goljan Flashcards
TYPE II HSR reactions
complement dependent – complement independent
complement dependent reactions
cell lysis :IgM (MAC) + IgG (C5a) —
phagocytosis : IgG + C3b
complement independent reaction
ADCC- IgG + IgE —
IgG autoantibodies against cell surface receptors
what type of HSR is causes by thermophilic actinomycetes
farmers lung - type of hypersensitivity pneumonitis - moldy hay – example of ARTHRUS REACTION
IL-12 fxn
secreted by macrophages — tells naïve CD4 Th cells to go to Th1 cells
what activates macrophages ?
IFN-gamma
what infection is big in bone marrow transplant
CMV
what happens to host blood group in bone marrow transplant
host assumes donor ABO group
allograft
same species-but different genetics
xenograft
different species
human organ transplant is which type of graft
allograft
grafts between identical twins
syngeneic graft ( isograft )
hyperacute rejection HSV and causes
type II HSV – ABO + HLA mismatch
MC transplant rejection
acute
is hyperacute reversible or irreversible
irreversible - have to replace organ!
is acute rejection reversible or irreversible
reversible
most successful transplant organ
cornea
what is the key cell that causes acute transplant rejection
dendritic cells from donor organ that has MHC class I and II cells
acute rejection contains which HSR
type 2 - anti HLA preformed antibodies —
type 4 - DTH and cytotoxicity
MC infection solid organ transplant
candida > aspergillus
MC infection bone marrow transplant
aspergillus > candida
autoimmune disease is a loss of ?
self tolerance
polyclonal B cell activators?
HIV, EBV, CMV — this creates AUTOANTIBODIES
what viruses are implicated in autoimmune disease
EBV, CMV, HHV-6, coxsackievirus, measles
autoimmune disease – EBV
hep B, SLE, RA
autoimmune disease – CMV
system sclerosis
MS - viruses
HHV6 + influenza A
autoimmune disease – measles
acute disseminated encephalomyelitis
autoimmune disease – coxsackievirus
B3 - myocarditis
B4 - type I DM
two bacteria that cause GUILLAIN BARRE
mycoplasma pneumonia + campylobacter jejuni
what non MHC gene is involved in CROHNs
NOD-2
what non MHC gene is involved in type 1 DM + RA
PTPN-22
mechanism of injury in SLE
- type 2 HSR – autoantibodies cause cytopenias
2. type 3 HSR – ICs ( DNA-anti DNA) cause systemic inflammation ( vascultis )
cardio manifestations in SLE
fibrinous pericarditis (serositis) w or w/o effusion MC — libman sacks endocarditis
what heart valve is affected in SLE
mitral valve — causes regurg
MC respiratory finding in SLE
pleuritic chest pain ( pain on INSPIRATION ) w or w/o effusion — SEROSITIS
lymph findings in SLE
generalized PAINFUL LAD + splenomegaly
MSK finding in SLE
arthralgia - MCP+PIP – non deforming
SKIN finding in SLE
malar rash on face
RENAL finding in SLE
membranous in nephrotic — DPGN in nephritic
MCCOD
RESPIRATORY finding in SLE
pleuritic chest pain — SEROSITIS
CNS findings in SLE
headache, seizures, strokes
what causes strokes in SLE
antiphospholipid syndrome causes vessel thrombosis
pregnancy complication in SLE
- heart block in newborns (IgG SS-A(RO)) crosses the placenta
- spontaneous abortion
drug induced SLE
procainamide + hydralazine
clinical findings in drug induced SLE
pleuritis, fever, arthralgia
what is seen on the hands in dermatomyositis?
purple papules on the knuckles and PIP+DIP joints
what is seen on the face in dermatomyositis?
swelling and red discoloration under the eyes
how is serum complement affected in SLE
decreased b/c of IC formation
what is used to treat SYSTEMIC SCLEROSIS
penicillamine for skin fibrosis — cyclophosphamide for interstitial fibrosis
what cells are increased in SCLERODERMA
CD4 Th2 cells causes cytokine release which damages endothelial cells leading to VASCULITIS
MC initial sign in SYSTEMIC SCLEROSIS
Raynaud’s phenomenon
skin findings in SYSTEMIC SCLEROSIS
narrowing of digits causes raynauds phenomenon, sclerodactyly, thickened skin, and edema of the hands — mouth has a mouse like appearance
respiratory findings in SYSTEMIC SCLEROSIS
PH, interstitial fibrosis leads to restrictive lung disease and eventually resp failure — MCCOD
what are the noninfectious inflammatory myopahties
DM + PM
both DM + PM have increased risk for
lung and bladder cancer + non Hodgkin malignant lymphoma