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IHO Week 3 > Diseases of the Immune System - Nelson > Flashcards

Diseases of the Immune System - Nelson Flashcards

1
Q

What are the two branches of the Adaptive Immune System?

A

Humoral Immunity

Cellular Immunity

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2
Q

What is the function of the immune system?

A

To protect against harmful microorganisms and cellular agents (malignant cells)

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3
Q

Define Immunodeficiencies

A

Disorders with decrease or loss of immune function, either acquired or congenital

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4
Q

What are Hypersensitivity Reactions and what are the 2 types of having TOO MUCH immunity?

A

Disorders with pathologic immune responses or reactions
Allergic Reactions
Autoimmune Reactions

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5
Q

Type I Hypersensitivity

A

Too much IgE crosslinking in response to environmental antigen leading to mast cell and basophil release of histamine, causing synthesis of prostaglandins and leukotreines, such as hay fever, asthma, hives, food allergies, and eczema.

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6
Q

Type II Hypersensitivity

A

IgG or IgM Mediated Autoimmunity due to antibodies that react against self, such as hemolytic disease of maternal antibodies reacting to fetal RBCs, Myasthenia Gravis (AChR antibodies), and Good Pasture’s Syndrome (Basement membrane antibodies causing nephritis).

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7
Q

Type III Hypersensitivity

A

Immune complexes of antigen and antibody that get stuck in small vessels, such as the kidneys, joints, pleura and skin. Complement is activated to respond to the antigen-antibody complex and healthy tissues are destroyed in the process, which happens in Lupus (making antibody to own DNA) and RA (making antibody to antibody); serum sickness, necrotizing vasculitis.

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8
Q

Type IV Hypersensitivity

A

Cell-mediated hypersensitivity caused by activated CD4+ Th1 T-Cells (autoimune or innocent bystander injury); Contact hypersensitivity, TB reactions, Granulomatous hypersensitivity

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9
Q

Humoral Immunity

A

B-cells that protect extracellular spaces release antibodies into bodily fluids.

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10
Q

Cell-Mediated Immunity

A

T-cells that survey surfaces of cells, looking for mutated cells or parasites.

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11
Q

Define Innate Immunity

A

Pre-existing defense mechanisms present prior to infection

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12
Q

Define Adaptive Immunity

A

Reactive immune mechanisms that are stimulated by microbes or other foreign antigens

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13
Q

Function of B Lymphocytes

A

Neutralization of microbe, phagocytosis, complement activation

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14
Q

Function of Helper T Lymphocytes (CD4+)

A

Activation of macrophages
Inflammation
Activation (proliferation and differentiation) of T and B lymphocytes

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15
Q

Function of Cytotoxic T Lymphocytes (CD8+)

A

Killing infected cells

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16
Q

Function of Regulatory T Lymphocytes

A

Suppression of Immune Response

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17
Q

Function of Natural Killer cells

A

Killing infected cells

18
Q

Define Generative (Primary) Lymphoid Organs

A

Sites where T (Thymus) and B (Bone Marrow) lymphocytes mature

19
Q

Define Peripheral (Secondary) Lymphoid Organs

A

Site where the adaptive immune response is initiated (lymph nodes, spleen)

20
Q

Class I MHC Molecules

A

coded by HLA-A, HLA-B, and HLA-C genes and display antigens to CD8+ T-cells and NK cells

21
Q

Class II MHC Molecules

A

coded by HLA-DP, HLA-DQ, HLA-DR genes and display antigents to CD4+ T-cells

22
Q

What are two uses for HLA testing?

A

1) determine disease risk

2) transplantation workup

23
Q

What is light chain restriction?

A

Monoclonal B-cells typically express only one type of immunoglobulin, either kappa or lambda.

24
Q

How can monoclonal light chain restriction be detected?

A

Flow cytometry - should be 1.5 kappa to lambda
Serum protein electrophoresis
Immunofixation electrophoresis
Kappa and lambda in situ hybridization - staining looking for proportions

25
Q

What are the 5 pillars of cancer treatment?

A 
Surgery
Chemotherapy
Radiation Therapy
Molecular Targeted Therapy
	Imatinib and Trastuzumab
	Target cancer cells by homing in on specific molecular changes seen primarily in those cells
Immunotherapy
	T-cells to attack the tumor
26
Q

Define Hypersensitivity Reactions

A

Sensitization to previous exposure to antigen and when re-exposed, pathologic immune reactions ensue with excessive, injurious reaction to the antigen

27
Q

What does a hypersensitivity reaction usually result from?

A

Imbalance between effector mechanisms of immune response and control mechanism to limit response

28
Q

What do eosinophils release in a type I hypersensitivity reaction?

A

Major Basic Protein and Eosinophil Cationic Protein = Toxic to epithelial cells

29
Q

Define Atopy

A

Predisposition of developing immediate hypersensitivity reactions; 50% correlated with positive family history; higher serum levels of IgE and more Il-4 producing Th2 cells

30
Q

Describe the immediate type I hypersensitivity reaction

A

Exposure to allergen –> Th2 response and IgE production –> IgE binds to Fc on Mast Cells –> Re-exposure to allergen leads to mast cell degranulation

Causes: Vasodilation
Vascular Leakage
Smooth Muscle Spasm

31
Q

Describe the late phase type I hypersensitivity reaction

A

Eosinophil infiltration with neutrophils and T-cells

Causes: Leukocyte Infiltration
Epithelial Damage
Bronchospasm

32
Q

Describe immediate hypersensitivity reactions with non-atopic allergies

A

Exercise or temperature induced, not mediated by T-cells or IgE

33
Q

Immediate Type I Hypersensitivity Systemic Anaphylaxis

A

Life threatening systemic allergic reaction with falling BP, vascular shock, bronchospasm, laryngeal edema and difficulty breathing due to massive mast cell activation

34
Q

What are the two mechanisms for T-cell Mediated Type IV Hypersensitivity?

A

CD4+ T-Cell Mediated Inflammation

CD8+ T-Cell Mediated Cytotoxicity

35
Q

Define Graulomatous inflammation

A

A distinctive pattern of chronic inflammation via strong activation of T-cells leading to activated macrophages resulting in tissue injury.

36
Q

What is a granuloma?

A

A focus of chronic inflammation consisting of a microscopic aggregation of macrophages that are transformed into epithelial-like cells called histiocytes; may also fuse to form multi-nucleated giant cells

37
Q

What causes granulomas to form?

A

Immune reactions or reaction to foreign material

38
Q

Foreign Body Granulomas

A

See foreign material within histiocytes or giant cells

39
Q

Caseating Granulomas

A

Granulomas that induce cell-mediated immune response with central necrosis; usually associated with infection (mycobacterial and fungal infections)

40
Q

Non-Caseating Granulomas

A

Granulomas that induce cell-mediated immune response without central necrosis (sarcoidosis, Crohn’s disease)

IHO Week 3 (14 decks)

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