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Mercy CLS 1: Immunology > 13) Hypersensitivity > Flashcards

13) Hypersensitivity Flashcards

1
Q

define hypersensitivity rxn

A

exaggerated/inappropriate immune response with damage to host

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2
Q

basic mechanism of TI HS rxn

A

IgE mediated
binds to masts and basos
histamine release

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3
Q

general sx of TI HS rxn

A

rhinitis
asthma
anaphylaxis

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4
Q

basic mechanism of TII HS rxn

A

IgG/IgM binds to cell and activates complement

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5
Q

immediate HS rxn (within minutes)

A

type I

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6
Q

cytotoxic HS rxn

A

type II

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7
Q

immune complex HS rxn

A

type III

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8
Q

TIII HS rxn timeframe

A

within hours

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9
Q

TIV HS rxn timeframe

A

1-2 days

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10
Q

cell mediated/delayed type HS rxn

A

type IV

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11
Q

basic mechanism of TIII HS rxn

A

IgG or IgM - Ag complexes accumulate in blood/tissues
granulocytes release damaging enzymes

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12
Q

basic mechanism of TIV HS rxn

A

T-cell cytokines activate macros, causing damage

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13
Q

3 phases of TI HS rxn

A
  • sensitization
  • activation
  • effector response
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14
Q

first exposure to Ag, IgE attaches to masts/basos

A

sensitization stage (type I)

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15
Q

reaginic Ab

A

IgE

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16
Q

stimultes/suppresses IgE production

A

stimulates: IL-4
suppresses: IFN-𝛾

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17
Q

begins activation phase of TI HS rxn

2 forms

A

challenge/2nd exposure to Ag

cutaneous injection
IV/parenteral injection

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18
Q

wheal & flare rxn part of type β€”- HS rxn

A

I

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19
Q

wheal & flare peaks in β€”β€” mins

sx

A

10-15

erythema
edema
β€œhives”

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20
Q

required for Ig to cause degranulation

A

2 Fc receptors crosslinked by Ag

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21
Q

triggers of mast cell degran

A
  • IgE
  • C3a, C5a
  • drugs
  • lectins
  • extreme heat & cold
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22
Q

control mechanism for mast cell degran (TI HS rxn activation phase)

A
  • adenylate cyclase converts ATP to cAMP during degranulation
  • sustained increase in intracellular cAMP slows or stops degranulation
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23
Q

2 types of mediators involved in TI HS rxn effector phase

A
  • preformed mediators - stores in granules
  • newly-synthesized mediators
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24
Q

main preformed mediator

A

histamine

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25
storage of histamine
electrostatic interaction with heparin
26
histamine binding sites
H1 (smooth muscle, endothelials) H2 (mucosal membranes)
27
effects of histamine
- smooth muscle constriction - vascular permeability - release of stomach acid
28
antihistamines block -----
H1
29
chemotactic factors involved in effector phase of TI HS rxn
- GM-CSF - IL-5 - TNF-a - ECF - PAF - IL-8
30
late indicator of IgE mediated rxn
eos
31
newly-synthesized mediators and source
- leukotrienes (arachidonic acid + lipoxygenase) - prostaglandins/thromboxanes (arachidonic acid + cyclooxygenase) - PAF (platelets)
32
cause prolonged constriction of smooth muscle even in presence of histamine
leukotrienes
33
cause bronchoconstriction and chemotactic for grans
prostaglandins thromboxanes
34
induces plt aggregation and release of histamine from them potent bronchoconstrictor and vasodilator
PAF
35
mediator that can cause shock-like sx
PAF
36
arachidonic acid released from...
membrane lipids
37
phase of TI HS rxn occurring after mast cell degranulation and activation
late phase rxn
38
mechanism of late phase rxn
- ECF and IL-5 recruits eos and neuts to site - they are activated - eos release PAF, MPB, ECP - neuts phagocytize Ag-AB complexes and release PAF, leukotrienes
39
neurotoxin and helminthotoxin
eosinophil cationic protein
40
examples of TI HS rxn
- allergic rhinitis/hay fever - food allergies - atopic dermatitis - asthma - insect bite allergies
41
airborne allergen reacts with IgE-sensitized mast cells in nasal passages/conjunctiva
allergic rhinitis (TI)
42
food allergen reacts with IgE-sensitized mast cells in GI tract
food allergy (TI)
43
allergen contacts skin, activating masts and attracting eos
atopic dermatitis
44
red and pus-filled skin rash
atopic dermatitis
45
chronic obstruction of lower airways related to chemicals, pollen, dust, viral Ag
asthma
46
2 methods of TI HS rxn detection
- skin allergy test - RAST (quantitative)
47
RAST
radioallergosorbent test
48
explain RAST principle
- allergen on bead/disc placed in pt serum - IgE binds - wash - add anti-IgE conjgate radioactively labelled - measure radioactivity
49
pharm interventions for TI HS rxn
- cromolyn sodium: prevents influx of Ca, degranulation - corticosteroids: block arachidonic pathway - antihistamine: block H1 - epinephrine: reverses effects of histamine (life-threatening rxn)
50
method of inducing tolerance to Ag by injecting pt with increasing doses over time
immunotherapy/hyposensitization
51
2 ways hyposensitization works
- induction of tolerance - production of IgG that binds Ag before IgE can
52
allergy shots are better for Ags ----------
in circulation (less IgG on mucosa)
53
complement fixation in TII HS rxn leads to ---- or -----
lysis or opsonization
54
examples of Ab-mediated cellular dysfunction
autoAb bind to cell receptors - myasthenia gravis (ACh receptor) - Graves (TSH receptor)
55
examples of TII HS rxn
- trxn - cold agglutinin - HDFN - goodpastures - pemphigus vulgaris - myasthenia gravis - Graves - drug-induced (chloramphenicol)
56
Arthus rxn
TIII HS rxn increasingly severe sx at site of inoculation first mild redness and swelling after several exposures - hemorrhagic, necrosis
57
complement fixes to Ab-Ag complexes and releases anaphylatoxins
TIII HS rxn
58
examples of TIII HS rxn
- serum sickness - infection-associated immune complex disease (Goodpasture, rheumatic fever) - hypersensitivity pneumonitis (Farmer's lung)
59
serum sickness
TIII HS rxn injection of serum from another species make Ab to foreign Ig
60
---------- size complexes most harmful
small/medium | large complexes removed by phagocytes
61
rheumatic fever
TIII HS rxn follows type A strep infection
62
cause of Farmer's lung
inhaling actinomycetes spores in moldy hay can cause Arthus type rxn in lungs
63
examples of TIV HS rxn
- contact sensitivity (metals, poison ivy) - allograft rejection - cutaneous basophil hypersensitivity
64
TIV HS reaction description
- takes days - erythema, induration - does not cause necrosis - resolves slowly - mainly macros, few neuts
65
----- suppresses TH2 and expands TH1, contributing to macrophage activation in TIV HS rxn
IL-12
66
giant cells made of clusters of epitheloids formed by macros accumulating in tissue
granuloma TIV HS rxn
67
rejected graft tissue is invaded by...
Ag-specific lymphs and monos
68
skin injection of Ag takes 24 hours redness, no induration may have link to parasites
cutaneous basophil hypersensitivity
69
example of cause of cutaneous basophil hypersensitivity
tick bites
70
activates macros to release inflammatory mediators
IFN-𝛾
71
↑ expression of adhesion molecules on blood vessels
TNF-Ξ²

Mercy CLS 1: Immunology (19 decks)

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