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Advanced Patho UC Exam #2 > Alterations in Immunity and Inflammation > Flashcards

Alterations in Immunity and Inflammation Flashcards

1
Q

alloimmunity

examples?

A

alloimmunity: directed against beneficial foreign tissues (transfusions, transplants, transient neonatal alloimmunity)

transient neonatal alloimmunity: fetus expressing parental antigens not found in the mother (Rh factor)

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2
Q

Type I Hypersensitivity

Receptors

s/s

A

IgE mediated, anaphylaxis (urticaria + bronchospasm), allergy

H1 & H2 receptors

H1 - bronchial constriction, edema, vasodilation
H2 - increased gastric secretions, decrease release of histamine from mast cells and basophils

angioedema, itching, conjunctivitis, rhinitis, bronchospasm, GI cramps

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3
Q

allergic rhinitis

s/s

A

when allergies occur year round, otherwise called hay fever

conjunctivitis, rhinitis

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4
Q

Type II hypersensitivity

How does it happen? Mediated by? Examples?

A

tissue specific, cytotoxic mediated

  • specific cell or tissue is the target of an immune response
  • mediated by IgG and IgM

Five mechanisms by which this occurs but one way is by antibody-dependent cell-mediated cytotoxicity

Examples: Graves disease, autoimmune hemolytic anemia, rheumatic fever

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5
Q

Type II hypersensitivity that occurs 1wk to 6mo. after group A beta hemolytic streptococcal pharyngitis

s/s

A

Rheumatic fever

fever, migratory polyarthritis, carditis –> causes rheumatic heart disease (chronic)

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6
Q

Type III hypersensitivity

A

immune (antigen-antibody) complex mediated

  • complexes are formed in the circulation and later deposited in vessel walls or extravascular tissues
  • IS NOT ORGAN SPECIFIC

Intermediate size complexes are the ones that are not cleared and get deposited in tissues

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7
Q

Type III hypersensitivity has periods of remission and exacerbation…what are some examples?

A

serum sickness - affects blood vessels, joints, and kidney; Raynaud phenomenon

arthus reaction - deposit in walls of local blood vessels (causes vascular permeability, edema, clotting, etc.)

SLE

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8
Q

Type IV - mediated by? destruction by?

Examples?

A

MS, skin test for TB, contact allergic reactions, DM 1, Hashimoto disease, Crohn’s disease

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9
Q

Which of the hypersensitivities involves allergies?

A

all of them

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10
Q

Type I allergens

A 
pollen, molds, fungi
foods
animals 
certain drugs 
cig smoke, house dust
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11
Q

Type II and III allergens

A

allergens are RARE in these, but can include abx like PCN, and antigens produced by Hep B

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12
Q

Type IV allergens

A

plant resins, metals, acetylates; chemicals in rubber, cosmetics, detergents, and topical abx

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13
Q

1 control of allergy is through

A

ANS - biochemical mediators (epi, acetylcholine) bind to appropriate receptors on mast cells and target cells of inflammation

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14
Q

antigenic targets of type IV hypersensitivity reactions

A

Type IV: mostly haptens that react with normal self-proteins in the skin

result: allergic contact dermatitis (Poison Ivy)

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15
Q

antigenic targets for type II and III

examples?

A

haptens that bind to the surface of cells and elicit an IgG or IgM response

drug allergy - type II

arthus reaction - type III

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16
Q

SLE what type of hypersensitivity?

autoantibodies against?

A

type III

autoantibodies against: nucleic acids, RBCs, coagulation proteins, phospholipids, lymphocytes, platelets, and many others

*deposition of circulating immune complexes containing antibody against the host’s DNA

17
Q

Clinical manifestations of SLE

A

joint pains, vasculitis and rash, renal disease, hematologic changes (anemia), cardiovascular disease

18
Q

Eleven findings present in SLE, 4 = dx

presence of what antibodies?

A

malar rash (face), discoid rash, photosensitivity, mouth ulcers, nonerosive arthritis, serositis, renal disorders, neuro disorders, hematologic disorders, immunologic disorders, and…

presence of antinuclear antibodies (ANAs)

19
Q

what type of hypersensitivity is a transfusion reaction

A

alloimmune type II hypersensitivity rxn (specific target - RBCs)

20
Q

Universal donor

A

O- blood type (no antigens on surface) anti-A and anti-b antibodies

21
Q

Universal recipient

A

AB+ (surface antigens A+B) and no antibodies

22
Q

Rh-positive

A

expresses the D antigen on the RhD protein

23
Q

hemolytic disease of the newborn

A

Rh- negative mother gives birth to a Rh+ infant

*Rh- individual makes anti-D antibodies if exposed to Rh+ RBCs

24
Q

Graft rejection (alloimmune rxn) - 3 types

A

hyperacute - rare d/t pre-existing antibodies

acute - cell-mediated against unmatched HLA antigens

chronic - months to years; d/t weak cell-mediated response reaction against minor antigens

25
Q

primary immune deficiency is….

secondary immune deficiency is…

hallmark of immune deficiency?

A

primary is genetic (congenital)

secondary is acquired (caused by illness)

recurrent infections

26
Q

recurrent gonorrhea suggests what deficiency

A

complement deficiency

27
Q

recurrent viral infections suggests what deficiency

A

t-cell

28
Q

recurrent microorganism requiring opsonization infection suggests

A

deficiency in B-cell and phagocytes

29
Q

causes of secondary immune deficiencies (acquired)

A

stress, diet insufficient, malignancies, met disease, trauma, treatments, infections (AIDS)

30
Q

erythema infectiosum (fifth disease)

infection by which virus?

A

parvovirus B19
droplet
up to 21 day incubation
slapped cheek syndrome

mild self-limiting viral disease - red macular rash first appearing on cheeks and ears
-low grade fever, h/a, rash, cold-like symptoms

31
Q

Hepangina caused by? s/s? transmitted how?

A

acute viral illness caused by enterovirus coxsackie A and B

s/s: fever, ulcerative mouth lesions, cough, coryza, pharyngitis, high fever (up to 106), sore throat, n/v/d, fatigue, etc.

tonsilor lesions - culture to r/o strep

fecal-oral and oral-oral

32
Q

Mono - transmitted how? Incubation? Screening?

A

EBV

Transmission oropharyngeal route (saliva) or blood

incubation 30-50 days

monospot screening (check for antibody) and consider EBV antibody titer (esp in older pt)

33
Q

influenza caused by? can undergo?

A

orthomyxovirus (ssRNA virus) that appears in Antigenic types A and B

antigenic drift or mutation: change in surface molecules

antigenic shift - recombination into a new virus from two different species

34
Q

Measles also called? caused by? s/s? transmitted how? dx?

A

Rubeola

RNA virus, paramyxovirus family

s/s: fever, red maculopapular rash, cough, coryza, conjunctivitis, characteristic rash or oral mucus membranes (Koplik spots)

transmitted by direct contact with infectious droplets, or less commonly by airborne spread (highly contagious)

dx: detected from nasopharyngeal secretions, conjunctiva, blood, urine

35
Q

Mumps (parotitis)

A

paramyxovirus or mumps virus

symptoms: tender swollen parotid glands for 7-10 days, fever

virus best collected in saliva

36
Q

rubella (german measles)

A

mild viral disease also known as 3-day measles

transmitted by direct or droplet contact with nasopharyngeal secretions

rubella virus (RNA, togaviridae fam)

s/s: maculopapular rash beginning on face and spreading to trunk that resolves by day 3

virus detected by nasal smear

*infants w/congenital rubella may shed virus for 1 yr or more

37
Q

varicella - also called? how is it spread? what virus? dx tests?

A

chickenpox

usually mild acute viral disease, highly contagious

caused by varicella zoster virus (herpes family)

airborne, touch (rarely)

can be contacted by someone who has shingles (herpes zoster)

no dx tests indicated

38
Q

west nile virus? s/s? how contracted? caused by what virus? dx

A

febrile, rash, arthritis, myalgia, weak, lymphadenopathy, meningoencephalitis, n/v, rash, h/a

caused by arbovirus family Flaviviridae

transmission: mos to bird, bird to mos to human

CSF with IgM antibody; pleocytosis: increased number of lymphocytes in CSF

39
Q

cytomegalovirus, transmitted how? s/s? remains in person? most common what?

A

DNA virus; herpesvirus

direct contact

immunocompromised at risk - think transplant

most common congenital infection in the US at delivery (5-15% of all newborns)

remains with person for life

symptoms: mono-like w/fever, fatigue, pharyngitis, ulcerative lesions in mouth; loss of vision

retinitis

Advanced Patho UC Exam #2 (5 decks)

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