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patho final > abnormal immune response > Flashcards

abnormal immune response Flashcards

1
Q

3 major types of abnormal immune responses?

A
  1. immunodeficiency
  2. hypersensitivity
  3. autoimmunity
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2
Q

what is immunodeficiency?

A

-partial or complete loss of immune response

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3
Q

what are the 2 categories of immune response?

A
  • antibody mediated (b cells)

- t cell response

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4
Q

immunodeficiency- which kind of response of the immune system is deficient?

A

either or! it could be one or the other or both

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5
Q

what is the primary immunodeficiency?

A

genetic or congenital

-immune system fails to develop (example the thymus)

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6
Q

what is secondary immunodeficiency?

A

acquired (post-natal)

  • example: infection (AIDS, HIV destroy T helper cells)
  • cancer treatment, some drugs
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7
Q

whats a primary disease?

A

stand alone disease, developed on its own

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8
Q

what is a secondary disease?

A
  • pneumonia developing because of the flu, not a stand alone disease
  • develops because of another diseas
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9
Q

what are the types of immunodeficiency (5)?

A
  1. B cell disorders–> impaired antibody production- either primary or secondary
  2. T cell disorder–> T cell function impaired
  3. T and B disorders–> nearly no immune response
  4. complement disorders (integral part of IR!)
  5. disorders of phagocytosis
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10
Q

treatment for immunodeficiency? (2)

A
  1. replacement therapy- giving the body antibodies (gamma globulins), supplementing the immune response
  2. marrow transplant?? if it is genetic or congenital
    - very complex, usually last resort
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11
Q

what is hypersensitivity?

A

exaggerated/inappropriate immune response.. never better, always a problem

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12
Q

4 types of hypersensitivity? (4)

A

Type 1- Allergy or IgE mediated H
Type 2- cytotoxic or tissue specific H
Type 3- Immune complex H
Type 4- T cell mediated or delayed H

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13
Q

acronym for hypersensitivity types

A

ACID

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14
Q

difference between the first 3 types of hypersensitivity and type 4

A

first three types are driven by antibodies

-type 4 is mediated by the T cells

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15
Q

What is shock?

A

acute hypo-perfusion due to CV failure—> hypoxia, systemic

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16
Q

types of shock? (4)

A

cardiogenic
hypovolemic
obstructive
distributive

17
Q

what is anaphylactic shock? what does it follow?

A

follows severe allergic reaction (type 1 H)

-will cause death unless reversed

18
Q

process of anaphylactic shock?

A 
1. allergen-->
mediator released-->
increased systemic vasodilation-->
increased capillary permeability--> 
circulatory failure--->
edema
19
Q

what is septic shock?

A

similar to anaphylactic but follows severe infection

  • also vasodilatory, multi organ failure
  • extension of type 1 hypersensitivity
20
Q

what is Type 1 hypersensitivity? (onset, why does it occur)

A
  • common form
  • mediated via IgE antibody, due to allergens
  • acute onset, occurs within minutes
21
Q

what happens the first time a person makes contact with an allergen?

A 
Th2 cytokines produced (mediated b Il-4)-->
B cell stimulation-->
plasma cell formation
---> leads to production of antibodies
---> igE binds to the mast cell
22
Q

what happens after re-exposure to an allergen?

A

allergen binds to IgE on mast cell—>
inflammation mediator release–>
inflammation (prostaglandin and histamine released at site of exposure)
—> at site, erythema, pruritus, swelling

23
Q

what is type 2 hypersensitivity?

A
  • mediated via IgG or IgM
  • antigens are developed during development that are self, and non-self
  • endo and exogenous antigens are mistargeted by antibodies
24
Q

antigens- endogenous vs exogenous

A

endogenous are your antigens

exogenous are human antigens but they are from someone else so your body reacts to it

25
Q

what is type 3 hypersensitivity?

A

The immune complex formed from antigen and antibody is not removed/degraded, so it deposits in the tissues

26
Q

where does the IC deposit in type 3 usually?

A

on the surface of endothelium–> abnormal, form of injury

27
Q

what happens when the IC deposits in tissues (type 3)?

A
  • defense cells come and attempt to remove it, triggers inflammation and damages vessels
  • complement is activated
28
Q

why are the ICs not degraded in type 3?

A

one of 2 reasons usually

  • some of the ICs are too tiny to be recognized by enzymes that break down ICs
  • the immune complexes are refractory to breakdown (resistant)
29
Q

what are 2 examples of type 3 hypersensitivity?

A
  • glomerulonphritis

- rheumatoid arthritis

30
Q

what is different about type 4 hypersensitivity?

A

T cell mediated! no antibodies involved

31
Q

what happens in Type 4?

A

macrophage presents bacterial cell (antigen)—> T cell is synthesized–> cytotoxic T cell
BUT… now the T cell destroys the macrophage too causing inflammation and tissue damage

32
Q

2 responses of type 4?

A
  1. direct response (very quick)
  2. delayed (occurs later because T cells produce mediators but this can take up to 72 hours, and it requires these mediators like lymphokines
33
Q

what is an example of type 4?

A

tuberculin skin test

34
Q

what is autoimmunity?

A

chronic problem, immune system is targeting cells within our body, the entire immune system!

35
Q

when self tolerance of antigens is lost, what will happen?

A

immune system will recognize “self” antigens as “foreign”
so, T cells and antibodies target self antigens
-causes inflammation, tissue damage, necrosis

36
Q

what can self-tolerance be lost by? (3)

A
  1. molecular mimicry
    - epitope on a bacteria similar to the epitope on our self antigens confuses the immune system—> thus antigen is mis-identified
  2. abnormal T cell function
    - example loss of suppression
  3. exposure of sequestered antigens in disease
    - immune system disregard or does not process the antigens that are internalized

patho final (40 decks)

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