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Raynaud's Phenomenon and Graft Rejection
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Raynaud's Phenomenon and Graft Rejection

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Questions and Answers

What is the primary target of Raynaud phenomenon?

  • Heart valves
  • Lacrimal and salivary glands (correct)
  • Muscle tissue
  • Nerves

    • Which finding is typically the earliest in involved salivary glands?

  • Periductal and perivascular lymphocytic infiltration (correct)
  • Epithelial hyperplasia
  • Fibrosis of the glandular tissue
  • Acinar cell atrophy

    • What contributes to the signs of endothelial activation and injury in Raynaud phenomenon?

  • Increased elasticity of blood vessels
  • Increased levels of von Willebrand factor (correct)
  • Decreased production of collagen
  • Reduced circulating platelet aggregates

    • What type of damage is noted in the pathogenesis of Raynaud phenomenon?

    <p>Vascular injury</p> Signup and view all the answers

    What condition may be involved along with the lacrimal and salivary glands in Raynaud disease?

    <p>Esophageal dysmotility</p> Signup and view all the answers

    Which mediator may contribute to the vascular injury in Raynaud phenomenon?

    <p>Mediators released by inflammatory cells</p> Signup and view all the answers

    What is a noted effect of chronic inflammation related to Raynaud phenomenon?

    <p>Increased platelet activation</p> Signup and view all the answers

    What effect do inflammatory cells have on the microvascular endothelium in Raynaud phenomenon?

    <p>They inflict damage.</p> Signup and view all the answers

    Which of the following is not an involved gland in Raynaud phenomenon?

    <p>Thyroid gland</p> Signup and view all the answers

    What is the primary consequence of an increase in the viral replication during the progression of HIV?

    <p>Depletion of CD4+ T cells</p> Signup and view all the answers

    During the clinical latency phase of HIV, what is primarily happening to the viral count and the immune system?

    <p>Viral count is stable while CD4+ count decreases</p> Signup and view all the answers

    What characterizes the progression from clinical latency to full-blown AIDS?

    <p>Destruction of lymphoid tissues and depletion of CD4+ T cells</p> Signup and view all the answers

    What role do the Anti-HIV antibodies or CTLs play in the early stages of HIV infection?

    <p>They help in partial control of viral replication</p> Signup and view all the answers

    What can potentially happen after 5 to 10 years of untreated HIV infection as lymphoid tissue destruction progresses?

    <p>Increased viral replication and disease progression</p> Signup and view all the answers

    What happens to the CD4+ T cell count as viremia increases in an HIV-infected individual?

    <p>CD4+ T cell count decreases continuously</p> Signup and view all the answers

    What is the main role of CD4+ cells in graft damage?

    <p>Inducing inflammation through cytokine secretion</p> Signup and view all the answers

    Which type of cellular rejection primarily involves inflammation and damage to the tubules?

    <p>Type I - Tubulointerstitial pattern</p> Signup and view all the answers

    What is the characteristic finding in endotheliitis associated with vascular rejection?

    <p>Lymphocytes between the endothelium and vessel wall</p> Signup and view all the answers

    What best describes chronic rejection of a graft?

    <p>Gradual loss of graft function over months or years</p> Signup and view all the answers

    Which type of rejection involves swelling of endothelial cells and may show necrosis of vessel walls?

    <p>Type II - Vascular rejection</p> Signup and view all the answers

    What is the expected response of patients with cellular rejection to immunosuppressive therapy?

    <p>Most patients respond well</p> Signup and view all the answers

    What type of inflammatory cells are commonly found in the graft during acute cellular rejection?

    <p>CD4+ and CD8+ T lymphocytes</p> Signup and view all the answers

    Which of the following describes a consequence of chronic rejection?

    <p>Interstitial fibrosis and graft arteriosclerosis</p> Signup and view all the answers

    Which process is mainly targeted by immunosuppressive therapy in preventing rejection?

    <p>Activation of alloreactive T cells</p> Signup and view all the answers

    What morphological pattern is characterized by inflammation of vessels during rejection?

    <p>Vascular pattern</p> Signup and view all the answers

    What type of rejection occurs immediately after the graft is implanted and involves preformed antibodies?

    <p>Hyperacute rejection</p> Signup and view all the answers

    Which antibodies are primarily involved in hyperacute graft rejection?

    <p>IgM antibodies specific for blood group antigens</p> Signup and view all the answers

    What is the main mechanism by which T-lymphocytes contribute to graft rejection?

    <p>They destroy tissue grafts through direct cytotoxicity</p> Signup and view all the answers

    What type of graft is exchanged between individuals of the same species?

    <p>Allograft</p> Signup and view all the answers

    Which of the following best describes xenografts?

    <p>Grafts transplanted from one species to another</p> Signup and view all the answers

    What is the result of antibody binding to the graft vascular endothelium during hyperacute rejection?

    <p>Activation of the complement system</p> Signup and view all the answers

    What is the purpose of testing potential recipients for antibodies against donor cells?

    <p>To assess compatibility for organ rejection</p> Signup and view all the answers

    What is the main reason why mismatched grafts are rare in clinical transplantation?

    <p>Donor and recipient matching protocols are rigorous</p> Signup and view all the answers

    Which of the following mechanisms is primarily involved in chronic rejection?

    <p>Gradual immune response leading to damage</p> Signup and view all the answers

    What can result from endothelial injury caused by hyperacute rejection?

    <p>Thrombosis and ischemic necrosis of the graft</p> Signup and view all the answers

    What is the consequence of a deficiency in fucosyl transferase?

    <p>Decreased synthesis of sialylated oligosaccharides</p> Signup and view all the answers

    What defect is seen in myeloperoxidase (MPO) deficiency?

    <p>Decreased microbial killing</p> Signup and view all the answers

    What is a result of defective classical pathway activation in the complement system?

    <p>Reduced resistance to infection</p> Signup and view all the answers

    What condition is characterized by defective phagolysosome function?

    <p>Chediak-Higashi Syndrome</p> Signup and view all the answers

    What receptor defect results in recurrent herpes simplex encephalitis?

    <p>TLR3</p> Signup and view all the answers

    What is the primary issue caused by a deficiency of complement protein C3?

    <p>Defective clearance of immune complexes</p> Signup and view all the answers

    What type of complement syndromes might result from excessive complement activation?

    <p>Angioedema</p> Signup and view all the answers

    What defines leukocyte adhesion deficiency type 2?

    <p>Mutations in fucosyl transferase</p> Signup and view all the answers

    What common outcome results from defects in Toll-like receptor (TLR) signaling?

    <p>Reduced pathogen recognition</p> Signup and view all the answers

    What is primarily affected in Chediak-Higashi Syndrome?

    <p>Lysosomal enzyme function</p> Signup and view all the answers

    Study Notes

    Raynaud's Phenomenon

    • Major targets of the disease include lacrimal and salivary glands, among other exocrine glands.
    • Initial histological finding in salivary glands is lymphocytic infiltration around ducts and blood vessels.
    • Associated symptoms include esophageal dysmotility, sclerodactyly, telangiectasia, and pulmonary hypertension.

    Pathogenesis

    • Characterized by an autoimmune response leading to vascular damage and collagen deposition.
    • Increased von Willebrand factor and platelet activation correlated with endothelial injury.
    • The exact cause of vascular injury remains unknown; may stem from chronic inflammation.

    Graft Rejection Mechanisms

    • Graft rejection classified into three types: Hyperacute, Acute, and Chronic.
    • Hyperacute Rejection:
      • Occurs immediately post-implantation due to pre-formed antibodies.
      • Can result from previous blood transfusions, pregnancies, or organ transplants.
      • Results in endothelial injury and graft ischemia.

    Allografts and Xenografts

    • Allografts involve tissue from the same species; xenografts are from different species.
    • Graft damage involves cytokine release by CD4+ T cells, inducing inflammation.
    • Immunosuppressive therapy is essential in reducing acute rejection by blocking T cell activation.

    Morphological Patterns of Injury

    • Tubulointerstitial Pattern (Type I): Extensive inflammation in the interstitium and tubules.
    • Vascular Pattern (Type II): Involves vessel wall inflammation and sometimes necrosis.
    • Chronic rejection manifests as long-term graft damage, characterized by interstitial fibrosis and vascular narrowing.

    Leukocyte Adhesion Deficiencies

    • Defective leukocyte adhesion leads to impaired immune response from mutations affecting selectin receptors.
    • Chediak-Higashi Syndrome results from defective lysosomal function, diminishing leukocyte efficacy.

    Complement System Defects

    • Deficiencies in complement pathways lead to increased susceptibility to infections.
    • Classical pathway defects inhibit immune complex clearance, resulting in retention in tissues.

    Defects in TLR Signaling

    • TLR3 deficiency leads to vulnerability to viral infections, such as herpes simplex encephalitis, due to lack of effective immune response.

    HIV Progression

    • HIV targets and depletes mucosal memory CD4+ T cells, eventually causing clinical latency.
    • Virus establishes in lymph nodes where it replicates slowly, leading to chronic infection.
    • Over time, immune control weakens, resulting in increased viral load and potential progression to AIDS.
    • AIDS features extensive destruction of lymphoid tissues and a significant drop in CD4+ T cells.

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    Related Documents

    PATHO-A-IMMUNE-2-MEDTRANS2027.docx.pdf

    Description

    This quiz explores Raynaud's phenomenon, focusing on its pathogenesis, major targets, and associated symptoms. Additionally, it delves into the mechanisms of graft rejection, covering types and causes of hyperacute rejection. Test your understanding of autoimmune responses and transplantation biology.

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