Disorders of the Immune System (P) Flashcards

Question

*What are the characteristics of type III hypersensitivity?

Answer 1

1) Presence of acute necrotizing vasculitis | 2) Fibrinoid necrosis

Answer 2

1) SLE 2) Polyarteritis nodosa 3) Post streptococcal glomerulonephritis 4) Acute glomerulonephritis 5) Arthus reaction 6) Serum sickness

Answer 3

1) DNA, nucleoproteins, others | 2) Nephritis, arthritis, and vasculitis

Answer 4

1) Hep B surface Ags | 2) Vasculitis

Answer 5

1) Streptococcal cell wall Ag(s) may be planted in GBM | 2) Nephritis

Answer 6

1) Bacterial, parasite, and tumor Ags | 2) Nephritis

Answer 7

1) Various foreign proteins | 2) Cutaneous vasculitis

Answer 8

1) Various proteins (e.g. *forein serum) | 2) Arthritis, vasculitis, and nephritis

Answer 9

Type IV hypersensitivity

Answer 10

By Ag-activated (sensitized) lymphocytes

Answer 11

1) Delayed type hypersensitivity | 2) T-cell mediated cytotoxicity

Answer 12

CD4+ T cells

Answer 13

1) IFN gamma(sign) 2) IL-2 3) TNF and lymphotoxin

Answer 14

For the activation of macrophages

Answer 15

For the proliferation of T cells

Answer 16

1) For the extravasation of lymphocytes and monocytes | 2) For granuloma formation

Answer 17

CD8+ T cells

Answer 18

Response to: 1) Viral infections 2) Tumor cells

Answer 19

1) Perforin-granzyme-dependent killing | 2) Fas-fas ligand- dependent killing

Answer 20

1) Anaphylaxis; allergies and bronchial asthma (atopic forms) 2) Production of IgE Abs; immediate release of vasoactive amines and other mediators from mast cells

Answer 21

1) AIHA (IIa), Goodpasture syndrome (IIb), graves, and myasthenia gravis (IIc) 2) Production of IgG, IgM; binds to Ag on target cells or tissue; phagocytosis or lysis of target cell by C8, C9 (IIa), or inflammation (IIb) or cellular dysfunction (IIc)

Answer 22

1) SLE, some forms of GN, serum sickness, and Arthus rxn 2) Deposition of Ag-Ab complexes; complement activation; recruitment of leukocytes; release of lysosomal enzymes and toxic moieties

Answer 23

1) TB (IVa), response to viral infections (IVb), and transplant rejection 2) Activated T lymphocytes; i) release of cytokines and macrophage activation; ii) T cell-mediated cytotoxicity

Answer 24

These results from tissue injury caused by T cells or Abs that react against self-Ags

Answer 25

1) Female predilection 2) Characterized by remissions and exacerbations 3) Increased incidence of malignancy 4) Familial prevalence of the same or other A.I.D. 5) Clinical and serologic overlaps 6) Pts often have increased Ig in the serum

Answer 26

1) Female > male (10:1 - 20:1) 2) 2nd - 3rd decade: acute -> older pts: less acute and better prognosis 3) Most common signs and symptoms: A. Hematologic: 100% B. Musculo-skeletal (arthritis): 90% C. Skin (butterfly rash): 85% D. Fever: 83% E. Renal, pulmonary, cardiac: 30 - 50% 4) Course: A. Acute: death within wks - mos B. Chronic: w/ treatment; 10 - 20 yrs -> most common cause of death: renal failure, then next is infection 5) Some factors related to pathogenesis: A. Genetic: associated w/ IgA, C2 deficiency; greater chance in family grps associated w/ certain haplotypes B. Environmental: drugs, U.V. light, and hormones C. Immunologic

Answer 27

1) Immune complex disease (type III) | 2) Abs directed against cell types (type II)

Answer 28

1) Abs against DNA 2) Abs to histones 3) Abs to nonhistone proteins bound to RNA 4) Abs to nucleolar Ags

Answer 29

1) Vasculitis in small arteries and arterioles - > in spleen, characteristic "onion-skin" lesions 2) Glomerulonephritis: type of w/c depends on size and dose - > 5 patterns: 1) minimal or no detectable abnormality (class I) 2) mesangial (class II) 3) focal proliferative (class III) 4) diffuse proliferative (class IV): most common; most serious 5) membranous GN class (class V) 3) Arthritis 4) Heart: pericarditis - > Libmann-Sacks endocarditis 5) Skin

Answer 30

1) Interstitial pneumonitis 2) Cerebral infarcts and hemorrhages 3) Pericarditis

Answer 31

1) RBC: anemia 2) WBC: leukopenia 3) PLTs: thrombocytopenia

Answer 32

1) History and PE: young female w/ malar rash, fever, joint pains, and hematologic problem 2) (+) ANA (peripheral pattern) 3) Ab to dsDNA and Smith (Sm) Ag 4) (+) lupus band test on skin biopsy 5) Decreased complement lvl (part C3) 6) Renal biopsy shows glomerulonephritis and immune complex deposits by immunofluorescence

Answer 33

1) Malar rash 2) Discoid rash 3) Photosensitivity 4) Oral ulcers 5) Arthritis 6) Serositis 7) Renal disorder 8) Neurologic disorder 9) Hematologic disorder 10) Immunologic disorder 11) Antinuclear Ab

Answer 34

1) Fixed erythema 2) Flat or raised 3) Over the malar eminences

Answer 35

1) Erythematosus raised patches 2) W/ adherent keratotic scaling 3) W/ follicular plugging 4) Atrophic scarring may occur

Answer 36

It is a skin rash as a result of exposure to UV light

Answer 37

1) Oral or nasopharyngeal ulceration 2) It is usually painless 3) These are observed by a physician

Answer 38

1) Nonerosive arthritis involving 2 or more peripheral joints 2) It is characterized by tenderness 3) It is characterized by swelling 4) It is characterized by effusion

Answer 39

1) Pleuritis: convincing history of pleuritic pain or rub heard by a physician or evidence of pleural effusion; or 2) Pericarditis: documented by electrocardiogram or rub or evidence of pericardial effusion

Answer 40

1) Persistent proteinuria 0.5 g/dL > or 3+ > if quantitation not performed; or 2) Cellular casts: may be RBC, hgb, granular, tubular, or mixed

Answer 41

1) Seizures: in the absence of offending drugs or known metabolic derangements (e.g. uremia, ketoacidosis, or electrolyte imbalance); or 2) Psychosis: in the absence of offending drugs or known metabolic derangements (e.g. uremia, ketoacidosis, or electrolyte imbalance)

Answer 42

1) Hemolytic anemia: w/ reticulocytosis, or 2) Leukopenia: < 4.0 x 10^9/L (4,000/uL) total on 2 or more occasions; or 3) Lymphopenia: < 1.5 x 10^9/L (1,500/uL) on 2 or more occasions; or 4) Thrombocytopenia: < 100 x 10^9/L (100 x 10^3/uL) in the absence of offending drugs

Answer 43

1) It has anti-ds DNA 2) It has anti-Sm 3) It has antiphospholipid

Answer 44

It is an abnormal titer of antinuclear Ab by immunofluorescence or an equivalent assay at any point in time and in the absence of drugs known to be associated w/ drug-induced lupus syndrome

Answer 45

1) Primary | 2) Secondary

Answer 46

1) It is almost genetically determined 2) It is usually X-linked 3) It is seen during infancy (6 mos - 2 yrs) 4) It is associated w/ recurrent infections

Answer 47

From altered immune function such as malnutrition, viral infection / irradiation, use of immunosuppressive drugs, and lymphoproliferative diseases

Answer 48

1) Stem cell deficiency 2) B-cell deficiency 3) T-cell deficiency 4) Deficiency of myeloid elements 5) Complement deficiency

Answer 49

1) It is an ex of B-cell deficiency 2) Lack of mature B cells in the circulation 3) Serum of all Igs are depressed 4) T cell #s are normal 5) T cell function are normal

Answer 50

Bruton's X-linked agammaglobulinemia

Answer 51

1) Double decrease | 2) Normal

Answer 52

The pt is susceptible to infections caused by pyogenic bacteria (such as staphylococcus, pneumococcus, etc)

Answer 53

Gamma(sign) globulin

Answer 54

B cells almost absent in: 1) Lymph nodes 2) Spleen 3) Bone marrow 4) Connective tissue

Answer 55

Failure of the development of the 3rd and 4th pharyngeal pouches

Answer 56

1) Occurrence of thymic hypoplasia or aplasia 2) Occurrence of parathyroid hypoplasia 3) Congenital defects of the heart and great vessels 4) Presence of dysmorphic facies

Answer 57

T-cell deficiency

Answer 58

Di George's syndrome

Answer 59

1) Decrease | 2) Double decrease

Answer 60

Susceptible to infections caused by intracellular microbes (virus, fungi, and T.B.)

Answer 61

Thymus graft

Answer 62

1) Low circulating T-lymphocytes 2) Depleted T-dependent paracortical areas of lymph node and T-dependent areas of spleen 3) Plasma cells normal in # in lymphoid tissues

Answer 63

Severe Combined Immunodeficiency Diseases

Answer 64

1) Double decrease | 2) Double decrease

Answer 65

Susceptible to all types

Answer 66

Bone marrow graft

Answer 67

1) Absence of T cells and B cells in blood 2) Absence of T cells and B cells in lymph nodes 3) Absence of T cells and B cells in spleen 4) Thymus devoid of lymphoid cells or Hassal's corpuscles

Answer 68

1) It is associated w/ increased susceptibility to bacterial infections (particularly C3) 2) It is associated w/ high incidence of connective tissue diseases (C2 and C4 deficiency w/ SLE)

Answer 69

1) C1 inhibitor 2) C2 3) C3 4) C5 - C9

Answer 70

1) Presence of angioneurotic edema 2) Presence of edema affecting the skin and mucosal surfaces (e.g. larynx and GIT) 3) Presence of asphyxia 4) Presence of nausea 5) Presence of vomiting 6) Presence of diarrhea after emotional stress

Answer 71

W/ connective tissue diseases (SLE)

Answer 72

W/ frequent bacterial infection

Answer 73

W/ repeated Neisseria infections

Answer 74

1) HIV1 2) HIV2 3) HIV subtype AE

Answer 75

1) HIV1: in U.S., Central Africa, Europe, and Asia 2) HIV2: in West Africa 3) HIV subtype AE: in the Philippines

Answer 76

1) Homosexuals or bisexual males 2) IV users 3) Hemophiliacs 4) Blood transfusion recipients 5) Heterosexual contacts

Answer 77

1) Via sexual contact 2) Parenteral 3) From infected mother to newborn

Answer 78

1) IS | 2) CNS

Answer 79

1) Loss of CD4^+ T cells (helper cells) 2) Macrophages are infected 3) Presence of abnormalities of B cell function 4) Due to these immunologic alterations, there is a loss of cell mediated and humoral responses

Answer 80

1) Acute retroviral syndrome 2) Middle chronic phase 3) Final or crisis phase (full blown AIDS)

Answer 81

1) It is self-limited | 2) It is an acute flu-like illness

Answer 82

1) The pt is asymptomatic or | 2) The pt has generalized lymphadenopathy

Answer 83

(+) HIV Ab test

Answer 84

1) Presence of acute symptoms | 2) Presence of generalized-lymphadenopathy

Answer 85

AIDS indicator diseases

Answer 86

1) Infections 2) Neoplasms 3) Neurologic effects

Answer 87

Opportunistic

Answer 88

1) Pneumocystis carinii pneumonia | 2) Fungal infections

Answer 89

1) Kaposi sarcoma 2) B-cell Non Hodgkin lymphoma 3) Primary lymphoma of the brain 4) Invasive cancer of the uterine cervix

Answer 90

1) Aseptic meningitis 2) Peripheral neuropathy 3) Progressive encephalopathy (AIDS-dementia complex)

Answer 91

1) It is non-specific | 2) It is a widespread opportunistic infection

Answer 92

1) Kaposi's sarcoma | 2) Lymphoma B-cell NHL

Answer 93

Follicular hyperplasia

Answer 94

B-cell activation

Answer 95

1) Follicular involution | 2) Generalized lymphocytic depletion

Answer 96

1) Aseptic meningitis 2) Peripheral neuropathy 3) Progressive encephalopathy (AIDS-dementia complex)