Autoimmune Diseases Overview
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Questions and Answers

What is the classical triad of symptoms associated with Type 1 diabetes mellitus?

  • Excessive sleepiness, muscle cramps, constipation
  • Goiter, hair loss, muscle weakness
  • Increased thirst, increased urination, weight loss (correct)
  • Increased appetite, fatigue, cold intolerance

What laboratory findings are indicative of diabetes mellitus?

  • Blood glucose < 100 mg/dL two hours after oral glucose
  • Random glucose > 150 mg/dL
  • Fasting glucose > 125 mg/dL (correct)
  • Fasting glucose > 150 mg/dL

What is the most common cause of primary hypothyroidism in the USA?

  • Graves' disease
  • Iodine deficiency
  • Hashimoto's thyroiditis (correct)
  • Thyroid cancer

Which of the following is NOT a complication associated with Type 1 diabetes mellitus?

<p>Hypoparathyroidism (B)</p> Signup and view all the answers

Which immune response mechanism is primarily involved in Hashimoto's thyroiditis?

<p>Delayed-type hypersensitivity (DTH) (C)</p> Signup and view all the answers

What is a common complication associated with Myasthenia gravis?

<p>Myasthenic crisis (B)</p> Signup and view all the answers

Which symptom is least likely to be associated with Myasthenia gravis?

<p>Severe abdominal cramps (C)</p> Signup and view all the answers

What diagnostic test shows improvement in symptoms for Myasthenia gravis?

<p>Edrophonium test (D)</p> Signup and view all the answers

Which of the following treatments is specifically used for Myasthenia gravis?

<p>Oral anticholinesterase inhibitors (A)</p> Signup and view all the answers

In Goodpasture's syndrome, what type of antibodies are primarily involved?

<p>Destructive autoantibodies (D)</p> Signup and view all the answers

Which of these symptoms is characteristic of a cholinergic crisis?

<p>Nausea and vomiting (B)</p> Signup and view all the answers

What is a significant risk factor for aspiration in patients with Myasthenia gravis?

<p>Inability to cough (D)</p> Signup and view all the answers

What imaging test is noted to potentially reveal thymoma in Myasthenia gravis patients?

<p>Chest CT (D)</p> Signup and view all the answers

What is a common initial misdiagnosis for hypothyroidism?

<p>Depression (A)</p> Signup and view all the answers

Which of the following symptoms is NOT typically associated with hypothyroidism?

<p>Increased sweating (B)</p> Signup and view all the answers

Which imaging technique is primarily used for the diagnosis of Multiple Sclerosis?

<p>MRI (A)</p> Signup and view all the answers

What type of thyroiditis is characterized by decreased radioactive iodine uptake (RAIU)?

<p>Hashimoto thyroiditis (B)</p> Signup and view all the answers

Which statement about Multiple Sclerosis (MS) is true?

<p>Recurrent episodes of neurologic deficits are characteristic of MS. (D)</p> Signup and view all the answers

Which of the following treatments is NOT typically used for Multiple Sclerosis?

<p>Antibiotics (C)</p> Signup and view all the answers

What is a notable feature of MRI findings in Multiple Sclerosis?

<p>Multiple foci of demyelination with gray discoloration (D)</p> Signup and view all the answers

Which antibodies are commonly tested in the diagnosis of Multiple Sclerosis?

<p>Anti-MBP and anti-MOG antibodies (A)</p> Signup and view all the answers

What is a common symptom of Goodpasture's Syndrome affecting the lungs?

<p>Coughing up of blood (C)</p> Signup and view all the answers

Which laboratory finding is most relevant for diagnosing Goodpasture's Syndrome?

<p>Presence of anti-GMB antibodies (A)</p> Signup and view all the answers

What is the primary treatment approach for a patient diagnosed with Goodpasture's Syndrome?

<p>Immunosuppressive drugs (D)</p> Signup and view all the answers

What symptom is NOT commonly associated with rapidly progressive glomerulonephritis?

<p>Shortness of breath (D)</p> Signup and view all the answers

Which autoimmune disease is characterized by T lymphocyte-mediated destruction of pancreatic Langerhans islet cells?

<p>Type 1 diabetes mellitus (C)</p> Signup and view all the answers

What is a consequence of insulin deficiency in Type 1 diabetes?

<p>Hyperglycemia and acidosis (C)</p> Signup and view all the answers

What unusual smell is often noted in the breath of a child experiencing ketoacidosis?

<p>Fruity (C)</p> Signup and view all the answers

How does increased glucose in the urine affect hydration status?

<p>It leads to dehydration (A)</p> Signup and view all the answers

Which symptom is not commonly associated with systemic lupus erythematosus (SLE)?

<p>Frequent urination (A)</p> Signup and view all the answers

What is a common method used to diagnose systemic lupus erythematosus?

<p>Antinuclear antibodies (ANA) testing (C)</p> Signup and view all the answers

Which statement regarding the prognosis of discoid lupus erythematosus is accurate?

<p>It has a much better prognosis than systemic lupus erythematosus. (B)</p> Signup and view all the answers

What role do corticosteroids play in the treatment of SLE?

<p>They reduce inflammation and immune response. (B)</p> Signup and view all the answers

Which of the following is a potential result of renal issues in systemic lupus erythematosus?

<p>Development of hematuria (C)</p> Signup and view all the answers

What is an important feature of drug-induced lupus erythematosus?

<p>Discontinuing the drug typically resolves the condition. (C)</p> Signup and view all the answers

Which of the following patients is most likely to develop systemic lupus erythematosus?

<p>A middle-aged female with a history of skin lesions (B)</p> Signup and view all the answers

Which immunological marker is specifically associated with systemic lupus erythematosus?

<p>Anti-double stranded DNA antibodies (D)</p> Signup and view all the answers

What specific symptom is most characteristic of rheumatoid arthritis?

<p>Morning stiffness lasting more than 1 hour (D)</p> Signup and view all the answers

Which antibody is primarily associated with rheumatoid arthritis?

<p>Rheumatoid factor (RF) (C)</p> Signup and view all the answers

What does the swan neck deformity in fingers typically indicate?

<p>Loosening of the proximal interphalangeal joint (C)</p> Signup and view all the answers

Which of the following is not a non-specific symptom of rheumatoid arthritis?

<p>Joint erosion (B)</p> Signup and view all the answers

Which area is least likely to be involved in the systemic manifestations of rheumatoid arthritis?

<p>Gastrointestinal tract (A)</p> Signup and view all the answers

What finding is most associated with severe disease in rheumatoid arthritis?

<p>High titer rheumatoid factor (C)</p> Signup and view all the answers

What is the main purpose of using anti-inflammatory drugs in rheumatoid arthritis treatment?

<p>To relieve pain and reduce inflammation (C)</p> Signup and view all the answers

Which of the following conditions can present with a positive rheumatoid factor (RF)?

<p>Endocarditis, malaria, and sarcoidosis (B)</p> Signup and view all the answers

Flashcards

Myasthenia Gravis (MG)

An autoimmune disease causing progressive muscle weakness, sometimes leading to respiratory failure.

Myasthenic Crisis

A severe exacerbation of MG, often due to insufficient medication, leading to respiratory failure.

Cholinergic Crisis

A medication-related complication of MG characterized by excessive acetylcholine, worsening with anticholinesterase inhibitors.

Goodpasture's Syndrome

An autoimmune disease causing bleeding in the lungs and kidneys.

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Progressive muscle weakness

A characteristic symptom of Myasthenia Gravis, affecting various muscle groups, starting from the eyes and extending to the body.

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Anticholinesterase test

A diagnostic test for MG, determining how muscle weakness responds to a medication that blocks the breakdown of acetylcholine.

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Thymoma

A type of tumor in the thymus gland, sometimes linked to Myasthenia Gravis.

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Respiratory failure

A serious condition where the lungs cannot provide enough oxygen to the body.

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Type 1 Diabetes

An autoimmune disease where the body's immune system attacks and destroys insulin-producing cells in the pancreas.

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Symptoms of Goodpasture's Syndrome (Lungs)

Coughing up blood (hemoptysis) and shortness of breath.

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Symptoms of Goodpasture's Syndrome (Kidneys)

Hematuria (blood in urine), edema, high blood pressure, and proteinuria.

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Type 1 Diabetes Symptoms

Frequent urination, extreme thirst, tiredness, and fruity-smelling breath.

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Diagnosis of Goodpasture's Syndrome

Kidney biopsy, anti-glomerular basement membrane antibodies (anti-GBM) test, and anti-alveolar antibodies test.

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Treatment of Goodpasture's Syndrome

Immunosuppressive drugs, like glucocorticoids and cyclosporine, to reduce immune response.

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Diagnosis of Type 1 Diabetes (historical)

Using 'urine wheel' to test urine for sweetness (glucose) and other indicators of the disease.

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Diabetic Ketoacidosis (DKA)

A serious complication of type 1 diabetes characterized by dangerously high blood sugar levels, a buildup of ketones in the blood, and dehydration. It can lead to coma and death if untreated.

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Hashimoto's Thyroiditis

An autoimmune disorder that causes inflammation and destruction of the thyroid gland, leading to hypothyroidism.

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Hypothyroidism

A condition where the thyroid gland doesn't produce enough thyroid hormone, leading to slowed metabolism, fatigue, and other symptoms.

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Insulitis

The process of inflammation and destruction of the insulin-producing cells in the pancreas, specifically in type 1 diabetes.

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Hypothyroidism Symptoms

Common signs of hypothyroidism include cold intolerance, hoarseness, decreased sweating, depression, memory problems, fatigue, hair loss, and a slow heart rate.

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Hypothyroidism Diagnosis

Diagnosing hypothyroidism involves measuring thyroid hormone levels (elevated TSH, low T4), checking for specific antibodies, and using imaging techniques like ultrasound and biopsy.

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What is RAIU?

RAIU stands for Radioactive Iodine Uptake. It's a test that measures how well the thyroid gland absorbs iodine.

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Hyperthyroidism Causes

Hyperthyroidism can be caused by Graves' disease, a condition affecting the thyroid gland.

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Hypothyroiditis Types

Types of hypothyroiditis (inflammation of the thyroid) include Hashimoto's thyroiditis, de Quervain's thyroiditis, and subacute granulomatous thyroiditis.

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MS Clinical Picture

Multiple sclerosis (MS) typically presents with recurrent episodes of neurological deficits, affecting young adults, with women more affected than men. Symptoms are varied but tend to worsen with time.

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MS Pathology

MS is characterized by demyelination (damage to the myelin sheath of nerve fibers) in the brain and spinal cord.

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MS Diagnosis

MS is diagnosed based on a combination of MRI scans, CSF analysis for oligoclonal bands, abnormal evoked potentials, and the presence of characteristic symptoms.

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Systemic Lupus Erythematosus (SLE)

An autoimmune disease where the body's immune system attacks its own tissues, leading to various symptoms like joint pain, fatigue, skin rashes, and organ damage.

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Butterfly Rash

A characteristic skin rash in SLE, appearing as a red, butterfly-shaped rash across the bridge of the nose and cheeks.

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ANA Test

A blood test to detect antinuclear antibodies, which are often present in people with SLE.

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SLE Complications

SLE can affect various organs, potentially leading to kidney problems (glomerulonephritis), anemia, nervous system disorders, and even heart and lung complications.

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SLE Treatment

SLE is treated with medications like corticosteroids and immunosuppressants to control the immune system's attacks.

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Discoid Lupus

A less severe form of lupus that primarily affects the skin, causing thick, red, scaly patches.

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Drug-Induced Lupus

A temporary condition caused by certain medications, mimicking SLE symptoms but resolving after discontinuing the drug.

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SLE Prognosis

With proper treatment and management, many people with SLE can live long and relatively normal lives.

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What is the typical rim pattern associated with SLE?

The rim pattern, a characteristic feature of systemic lupus erythematosus (SLE), is associated with positive anti-dsDNA antibodies.

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What are the common antibodies detected in a SLE rim pattern?

The rim pattern in SLE is often associated with antibodies against double-stranded DNA (dsDNA), single-stranded DNA (ssDNA), histones, and ribonucleoprotein.

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What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is a systemic autoimmune disease primarily affecting the joints, causing inflammation and pain, and can also impact other tissues like skin, heart, eyes, lungs, and kidneys.

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What are the specific symptoms of RA?

Specific symptoms of rheumatoid arthritis (RA) include morning stiffness lasting over an hour, painful swollen joints, especially small joints, subcutaneous nodules, symmetric arthritis, and positive rheumatoid factor (RF).

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What is rheumatoid factor (RF)?

Rheumatoid factor (RF) is an antibody, typically of IgM, IgG, or IgA type, that targets the Fc portion of IgG antibodies. While its exact function is unclear, it is associated with rheumatoid arthritis.

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What is the significance of anti-CCP antibodies in RA?

Anti-cyclic citrullinated peptide (anti-CCP) antibodies are highly specific to rheumatoid arthritis (RA). They are often present in the blood of individuals with RA, even before the onset of symptoms.

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Swan Neck Deformity

A swan neck deformity in RA occurs when the proximal interphalangeal (PIP) joint of a finger hyperextends, leading to a swan-like appearance of the finger due to joint loosening.

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What are MCP joints?

MCP joints, or metacarpophalangeal joints, are the joints located between the hand bones (metacarpals) and the finger bones (phalanges). They form the 'knuckles' at the base of the fingers.

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Study Notes

Autoimmune Diseases

  • Autoimmune diseases occur when the immune system mistakenly attacks the body's own tissues.
  • Important examples include rheumatoid arthritis, multiple sclerosis, type 1 diabetes, Graves' disease, and myasthenia gravis.
  • The exact cause of most autoimmune diseases is unknown.
  • Pathogenic antibodies and immune cells (T cells) are believed to cause damage in many cases.
  • Autoimmune diseases are common (estimated 8 million people affected in the US alone).
  • They often affect young adults.
  • Most are chronic, long-term conditions with significant personal and economic impacts.
  • Autoimmune diseases are a subset of immune system-related disorders.
  • Hypersensitivity disorders (e.g., allergies) are also related to the immune system.
  • Immunodeficiencies, where the immune system is weakened, also fall under this category.
  • Cancers of the immune system, like leukemias and lymphomas, are considered neoplasia.

Some Notable Facts about Autoimmune Diseases

  • Autoimmune diseases are prevalent affecting millions in the US.
  • They frequently affect young adults.
  • Chronic, long-term conditions with high associated costs. (e.g., 30,000/yearmedicationand30,000/year medication and 30,000/yearmedicationand30,000 loss in wages, minimum $24 billion/year cost to the US (for MS))
  • Can occur spontaneously or be induced by things like drugs or infections (e.g., rabies vaccine)
  • Currently, there is no cure for most autoimmune diseases, but treatments exist with possible side effects.

Current Treatments and Problems

  • Glucocorticoids (e.g., Prednisolone) lead to immunosuppression and have side effects like hyperglycemia, skin atrophy, bruising, muscle atrophy, osteoporosis, weight gain, glaucoma, cataracts, and euphoria/psychosis.
  • Mitoxantrone, a cancer drug, causes nausea, vomiting, hair loss, immunosuppression, and cardiomyopathy
  • TNF inhibitors (e.g., infliximab, adalimumab) can lead to T cell lymphomas and opportunistic infections (tuberculosis).
  • Interferon beta can have flu-like symptoms.
  • Rituximab (anti-CD20) may cause cardiac arrest, acute renal failure, infections, and progressive multifocal leukoencephalopathy (PML).
  • Tysabri (anti-VLA-4) and Campath (anti-CD52) are associated with progressive multifocal leukoencephalopathy, and in the former case, pulmonary problems.
  • Fingolimod (FTY720) can induce skin cancer and hemorrhagic encephalitis.
  • Treatment options exist, however, they may have undesirable side effects.

How Autoimmune Diseases Arise

  • Molecular mimicry: The immune system mistakes microbial proteins for self-proteins, triggering an immune response against one's tissues. Examples include rheumatic fever and Guillain-Barre syndrome.
  • Failure of regulatory mechanisms: The immune system's tolerance mechanisms fail to suppress autoreactive T or B cells. A mutation in Foxp3, for instance, causes IPEX syndrome.
  • Access to "forbidden sites": Normally hidden antigens become accessible to the immune system, triggering an immune response, such as is seen in inflammation of the brain, testes, or eye.
  • Genetic and environmental factors contribute to autoimmune diseases, with specific genes like HLA and environmental factors such as smoking, infections, and microbiome.

Genetic Base of Autoimmune Diseases

  • HLA (MHC class II) genes are highly linked to autoimmune disorders. Specific HLA alleles are associated with particular autoimmune conditions (e.g., HLA-DR2 in multiple sclerosis, HLA-DR1 and DR4 in rheumatoid arthritis, HLA-DQ2 and DQ8 in celiac disease, DQ8, DQ2 in Type 1 diabetes)

Other Genes in Autoimmune Diseases

  • AIRE (Autoimmune regulator)
  • Foxp3 (affects regulatory T cells)
  • Fas (involved in death receptors)
  • Polymorphisms in genes like TNF or TNF receptor.
  • CTLA-4
  • IL-7R

Environmental Factors in Autoimmune Diseases

  • Certain infections (e.g., Campylobacter jejuni, Group A Streptococcus pyogenes, EBV, Coxsackie B virus)
  • Gut microbiome
  • Smoking
  • High-salt diets
  • Obesity

Classification of Autoimmune Diseases

  • Organ-specific: antibody-mediated (Graves' disease, myasthenia gravis, Goodpasture's syndrome), cell-mediated (multiple sclerosis, type 1 diabetes).
  • Systemic: systemic lupus erythematosus and rheumatoid arthritis. Frequently, both antibodies and immune cells may contribute to autoimmune pathologies.

Diagnosis and Treatment of Diseases

The provided text includes details about various autoimmune diseases including their diagnosis and, in some cases, treatment approaches. Specific details will vary between the diseases covered.

Additional Information

  • The provided texts describe several autoimmune diseases, and associated information, such as pictures, case studies, and laboratory findings.

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Description

This quiz explores autoimmune diseases and their impact on health. Participants will learn about various autoimmune conditions, their causes, symptoms, and relationships with the immune system. Aimed at providing a comprehensive understanding of these chronic disorders.

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