Term
| Please define "Autoimmunity" |
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Definition
| 1) expression of immunologic reactivity against host self-constituents (endogenous antigen) or an immunological response to an endogenous antigen that is inappropriate or damaging and not shown by all members of the species. |
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Term
| What are some characteristics of the immune system? |
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Definition
Self Tolerance
Ability to differentiate self from non-self
memory
specificity |
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Term
| What percentage of the US population experiences Autoimmune diseases? |
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Definition
| 5-10%. Higher in women and relatives of those who have autoimmune disease. |
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Term
Complete this sentence:
More than ____% of people in their 70's have at least one type of autoantibody readily detectable in the serum. |
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Definition
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Term
| What accounts for the increased incidence of autoimmune diseases in the elderly? |
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Definition
| the loss of T-cell suppressor cells. |
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Term
Complete this sentence:
Autoimmune phenomena are capable of producing _______ damage. |
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Definition
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Term
| How can tissue damage initiate an autoimmune response? |
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Definition
| by releasing a sequestered antigen not previously exposed to lymphoid tissue. |
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Term
| Please name two notable examples of proteins that reside in immunologically privileged sites. |
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Definition
-Ocular antigens
-Spermatozoa |
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Term
| The exposure of sequestered antigens is usually the result of: |
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Definition
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Term
| Please describe the process of development for neoantigens. |
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Definition
1)foreign antigens or drugs enter body
2)bind to host protein
3)initiate an immunological reaction |
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Term
| What happens with haptens? |
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Definition
| haptens are neoantigens that become immunological when bound to a host protein. |
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Term
| If foreign antigens form an immune complex leading to inflammation, what type of injury is this? |
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Definition
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Term
Please complete this sentence:
The emergence of "________ _______ (2 words)" of lymphocytes can lead to a loss of tolerance. |
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Definition
"Forbidden clones"
lymphocytes that react to self-antigens are suppressed from developing. They can proliferate later in life. |
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Term
| What are 3 key points relating to the role of T-cell suppressors in the loss of tolerance? |
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Definition
-suppressor T-cells suppress immune reponses.
-if dysfunctional, unwanted antibodies may develop.
-T-cell suppressor function declines with age. |
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Term
| Organ specific autoimmune diseases are characterized by: |
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Definition
| Chronic inflammatory changes in a specific organ. |
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Term
Please complete this sentence:
Most organ specific autoimmune diseases are _________ disorders. |
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Definition
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Term
| What is a possible antigen for Type 1 diabetes? |
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Definition
| beta islet cell of pancreas |
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Term
| What is a possible antigen for Addison's disease? |
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Definition
| Adrenal cell cytoplasm (cortex) |
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Term
| What is a possible antigen for thyrotoxicosis (Grave's disease)? |
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Definition
| Thyroid cell surface (TSH receptor) |
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Term
| What is a possible Antigen for Hashimoto's autoimmune thyroiditis? |
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Definition
| thyroglobulin, and others. |
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Term
| What are some anti-TSH receptors associated with Grave's disease? |
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Definition
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Term
Please complete this sentence:
A ______ is a physical sign that characterizes Grave's disease. |
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Definition
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Term
Please complete the following sentence regarding Grave's disease:
Viral infections may cause ________ stimulation. |
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Definition
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Term
Regarding specific examples of agonistic antibodies stimulating G protein-coupled receptors, please complete the following sentence:
Anti-ATIR antibodies act as agonists. Implicated in ____________ and possibly malignant hypertension. |
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Definition
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Term
Regarding specific examples of agonistic antibodies stimulating G protein-coupled receptors, please complete the following sentence:
Asthmatic patients may have INHIBITORY antibodies to the ______ 2 adrenoreceptor. |
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Definition
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Term
| The most common autoimmune disease, which is thirty times more common in women, is: |
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Definition
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Term
| All thyroid diseases are more common in which sex? |
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Definition
| female, particularly between the ages of 30 and 50. |
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Term
| which is characteristic of Hashimoto's thyroiditis- hypo or hyper thyroidism? |
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Definition
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Term
| Grave's and Hashimoto's thyroiditis are which type of injury? |
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Definition
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Term
| What treatments are common for Hashimoto's thyroiditis? |
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Definition
| thyroid replacement and surgical removal of goiter. immunosuppressive therapy is not warranted. |
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Term
| What is the primary mechanism of injury in non-organ specific autoimmune diseases? |
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Definition
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Term
Name the non-organ specific autoimmune disease with the following features:
-involves connective tissue
-effects 1 in 2000
-higher incidence in African-Americans, Hispanics
-rapidly progressing or episodic |
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Definition
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Term
Please fill in each blank:
Regarding the sex hormone influence in Lupus, __1__ are protective and depress immune response, and ___2___ enhance the immune response. |
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Definition
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Term
| Why is lupus known as "the great imitator"? |
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Definition
| because it has a wide variety of episodic clinical features that rarely appear all at once. |
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Term
True or false:
There is no one single diagnostic test for lupus. |
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Definition
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Term
| What is one test commonly used to test for lupus? |
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Definition
| ANA or anti-nuclear antibody test. not specific for lupus. this is an immunoflourescence test that detects antibodies. |
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Term
Please complete the following sentence:
In one test for lupus, a/an ________ in erythrocyte sedentation rate (ESR) may indicate a positive diagnosis. |
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Definition
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Term
| Name a couple of treatment options for lupus. |
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Definition
-education
-long-term management
-prophylaxis- avoid sun, get rest. |
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Term
| What site/antigen is associated with multiple sclerosis? |
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Definition
| CNS myelin, immune complex injury. |
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Term
| what site/antigen is associated with Goodpasture's disease? |
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Definition
| basement membrane of lung, kidney |
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Term
| The drug Hydantoin can produce antibodies to what? |
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Definition
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Term
| the drugs diphenylhydantoin and hydralazine can induce what non-organ specific autoimmune disease? |
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Definition
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Term
True or false:
Lupus can be temporary. |
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Definition
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Term
True or false:
Gout is the 2nd most frequently occurring form of arthritis. |
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Definition
| False. It is the 3rd most frequent. |
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Term
| Acute severe arthritis of gout is directly associated with what? |
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Definition
| hyperuricemia, and eventual uric acid deposits. |
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Term
| What are three sources of uric acid? |
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Definition
1) foods containing purines
2) synthesis of purine nucleotides
3) breakdown of nucleic acids (cell turnover) |
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Term
| How is uric acid eliminated? (mention four aspects) |
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Definition
1) eliminated by kidney and GI
2) freely filtered
3) reabsorbed in proximal tubule
4) secreted in distal tubule |
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Term
True or false:
Gout is found mainly in women. |
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Definition
| false. Gout occurs in both men and women, but much more in men. |
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Term
True or false:
women may have an increased incidence of gout after menopause because estrogens promote uric acid excretion. |
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Definition
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Term
True or false:
Gout classified as primary occurs due to an inherent defect in purine metabolism, mainly in men. |
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Definition
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Term
| One major enzymatic defect that leads to an error in purine metabolism is a lack of the enzyme: |
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Definition
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Term
| Nyhan syndrome, an x-linked, recessive condition, experience an overproduction of what? |
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Definition
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Term
| Increased activity of PRPP synthetase leads to the overproduction of purine pathway, and hence: |
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Definition
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Term
| Deficiency in glucose-6-phosphatase is an autosomal recessive disorder that results in what? |
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Definition
-decreased uric acid clearance
-overproduction and under excretion of uric acid |
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Term
| What are the normal levels of uric acid in plasma and body fluids for men and women? |
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Definition
Men: 5 +/- 1 mg/dL
Women: 4 +/- 1 mg/dL |
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Term
| What percentage of hyperuricimia patients develop gout? |
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Definition
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Term
| What are the four stages of gout, in order of occurrence? |
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Definition
1) asymptomatic hyperuricemia
2) acute gouty arthritis
3) intracritical gout
4) chronic tophaceous gout |
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Term
| when uric acid levels are at 9-10 mg/dL, but the patient has no overt symptoms, this is called...? |
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Definition
| Asymptomatic hyperuricemia |
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Term
| monarticular arthritis attacks that usually involve only a single joint and typically occur at night are signs of: |
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Definition
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Term
| the phase of gout whose clinical cause is variable, may only present one attack, and may demonstrate no symptoms is called: |
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Definition
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Term
| the phase of gout in which chronic inflammation results from the presence of urate crystals, and grotesque deformities may be present, is called: |
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Definition
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Term
| deposits of urate crystals surrounded by granuloma are called: |
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Definition
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Term
| Is urate less soluble at a higher or lower temperature? |
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Definition
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Term
| How can one tell the difference between tophi and rheumatoid nodules? |
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Definition
| tophi will have uric crystals, rheumatoid nodules have rheumatoid factor. |
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Term
| Second to arthritis, the most common clinical manifestation of gout is: |
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Definition
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Term
| this is a result of deposition of the urate salt crystals in renal interstitium. |
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Definition
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Term
| this results from deposition of uric acid crystals (renal stones) in collecting tubules. |
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Definition
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Term
| Uric acid nephropathy can result in renal failure. Renal failure accounts for what percent of the deaths in patients with gout? |
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Definition
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Term
| what percentage of patients experiencing gout are overweight? |
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Definition
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Term
| what are some drugs that block uric acid excretion? |
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Definition
| diuretics, nicotinic acid, and levodopa |
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Term
| what are some other medical disorders that are associated with gout and hyperuricemia? |
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Definition
| lead poisoning, starvation, hypertension, and diabetes |
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Term
True or false:
the correlation between alcohol use and gout has been disproven. |
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Definition
| false. There is a strong correlation between alcohol use and gout. |
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Term
| what kinds of meats are high in purines? |
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Definition
| organ meats- liver, brains, etc. Also sardines and anchovies. |
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Term
| To be diagnosed with gout, a patient must fulfill just one of the what three criteria? |
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Definition
1) presence of monosodium urate crystals in leukocytes found in the synovial fluid of the inflamed joint
2) urate crystals in biopsy or aspirate of topih
3) combination of:
-hyperuricemia
-synovitis following colchicine administration (reduced PMN chemotaxis)
- history of monarticulate arthritis followed by period of no symptoms. |
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Term
| What are some other rheumatic disorders that we did not cover in depth in class? |
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Definition
psoriatic arthritis
ankylosing sondylitis
Reiter's syndrome
Infectious arthritis
Progressive systemic sclerosis (PSS)
Polymyositis and Dermatomyositis |
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