S3) Autoimmunity Flashcards Preview

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Flashcards in S3) Autoimmunity Deck (29)
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1
Q

Define auto-immunity

A

Autoimmunity is an immune response against the host due to the loss of immunological tolerance of self-antigen(s)

2
Q

What are autoimmune diseases?

A

Autoimmune diseases are diseases caused by tissue damage or disturbed physiological responses due to an auto-immune response

3
Q

What are the two types of autoimmune disease?

A
  • Organ specific
  • Non-organ specific
4
Q

Distinguish between organ specific and non-organ specific autoimmune diseases

A

Organ specific: 1/more self antigens within one single organ or tissue

Non-organ specific: self antigens widely distributed throughout the body

5
Q

Which systems in the body do auto-immune diseases commonly affect?

A
  • Nervous disease
  • Respiratory disease
  • Endocrine disease
  • Joint diseases
  • Haematological disease
6
Q

Identify the two mechanisms of tissue damage in autoimmune diseases

A
  • Autoantibodies
  • Autoreactive T Cells
7
Q

How do autoantibodies cause tissue damage?

A
  • Complement activation
  • Antibody-mediated cell cytotoxicity
  • Neutrophil activation
8
Q

What do autoreactive T cells use to cause tissue damage?

A
  • Cytotoxic T cells
  • Macrophages
9
Q

Identify the six criteria for diagnosing an autoimmune disease

A
  • Presence of (1) autoantibodies/autoreactive T cells at the (2) site of tissue damage
  • Levels of cells (3) correlate with disease severity and (4) transfer of cells to a healthy host induces the autoimmune disease
  • Clinical benefit provided by (5) immunomodulatory therapy and there is (6) family history
10
Q

Identify the three steps involved in the induction of autoimmunity

A
  • Breakdown of central tolerance
  • Breakdown of peripheral tolerance
  • Activation of autoreactive B cells
11
Q

What causes the breakdown of central tolerance?

A

Failure to delete autoreactive T cells

12
Q

What causes the breakdown of peripheral tolerance?

A
  • Regulatory T cells defects
  • Impaired immunomodulation
  • Altered self-antigens
13
Q

What causes the activation of autoreactive B cells?

A
  • T cell-independent activation of B cells
  • Carrier effect (complex foreign-self antigens)
14
Q

Which two types of factors trigger autoimmunity?

A
  • Genetic factors
  • Environmental factors
15
Q

Identify the three environmental factors that trigger autoimmunity

A
  • Hormones
  • Infections
  • Drugs
16
Q

Identify 3 genetic factors that trigger autoimmunity

A
  • Increased risk with an affected sibling
  • Increased risk with an affected identical twin
  • Associated with some MHC variants
17
Q

Which therapeutic strategies can be used to target autoantibodies in the pathogenesis of auto-immune diseases?

A
  • Plasma exchange
  • Monoclonal antibodies
18
Q

Which therapeutic strategies can be used to target autoreactive T cells in the pathogenesis of auto-immune diseases?

A
  • Immunosuppresive drugs
  • Monoclonal antibodies
19
Q

Which therapeutic strategy can be used to target tissue damage in the pathogenesis of auto-immune diseases?

A

Anti-inflammatory drugs

20
Q

Which therapeutic strategies can be used to target organ dysfunction in the pathogenesis of auto-immune diseases?

A
  • Replacement therapy
  • Surgery
21
Q

Identify 5 common symptoms of SLE and RA

A
  • Pain: pleuritic chest pain, joint pain
  • Stiffness
  • Swelling
  • Fatigue
  • Fever
22
Q

The ‘glove and sweater’ approach is used to take history for autoimmune rheumatic diseases.

Describe the glove component

A

History:

  • Raynauds
  • Hand rash
  • Joint pains and swelling
23
Q

The ‘glove and sweater’ approach is used to take history for autoimmune rheumatic diseases.

Describe the sweater component

A

History:

  • Hair loss
  • Eye and mouth dryness
  • Nose bleeds
  • Truncal rash/photosensitivity
  • Limb weakness
24
Q

In the examination for ARDs, what should one check for when examining the hand?

A
  • Raynauds
  • Synovitis
  • Hand rash
25
Q

In the examination for ARDs, what should one check for when examining the head region?

A
  • Face rash
  • Alopecia
  • Mouth ulcers
26
Q

In the examination for ARDs, what should one check for when examining the trunk?

A
  • Truncal rash
  • Listen for pericardial/pleuritic rub
27
Q

In the examination for ARDs, what should one check for when examining the extremeties?

A
  • Proximal muscle weakness
  • Large joint swelling
  • Nerve involvement
  • Limb Rash
28
Q

Identify 5 investigations one can perform for ARDs

A
  • FBC
  • Urea, electrolytes, creatinine
  • Liver enzymes
  • CRP (should be normal)
  • Plasma viscosity and ESR
29
Q

Identify 3 Lupus associated bloods one can perform when assessing a patient with SLE

A
  • Anti-Sm antibodies
  • Antinuclear antibodies
  • Anti-DsDNA antibodies