antibody

Question 57

Drug induce Lupus-w/ ss-DNA [antinuclear antibody interpretation]

Answer 57

Anti - histone antibody

Question 58

SPECIFIC FOR LUPUS, It cannot be found in other autoimmune. [antinuclear antibody interpretation]

Answer 58

Anti - Sm (Smith)

Question 59

Often found in cutaneous manifestations of SLE, especially PHOTOSENSITIVITY and DERMATITIS. [antinuclear antibody interpretation]

Answer 59

Anti SS-A/ Ro and SS-B/ro

Question 60

Highly prevalent in SCLERODERMA and SJOGREN SYNDROME. [antinuclear antibody interpretation]

Answer 60

Anti SS-A/Ro and SS-B/Ro

Question 61

HETEROGENOUS group of antibodies that BIND TO PHOSPHOLIPID ALONE or are complexed with protein. [antinuclear antibody interpretation]

Answer 61

Antiphospholipid antibodies

Question 62

Associated with DEEP VEIN and ARTERIAL THROMBOSIS and with morbidity and pregnancy. [antinuclear antibody interpretation]

Answer 62

Antiphospholipid antibodies

Question 63

Fever And Arthritis [sle, drugs]

Answer 63

Aspirin, Anti-inflammatory drugs

Question 64

Skin Manifestation [sle, drugs]

Answer 64

Hydroxychloroquine or Chloroquine, Tropical Steroids

Question 65

Acute Fulminant Lupus, Lupus Nephritis ,CNS Complications Systemic [sle, drugs]

Answer 65

Corticosteroids

Question 66

A SECOND WAY that microbes might TRIGGER autoimmunity is through a?

Answer 66

Bystander effect

Question 67

Expansion of the immune response to unrelated antigens.

Answer 67

Epitope spreading