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PCM II Final > Approach To Hypersensitivity > Flashcards

Approach To Hypersensitivity Flashcards

1
Q

Type I Immediate Hypersensitivity

A

Step 1: Antigen exposure
Step 2: IgE cross-linking on mast cell
Step 3: Histamine, leukotriene, prostaglandin, tryptase release
Step 4: Symptoms of urticaria, rhinitis, wheezing, diarrhea, vomiting, hypotension, and anaphylaxis within minutes of exposure

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2
Q

Type II Cytotoxic Hypersensitivity

A

IgM or IgG Ab destroys cells by:

  • obsonization
  • complement mediated lysis
  • Ab-dependent cellular cytotoxicity
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3
Q

Examples of Type II hypersensitivity

A

ABO mismatch
Graves Disease
Myasthenia Gravis

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4
Q

Type III Hypersensitivity

A

Step 1: Ag-Ab complex

Step 2: Complex active complement, neutrophils invade

Step 3: tissue inflammation (Tumor, Rubor, Calor, Dolor)

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5
Q

Examples of Type III hypersensitivity?

A

Systemic Lupus erythematosus
Rheumatoid Arthritis
Farmer’s Lung

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6
Q

6yo boy comes in early spring with rhinitis and sneezing for past week. What type of hypersensitivity?

A

Type I

-pollen allergy, mediated by histamine

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7
Q

25 yo female comes in with fatigue, blurry vision. She has ptosis and progessive muscle weakness. What type of hypersensitivity?

A

Type II

-due to IgM or IgG Ab destruction

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8
Q

58 yo male presents in afternoon w fever, chills, cough, chest tightness, and SOB. He had no signs this morning. Crackles are heard upon auscultation. What type of hypersensitivity?

A 
Type III (farmers lung)
-immune complexes depositing, neutrophils invading (fever, chills)
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9
Q

Type IV Cell mediated hypersensitivity

A

Delayed type

Step 1: Ag exposure sensitized cells
Step 2: T Cell activation 48-96 hours later

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10
Q

Examples of Type IV hypersensitivity

A

Poison Ivy, PPD testing for TB

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11
Q

12 yo boy comes in with rash on legs bilaterally after exploring through woods with his friends two days ago. States that the rash is itchy. What type of hypersensitivity?

A

Type IV

-delayed!

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12
Q

What is rheumatoid arthritis?

A

Systemic inflammatory tissue where granulationtissue develops in synovialjoint spaces and erodes into articular cartilage and bone

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13
Q

Who is more at risk for RA?

A

Females>Males

-also has genetic component

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14
Q

RA Presentation

A

Joint swelling, warmth, erythema, and decreased ROM

Stiffness in morning for >1hr

PIP, MCP, wrist, knees and ankles most affected

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15
Q

Pt comes in with pain in DIP, carpometacarpal joint, and you notice herbdens nodes. Morning stiffness lasts less than one hour and gets worse with effort. What is diagnosis?

A

Osteoarthritis
-NOT RA

RA has morning stiffness greater than 1hr, worse after rest, and swellings at MCP and PIP with no herbdens nodes

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16
Q

Juvenile Idiopathic Arthritis

A

Collagen vascular disorder w persistent inflammation in 1 or more joints for 6+ weeks in pt <16 yo

Onset is typically at 1-3yo
-females>males

17
Q

Presentation of JIA?

A

Pauciarticular
-Large joints that are asymmetric

Polyarticular
-large and small joints are symmetric

Systemic

  • recurrent, high fevers
  • myalgia, pericarditis
  • anemia, leukocytosis
18
Q

Systemic Lupus Erythematosus

A

Inflammatory disorder with recurrent exacerbation and remission, secondary to autoAb formation
-type III hypersensitivity

19
Q

Who is at most risk for systemic lupus erythematosus?

A

Females, especially if African American

Also has genetic component of HLA-DR2/DR3

20
Q

Key characteristics for deciding between SLE and RA

A
  1. Morning stiffness lasts minutes for SLE, but hours for RA
  2. Erosions are uncommon in SLE, but common in RA
  3. Deforming arthritis uncommon in SLE, but common in RA
21
Q

What is psoriasis?

A

Chronic, hyperproliferative inflammatory disorder characterized by thick, adherent scales

Females=males

22
Q

What is buzzword for psoriasis?

A

“Salmon pink” plaques with silver white scale

23
Q

Multiple sclerosis

A

Demyelination disorder of CNS

24
Q

Who is at risk for MS?

A

Females>Males

-genetic component as well

25
Q

30 yo female comes in with vision changes, vertigo, and progressive weakness along with numbness and tingling in her arms. She has also been noticing a lot of urinary incontinence lately.. what could be diagnosis?

A

Sounds a lot like MS

-get MRI/CSF

26
Q

Clinical Signs to Suggest Primary Immunodeficiency?

A
  • FH
  • Infections in multiple locations
  • Increasing frequency and severity of infections
  • Reccurent serious infections
27
Q

T Cell immunodeficiency

A

Presents in first 3-4 months of life

-disseminated intracellular diseases

28
Q

Example of T Cell immunodeficiency?

A

DiGeorge

29
Q

B Cell Immunodeficiency

A

Present after 6mo (mom protects until then)

-sinopulmonary and GI infections

30
Q

T/B Cell Combined Immunodeficiency

A

SCID is classic example

Combo of Sinopulmonary and GI infections with Disseminated intracellular diseases

31
Q

Phagocytic Immunodeficiency

A

Sinopulmonary and Soft tissue infections

32
Q

Example of Phagocytic immunodeficiency?

A

Chediak-Higashi syndrome

-defect in MT fxn=decreased phagocytosis

33
Q

HIV/AIDS

A

Spread through transmission of body fluids

-more prevelant in males

34
Q

Presentation of HIV/AIDs

A

Flu like symptoms

  • myalgia
  • fever
  • anorexia
  • headache
  • fatigue
  • pharyngitis

PCM II Final (7 decks)

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