CLIN PATH I: EXAM #1 (LEC 1.C SLE/AIDS)

__________________ is a chronic inflammatory disease that is generally characterized by multiple relapses and remissions over decades and can affect virtually every organ system.

Systemic lupus erythematosus (SLE)

What disease is considered an autoimmune or collagen-vascular disease?

A. SLE

B. AIDS

SLE

What clinical manifestation of SLE is most frequent in pt populations?

Butterfly rash

___________________ or defective suppressor T cell function induces clones of hyperactive B lymphocytes to synthesize a variety of antibodies (known as autoantibodies) against native tissues.

Excessive helper T cell

SLE: Excessive helper T cell or ___________________ induces clones of hyperactive B lymphocytes to synthesize a variety of antibodies (known as autoantibodies) against native tissues.

defective suppressor T cell function

SLE: Excessive helper T cell or defective suppressor T cell function induces clones of hyperactive B lymphocytes to synthesize a variety of antibodies (known as ______________) against native tissues.

autoantibodies

SLE: Since the immune system does not inherently attack native tissues, this phenomenon is known as what?

loss of immune self-tolerance

SLE: Native tissues are apparently rendered foreign by exposure to various environmental agents (e.g., _____).

EBV

Autoantibodies have been identified against many nuclear and cytoplasmic components, including what?

DNA

These autoantibodies combine with antigens against which the antibodies were produced (autoantigens) and _____________________________________________ are formed.

antigen-antibody complexes (immune complexes)

SLE: An intense inflammatory reaction develops to rid the body of the foreign immune complexes. What type of hypersensitivity rxn is this?

Type III immune complex-mediated hypersensitivity immune reaction

SLE: Immune complexes form on cell surfaces. Subsequent activation of critical proteins of the complement system in response to immune-complex formation results in cell lysis. What type of hypersensitivity rxn is this?

Type II complement-mediated cytotoxic hypersensitivity immune reaction

What is the ultimate cause of tissue and organ injury (e.g., arthritis and nephritis) in SLE?

Inflammation

SLE: Platelet surface antigen --> __________ --> Thrombocytopenia

A. Type II

B. Type III

Type II

SLE: RBC surface antigen --> _________ --> Anemia

A. Type II

B. Type III

Type II

SLE: WBC surface antigen --> __________ --> Leukopenia, lymphopenia

A. Type II

B. Type III

Type II

SLE: DNA, other nuclear or cytoplasmic antigens --> ________ --> Glomerulonephritis, Arthritis, Dermatitis, Pleuritis, Pericarditis, Seizures, behavioral changes, stroke, vasculitis

A. Type II

B. Type III

Type III

_______________ represents the most advanced—and most serious—stage of the clinical course following infection with human immunodeficiency virus (HIV) strains 1 or 2.

Acquired immunodeficiency syndrome (AIDS)

AIDS is a ____________ (i.e., acquired) chronic immunodeficiency disorder.

secondary

AIDS is a secondary (i.e., acquired) chronic immunodeficiency disorder characterized by:

◦ A profound defect in cellular immunity

◦ Low CD4 (helper) T lymphocyte count (_____________________)

◦ Reversal of normal CD4:CD8 lymphocyte ratio

◦ And 26 conditions that are common in advanced HIV disease but rarely occur in healthy people

< 200 cells/mm3 blood

Transmission occurs via exposure to infected ____________:

◦ Sexual contact

◦ Sharing needles

◦ Perinatally

bodily fluids

What is the most common associated opportunistic infection in an AIDS pt?

Pneumonia

What organism causes the most common opportunistic pneumonia infection?

Pneumocystis jiroveci

Lentivirus (an animal retrovirus) exhibits ______________ and aggressive cell injury

long-term latency

Results in _______, slowly progressive diseases that include immunodeficiency states, wasting syndromes, and central nervous system (CNS) degeneration.

fatal

Pathogenesis of HIV:

HIV attaches to CD4 receptor --> un-coating/internalization of HIV --> RNA converts to DNA --> Integration of viral DNA into host DNA --> host cell assembles and releases new viral particles (bursts)

Pathogenesis of HIV:

HIV attaches to ____________ --> un-coating/internalization of HIV --> RNA converts to DNA --> Integration of viral DNA into host DNA --> host cell assembles and releases new viral particles (bursts)

CD4 receptor

Pathogenesis of HIV:

HIV attaches to CD4 receptor --> _________________________ of HIV --> RNA converts to DNA --> Integration of viral DNA into host DNA --> host cell assembles and releases new viral particles (bursts)

un-coating/internalization

Pathogenesis of HIV:

HIV attaches to CD4 receptor --> un-coating/internalization of HIV --> ______ converts to DNA --> Integration of viral DNA into host DNA --> host cell assembles and releases new viral particles (bursts)

RNA

Pathogenesis of HIV:

HIV attaches to CD4 receptor --> un-coating/internalization of HIV --> RNA converts to DNA --> Integration of ___________ into host DNA --> host cell assembles and releases new viral particles (bursts)

viral DNA

Pathogenesis of HIV:

HIV attaches to CD4 receptor --> un-coating/internalization of HIV --> RNA converts to DNA --> Integration of viral DNA into host DNA --> host cell assembles and releases _____________ (bursts)

new viral particles

What are some common clinical manifestations of AIDS?

Fever/fatigue, Unexplained weight loss, LAD