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DEN 7102 Micro & Immuno Concepts > Exam 3 - Hypersensitivity and Autoimmunity Part 2 > Flashcards

Exam 3 - Hypersensitivity and Autoimmunity Part 2 Flashcards

1
Q

Type II (cytotoxic) hypersensitivity is a ____ response

A

Humoral

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2
Q

Cytotoxic (Type II) Hypersensitivity is associated with what diseases?

A
  • hemolytic disease of the newborn (Rhesus incompatibility)
  • Rheumatic fever
  • Sympathetic opthalmia
  • Drug-induced hemolytic anemia
  • Autoimmunity
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3
Q

Type III hypersensitivity also known as:

A

Immune complex diseases

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4
Q

Type III hypersensitivity involves ____ bound to ____ which forms _____

A

IgG; soluble antigens; Antigen-antibody complex

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5
Q

Antigen-antibody complex is mostly cleared by ____, but sometimes are not cleared and leads to ____

A

innate mechanisms; Type III hypersensitivity

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6
Q

Type III hypersensitivity diseases

A
  • Systemic lupus erythematosus
  • Rheumatoid arthritis
  • Arthus reaction
  • Serum sickness
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7
Q

Anti-snRNP or anti-SmDNA antibodies are associated with what disease?

A

Systemic lupus erythematosus

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8
Q

Systemic lupus erythematosus - clinical presentation

A
  • malar rash (butterfly)
  • oral ulcers
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9
Q

Another name for antibodies against snRNPs

A

Anti-Smith antibodies

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10
Q

Complications of systemic lupus erythematosus include:

A
  • Non-infectious endocarditis (Libman-Sacks)
  • Membranous glomerulonephritis
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11
Q

What occurs in lupus-related non-infectious endocarditis?

A

Mitral/tricuspid valve has IgG-Sm (snRNP) complex buildup

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12
Q

What occurs in lupus-related membranous glomerulonephritis?

A

immune complex depositing in renal glomeruli (wire loop)

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13
Q

Lupus treatments are often:

A

Palliative (relieving symptoms without addressing cause of symptoms)

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14
Q

Lupus treatment includes:

A
  • NSAIDs
  • corticosteroids
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15
Q

Triggers for Lupus

A
  • UV light
  • vitamin D deficiency
  • infectious agents
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16
Q

Relative risk of lupus

A

Females 9:1

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17
Q

Rheumatoid arthritis

A
  • Chronic autoimmune disorder that affects joints
  • typically results in swollen, painful joints mainly linked with RF
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18
Q

What is Rheumatoid factor?

A

Autoantibody against IgG Fc portion

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19
Q

In rheumatoid arthritis, RF and IgG form ____ contributing to disease progression

A

Complexes

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20
Q

Rheumatoid factor is considered a:

A

Cryoglobulin - form solid or gel like complexes under 99F

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21
Q

Type 2 Rheumatoid arthritis

A

Monoclonal IgM against polyclonal IgG

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22
Q

Type 3 Rheumatoid arthritis

A

Polyclonal IgM against polyclonal IgG

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23
Q

In rheumatoid arthritis, immune complexes cluster in ____, leading to ____

A

Joints; synovial damage

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24
Q

____ occurs at synovial lining of joint mainly due to inflammation

A

Granulation

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25
Q

Granulation in rheumatoid arthritis consists of:

A

Immune complexes and inflammation

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26
Q

Granulation in rheumatoid arthritis is also called:

A

Pannus

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27
Q

Granulation at joints leads to:

A
  • bone loss
  • calcification
  • loss of joint space
  • ankylosis
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28
Q

Ankylosis

A

Stiffening of joint

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29
Q

Arthus reaction is a Type ___ hypersensitivity involving ____

A

3; vaccine administration

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30
Q

Rare complication of some types of immunization

A

Arthus reaction

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31
Q

Arthus reaction is infrequently reported with:

A

Diphtheria and tetanus (toxoid vaccines)

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32
Q

Serum sickness is a major treatment risk with:

A

Xenogeneic anti-toxin

33
Q

Serum sickness can induce:

A
  • inflammation
  • fever
  • urticaria (hives) for days/weeks
34
Q

Serum sickness - easy or hard to clear?

A

Hard to clear

35
Q

Type IV hypersensitivity is also called:

A

delayed-type hypersensitivity (DTH)

36
Q

True or false: Type IV hypersensitivity involves antibodies/antibody complexes

A

False - does not

37
Q

Type IV hypersensitivity is associated with ___ response

A

Th1 (macrophages)

38
Q

Type IV hypersensitivity occurs after:

A

48-72 hours

39
Q

Contact sensitivity is type ____

A

Type IV hypersensitivity

40
Q

Contact hypersensitivity occurs in contact with:

A
  • poison ivy or poison oak
  • hair dyes
  • latex protein
  • nickel (small metal ions)
41
Q

Contact hypersensitivity with nickel results in:

A

Inflammation

42
Q

Examples of Type IV hypersensitivity

A
  • contact hypersensitivity
  • tuberculin hypersensitivity
  • granulomatous hypersensitivity
43
Q

Tuberculin hypersensitivity occurs with:

A

PPD tuberculin test

44
Q

The Mantoux skin test (PPD) is read after ____ which is a classic ____ response

A

48-72 hours; DTH

45
Q

What is measured after PPD skin test

A

Induration

46
Q

Mycobacterium tuberculosis has mycolic acids in the cell wall which are ____ and inhibits ____ formation. This allows for replication in ____

A

anti-phagocytic; phagolysosome; macrophages

47
Q

Granuloma formation from tuberculosis infection occurs as a result of:

A

Failure of acute inflammation resolution

48
Q

End stage macrophages

A

Epithelioid cells

49
Q

Autoimmunity appears to preferentially affect _____ due to _____

A

Females; increase of age-associated B cells (AABCs)

50
Q

Age associated B cells express surface markers ___

A

CD11c

51
Q

Age associated B cells express transcription factor:

A

T-bet

52
Q

Age associated B cells have a robust response to ____ which bind ____

A

TLR7 and TL9; bind bacterial or viral DNA

53
Q

Relative risk for autoimmune diseases are greater among ____. What is the exception?

A

Females; Ankylosing spondylitis is higher among males

54
Q

Ankylosing spondylitis RR

A

1:3 (males affected more)

55
Q

What is ankylosing spondylitis?

A

Type of arthritis in the joints of the spine

56
Q

Over 90% of ankylosing spondylitis patients have:

A

HLA-B27

57
Q

Lichen planus is mediated by:

A

Cytotoxic T cells (CD8+)

58
Q

Lichen planus commonly affects ____ of the oral mucosa

A

Basal keratinocytes

59
Q

Lichen planus looks a lot like:

A

Pemphigus/pemphigoid

60
Q

Patients with lichen planus are usually taking ____

A

Immunosuppressants (more oral and viral diseases)

61
Q

Oral lichen planus commonly presents as:

A
  • bilateral white lesions of buccal mucosa (reticular white lacy lines)
  • confluent white papules on dorsal tongue
62
Q

Systemic sclerosis is also known as

A

Scleroderma

63
Q

What is systemic sclerosis?

A
  • autoimmune disease of connective tissue
  • thickening of skin (collagen accumulation)
  • frequent damage to small arteries
64
Q

Systemic sclerosis may result in

A

Disfiguring disease, auto-amputation of phalanges

65
Q

Common feature of systemic sclerosis

A

Narrowing of esophagus

66
Q

Main oral symptom of systemic sclerosis

A

Dysphagia (difficulty swallowing)

Also incomplete mouth closure, sclerosis of frenulum

67
Q

Multiple sclerosis is a ____ disease

A

Demyelinating

68
Q

In multiple sclerosis, autoreactive ____ can cause damage and inflammation

A

T-lymphocytes

69
Q

Multiple sclerosis involves:

A
  • T-lymphocytes
  • CNS macrophages
70
Q

Initial infection with _____ may trigger multiple sclerosis response

A

Epstein Barr virus

71
Q

There is a ____ risk of multiple sclerosis after EBV infection

A

EBV infection

72
Q

Type I diabetes is also known as

A

Insulin dependent diabetes mellitus

73
Q

Type I diabetes is caused by

A

Autoimmune damage to insulin-producing pancreatic beta cells

74
Q

What allelic variations are associated with type 1 diabetes?

A
  • HLA-DR3 plus HLA-DR4 (highest risk)
  • HLA-DQ*B1 (associated)
75
Q

Type 1 diabetes can lead to what oral manifestations?

A
  • periodontitis
  • hyperplastic gingivitis

another reason why kids may have periodontitis

76
Q

Addison’s disease is also known as

A

Primary adrenal insufficiency

77
Q

Addison’s disease involves antibodies against

A

21-hydroxylase in adrenal cortex

78
Q

Addison’s disease results in

A

Endocrine disorder - hypocortisolism

79
Q

Addison’s disease causes ____ in oral mucosa

A

Hyperpigmentation

DEN 7102 Micro & Immuno Concepts (26 decks)

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