15. Hypersensitivity II

Question 1

what is type II hypersensitivity?
mediated by?
what causes tissue injury?
what 3 mechanisms are seen with antibody mediated and complement mediated?

Answer 1

3 mechanisms: inflammation, osonizaing, interfereing with normal cellular functions such as hormone receptor signaling

Question 2

why are RBC vulnerable to type II hyersens?
what is treament for antibodies to RBC antigens?

Question 3

explain antibody from mother to newborn
why can it cross the placent?
treatment?

Question 4

explain goodpasteur,
graves
and myasthenia gravis>
what type of hypersensitivity is this?

Question 5

describe type III hypersensitvity

Question 6

what is serum sickness?
what type of hypersensitivity is it?
what did it used to be triggered bY?
now what is it triggered by?
classic clinical sign?

Answer 6

Note: seen today with anti-venoms and treatment of rheumatoid arthritis (anti-TNFa mAb) in small % of patients

Question 7

arthus rxn?
what 2 things are required?

Question 8

what are the type III hypersensitivity diseases? (5)

Question 9

how do we normally clear complexes from the blood?

Question 10

List the types of T cell mediated diseases (8)

Answer 10

multiple sclerosis
crohns
type I diabetes
contact sensitivity
Rheumatoid arthritis
viral hepatitis
toxic shock syndrome
tuberculosis and chronic infections

Question 11

what are the three types of Type 4 sensitivity

Answer 11

delayed,
contact,
gluten insensitvity

Question 12

how long does type 4 hypersensitivity take
what is the mechanism
what drug mechanism can inhibit it?
how do T cells affect blood vessels? (4)

Question 13

what are the steps involved in contact hypersensitivity?
what is a hapten?
describe the sensitization
and elicitation phases
poison ivy?

Question 14

Why can a rash develop on an individuals check who uses a cell phone constantly?

Question 15

what really is celiac disease?
genetic correlation?
mechanism?
what is this gene for ?
what happens to the intestine?
how do we explain antibody productin?

Question 16

DQ2 or ___ are associated haoltypes of HLA class II associated with celiac disease .
what is the difference between gluten senstivity and wheat allergy?
what chromosome is the gene on?
what is the concordance rate in monozygotic twins?

Answer 16

DQ8
wheat allergy mediated by IgE

Question 17

what are non dietary factors of celiac disease?
role of cytokines?
what is the difference between silent and latent celiac disease?
asymptomatic? do they still have to follow gluten free?
what are clinical manifestations?

Most common non GI manifestation?
other clinical non GI manifestations?

Answer 17

parasite, viruses, birth (higher risk in summer) breasfeeding and interestingly, low socioeconomic class is protective 
up regulation of IL2 receptor expression and increased inerferon gamma and IL15, TNFalpha

iron-deficiency anemia resistant to oral iron

Question 18

what tests diagnose celiac disease?
which pts have false negative for TTG antibodies?
which is the best test?
what are you looking for in a biopsy?

Answer 18

HLA testing is highly predictive. negatie for DQ2/8 exlcudes diagnosis for celiac disease with 99 % confidence.