A 39-year-old White woman tested positive for antinuclear antibody (ANA) after demonstrating signs of systemic lupus erythematosus (SLE). What is the pathogenesis of SLE?
Inappropriate treatment of Strep throat and scarlet fever infections
Genetic predisposition in the setting of environmental and/or stochastic triggers, leading to innate immune system activation
Infection with Epstein-Barr virus
Infection with human papillomavirus (HPV)
The Correct Answer is B
Choice A reason: While untreated streptococcal infections can lead to rheumatic fever or glomerulonephritis, they are not implicated in the pathogenesis of SLE. SLE is an autoimmune disease, not a post-infectious sequela of strep or scarlet fever.
Choice B reason: SLE arises from a complex interplay of genetic susceptibility and environmental triggers (e.g., UV light, infections, medications). These factors activate the innate immune system, leading to autoantibody production, immune complex deposition, and systemic inflammation. ANA positivity reflects this autoimmune activity.
Choice C reason: Epstein-Barr virus has been studied as a potential environmental trigger in autoimmune diseases, including SLE, but it is not the primary cause. Its role is contributory rather than causative.
Choice D reason: HPV is associated with cervical dysplasia and cancer, not autoimmune diseases like SLE. There is no established link between HPV infection and the pathogenesis of lupus.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: While mumps can cause inflammation and damage to the testes, there is no strong evidence linking mumps infection directly to an increased incidence of testicular cancer. This choice is misleading and not supported by current pathophysiological understanding.
Choice B reason: Decreased sperm count may occur as a consequence of mumps-related orchitis, but it is not the primary pathophysiological mechanism. The underlying cause is testicular inflammation and atrophy, which subsequently affects spermatogenesis.
Choice C reason: Mumps can lead to orchitis, particularly in post-pubertal males. Orchitis causes inflammation of the testicles, which can result in testicular atrophy and impaired sperm production. This is the most direct and well-established mechanism by which mumps affects male fertility.
Choice D reason: Varicocele is a separate condition involving dilated veins in the scrotum and is not caused by mumps. While varicocele can impair sperm quality, it is unrelated to the viral pathophysiology of mumps.
Correct Answer is A
Explanation
Choice A reason: Excessive iodine intake can paradoxically inhibit thyroid hormone synthesis through the Wolff-Chaikoff effect, leading to hypothyroidism. This autoregulatory mechanism protects against hyperthyroidism but can result in reduced hormone production if iodine levels remain high.
Choice B reason: While iodine intake influences thyroid function, small changes do not “reset” the thyroid system. The thyroid gland responds to iodine availability, but regulation is more complex and involves feedback from TSH and circulating thyroid hormones.
Choice C reason: Iodine deficiency typically leads to hypothyroidism, not hyperthyroidism. In rare cases, iodine deficiency may cause goiter and nodular thyroid disease, which can result in hyperthyroidism, but this is not the usual outcome.
Choice D reason: Iodine is essential for the synthesis of thyroid hormones (T3 and T4). It is directly involved in thyroid regulation, and its absence or excess can significantly impact thyroid function.
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