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Year 2 MIS > Allergy > Flashcards

Allergy Flashcards

1
Q

What does the term atopy mean?

A
  • when an individual is more susceptible to develop allergies
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2
Q

In an allergic reaction there are 2 phases, acute and chronic. In the acute phase which antibody is associated with this type I hypersensitivity?

1 - IgA
2 - IgE
3 - IgM
4 - IgD

A

2 - IgE

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3
Q

In an allergic reaction there are 2 phases, acute and chronic. In the acute phase IgE is secreted in response to the allergen (antigen). What cell do these antibodies then bind with and then activate resulting in degranulation?

1 - neutrophils
2 - basophils
3 - eosinophils
4 - mast cells

A

4 - mast cells

- bind to the Fc epsilon receptor on mast cells

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4
Q

In an allergic reaction there are 2 phases, acute and chronic. In the acute phase IgE is secreted in response to the allergen (antigen). The IgE antibodies are able to bind with the Fc epsilon receptor on mast cells, resulting in degranulation. What key inflammatory mediator is release from the mast cells that is key in allergies?

1 - TNF-a
2 - histamines
3 - IL-6
4 - NF-KB

A

2 - histamines

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5
Q

There is a long list of factors which increase the risk of atopy. One that has received a lot of interest is the hygiene hypothesis. What is the hygiene hypothesis?

A
  • the use of clean procedures limits exposure to microorganisms and antigens at an early age
  • early exposure to a range of microorganisms and antigens reduces the risk of atopy
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6
Q

In an allergic reaction there are 2 phases, acute and chronic. In the acute phase IgE is secreted in response to the allergen (antigen). The IgE antibodies are able to bind with the Fc epsilon receptor on mast cells, resulting in degranulation and the release of the key inflammatory mediator histamine. What 2 other inflammatory mediators are produced as a results of histamine release from mast cells?

1 - leukotrienes and TNF-a
2 - leukotrienes and prostaglandins
3 - prostaglandins and TNF-a
4 - prostaglandins and IL-6

A

2 - leukotrienes and prostaglandins

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7
Q

In an allergic reaction there are 2 phases, acute and chronic. In the acute phase IgE is secreted in response to the allergen (antigen). The IgE antibodies are able to bind with the Fc epsilon receptor on mast cells, resulting in degranulation and the release of the key inflammatory mediator histamine. What affect does degranulation of mast cells have on the GI tract?

A
  • increased fluid secretions and peristalsis

- diarrhoea and vomitting

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8
Q

In an allergic reaction there are 2 phases, acute and chronic. In the acute phase IgE is secreted in response to the allergen (antigen). The IgE antibodies are able to bind with the Fc epsilon receptor on mast cells, resulting in degranulation and the release of the key inflammatory mediator histamine. What affect does degranulation of mast cells have on the respiratory tract?

A
  • histamine binds H1 receptors

- smooth muscle of bronchi contract and increase difficulty breathing

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9
Q

In an allergic reaction there are 2 phases, acute and chronic. In the acute phase IgE is secreted in response to the allergen (antigen). The IgE antibodies are able to bind with the Fc epsilon receptor on mast cells, resulting in degranulation and the release of the key inflammatory mediator histamine. What affect does degranulation of mast cells have on the blood vessels?

A
  • binds H1 receptors releasing nitric oxide

- increases vasodilation and blood vessel permeability

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10
Q

In an allergic reaction there are 2 phases, acute and chronic. In the chronic phase Granulocyte-macrophage colony-stimulating factor (GM-CSF) is activated. What is the role of GM-CSF?

A
  • stimulates bone marrow

- proliferation of eosinophils

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11
Q

What is immune tolerance?

A
  • immune systems ability to determine what is pathogenic and what is not
  • we don’t want immune response if not needed, like in type I hypersensitivity
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12
Q

In patients who suffer with chronic asthma and who are poorly controlled with their inhalers, what happens to the airways of these patients?

1 - re-modelling of muscle surrounding bronchi
2 - death of bronchi
3 - growth of bronchi
4 - no effect

A

1 - re-modelling of muscle surrounding bronchi

- smooth muscle and basement membrane undergo hyperplasia

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13
Q

Following the acute phase of an allergic reaction, how long can it take for the late phase to begin?

1 - 2-6 minutes
2 - 2-6 hours
3 - 2-6 days
4 - 2-6 weeks

A

2 - 2-6 hours

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14
Q

Physically are we able to see any symptoms in a patients affected tissue in the late phase of an allergic reaction?

1 - no all inside the body
2 - redness and swelling
3 - psoriasis develops
4 - loss of function of tissue

A

2 - redness and swelling

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15
Q

In the late phase reaction which cells can be located in higher than normal concentrations at the site of allergic inflammation?

1 - eosinophils, neutrophils, macrophages, lymphocytes (CD4 T cells)
2 - eosinophils, neutrophils, mast cells, lymphocytes (CD4 T cells)
3 - eosinophils, neutrophils, mast cells and B cells
4 - macrophages, neutrophils, macrophages, lymphocytes (CD4 T cells)

A

2 - eosinophils, neutrophils, mast cells, lymphocytes (CD4 T cells)

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16
Q

There are 4 main types of CD4 T helper cells (Th1, Th2, Th17 and Tregs). Which transcription factor stimulates the transformation of a CD4 T helper cell into a T1 helper cell?

1 - Foxp3
2 - GATA-3
3 - RORyt
4 - T-bet

A

4 - T-bet

- anti-viral in function

17
Q

There are 4 main types of CD4 T helper cells (Th1, Th2, Th17 and Tregs). Which transcription factor stimulates the transformation of a CD4 T helper cell into a T2 helper cell?

1 - Foxp3
2 - GATA-3
3 - RORyt
4 - T-bet

A

2 - GATA-3

  • anti-parasitic
  • specific transformation factor ensures body is prepared to fight parasites
18
Q

There are 4 main types of CD4 T helper cells (Th1, Th2, Th17 and Tregs). Which transcription factor stimulates the transformation of a CD4 T helper cell into a T17 helper cell?

1 - Foxp3
2 - GATA-3
3 - RORyt
4 - T-bet

A

3 - RORyt = RAR-related orphan receptor gamma

- anti-bacterial

19
Q

There are 4 main types of CD4 T helper cells (Th1, Th2, Th17 and Tregs). Which transcription factor stimulates the transformation of a CD4 T helper cell into a Treg helper cell?

1 - Foxp3
2 - GATA-3
3 - RORyt
4 - T-bet

A

1 - Foxp3

- suppression of T cells and antigen presenting cells

20
Q

There are 4 main types of CD4 T helper cells (Th1, Th2, Th17 and Tregs). Which T helper cell has been associated with the chronic response in allergies?

1 - Th1
2 - Th2
3 - Th17
4 - Tregs

A

2 - Th2, specifically the secretions from this cell

- IL-4, IL-5 and IL-13

21
Q

What % of people living with allergies have a severely debilitating form of their condition?

1 - 20%
2 - 40%
3 - 60%
4 - 80%

A

1 - 20%

- can be asthma attack, anaphylactic shock, or even death from an allergic reaction

22
Q

What % of the developed world populations have allergies?

1 - 20%
2 - 40%
3 - 60%
4 - 80%

A

1 - 20%

23
Q

Can genetics explain all allergies?

A
  • no

- likely to be polygenic, but no direct cause

24
Q

The hygiene hypothesis states that the use of clean procedures limits exposure to microorganisms and antigens at an early age. This could mean that early exposure to a range of microorganisms and antigens is reduced and increases the risk of atopy. What affect does low hygiene have on:

  • pathogen load
  • number of T2 and T1 helper cells
  • number of Treg cells
A
  • pathogen load = increased
  • more T1 than T2 helper T cells
  • Treg cells = increased in number
25
Q

The hygiene hypothesis states that the use of clean procedures limits exposure to microorganisms and antigens at an early age. This could mean that early exposure to a range of microorganisms and antigens is reduced and increases the risk of atopy. What affect does high hygiene have on:

  • pathogen load
  • number of T2 and T1 helper cells
  • number of Treg cells
A
  • pathogen load = decreased
  • more T2 than T1 helper T cells which is hypothesised why they have allergies
  • Treg cells = decreased in number, so no monitoring of T cells that shouldn’t be activated
26
Q

What is the skin allergen test that is able to test for allergens?

A
  • patient receives drops of common allergens placed on their forearm
  • patient then has a prick for each allergen to get allergen under the skin
  • patients are then left for 15 minutes to see if they have any reactions
27
Q

In the skin allergen test, if a patient is allergic to one of the allergens, what will happen to the skin where that allergen was administered?

A
  • red
  • itchy
  • slightly swollen lumps
28
Q

In the skin allergen test, what is the positive control that all people should react with?

1 - pollen
2 - cat hair
3 - dog hair
4 - histamine

A

4 - histamine

29
Q

In the skin allergen test, what layer of skin is punctured?

1 - epidermis
2 - dermis
3 - subcutaneous
4 - intravenous

A

1 - epidermis

- there shouldn’t be bleeding

30
Q

Allergies are normally diagnosed using an indirect ELISA. Organise the ELISA steps below used when diagnosing an allergy?

  • allergen of interest is used to coat bottom of the wells
  • colour changes and read on a plate reader
  • polyclonal antibody containing fluorophore is added
  • patients serum is added and incubated with allergen
A 
1st = allergen of interest is used to coat bottom of the wells
2nd = patients serum is added and incubated with allergen
3rd = polyclonal antibody containing fluorophore is added
4th = colour changes and read on a plate reader

wash and incubation steps occur throughout

31
Q

If a patient has an allergy and has asthma, they may begin to have an asthma attack. What treatment should these patients use to relieve their symptoms?

1 - B2 agonists (salbutamol)
2 - adrenalin
3 - anti-histamines
4 - B1 agonist

A

1 - B2 agonists (salbutamol)

- vasodilate blood vessels

32
Q

If a patient goes into anaphylactic shock due to an allergic reaction, they are generally given medication through a pen. What drug is contained within the pen?

1 - B2 agonists (salbutamol)
2 - adrenalin
3 - anti-histamines
4 - B1 agonist

A

2 - adrenalin

- called an epi pen for epinephrine, which is another name for adrenalin

33
Q

What is the core anti-histamine drug that we need to know?

1 - B2 agonists (salbutamol)
2 - adrenalin
3 - anti-histamines
4 - Chlorphenamine

A

4 - Chlorphenamine

34
Q

Chlorphenamine is the core anti-histamine drug that we need to know. What is the mechanism of action of this drug?

1 - binds anti-histamine and renders it inactive
2 - binds H1 receptors as an agonist
3 - binds H1 receptors and impairs binding of histamine
4 - binds to smooth muscle in bronchi

A

3 - binds H1 receptors and impairs binding of histamine

35
Q

What is the only core leukotriene receptor antagonist that is licensed in the UK?

1 - chlorphenamine
2 - adrenalin
3 - montelukast
4 - salbutamol

A

3 - montelukast

  • not as affective as H1 receptor anti-histamines
  • BUT more commonly used in chronic asthma
36
Q

Which glucocorticoid can be used to treat an allergy and is inhaled?

1 - Methylprednisolone
2 - Beclometasone
3 - Prednisolone
4 - Hydrocortisone

A

2 - Beclometasone

37
Q

Which glucocorticoid can be used to treat an allergy and is applied to the skin?

1 - Methylprednisolone
2 - Beclometasone
3 - Prednisolone
4 - Hydrocortisone

A

4 - Hydrocortisone

38
Q

There is a steroid medication that has equal has equal glucocorticoid and mineralocorticoid activity and can elicit the following effects:

  • inhibition of phospholipase A2
  • inhibition of Nuclear Factor-kappa B,
  • inhibition of other inflammatory transcription factors
  • promotion of anti-inflammatory genes

Which steroid medication is this?

1 - Methylprednisolone
2 - Beclometasone
3 - Prednisolone
4 - Hydrocortisone

A

4 - Hydrocortisone

Year 2 MIS (48 decks)

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