Autoimmune 1/2

Question 1

Type 1 Hypersensitivity is mediated by

Answer 1

IgE antibodies

Question 2

IgE antibodies action

Answer 2

activation of mast cells by binding antigen

Question 3

Which granulocytes are recruited in Type 1 HS

Answer 3

eosinophils, neutrophils

Question 4

Anaphylactic shock and asthma are which type of HS rxn

Answer 4

Type 1

Question 5

Which HS reaction is antibody-mediated

Answer 5

Type 2

Question 6

In type 2, there are three kinds of antibody-mediated tissue damage

Answer 6

1) Ab opsonization
2) Ab’s trigger complement
3) Ab’s bind normal structures to either up or downregulate

Question 7

Graves disease is what type of HS and is it an up regulation or down regulation

Answer 7

Type 2, up regulation of function

Question 8

Myasthenia Gravis is an up regulation or down regulation and what type of HS

Answer 8

Type 2, down regulation

Question 9

Type III HS diseases are mediated by what

Answer 9

immune complex-mediated

Question 10

How are immune complexes formed in type 3

Answer 10

Ab against self/foreign antigens cause formation of immune complexes

Question 11

Systemic effects of Typ3

Answer 11

Deposits of complexes in walls of blood vessels
- local effects are less common

Question 12

Type 4 HS mediated by what

Answer 12

Mediated by T cells

Question 13

2 classes of Type 4 HS

Answer 13

DTH (delayed type HS) and cell-mediated cytotoxicity

Question 14

What is DTH

Answer 14

APC’s present an antigen which is stored by memory T, and next time its seen the reaction is stronger
- TB bubble test

Question 15

what is cell-mediated cytotoxicity

Answer 15

CD8+ release granules to kill cells

Question 16

Anergy

Answer 16

Inactivation anstatt death

Question 17

ITP, Goodpasture, Pemphigus Vulgaris, Graves and Myasthenia Gravis are all examples of

Answer 17

Type II autoimmune diseases

Question 18

ITP physical clues

Answer 18

• bleeding tendency, but normal coag. tests
• petechiae or ecchymoses on skin, GI, GU

Question 19

Chronic ITP

Answer 19

80% of women 20-40 have antibodies against platelet membrane glycoproteins

Question 20

in chronic ITP, what platelet membrane glycoproteins do antibodies destroy

Answer 20

Integrins: IIb/IIIa/Ib/Ix

Question 21

When is acute ITP found

Answer 21

in children after viral infections

Question 22

Goodpasture physical clues

Answer 22

renal and pulmonary lesions, requires eventual renal transplant

Question 23

Goodpasture mechanism

Answer 23

antibodies against a3 chain of collagen 4 in 90% of pts

Question 24

Goodpasture treatment

Answer 24

plasma exchange, immunosuppressive drugs

Question 25

Pemphigus Vulgaris physical

Answer 25

blistering within epidermis, squamous mucosal epithelium

Question 26

Pemphigus vulgaris mechanism

Answer 26

IgG attack intercellular attachments, shown as fishnet pattern on IF

Question 27

Graves disease physical

Answer 27

thyrotoxicosis, opthalmopathy, pretibial myxedema

Question 28

Graves disease mechanism

Answer 28

intolerance of thyroid antigens (mainly TSH)

Question 29

Graves disease diagnosis

Answer 29

increased T3/4, decreased TSH

Question 30

Myasthenia Gravis mechanism

Answer 30

Antbodies block Ach receptors at motor end plates leading to degradation and depletion

Question 31

SLE is which type of autoimmune?

Answer 31

Type III, immune complex mediated

Question 32

SLE physical

Answer 32

lesions that affect CT and vessels of involved organs - renal failure - common involvement of skin, joints, CNS

Question 33

SLE mechanism

Answer 33

failure to maintain self-tolerance leads to production of large numbers of autoantibodies that either cause direct damage or create deposits - auto-ab against RBC, WBC, platelets

Question 34

SLE immunologic abnormalities

Answer 34

RBC exposed to IFN-a - also TLR produce signals that activate self-nuclear antigens

Question 35

IFN-a

Answer 35

type 1 interferon from dendritic cells

Question 36

Which TLR recognizes DNA?

Answer 36

TLR9

Question 37

Which TLR recognizes RNA?

Answer 37

TLR7

Question 38

MS is what type of autoimmune diseases?

Answer 38

Type 4 T-cell mediated

Question 39

MS physical

Answer 39

lesions of white matter myelin called plaques, stepwise disease progression

Question 40

MS mechanism

Answer 40

loss of tolerance to myelin basic protein and proteolipid protein - some involvement of B cells - T cells trigger release of proinflammatory cytokines

Question 41

Which antibody is responsible for ADCC?

Answer 41

IgG, provides binding site for WBC to kill cell

Question 42

Which antibody is responsible for placental transfer?

Answer 42

IgG

Question 43

Which antibodies are responsible for complement activation?

Answer 43

IgG and IgM

Question 44

Which antibody is responsible for allergic reactions

Answer 44

IgE

Question 45

which antibody binds mast cells, eosinophils

Answer 45

IgE

Question 46

Which antibody functions in neutralization, tolerance?

Answer 46

IgA

Question 47

what do chemokine do?

Answer 47

Activate leukocytes, recruit lymphocytes to lymph nodes

Question 48

Which cells release perforin

Answer 48

Cytotoxic T, NK

Question 49

Which cells release Granzymes

Answer 49

Cytotoxic T, NK

Question 50

What do granzymes do

Answer 50

serine proteases that induce apoptosis

Question 51

TNF

Answer 51

released by Th1, MØ, active in fever, pro-inflammatory, implicated in chronic inflammation, also a death receptor that induces apoptosis