ch 20 Tolerance and Autoimmunity
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Questions and Answers

What is the term used to describe the failure of the host's immune systems to distinguish self from non-self?

  • Humoral immune system
  • Horror Autotoxicus (correct)
  • Cellular immune system
  • Autoimmunity

    • What can be the result of autoimmunity?

  • Increased immune response
  • Tissue and organ damage (correct)
  • Enhanced self-recognition
  • Improved host defense

    • What does autoimmunity refer to?

  • Failure of the immune system against non-self components
  • Enhanced host defense mechanisms
  • Self-recognition by the immune system
  • Inappropriate response of the immune system against self-components (correct)

    • Which of the following is the primary mechanism for deleting T or B clones before maturity if they have receptors that recognize self-antigens with great affinity?

    <p>Central tolerance</p> Signup and view all the answers

    Where does peripheral tolerance kill lymphocytes?

    <p>Secondary lymphoid tissue</p> Signup and view all the answers

    What regulates the life span of lymphocytes?

    <p>Apoptosis regulation</p> Signup and view all the answers

    Which mechanism exists to protect individuals from self-reactive lymphocytes by killing lymphocytes in the secondary lymphoid tissue?

    <p>Peripheral tolerance</p> Signup and view all the answers

    Central tolerance is a primary mechanism that deletes T or B clones before maturity if they have receptors that recognize self-antigens with great affinity.

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

    Peripheral tolerance kills lymphocytes in primary lymphoid tissue.

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

    The life span of lymphocytes is regulated by mitosis.

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

    What is the main function of T Recognize cells in inducing peripheral tolerance?

    <p>Recognize and suppress immune response against self-antigens</p> Signup and view all the answers

    How do T reg cells contribute to peripheral tolerance?

    <p>Induce cell death in some immune cells</p> Signup and view all the answers

    Which type of antigens can produce tolerance and are not considered immunogens?

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

    Which of the following is correct promotes tolerance rather than stimulation of the immune system by a given antigen?

    <p>All of the above</p> Signup and view all the answers

    What is the term used to describe unresponsiveness to antigenic stimulus due to apoptotic cell death?

    <p>Clonal anergy</p> Signup and view all the answers

    What type of antigens are ignored by the immune system, resulting in clonal ignorance?

    <p>Self antigens</p> Signup and view all the answers

    Whaich of the following is correct Auto or Self antigens?

    <p>Both a and b</p> Signup and view all the answers

    What can alter one's own cells to become non-self antigens?

    <p>Action of bacteria, viruses, chemicals, or drugs</p> Signup and view all the answers

    Which of the following is TRUE an Auto antibody?

    <p>Both a and b</p> Signup and view all the answers

    Which of the following is correct Auto Immunity?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is correct cause of tissue injury in autoimmune diseases?

    <p>A+B</p> Signup and view all the answers

    How does the immune system normally respond to self-cells?

    <p>The immune system not attacks self-cells.</p> Signup and view all the answers

    In autoimmune diseases, the immune system attacks:

    <p>Both specific tissues and a large number of tissues.</p> Signup and view all the answers

    Which of the following statements about autoimmune diseases is true?

    <p>Autoimmune diseases can be caused by humoral or cell mediated immune responses.</p> Signup and view all the answers

    Which of the following is correct cause of autoimmune diseases?

    <p>All of the above</p> Signup and view all the answers

    In which autoimmune disease are high levels of both class I and class II MHC molecules expressed by pancreatic beta cells?

    <p>Insulin-dependent diabetes mellitus (IDDM)</p> Signup and view all the answers

    Which tissue can induce auto-antibody formation in some men after a vasectomy?

    <p>Eye lens protein</p> Signup and view all the answers

    Which autoimmune disease is characterized by the expression of Class II MHC molecules on the membranes of thyroid acinar cells?

    <p>Graves' disease</p> Signup and view all the answers

    What can induce nonspecific polyclonal B-cell activation?

    <p>Gram-negative bacteria</p> Signup and view all the answers

    Which genes show the strongest associations with autoimmunity?

    <p>HLA genes, especially class II HLA genes</p> Signup and view all the answers

    Which of the following is correct relase of sequestered Antigen ?

    <p>All of the above</p> Signup and view all the answers

    Genetic factors, especially HLA genes, are strongly associated with autoimmunity.

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

    Which of the following correct Classification of Autoimmune Diseases Broadly classified ?

    <p>All of the above</p> Signup and view all the answers

    Which type of blood components can be targeted by autoantibodies in haemolytic autoimmune diseases?

    <p>RBCs, Platelets or Leucocytes</p> Signup and view all the answers

    What causes the lysis of red blood cells in autoimmune hemolytic anemia?

    <p>Production of autoantibodies against the RBC-antigens.</p> Signup and view all the answers

    Which form of autoimmune anemia is drug-induced?

    <p>Hemolytic anemia caused by certain medications like Penicillin or Anti-hypertensive agents like methyldopa</p> Signup and view all the answers

    What is the characteristic half-life of RBCs of haemolytic autoimmune diseases?

    <p>120 days</p> Signup and view all the answers

    Haemolytic autoimmune diseases are caused by destruction of blood components by autoantibodies.

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

    The immunodiagnostic test for autoimmune hemolytic anemias generally involves a Coombs test.

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

    Which autoimmune disease attacks the myelin coating of nerve axons?

    <p>Multiple sclerosis</p> Signup and view all the answers

    What is the specific target of Myasthenia gravis?

    <p>Nerve-muscle junction</p> Signup and view all the answers

    Which autoimmune disease attacks the insulin-producing cells?

    <p>Juvenile diabetes</p> Signup and view all the answers

    Which autoimmune disease attacks the Thyroid?

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

    What is Hashimoto's thyroiditis?

    <p>An autoimmune condition where an individual produces antibodies and sensitized TH1 cells specific for thyroid antigens.</p> Signup and view all the answers

    What is the physiological response to hypothyroidism in Hashimoto's thyroiditis?

    <p>Visible enlargement of the thyroid gland</p> Signup and view all the answers

    Which of the following is primary targets of antibodies formed in Hashimoto's thyroiditis?

    <p>Thyroglobulin and thyroid peroxidase</p> Signup and view all the answers

    All of the following is correct characteristic is most frequently observed in individuals with Hashimoto’s thyroiditis except?

    <p>High expression of MHC molecules in pancreatic beta cells</p> Signup and view all the answers

    What is the primary cause of insulin-dependent diabetes mellitus (IDDM)?

    <p>Autoimmune attack on the pancreas</p> Signup and view all the answers

    What is the specific target of the autoimmune attack in insulin-dependent diabetes mellitus?

    <p>Beta cells of the islets of Langerhans</p> Signup and view all the answers

    What is the consequence of the autoimmune attack in insulin-dependent diabetes mellitus?

    <p>Destroyed beta cells leading to decreased insulin production</p> Signup and view all the answers

    What is the physiological effect of decreased insulin production in insulin-dependent diabetes mellitus?

    <p>Elevated levels of glucose in the bloodstream</p> Signup and view all the answers

    What is insulin-dependent diabetes mellitus (IDDM) caused by?

    <p>An autoimmune attack on the pancreas</p> Signup and view all the answers

    What regulates the production of thyroid hormones?

    <p>Thyroid-stimulating hormone (TSH)</p> Signup and view all the answers

    What is the role of autoantibodies in Graves' disease?

    <p>They bind the receptor for TSH and mimic the normal action of TSH</p> Signup and view all the answers

    Which of the following is consequence of unregulated autoantibodies in Graves' disease?

    <p>Stimulation of thyroid and development of hyperthyroidism</p> Signup and view all the answers

    Which of the following is Correct the primary cause of Myasthenia Gravis?

    <p>Autoantibody against muscle antigen that binds acetylcholine receptor antigen</p> Signup and view all the answers

    Which of the following is the characteristic feature of Myasthenia Gravis?

    <p>Progressive muscular weakness</p> Signup and view all the answers

    Which of the following is Correct the consequence of Myasthenia Gravis on the neuromuscular junction?

    <p>Severe impairment of the neuromuscular junction</p> Signup and view all the answers

    Which of the following is Correct the eventual cause of death in Myasthenia Gravis?

    <p>Respiratory failure</p> Signup and view all the answers

    What are the early signs of Myasthenia Gravis?

    <p>Drooping eyelids and inability to retract the corners of the mouth</p> Signup and view all the answers

    How does a person with Myasthenia Gravis appear?

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

    Which autoimmune disease can harm the kidneys, heart, brain, lungs, and skin?

    <p>Systemic Lupus Erythematosus</p> Signup and view all the answers

    What is the cause of Rheumatic fever?

    <p>A+C</p> Signup and view all the answers

    Which of the following is Correct characteristic feature is OBSERVED in Systemic Lupus Erythematous (SLE)?

    <p>Blood red spots over the bridge of nose &amp; cheeks</p> Signup and view all the answers

    In Systemic Lupus Erythematous (SLE), which type of reaction develops when immune complexes of auto-antibodies are deposited along the walls of small blood vessels?

    <p>Type III hypersensitive reaction</p> Signup and view all the answers

    What is the main consequence of immune complexes in Systemic Lupus Erythematous (SLE) activating the complement system and damaging the walls of blood vessels?

    <p>Vasculitis and glomerulonephritis</p> Signup and view all the answers

    Which tissue antigens are affected in Systemic Lupus Erythematous (SLE)?

    <p>DNA, histones, RBCs, platelets, leukocytes, and clotting factors</p> Signup and view all the answers

    Systemic Lupus Erythematous (SLE) is characterized by fever, weakness, arthritis, skin rashes, pleurisy, and kidney dysfunction.

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

    In SLE, the immune complexes activate the complement system and generate membrane-attack complexes that damage the walls of the blood vessels.

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

    What is the primary target of the autoimmune attack in Multiple Sclerosis (MS)?

    <p>Myelin coating of nerve axons</p> Signup and view all the answers

    Which of the following is Correct the characteristic feature of Myasthenia Gravis?

    <p>Neuromuscular junction dysfunction</p> Signup and view all the answers

    What disease causes inflammation along the myelin sheath of nerve fibers, leading to various neurological dysfunctions?

    <p>Multiple Sclerosis (MS)</p> Signup and view all the answers

    Which of the following is Correct severe symptoms of Multiple Sclerosis (MS)?

    <p>Paralysis and loss of vision</p> Signup and view all the answers

    Which of the following is correct Mild symptoms of Multiple Sclerosis (MS)?

    <p>numbness in the limbs</p> Signup and view all the answers

    All of the following is FALSE characteristics of rheumatoid arthritis except?

    <p>Increased number of T-cells and macrophages in synovial fluid, and inflammatory changes in the synovial membrane</p> Signup and view all the answers

    What is the primary cause of tissue injury in rheumatoid arthritis?

    <p>Deposition of IgM-IgG complexes in the joints</p> Signup and view all the answers

    Rheumatoid Arthritis is a systemic disease of the joints.

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

    Rheumatoid factors in individuals with rheumatoid arthritis are reactive with determinants in the Fc region of IgG.

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

    The synovial fluid of patients with rheumatoid arthritis contains increased numbers of T-cells and macrophages.

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

    Rheumatoid Arthritis is characterized by atrophy of bones.

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

    Which of the following is correct auto immune diseases diagnosed?

    <p>By identifying autoantibodies in the serum</p> Signup and view all the answers

    Which of the following is Correct used to demonstrate autoantibodies?

    <p>Immunofluorescent antibody test</p> Signup and view all the answers

    Which of the following is Correct used to demonstrate Autoantibodies ?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is examples of broad-spectrum immunosuppressive treatments?

    <p>Corticosteroids, azathioprine, cyclophosphamide, methotrexate</p> Signup and view all the answers

    How do broad-spectrum immunosuppressive treatments work?

    <p>Both a and b</p> Signup and view all the answers

    Which mediator, playing a role in autoimmune inflammatory processes, is widely used to treat rheumatoid arthritis, psoriasis, and Crohn’s disease?

    <p>TNF-α (adalimumab)</p> Signup and view all the answers

    Which therapy is a monoclonal antibody against the B cell-specific antigen CD20 that provides short-term benefit for patients with RA?

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

    What is the specific treatment for rheumatoid arthritis?

    <p>Anti-inflammatory drugs</p> Signup and view all the answers

    Which medication is used to treat Myasthenia Gravis?

    <p>Choline esterase inhibitors</p> Signup and view all the answers

    What type of drugs are used to treat Thyrotoxicosis?

    <p>Antithyroid drugs</p> Signup and view all the answers

    Which medication is used to treat Lupus Erythematous?

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

    Autoimmune diseases primarily affect men more than women.

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

    Hemolytic anemia: Treated with VitB12

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

    Lupus Erythematous : Treated with immunosuppressive or antimitotic drugs such as Corticosteroid, Cyclophosphamide and azathioprine.

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

    True or False: Autoimmune diseases can only be diagnosed based on clinical symptoms.

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

    What happens to the red cells if IgG auto-antibodies are present?

    <p>They become agglutinated by the antiserum</p> Signup and view all the answers

    How does the interference of auto-antibodies with iodine uptake affect the production of thyroid hormones?

    <p>It decreases the production of thyroid hormones</p> Signup and view all the answers

    What happens when immune complexes accumulate in tissues?

    <p>A+B</p> Signup and view all the answers

    Study Notes

    Immune System and Autoimmunity

    • Autoimmunity refers to the failure of the host's immune system to distinguish self from non-self, resulting in an immune response against the body's own cells, tissues, and organs.
    • Autoimmune diseases occur when the immune system mistakenly attacks and damages its own cells, tissues, and organs.

    Central Tolerance

    • Central tolerance is a primary mechanism that deletes T or B clones before maturity if they have receptors that recognize self-antigens with great affinity.
    • This process occurs in the thymus for T cells and bone marrow for B cells.

    Peripheral Tolerance

    • Peripheral tolerance kills lymphocytes in secondary lymphoid tissues, preventing an immune response against self-antigens.
    • T regulatory cells (Tregs) contribute to peripheral tolerance by killing lymphocytes in secondary lymphoid tissues.

    Autoimmune Diseases

    • Autoimmune diseases are caused by the immune system attacking the body's own cells, tissues, and organs.
    • Examples of autoimmune diseases include rheumatoid arthritis, lupus, multiple sclerosis, type 1 diabetes, and Hashimoto's thyroiditis.

    Causes of Autoimmune Diseases

    • Genetic factors, especially HLA genes, are strongly associated with autoimmunity.
    • Environmental triggers, such as infections, can also contribute to the development of autoimmune diseases.

    Effects of Autoimmune Diseases

    • Autoimmune diseases can cause tissue injury and organ damage, leading to various symptoms and complications.
    • Examples of tissue injury and organ damage include joint inflammation in rheumatoid arthritis, demyelination in multiple sclerosis, and thyroid inflammation in Hashimoto's thyroiditis.

    Diagnosis and Treatment of Autoimmune Diseases

    • Autoimmune diseases are diagnosed based on a combination of clinical symptoms, laboratory tests, and imaging studies.
    • Treatment of autoimmune diseases involves managing symptoms, suppressing the immune system, and replacing damaged cells and tissues.

    Examples of Autoimmune Diseases

    • Rheumatoid arthritis: An autoimmune disease that attacks the lining of the joints, leading to inflammation and pain.
    • Lupus: An autoimmune disease that can affect various organs, including the skin, joints, kidneys, and nervous system.
    • Multiple sclerosis: An autoimmune disease that attacks the myelin coating of nerve axons, leading to neurological symptoms.
    • Hashimoto's thyroiditis: An autoimmune disease that attacks the thyroid gland, leading to hypothyroidism.
    • Type 1 diabetes: An autoimmune disease that attacks the insulin-producing cells in the pancreas, leading to insulin deficiency.

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    Explore the concepts of tolerance and autoimmunity and their impact on the immune system. Learn about horror autotoxicus and the consequences of autoimmunity, including tissue and organ damage.

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