6-7 Hypersensitivity

Question 1

(LO) What’re the four types of hypersensitivity?

Type I HS _______
Type II hypersensitivity cell-bound __________
Type III HS ________ ______
Type IV HS ________

Answer 1

….allergy
Antigens
Immune complex
Delayed

Question 2

(LO) Explain hemolytic disease of the newborn, and how RhoGAM works.

Rh _______ mom pregnant with first Rh ________ fetus.

Fetal-maternal bleed releases __+ ____ into mom’s circulation.

Mom produces anti-Rh Ig_

Mom’s anti-Rh antibodies cross ________

How does RhoGAM work?

Answer 2

Negative. Positive.

Rh+ rbc (red blood cells)

IgG!!

Placenta

RhoGAM is injected into the muscle of an Rh-Negative mother, antibodies circulate in her bloodstream and protects her against any Rh-Positive red blood cells from the fetus. Her immune system takes no further action

Question 3

(LO) What does each hypersensitivity mechanism protect against?

I?
II?
III?
IV?

Answer 3

I-expulsion of parasitic worms

II- elimination of extracellular microbes

III- elimination of microbes, extracellular viral particles & toxins

IV-elimination of intracellular viral, parasitic, or bacterial microbes

Question 4

(LO) Recognize the physiological importance of histamine in the primary Type I and
the similarity in response (plus relative potency) of leukotrienes in the late
phase Type I Hypersensitivity responses; identify the drug used to treat
anaphylaxis; Differentiate shock related to anaphylaxis vs shock related to an
incompatible blood transfusion

Answer 4

Histamine is important in the early degranulation. Is produced when allergen binds to antibodies, can cause dramatic drop in blood pressure and lead to anaphylactic shock. Triggers arachidonic acid cascade. Leukotrienes have 1000X potency of histamine.

The drug is Epinephrine!

Incompatible blood creates shock by Type II HS

Question 5

(LO) Match the following autoimmune diseases with their characteristic signs/symptoms, target tissue(s) and hypersensitivity type(s): Which one….. Multi organ: TYPE III. Butterfly rash and circulating immune complexes in vessels

multiple sclerosis (neuro)
 Graves' disease (hyperthyroid)
Hashimoto's thyroiditis (hypothyroid)
type 1 diabetes (hyperglycemia)
lupus erythematosis (butterfly rash)

Answer 5

Lupus erythematosis!

Multi organ: TYPE III. Butterfly rash and circulating immune complexes in vessels

Question 6

(LO) Which type of HS rxn presents with anaphylaxis, atrophy, asthma, hives, hay fever?

Which presents with serum sickness, Arthur rxn, Farmer’s lung, vasculitis?

Which presents a TB skin test, type 1 diabetes, granulomas?

Which presents transfusion rxn, Graves’ disease, immune hemolytic anemia?

Answer 6

Type I (allergy)

Type III (immune complex)

Type II (cell bound/cytotoxic)

Type IV (delayed)

Question 7

(TP) Select the categories of HSS that corresponds to type 1,2,3,4 starting with type 1.

1) Allergy cytotoxic immune complex delayed
2) Allergy cytotoxic delayed immune complex
3) Allergy delayed immune complex cytotoxic

Answer 7

First one!

Allergy, Cytotoxic, immune complex, delayed

Question 8

(TP) Identify which type of HS is suggested by eosinophils?

Type 1 allergy 
Type 2 cytotoxic 
T3 immune complex
T4 delayed 
T5 cell bound stimulation

Answer 8

Type 1 allergy

Question 9

(LO) What type of HS has a triggering mechanism that circulates immune complexes containing complement-fixing antibodies (IgG)?

Which type uses allergen cross-links mast cell-bound IgE.. triggers degranulation?

Which type uses complement-activating antibodies (IgG/IgM) bind to cells and trigger lysis?

Which one uses sensitized lymphocytes (TH1)?

Answer 9

Type III

Type I

Type II

Type IV

Question 10

(LO) what’s the onset for:

Type I?
II?
III?
IV?

Answer 10

Seconds/minutes if specific IgE performed

Seconds/minutes if specific IgG performed

2-8hrs (6hrs)

24-72 hrs (days)

Question 11

(TP) subsequent pregnancy with Rh+ fetus puts baby at risk. What type of antibodies are attacking baby??

Answer 11

IgG

Question 12

(TP) While recieving blood, patient goes into shock, if due to HS rx, what could cause person to go into shock? (Pick 2)

Type 1 allergy 
Type 2 cytotoxic 
Type 3 immune complex
Type 4 delayed 
Type 5 cell bound stimulation

Answer 12

Types I and II! :)

Question 13

(TP_ Which of the following mediators are produced during the late phase of an IgE mediated allergic reaction? Pick one

Heparin
Histamine
Tryptase
Leukotrienes

Answer 13

Leukotrienes

Question 14

(LO) Match the following autoimmune diseases with their characteristic signs/symptoms, target tissue(s) and hypersensitivity type(s): Which one is in myelin, has myelin reactive T-cells: HS TYPE IV

multiple sclerosis (neuro)
 Graves' disease (hyperthyroid)
Hashimoto's thyroiditis (hypothyroid)
type 1 diabetes (hyperglycemia)
lupus erythematosis (butterfly rash)

Answer 14

Multiple sclerosis (neuro)

Question 15

(LO) Match the following autoimmune diseases with their characteristic signs/symptoms, target tissue(s) and hypersensitivity type(s): which type targets the Thyroid: TSH is very HIGH!! Shows T-cell mediated destruction. HS TYPE IV??

multiple sclerosis (neuro)
 Graves' disease (hyperthyroid)
Hashimoto's thyroiditis (hypothyroid)
type 1 diabetes (hyperglycemia)
lupus erythematosis (butterfly rash)

Answer 15

Hashimoto’s thyroiditis (hypothyroid)

Question 16

(LO) Match the following autoimmune diseases with their characteristic signs/symptoms, target tissue(s) and hypersensitivity type(s): which type targets the Pancreas: HS TYPE IV. B cells are targeted specifically??

multiple sclerosis (neuro)
 Graves' disease (hyperthyroid)
Hashimoto's thyroiditis (hypothyroid)
type 1 diabetes (hyperglycemia)
lupus erythematosis (butterfly rash)

Answer 16

type 1 diabetes (hyperglycemia)

Question 17

(LO) Match the following autoimmune diseases with their characteristic signs/symptoms, target tissue(s) and hypersensitivity type(s): Which one has HIGH fT4 levels (low TSH), targets the Thyroid, HS Type II/non-cytotoxic??

multiple sclerosis (neuro)
Graves' disease (hyperthyroid)
Hashimoto's thyroiditis (hypothyroid)
type 1 diabetes (hyperglycemia)
lupus erythematosis (butterfly rash)

Answer 17

Graves’ disease (hyperthyroid)