EXAM I - Immunity and Hypersensitivity Flashcards
Which immunity has antigens enter the body naturally?
naturally acquired active
Which immunity has antibodies pass from mother to fetus?
naturally acquired passive
Which immunity has antigens introduced by vaccines?
artificially acquired active
Which immunity introduces preformed antibodies via serums?
artificially acquired passive
What are all the types of cytokines?
interleukins, TNFs, CSFs and interferons
What cells have IL-1?
macrophages
What cells have IL-2?
CD4+ T-cells
What cells have IL-4?
CD4+ T-cells, mast cells, basophils and eosinophils
What cells have IL-6?
CD4+ T-cells, mast cells, macrophages and fibroblasts
What cells have TNF-alpha?
macrophages, NK cells, mast cells
What cells have interferon-alpha? Function?
monocytes; antiviral
What drug is a G-CSF?
filagrastim (Neupogen)
What does filgrastim do?
stimulates proliferation of neutrophils
What drug is a GM-CSF?
sargramostim (Leukine)
What does sargramostim do?
promotes leukopoiesis (WBCs)
What drug is an IL-2?
aldesleukin (Proleukin)
What does aldesleukin do?
anti-neoplastic and immunomodulator
What drugs are interferon-betas?
Avonex, Rebif and Betaseron
What drugs are erythropoietins?
Epogen, Procrit and Aranesp
What are the indications for sargramostim?
bone marrow transplants, HIV, chemotherapy-induced neutropenia
What are the adverse effects of sargramostim?
fever, diarrhea, N/V, fatigue, rash
What are the indications for filgrastim?
bone marrow transplants, HIV, chemotherapy-induced neutropenia
What are the adverse effects of filgrastim?
bone pain, N/V, increased uric acid, allergic reactions
What are the indications for ESAs?
anemia from ESRD, zidovudine treated HIV, chemotherapies
What are the adverse effects of ESAs?
HTN, fever, N/V, HA, itching, joint aches, cough
What drugs are interferons?
peginterfon alfa-2a/b (Pegasys and PegIntron), peginterferon beta-1a (Plegridy)
What are the indications for peginterferon alfa-2a/b?
HCV
What are the indications for peginterferon beta-1a?
relapsing multiple sclerosis
What are the adverse effets of peginterferon?
bone pain, myalgia, HA, fever
Explain IgM?
largest, pentamer, links and involved in infections
Explain IgA?
secreted in mucus, tears, saliva, colostrum
Explain IgG?
most common, crosses the placenta
Explain IgD?
B cell receptor
Explain IgE?
involved with allergies and antiparasitic activity
What is IVIg?
IV blood product containing at least 90% of pooled IgG from at least 1000 patients
What are the indications for IVIg? (4)
primary immunodeficiency, idiopathic thrombocytopenia purpura, neonatal sepsis, acute infections
What drugs are liposomal conjugates?
amophotericin B and doxorubicin
Is SCID a primary or secondary immunodeficiency?
primary
What cells have CD3?
all T-lymphocytes
What cells have CD4?
helper T-lymphocytes
What cells have CD8?
cytotoxic T-lymphocytes
What is anergy?
defective/lack of immune response
What is one drug used to treat lupus?
belimumab (Benlysta)
What drugs are fusion proteins that are TNF-alpha inhibitors?
etanercept (Enbrel)
What drugs are MoAbs that are TNF-alpha inhibitors?
infliximab and adalimumab
What is alloimmunity?
immune response to tissue of another individual (transplants/transfusions)
What drug is given for Type I hypersensitivty reactions?
epinephrine 1:1000 IM or SQ every 15-20 minutes
What else can be given during anaphylaxis?
oxygen, diphenhydramine (parenteral), H2 receptor blockers (famotidine for late phase), IV fluids/colloids and hydrocortisone sodium succinate
What is the major determinant for skin testing reactivity?
penicilloyl
What Ig is activated in each hypersensitivity reaction?
IgE for Type 1, IgG for Types 2 and 3, various non-Igs for Type 4
Explain complement mediated lysis?
antigen attacks target cell and activates complement system for lysis
Explain macrophage mediated phagocytosis?
cell destruction by macrophages once IgG and C3 opsonize target cell
What drug is given to mother to prevent erythroblastis fatalis?
Rho-Gam
What is Grave’s disease an example of?
Type II hypersensitivity
What is drug-induced lupus an example of?
Type III hypersensitivity
What drugs are known to cause serum sickness? (10)
animal serums, bee venom injections, cefaclor, ciprofloxacin, insulin, iron dextran, MoABs, penicillins, and sulfonamides
What diseases are manifested by Type IV hypersensitivity? (7)
tuberculosis, leprosy, schistosomiasis, sarcoidosis, contact dermatitis, eczema, and maculopapular exanthemas
What are treatments for contact dermatitis?
topical steroids, antihistamines, immunomodulators (tacrolimus), calamine lotion, oatmeal baths
What are causes for a false negative skin TB test? (7)
edlerly, severe debility, disseminated TB, HIV, immunosuppressive treatment, glucocorticoid therapy, recent viral infection
What patients are at higher risk for developing SJS/TEN? (4)
bone marrow transplantees, pneumocystis jirovecii-infected HIV, SLE, and chronic rheumatologic diseases