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Aani Immuno: Hypersensitivity Flashcards

1
Q

Mnemonic for remembering the types of Hypersensitivity Reaction?

A

ACID

  1. Allergic - IgE
  2. Cytotoxic (ab mediated) - IgG or IgM
  3. Immune complex mediated -IgG or IgM
  4. Delayed - T cell mediated
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2
Q

Which Abs are involved in Type 1 Hypersensitivity Reaction?

A

IgE

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3
Q

Which Abs are involved in Type 2 Hypersensitivity Reaction?

A

IgG or IgM

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4
Q

Which Abs are involved in Type 3 Hypersensitivity Reaction?

A

IgG or IgM

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5
Q

Symptoms of Type 1 Hypersensitivity reaction?

A

Angiodema, Rash, Urticaria, Wheeze, Diarrhoea, Rhinoconjunctivitis, Anaphylaxis

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6
Q

4 Most common Type 1 Hypersensitivity reaction in Children?

A
  1. Asthma
  2. Allergic Rhinitis (hayfever)
  3. Eczema
  4. Food
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7
Q

What is atopy?

A

Triad eczema, asthma, hayfever. Predisposition to developing allergic hypersensitivity reactions.

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8
Q

Can a baby get a peanut reaction the first time they’ve had peanuts?

A

No, you need to be sensitised first. IgE sensitised.

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9
Q

what is Oral allergy Syndrome? (OAS)

A

When exposure to pollen can induce food allergy e.g. Birch Pollen Allergy Syndrome.
IgE are directed to proteins in fruit/nuts following respiratory exposure to birch pollen

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10
Q

what are the types of allergic rhinitis?

A

Seasonal (grass pollen etc)
Perennial (pets, house dust mites)
Occupational (latex, lab animals)

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11
Q

How long does it take for Acute Urticaria to resolve?

A

Wheals resolve within 6 weeks. If they last longer than 6 weeks, this is Chronic Urticaria

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12
Q

What is anaphylaxis?

A

A severe systemic allergic reaction

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13
Q

What are the symptoms of anaphylaxis?

A

Respiratory: Wheeze, cough, throat swelling, breathing difficulty
Hypotension: Faint/raised HR
Skin: Erythema, Urticaria, Swelling, Itch

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14
Q

Why does anaphylaxis happen?

A

Following exposure to allergen, you get IgE mediated mast-cell degranulation. You can also get Non-IgE mediated anaphylaxis

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15
Q

Common causes for IgE mediated Anaphylaxis?

A

Wasps
Peanuts
Latex
Penicillin

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16
Q

Common causes for Non-IgE mediated Anaphylaxis?

A

NDAIDs
IV Contrast medium
Opioids

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17
Q

Which tests are used in Allergy?

A

Skin Prick Test
RAST
Complement Resolved Diagnostics
Challenge Test

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18
Q

What is the criteria for diagnosing Anaphylaxis?

A

Amina Said So
Airways affected (Life threatening breathing impairment)
Sudden onset/rapid progression
Skin involvement

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19
Q

Management of Anaphylaxis?

A

8 things

IM Adrenaline 500 micrograms
100% Oxygen
Raise legs
Hydrocortisone 100mg IV
Inhaled bronchodilators
Antihistamine e.g. Chlorphenamine
Refer to allergy specialist
IV Fluids
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20
Q

What is an important criteria for the Skin Prick test to work?

A

Must stop antihistamines for 48 hours before test

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21
Q

If you cannot stop your anti-histamines what can you do instead of the skin prick test?

A

RAST.

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22
Q

What does RAST do?

A

Measures IgE made against a certain allergen

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23
Q

What is the gold standard investigation for food allergy?

A

Challenge Test

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24
Q

What can you measure in the blood to check if anaphylaxis has occured?

A

Mast Cell Tryptase. (Peaks at 1-2 hours. Goes back down by 6 hours).
It is a protein released by mast cells that have undergone degranulation

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25
Q

Other differentials for anaphylaxis?

A 
Pheochromacytoma
Anxiety
ACE inhibitors (low BP)
Inhaled foreign body
Chronic Urticaria
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26
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Haemolytic Disease of the Newborn

A

Antigen on neonatal erythrocytes e.g. A, B, Rh

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27
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Goodpasture’s Syndrome

A

Glomerula basement membrane of Collagen 4

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28
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Graves Disease

A

TSH receptor

not just TSH

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29
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Churg Strauss Syndrome

A

Medium & Small Vessels

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30
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Wegener’s Granulomatosis

A

Medium & Small Vessels

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31
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Pernicious Anaemia

A

Intrinsic Factor

or

Gastric Parietal Cells

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32
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Pemphigus Vulgaris

A

Epidermal Cadherin

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33
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Autoimmune Thrombocytopaenic Purpura

A

Glycoprotein 2a/3b on platelets

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34
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Chronic Urticaria

A

Allegerns e.g. drugs, bites etc

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35
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Autoimmune Haemolytic Anaemia

A

Blood Group Antigens on Erythrocytes

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36
Q

What is Evans syndrome?

A

Autoimmune Haemolytic Anaemia + Immune Thrombocytopaenic Purpura

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37
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Myasthenia Gravis

A

Acetylcholine receptor

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38
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Microscopic Polyangitis

A

Pauci-immune necrotizing small vessels

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39
Q

Which antigen is attacked by an Ab in the following type 2 hypersensitivity disease:

Acute Rheumatic Fever

A

M proteins on Group A Strep

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40
Q

Which specific test(s) can be carried out for:

Myasthenia Gravis

A
  1. Anti Ach R Abs
  2. Tensilon Test
  3. Abnormal EMG
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41
Q

Which specific test(s) can be carried out for:

Goodpasture’s Syndrome?

A
  1. Anti GBM Ab

2. Smooth linear line visible on IF staining (IgG deposits on BM)

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42
Q

Which specific test(s) can be carried out for:

Wegener’s Granulomatosis?

A

c-ANCA granulomas

43
Q

Which specific test(s) can be carried out for:

Churg-Straus Syndrome?

44
Q

Which specific test(s) can be carried out for:

Microscopic Polyangiitis?

45
Q

What are the clinical features of Rheumatic Fever?

A

Myocarditis
Arthritis
Sydenham’s Chorea

46
Q

Name some Type 3 hypersensitivity Reactions

A 
SLE (DNA/histone complexes)
Polyarteririts Nodosa (hepatitis B/C virus antigen complexes)
47
Q

How do Type 4 hypersensitivity Reactions work?

A

Antigens attacked by T cells.

48
Q

Which antigen is attacked by an Ab in the following type 4 hypersensitivity disease:

T1DM

A
  1. Pancreatic Beta Cell

2. Glutamate Decarboxylase (GAD)

49
Q

Which antigen is attacked by an Ab in the following type 4 hypersensitivity disease:

MS

A
  1. Myelin Basic Protein

2. Proteolipid Protein

50
Q

Which antigen is attacked by an Ab in the following type 4 hypersensitivity disease:

Rheumatoid Arthritis

A

Synovial Membrane Antigens

51
Q

Which antigen is attacked by an Ab in the following type 4 hypersensitivity disease:

Contact Dermatitis

A

Chemicals in environment that touch you init

52
Q

Which antigen is attacked by an Ab in the following type 4 hypersensitivity disease:

Mantoux test

A

Tuberculin

53
Q

Which test can be done to diagnose the following Type 4 Hypersensitivity Reaction:

MS

A

Oligoclonal band of igG on electrophoresis

54
Q

Which test can be done to diagnose the following Type 4 Hypersensitivity Reaction:

T1DM

A

Ketones in urine
Blood glucose
Islet cell Abs
Glutamate Decarboxylase Abs

55
Q

Which test can be done to diagnose the following Type 4 Hypersensitivity Reaction:

RA

A

Anti-CCP
Rh Factor
X Ray
High CRP and ESR

56
Q

Which test can be done to diagnose the following Type 4 Hypersensitivity Reaction:

Contact Dermatitis

A

Clinical diagnose, patch test

57
Q

Which HLA is associate with:

Ankylosing Spondylitis

58
Q

Which HLA is associate with:

SLE

59
Q

Which HLA is associate with:

T1DM

A

HLA DR3 and DR4

60
Q

Which HLA is associate with:

RA

61
Q

Which HLA is associate with:

Graves

62
Q

Which HLA is associate with:

Goodpasture’s Syndrome?

A

HLA DR15/DR2

63
Q

What is limited cutanous scleroderma?

A 
CREST
Calcinosis
Reynauds
Esophageal Dysmotility
Sclerodactily (thickening of skin) 
Telangiectasia
64
Q

Which Abs are present in Limited Cutaneous Scleroderma?

A

Anti Centromere

65
Q

Which Abs are present in Diffuse Cutaneous Scleroderma?

A

Anti Topoisomerase

Anti Fibrilarin

66
Q

What is Diffuse Cutaneous Scleroderma?

A

CREST but scleroderma can occur anywhere and there is also multiorgan involvement

67
Q

What is Sjogren’s Syndrome?

A

Dry mucous membranes, mouth, eyes, skin etc.

68
Q

Which Abs are present in Sjogren’s Syndrome?

A

Anti-Ro

Anti-La

69
Q

Which test is done for Sjogren’s Syndrome?

A

Schirmer test: tear measurement test

70
Q

What is IPEX?

A

Immune dysregulatopn Polyendocrinopathy Enteropathy Xlinked

71
Q

Which mutation is ass. with IPEX?

72
Q

What is the gold standard test for Coeliac Disease?

A

Duodenal Biopsy

73
Q

What do you see on a Coeliac Duodenal Biopsy?

A

Villous Atrophy

Crypt Hyperplasia

74
Q

Which Abs are ass. with Coeliac Disease?

A

Anti Endomesial Abs (EMA)
Anti Tissue transglutaminase (Anti TTG)
Anti Gliadin

75
Q

Which Ig type is Anti-EMA in Coeliac?

76
Q

Which Ig type is Anti-TTG in Coeliac?

77
Q

Which Ig type is Anti-Gliadin in Coeliac?

78
Q

Which HLA is associate with:

Coeliac Disease

79
Q

Describe the autoantibody(s) found in:

Limited Cutaenous Scleroderma (CREST)

A

Anti-Centromere Ab IgG

80
Q

Describe the autoantibody(s) found in:

Myasthenia Gravis

A

Anti-Acetylcholine Receptor Ab IgG

81
Q

Describe the autoantibody(s) found in:

Pernicious Anaemia

A

Anti-Intrinsic Factor (50%)
OR
Anti-Gastric Parietal Cell (more common- 90%)

IgG

82
Q

Describe the autoantibody(s) found in:

T1DM

A

Anti-Glutamate Decarboxylase
OR
Anti Pancreatic Beta Cell
IgG

83
Q

Describe the autoantibody(s) found in:

Dermatomyositis

A

Anti-Jo-1 IgG (t-RNA synthetase)

Same as Polymositis

84
Q

Describe the autoantibody(s) found in:

Dermatitis Herpatiformis

A

Anti-Endomesial (EMA) IgA

85
Q

Describe the autoantibody(s) found in:

Anti-Phospholipid Syndrome

A

Anti-Cardiolipin IgG
OR
Anti B2 Glycoprotein IgG

86
Q

Describe the autoantibody(s) found in:

Churg-Strauss Syndrome

A

p-ANCA IgG

87
Q

Describe the autoantibody(s) found in:

Polymyositis

A

Anti-Jo-1 IgG (t-RNA synthetase)

Same as Dermatomyositis

88
Q

Describe the autoantibody(s) found in:

SLE

A

Anti-dsDNA IgG
OR Anti-Histone IgG
AND Ro, La, U1RNP

89
Q

Describe the autoantibody(s) found in:

RA

A

Anti-CCP IgG

Rh Factor also found

90
Q

Describe the autoantibody(s) found in:

Sjogren’s Syndrome

A

Anti-Ro IgG
Anti-La IgG
(60% have + Rheumatoid Factor)

91
Q

Describe the autoantibody(s) found in:

Microscopic Polyangitis (MPA)

A

p-ANCA IgG

92
Q

Describe the autoantibody(s) found in:

Wegener’s Granulomatosis (GPA)

A

c-ANCA IgG

93
Q

Describe the autoantibody(s) found in:

Hashimoto’s Thyroiditis

A

Anti-Thyroperoxidase (TPO) Or Anti-Thyroglobulin IgG

94
Q

Describe the autoantibody(s) found in:

Mixed Connective Tissue Disease

A

Anti-U1RNP IgG

95
Q

Describe the autoantibody(s) found in:

Autoimmune hepatitis

A

Anti-Smooth Muscle IgG
Anti- Liver Kidney Microsomal-1 (LKM-1) IgG
Anti- Soluble Liver Antigen (SLA) IgG

96
Q

Describe the autoantibody(s) found in:

Coeliac Disease

A

Anti-EMA IgA
Anti-TTG IgA
Anti-Gliadin IgG

97
Q

Describe the autoantibody(s) found in:

Congenital Heart Block in infants of mothers with SLE

A

Anti-Ro IgG

98
Q

Describe the autoantibody(s) found in:

Diffuse Cutaneous Scleroderma

A

Anti-Topoisomerase IgG

Anti- Fibrillarin IgG

99
Q

Describe the autoantibody(s) found in:

Goodpasture’s Syndrome

A

Anti-GlomerularBasement Membrane (GBM) IgG

100
Q

Describe the autoantibody(s) found in:

Graves Disease

A

Anti-TSH Receptor Ab IgG

101
Q

Describe the autoantibody(s) found in:

Primary Billiary Cirrhosis

A

Anti-Mitochondrial Ab IgG

102
Q

Describe the autoantibody(s) found in:

Autoimmune Thrombocytopaenic Purpura

A

Anti Glp 2b/ Anti Glp 3a IgG

or Ib-9-Ab IgG

103
Q

Describe the autoantibody(s) found in:

Auto-immune Haemolytic Anaemia

A

Anti-Rh Blood Group Antigen IgG

AANIYA PATH (31 decks)

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