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342 - Pathologic Basis of Disease > Diseases Of Immunity > Flashcards

Diseases Of Immunity Flashcards

1
Q

Type I (Immediate-Type or Allergic) hypersensitivity reactions (HRs) may be localized or systemic. Localized type I HRs with an underlying genetic predisposition to “over-react” to innocuous antigens are called atopy.

Give four examples of atopic diseases seen relatively commonly in veterinary medicine.

A

Allergic dermatitis
Allergic rhinitis
Food allergy
Asthma

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2
Q

Type II hypersensitivity reactions may target any tissue or cell type but do tend to target one group. Which is this?

a. Allografts and xenografts
b. Blood cells and components
c. Cardiac myocytes
d. Cells containing intracellular but indigestible microbes
e. Nervous tissues and associated support cells
f. The glomerular basement membrane of the kidney
g. The iris, ciliary body and choroid (uveal tissues)

A

Blood cells and components

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3
Q

Which of the following terms is/are synonymous with Type I hypersensitivity?

Allergy
Antibody-Mediated Hypersensitivity
Cell-Mediated Hypersensitivity
Cytotoxic Hypersensitivity
Delayed-Type Hypersensitivity
Immediate-Type Hypersensitivity
Immune Complex Hypersensitivity

A

Allergy
Immediate-Type Hypersensitivity

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4
Q

Using the commonly accepted classification scheme four types of hypersensitivity reactions are recognized (I-IV). Which is/are antibody- mediated, and which is/are T cell-mediated?

A

Antibody-mediated: Types I, II and III
T cell-mediated: Type IV

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5
Q

True or false: The beneficial effects of immunity and the harmful effects of hypersensitivity occur through entirely different cellular mechanisms.

A

False. The outcomes are different, but the mechanisms are the same. HRs are just inappropriate or misdirected responses but use the same mechanisms as beneficial immunity.

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6
Q

Mast cell degranulation is primarily a feature of which type of hypersensitivity reaction?

A

Type I (Immediate-Type Hypersensitivity / Allergy)

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7
Q

Type I (Immediate-Type or Allergic) hypersensitivity reactions (HRs) may be localized or systemic.

What is the term for localized type I HRs with an underlying genetic predisposition to “over-react” to innocuous antigens?

A

Atopy

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8
Q

Type II hypersensitivity reactions tend to kill cells in one of two ways, and “monkey” with them in a third way. Please describe all these three mechanisms.

A

Killing cells: This occurs either through antibody-dependent cellular cytotoxicity (ADCC; where cells are opsonized and targeted for destruction) or through complement activation (–> inflammation is elicited, which kills the cell).

“Monkeying”: In rare diseases (e.g., myasthenia gravis) the antibodies in type II HRs can interfere with surface receptors, thus impacting a cell’s function but not killing it.

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9
Q

Using the commonly accepted classification scheme four types of hypersensitivity reactions are recognized (I-IV). Three are antibody- mediated. Which of these is/are mediated by IgE, and which is/are mediated by IgM or IgG?

A

IgE-mediated: Type I
IgG or IgM-mediated: Types II and III

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10
Q

Which of the following is/are NOT associated with the mediators released from mast cell granules?

Bronchodilation
Hemostasis
Increased vascular permeability
Leukocyte chemotaxis
Smooth muscle spasm
Vasodilation

A
  1. Bronchodilation (they cause bronchospasm, not bronchodilation)
  2. Hemostasis
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11
Q

Which of the following terms is/are synonymous with Type IV hypersensitivity?

Allergy
Antibody-Mediated Hypersensitivity
Cell-Mediated Hypersensitivity
Cytotoxic Hypersensitivity
Delayed-Type Hypersensitivity
Immediate-Type Hypersensitivity
Immune Complex Hypersensitivity

A
  • Cell-Mediated Hypersensitivity
  • Delayed-Type Hypersensitivity
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12
Q

Using the commonly accepted classification scheme four types of hypersensitivity reactions are recognized (I-IV). Three are antibody- mediated. Which of these is/are mediated by IgE, and which is/are mediated by IgM or IgG?

A

IgE-mediated: Type I
IgG or IgM-mediated: Types II and III

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13
Q

What is the term for an antigen that is too small to elicit an immune response by itself, and needs to be complexed with a larger protein to become antigenic? Examples include drugs, pesticides, and food toxins.

A

Hapten

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14
Q

Describe the pathogenesis of a type III hypersensitivity reaction

A

Antibody-antigen complexes (immune complexes) get “stuck” in tissues –> complement activation –> neutrophils called in –> “innocent bystander” tissue damage as neutrophils release enzymes

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15
Q

Eosinophil degranulation is primarily a feature of which type of hypersensitivity reaction?

A

Type I (Immediate-Type Hypersensitivity / Allergy)

This is associated with mast cell degranulation.

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16
Q

Which type of hypersensitivity reaction is most associated with granulomatous inflammation?

Type I
Type II
Type III
Type IV

A

Type IV (delayed or cell-mediated) hypersensitivity

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17
Q

Widespread mast cell activation and histamine release leading to a shock-like state involving multiple organ systems is known as what? Please give TWO terms.

A

Anaphylaxis, or a systemic type I hypersensitivity reaction

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18
Q

The following is the definition of which term? “Inappropriate or misdirected responses to a specific antigen that result in harmful reactions upon exposure of a sensitized host to that specific antigen.”

A

Hypersensitivity, or hypersensitivity reaction

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19
Q

Glomerulonephritis in dogs is an unexpected complication of many seemingly unconnected diseases, including bacterial uterine infection (pyometra). It results from deposition of antibody-antigen complexes in the glomerular basement membrane. What type of hypersensitivity reaction is this?

A

Type III hypersensitivity (immune complex hypersensitivity)

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20
Q

Using the commonly accepted classification scheme, how many types of hypersensitivity reactions are recognized?

A

Four

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21
Q

Type I (Immediate-Type or Allergic) hypersensitivity reactions (HRs) may be localized or systemic. A systemic type I HR is called anaphylaxis.

Give some of the clinical signs of anaphylaxis in order of least to most severe.

A

Pruritus (skin itchiness)
Hyperemia (turning red)
Angioedema (tissue edema)
Hypotension (falling blood pressure)
Bronchospasm (constricted airways within the lungs)
Laryngeal edema (constricted throat due to soft tissue edema)
Dyspnea (difficulty breathing)
Death (probably needs no explanation)

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22
Q

Which of the following terms is/are synonymous with Type II hypersensitivity?

Allergy
Antibody-Mediated Hypersensitivity
Cell-Mediated Hypersensitivity
Cytotoxic Hypersensitivity
Delayed-Type Hypersensitivity
Immediate-Type Hypersensitivity
Immune Complex Hypersensitivity

A

Antibody-Mediated Hypersensitivity
Cytotoxic Hypersensitivity

23
Q

A hypersensitivity reaction associated with development of antibodies against antigens on the surface of a cell or tissue is called what? Please give TWO terms.

A

“Type II hypersensitivity or
Cytotoxic hypersensitivity or
Antibody-mediated hypersensitivity”

24
Q

Hypersensitivity reactions (HRs) types I-III are all antibody-driven. HR type II is associated mainly with which antibody/bodies?

A

IgG and IgM

25
Q

What is a hapten?

A

A hapten is an antigen that is too small to elicit an immune response by itself. It needs to be complexed with a larger protein to become antigenic. Examples include drugs, pesticides, and food toxins.

26
Q

This describes the pathogenesis of a type III hypersensitivity reaction in simple terms:

“Antibody-antigen complexes (immune complexes) get “stuck” in tissues –> complement activation –> neutrophils called in –> “innocent bystander” tissue damage as neutrophils release enzymes”

Which types of antibodies (Ig type) are most commonly involved?

A

IgG and IgM

27
Q

If mast cells are activated by IgE, this is called a type I (allergic or even anaphylactic) reaction. If they are activated by non-IgE factors such as temperature or drugs, what is this called?

A

This is called an anaphylactoid (-oid, not -ic) reaction

28
Q

True or false: The beneficial effects of immunity and the harmful effects of hypersensitivity occur through the same cellular mechanisms.

A

True. The outcomes are different, but the mechanisms are the same. HRs are just inappropriate or misdirected responses but use the same mechanisms as beneficial immunity.

29
Q

Define the term anaphylaxis (also called a systemic type I hypersensitivity reaction).

A

Widespread mast cell activation and histamine release leading to a shock-like state involving multiple organ systems.

30
Q

Hypersensitivity reactions (HRs) types I-III are all antibody-driven. HR type III is associated mainly with which antibody/bodies?

A

IgG and IgM

31
Q

Using the commonly accepted classification scheme four types of hypersensitivity reactions are recognized (I-IV). Which is/are antibody- mediated, and which is/are T cell-mediated?

A

“Antibody-mediated: Types I, II and III
T cell-mediated: Type IV”

32
Q

True or false: Type II hypersensitivity reactions usually result in destruction of the affected cell(s).

A

“True. This occurs either through antibody-dependent cellular cytotoxicity (ADCC; where cells are opsonized and targeted for destruction) or through complement activation (–> inflammation is elicited, which kills the cell).

Remember that in rare diseases (e.g., myasthenia gravis) the antibodies in type II HRs can block receptors, thus impacting a cell’s function but not killing it.”

33
Q

Using the commonly accepted classification scheme four types of hypersensitivity reactions are recognized (I-IV). Three are antibody- mediated. Which of these is/are mediated by IgE, and which is/are mediated by IgM or IgG?

A

“IgE-mediated: Type I
IgG or IgM-mediated: Types II and III”

34
Q

What is the primary effect of histamine (released by activated mast cells) on the vasculature?

A

Vasodilation
Note: Mast cell granules also cause increased vascular permeability (or “leakiness”) but the mediators that achieve this are not histamine.

35
Q

True or false: Hypersensitivity reactions (HRs) cannot occur first exposure to an antigen.

A

True. HRs require initial exposure to an antigen (sensitization phase), time to mount an immune response, and then can only occur (effector phase) upon a subsequent exposure of the sensitized host to that specific antigen.

36
Q

Type IV (delayed-type or cell-mediated) hypersensitivity reactions are associated with all of the following EXCEPT:

a. Antibody-antigen complex formation and deposition
b. Antigens released by multicellular parasites
c. Antigens that are too small to elicit immune responses by themselves and need to be complexed with larger proteins to become antigenic
d. Cell surface receptors
e. Inhaled antigens such as pollen
f. Intracellular microbes that are able to avoid destruction
g. Peanuts and dairy products
h. Transplanted tissues and organs

A

a. Antibody-antigen complex formation and deposition
b. Antigens released by multicellular parasites
d. Cell surface receptors
e. Inhaled antigens such as pollen
g. Peanuts and dairy products

37
Q

Hypersensitivity reactions (HRs) types I-III are all antibody-driven. HR type I is associated mainly with which antibody/bodies?

A

IgE

38
Q

Type III hypersensitivity reactions are associated with which of the following?

a. Antigens that are too small to elicit immune responses by themselves and need to be complexed with larger proteins to become antigenic
b. Environmental antigens such as pollen
c. Immune complex deposition in tissues
d. Intracellular microbes
e. Neoplastic cells
f. Organ transplants
g. Parasitic antigens
h. Peanut and shellfish ingestion

A

c. Immune complex deposition in tissues

39
Q

Which type of hypersensitivity reaction is most associated with haptens?

Type I
Type II
Type III
Type IV

A

Type IV (delayed or cell-mediated) hypersensitivity

40
Q

Type I (Immediate-Type or Allergic) hypersensitivity reactions (HRs) may be localized or systemic. A systemic type I HR is called anaphylaxis.

Which vasoactive mediator is most strongly associated with anaphylaxis?

A

Histamine (released from mast cells)

41
Q

Using the commonly accepted classification scheme, four types of hypersensitivity reactions are recognized (Types I-IV).

For each one, give an alternate name then, for three of them, give a second alternate name.

A

Type I: Immediate-Type Hypersensitivity / Allergy
Type II: Cytotoxic Hypersensitivity / Antibody-Mediated Hypersensitivity
Type III: Immune Complex Hypersensitivity
Type IV: Delayed-Type Hypersensitivity / Cell-Mediated Hypersensitivity

42
Q

Hypersensitivity reactions (HRs) types I-III are all antibody-driven. HR type III is associated mainly with which antibody/bodies?

A

IgG and IgM

43
Q

Define the term anaphylaxis (also called a systemic type I hypersensitivity reaction).

A

Widespread mast cell activation and histamine release leading to a shock-like state involving multiple organ systems.

44
Q

True or false: Hypersensitivity reactions (HRs) can result on first exposure to an antigen.

A

False. HRs require initial exposure to an antigen (sensitization phase), time to mount an immune response, and then can only occur (effector phase) upon a subsequent exposure of the sensitized host to that specific antigen.

45
Q

Define the term “hypersensitivity reaction.”

A

Inappropriate or misdirected responses to a specific antigen that result in harmful reactions upon exposure of a sensitized host to that specific antigen.

46
Q

Type II (cytotoxic or antibody-mediated) hypersensitivity may be directed against endogenous or exogenous cell surface antigens. Give one example of each type of antigen.

A

Endogenous: Normal cellular protein; Surface receptor
Exogenous but adhered to cell surface: Drug; Microbial protein

47
Q

Type IV (delayed-type or cell-mediated) hypersensitivity reactions are associated with which of the following?

a. Antibody-antigen complex formation and deposition
b. Antigens released by multicellular parasites
c. Antigens that are too small to elicit immune responses by themselves and need to be complexed with larger proteins to become antigenic
d. Cell surface receptors
e. Inhaled antigens such as pollen
f. Intracellular microbes that are able to avoid destruction
g. Peanuts and dairy products
h. Transplanted tissues and organs

A

c. Antigens that are too small to elicit immune responses by themselves and need to be complexed with larger proteins to become antigenic
f. Intracellular microbes that are able to avoid destruction
h. Transplanted tissues and organs

48
Q

Which of the following terms is/are synonymous with Type III hypersensitivity?

Allergy
Antibody-Mediated Hypersensitivity
Cell-Mediated Hypersensitivity
Cytotoxic Hypersensitivity
Delayed-Type Hypersensitivity
Immediate-Type Hypersensitivity
Immune Complex Hypersensitivity

A

Immune Complex Hypersensitivity

49
Q

Which cell’s granules are most associated with release of the vasoactive mediator histamine?

Eosinophil
Mast cell
Neutrophil

A

Mast cell

50
Q

Which type of hypersensitivity reaction is described below?

Antibody-antigen complexes get “stuck” in tissues –> complement activation –> neutrophils called in –> “innocent bystander” tissue damage as neutrophils release enzymes

A

Type III hypersensitivity (immune complex hypersensitivity)

51
Q

Mast cells are particularly “known” for summoning which type of granulocyte?

A

Eosinophils (although they can also summon neutrophils)

52
Q

“Blue eye” in dogs is the lay term for the uveitis that sometimes follows infection with the virus that causes canine hepatitis. It results from deposition of antibody-antigen complexes in the iris, ciliary body, and choroid. What type of hypersensitivity reaction is this?

A

Type III hypersensitivity (immune complex hypersensitivity)

53
Q

Type I (Immediate-Type or Allergic) hypersensitivity reactions (HRs) may be localized or systemic.

What is the term for a systemic type I HR?

A

Anaphylaxis

342 - Pathologic Basis of Disease (14 decks)

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