Hypersensitives (Final)

Question 1

Immune system

Answer 1

Complex system in charged of protecting our body from foreign substances

Immune system can identify these antigens to destroy these

Question 2

Hypersensitivity is a normal immune response that is:

Answer 2

-Inappropriately trigger

or

-Excessive

or

-Produces undesirable effects on the body

Question 3

Hypersensitivity: Basic trigger

Answer 3

-Specific antigen antibody reaction or a specific antigen lymphocyte interaction

Question 4

Four types of hypersensitivity

Answer 4

-Type I II II = mediated by antibodies produces by B cells (specifically plasma cells)

-Type IV = Mediated by T cells

Question 5

B cells

Answer 5

Are antibodies

Question 6

T cells

Answer 6

Long term immunity

Question 7

Type 1: IgE mediated Reaction

Answer 7

-How does someone develop an allergy to something this cute?

-Pet dander - Nuts - Pollen

Question 8

Type 1 hypersensitivity: Key characterisitics

Answer 8

Immediate reaction (15-20 min)

This reaction occurs after being sensitized to an antigen

Question 9

Type 1 Hyper Sensitivity: Antigens

Answer 9

-Environmental (bee sting - Pet dander)

-Foods (Nuts - Shellfish)

-Medications (Penicillin - Contrast Dye)

Question 10

Type 1 Hypersensitivity: Etiology

Answer 10

-Genetic link
1 Parent = 30% chance
2 Parent = 50% chance

Question 11

Key cells involved in Type 1

Answer 11

-B lymphocytes

-igE (antibody)

-Mast cells (granulocyte)

Question 12

Type 1: Pathogenesis

Answer 12

-Antigen (Ragweed) attaches to B cell during the first time they are exposed

-B cell is triggered to form into a plasma cells. This plasma cells starts producing IgE antibodies

-IgE attach to mast cells and lie and wait

-Next time the person is exposed to allergen. it binds to the IgE antibodies that are attached to the mast cells. This triggers the release of chemical mediators from the mast cell

Question 13

Type 1 Response

Answer 13

Histamines

Question 14

Type 1 Mediator Activites (know these)

Answer 14

Potent vasodilation - Stuffy nose, lower BP, Wheals on skin

Increased vascular permeability - Edema and runny nose

Bronchial smooth muscle contraction - Breathing difficulties and wheezing

Stimulates irritant receptor - Itching (pruritus)

Question 15

Type 1: Atopic reactions (Local)

Answer 15

-Allergic Rhinitis

-Asthma

-Urticaria (hives)

Question 16

Type 1: Anaphylaxis Reaction (Systemic)

Answer 16

-Systemic release of chemical mediators

-Life threatening because of bronchial constriction - airway obstruction - vascular collapse

Question 17

What are most common triggers of anaphylaxis?

Answer 17

-Medications

-Bee stings

-Foods

Question 18

Type II hypersensitivity: Cytotoxic reaction

Answer 18

What would happen if….

A patient received the wrong blood type?

Incompatible blood

Question 19

Type II: Etiology

Answer 19

-Exposure to antigen or foreign tissue / cells

-Antigens are located on cell surface

Question 20

Type II: Key Characteristics

Answer 20

-Antigen stimulate antibody production

-Antibodies recognize and attach to cell surface antigens

-Direct destruction of targeted cells that contain the antigen (Cell lysis) (Phagocytosis)

-Do this or purpose with transplant patients. Give medication that slow down and decrease immune response so we don’t have this reaction

Question 21

Type II Hypersensitive: Immune Cells involved

Answer 21

-Antibodies (IgG and IgM)

-Complement (Fixes to foreign cell and lysis it)

-WBC’s (Phagocytes)

Question 22

Examples of Type II antigens

Answer 22

Blood

Some of your bodies own cells (auto immune conditions like diabetes)

Erythroblastosis fetalis (Hemolytic Anemia) (RH factor difference between parent and fetus)

Question 23

Slide for type 2 can go here

Question 24

Type II response: Example disorders

Answer 24

-Blood transfusion

-Rg incompatibility in pregnancy birth

-Autoimmune disorders

-Certain drug reactions

Question 25

RH parents slide

Answer 25

RH+ father

RH- mother carrying her first RH+ fetus. RH antigens from the developing fetus can enter the mothers blood during delivery

In response to the fetal Rh antigens, the moth will produces anti-Rh antibodies

IF the woman becomes pregnant with another Rh+ fetus, her antibodies will cross the placenta and damage fetal red blood cells

Question 26

Type II manifestations: transfusion Reaction

Answer 26

-Fever - Chills - Flushing (first sign)

-Increase HR

-Decrease BP

-Chest pain or back pain

-N/V

-Restlessness and anxiety

-Headache

Question 27

Type III hypersensitivity: Immune Complex Reaction

Answer 27

What happens when you have rheumatoid arthritis?

Inflammation of tissue that causes the damage

Question 28

Type III: Key Charactersitics

Answer 28

1. Antigen anitbody complexes form (IgG and IgM)
2. There are deposited into tissues
3. Inflammatory response cause tissue damage

Question 29

Type III: Etiology

Answer 29

-Autoimmune attack

-Low grade infection

-Inhaled antigens from molds or contaminated plants

Question 29

Type III: Possible offending antigens

Answer 29

-Inhaled from antigens from molds or contaminated plants

-Body’s own response

-Bacteria and viruses

Question 30

Type III: Key immune cells involved

Answer 30

-Antibodies IgG and IgM taht clump with antigens

-Complement

-Neutrophils and mast cells

Question 31

Type III: Pathogenesis

Answer 31

antibody complex formed in blood

Deposits in tissue

Activation of complement and chemo attraction of neutrophils

Release of enzymes and free radicals

A ton of inflammation going on

Question 32

Type III: Clinical Manifestations

Answer 32

-Manifestations depend on where the complexes are deposited in the tissue

Rheumatoid arthritis = Joints

Glomerulonephritis = Kidney Failure

Systemic lupus erythematosus = skin and organs

Question 33

Type II vs Type III

Answer 33

Type II: Reacitons occur on the cell surface and result in direct cell death or malfunction

Type III: Immune complexes are deposited into tissues and the resulting inflammation destroys the tissue

Question 33

Type IV: Delayed Hypersensitivity

Answer 33

• Have you ever had poison ivy? Postive TB skin test? Jellyfish sting? Allergic reaction to jewelry? Chron’s disease?

Question 34

Type IV hypersensitivity: Key characteristics

Answer 34

-Delayed response

-No antibody involvement

Question 35

Type IV: Key Immune cells

Answer 35

-T cells (NO B CELLS)

-Cytokines

-Mast cells and Macrophages

Question 36

Type IV: Etiology

Answer 36

Delayed cellular reaction to antigen. Because it takes time for the T cells to make their journey to the site

Question 37

Type IV: Possible Antigens

Answer 37

-Plant oil

-Cosmetics and clothings

-Nickel alloys

-Tuberculin antigen (TB test)

-Organ transplant or skin graft

-Gluten

Question 38

Type IV: Pathogenesis

Answer 38

-Small, incomplete antigen, call a hapten penetrates the skin

-The hapten combines with human protein to form a complete antigen

-T cells become aware of antigen (antigen processing cell)

-T cells attack the antigen via:
1. Direst attack from T cells
2. Release of cytokine (inflammation)
3. Macrophages (cell destruction)

Question 39

Type IV: Clincial Maifestiations

Answer 39

-Peak 49-72 hours

-Contact dermatitis: Redness, edema, itching, blisters

-Tuberculin hypersensitivity: Redness, induration and inflammation

Question 40

Hypersinsitivity Reaction: Pharmacotherapy Options

Answer 40

Immunosuppressants (transplant patients) (Lower the immune response)

Antihistamines (reduces symptoms) (do not stop reaction)

Epinephrine (Important with anaphlyic reaction)

Question 41

People on immune suppressants we need to watch for what?

Answer 41

Infections

Question 42

Antihistamines

Answer 42

not stoping reaction just suppressing symptoms

Question 43

Organ transplatn and drug therapy options (know slide)