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PBD I Exam 2 > Diseases of the Immune System II > Flashcards

Diseases of the Immune System II Flashcards

1
Q

four categories of immune pathology

A

1 - hypersensitivity
2 - autoimmune
3 - deficiency
4 - amyloidosis

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2
Q

hypersensitivity

A

excessive response to antigen

  • often associated with inherited genes
  • imbalance of activation/inhibition signals
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3
Q

type I hypersensitivity

A

aka immediate
mediated by Th2 cells - IgE antibodies, and mast cells
-vessels, smooth muscles, and inflammation
-occur within minutes
-systemic or local

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4
Q

type II hypersensitivity

A

aka antibody-mediated
mediated y IgM and IgG
-injury to tissue by phagocytosis, lysis
-inflammation

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5
Q

type III hypersensitivity

A

aka immune complex mediated
IgG and IgM bind antigens in circulation
-create immune complexes
-in circulation

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6
Q

type IV hypersensitivity

A

aka cell mediated

-T cells - Th1, Th17, CTLs

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7
Q

allergy

A

type I hypersensitivity

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8
Q

Sx of type I hypersensitivity

A 
localized skin swelling
nasal discharge
hay fever
bronchial asthma
allergic gastroenteritis

or shock (systemic)

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9
Q

two phases of type I hypersensitivity

A

immediate - vasodilation, leakage, gland secretion, and smooth muscle contraction (broncho)
-within 5-30 minutes

late-phase - infiltration of eosinophils, neutrophils, basophils, monocytes, CD4 T cells

  • tissue destruction
  • 2-24 hours
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10
Q

IgE

A

stimulation of type I hypersensitivity

-activate mast cells and other leukocytes

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11
Q

vasoactive amines and lipid mediators

A

immediate phase of type I

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12
Q

cytokines

A

late phase of type I

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13
Q

C5a and C3a

A

anaphylatoxins

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14
Q

mast cells

A

in tissues

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15
Q

basophils

A

in circulation

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16
Q

IL-4

A

class switching to produce IgE

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17
Q

IL-5

A

activates eosinophils

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18
Q

IL-13

A

enhances IgE production and stimulates mucus production

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19
Q

mast cell granules

A

preformed mediators of type I

  • vasoactive amines - histamine (bronchoconstriction)
  • enzymes - tissue damage
  • proteoglycans - heparin (anticoagulant)
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20
Q

lipid mediators from mast cells

A

arachidonic acid (released by phospholipase A2)

  • leukotrienes - vasoactive
  • prostaglandins - mucus and bronchospasm
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21
Q

cytokines of mast cells

A

initiate late-phase rxns

-TNF, IL-1, chemokines (leuko recruiters)

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22
Q

mellitin

A

in bee venom

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23
Q

leukotriene B4

A

chemotactic

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24
Q

prostaglandin D2

A

bronchospasm and mucus production

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25
Q

PAF

A 
platelet aggregation
histamine release
bronchoconstriction
vasodilation
vascular permeability
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26
Q

IL-4

A

amplifies Th2 response

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27
Q

atopy

A

predisposition to localized immediate hypersensitivity reactions
-higher serum IgE
more Il-4 producing Th2 cells

linkage to GLA genes

28
Q

non-atopic allergy

A

type I hypersensitivity triggered by temperature and exercise

29
Q

hygiene hypothesis

A

more type I

-because of decreased antigen exposure when younger

30
Q

systemic anaphylaxis

A

vascular shock, edema, difficulty breathing

  • type I hypersensitivity reaction
  • in prior sensitized individuals
31
Q

local type I reactions

A

urticaria (hives)
rhinitis (hay fever)
bronchial asthma
angioedema

32
Q

mechanisms of type II hypersensitivity

A

opsonization and phagocytosis
inflammation
cellular dysfunction

33
Q

opsonization of type II

A

IgG opsonized recognized by Fc receptors

-also, IgM and IgG activate complement

34
Q

ADCC

A

antibody dependent cellular cytotoxicity

-coated with IgG - stimulates killing by effector cells

35
Q

examples of type II hypersensivities

A

transfusion rxns
erythroblastosis fetalis
autoimmune hemolytic anemia, agranulocytosis, thrombocytopenia
drug rxns

36
Q

inflammation of type II

A

C5a - increases inflammation - chemotactic
C3a and C5a - vasc permeability

complement and Fc-dependent

glomerulonephritis and vascular rejection in transplant

37
Q

myasthenia gravis

A

antibody against acetylcholine receptors
-muscle weakness

type II hypersensitivity

38
Q

graves disease

A

type II hypersensitivity

antibody against TSH receptor
-cause hyperthyroidism

39
Q

goodpasture syndrome

A

antibody for non-collagen protein in lung and kidney

-nephritis and lung hemorrhage

40
Q

autoimmune hemolytic anemia

A

antibody for RBCs

41
Q

autoimmune thrombocytopenia purpura

A

antibody for platelets

42
Q

pemphigus vulgarus

A

antibody for epidermal junction protein

-bullae (blisters)

43
Q

acute rheumatic fever

A

antibody for streptococcal antigen cross reacts with myocardial antigen
-myocarditis and arthritis

44
Q

insulin-resistant diabetes

A

antibody for insulin receptor

-hyperglycemia and ketoacidosis

45
Q

immune complex

A

antigen and antibody combine in circulation

  • deposit somewhere - typically vessel walls
  • results in type III hypersensitivity
46
Q

acute serum sickness

A

administer large serum doses

  • antibody binds foreign antigen
  • deposition causes arthritis, vasculitis, nephritis
47
Q

3 phases of immune complex disease

A

1 - formation of antigen-antibody complex (IgM and IgG)
2 - deposition of immune complex
3 - inflammatory rxn at site

48
Q

favored sites of deposition for immune complexes

A

glomeruli and joints

  • blood filtered at high pressure
  • catches complexes
49
Q

vasculitis

A

inflammation of vessesls

50
Q

glomerulonephritis

A

inflammation of renal glomeruli

51
Q

arthritis

A

inflammation of joints

52
Q

C3 levels and type III

A

decreased serum C3 levels occur during type III rxns and can monitor disease activity

53
Q

acute necrotizing vasculitis

A

fibrinoid necrosis - of vessel wall

complexes seen with immunofluorescent microscopy

54
Q

systemic lupus erythematous

A

chronic serum sickness

-persistant antibodies against autoantigens

55
Q

arthus rxn

A

local immune complex vasculitis

  • skin usually
  • fibrinoid necrosis in vessel walls causes ischemic injury
56
Q

delayed type hypersensitivity

A

type IV mediated by CD4 T cells

  • immune inflammation
  • Th1 - lots of M0
  • Th17 - lots of neutrophils
57
Q

percentage of neutrophils vs. macrophages in type IV delayed type

A

lots of M0 - Th1

lots of neutrophils - Th17

58
Q

IL-12

A

from APCs

-stimulates Th1 formation

59
Q

IL-1, IL-6, IL-23

A

from APCs

-stimulate Th17 formation

60
Q

tuberculin reaction

A

delayed type hypersensitivity

-previously sensitized individual will have reddening and induration within 8-12 hours and peak at 24-72 hours

61
Q

epitheloid cells

A

transformed macrophages

  • occurs with non-degradable antigens
  • form granuloma
62
Q

contact dermatitis

A

urushiol - poison ivy and oak

-delayed-type hypersensitivity

63
Q

type I diabetes

A

CD8 T cells against pancreatic beta cells

64
Q

viral infected cells

A

displayed by class I MHC

65
Q

examples of type IV hypersensitivites

A

multiple sclerosis - T cell against CNS myelin
rheumatoid arthritis - T cell against antigen in joints
crohns disease - T cell against antigen in intestine

66
Q

CD8 T cell killing

A

perforins and granzymes

  • perforins - break membrane
  • granzymes - cleave and activate caspases

also Fas ligand - induce apoptosis

PBD I Exam 2 (18 decks)

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