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Basic Pathology > Hypersensitivities > Flashcards

Hypersensitivities Flashcards

1
Q

hypersensitvity

A
  • altered immunologic response to an antigen
  • results in disease/damage to host
  • inappropriate activation of the immune system
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2
Q

requirements for hypersensitivity

A
  • have to be genetically predisposed

- initial exposure alters immunologic homeostasis

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3
Q

Type I hypersensitivity

A

immediate/IgE mediated

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4
Q

Type II hypersensitivity

A

cytotoxic/tissue-specific

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5
Q

Type III hypersensitivity

A

immune complex mediated

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6
Q

Type IV hypersensitivity

A

delayed/cell mediated

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7
Q

hypersensitivity by immune mechanism:

antibody mediated

A
  • Type I
  • Type II
  • Type III
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8
Q

hypersensitivity by immune mechanism:

cell mediated

A

-Type IV (only one not involving antibodies)

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9
Q

hypersensitivity by antigen:

allergy

A

environmental antigens, not “self”

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10
Q

hypersensitivity by antigen:

autoimmunity

A

self-antigens

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11
Q

hypersensitivity by antigen:

alloimmunity

A

“other” antigens; tissue of same species, not self (transplant)

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12
Q

hypersensitivity by speed of response:

immediate

A
  • minutes to hours
  • antibody mediated (Types I, II, and III)
  • anaphylaxis
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13
Q

hypersensitivity by speed of response:

delayed

A 
-hours to days
cell mediated (Type IV)
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14
Q

Type I Hypersensitivity:

  • _____ antigens
  • _____ mediated, bound to ____
  • 2nd exposure activates _____
  • antigen _____
  • mast cell _____, secondary to ____, releases _____
  • mast cell initiates _____
A 
environmental;
IgE; Fc receptors;
mast cells;
cross links adjacent IgE;
degranulates; Fc structure change; vasoactive substances;
cytokine synthesis
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15
Q

Type I Hypersensitivity symptoms

A
  • pruritus
  • angioedema
  • urticaria
  • conjunctivitis
  • rhinitis
  • hypotension
  • bronchospasm
  • dysrhythmias
  • GI cramps and malabsorption
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16
Q

Type I Hypersensitivity:

IgE mediated chronic diseases

A
  • allergic asthma
  • chronic urticaria
  • eczema
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17
Q

Type I Hypersensitivity treatment

A
  • desensitization

- tolerance

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18
Q

Type I Hypersensitivity:

desensitization

A
  • increases threshold

- still allregic

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19
Q

Type I Hypersensitivity:

tolerance

A
  • long-term immunologic change

- no longer allergic

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20
Q

anaphylaxis:

  • Type _____ hypersensitivity reaction
  • due to _____
  • mildly sensitized: _____
  • severely sensitized: _____
A

I;
widespread degranulation of mast cells;
mild reactions (itching, hives, skin erythema, contraction of respiratory bronchioles);
sever reactions (laryngeal edema, vascular collapse, death)

21
Q

most common cause of death from anaphylaxis and how does it happen?

A

hypotension;
inflammation in vessels causes vasodilation and increased permeability, blood leaves vascular compartment and enters interstitial fluid –> hypovolemic shock, blood pressure decreases and heart rate increases

22
Q

how does EpiPen work?

A
  • epinephrine injection
  • constricts blood vessels (raises blood pressure)
  • relaxes smooth muscles (improves breathing)
  • stimulates heartbeat
  • reduces swelling
23
Q

Type II Hypersensitivity:

  • _____ mediated diseases
  • abnormal production of ____
  • ____ mechanisms
A

tissue-specific antibody;
IgM or IgG directed against antigens on specific tissues/cells;
5

24
Q

5 mechanisms of Type II Hypersensitivity

A

1) complement-mediated lysis
2) opsonization and phagocytosis
3) neutrophil-mediated damage
4) antibody dependent cell mediated cytotoxicity
5) induced cell malfunction

25
Q

Type II Hypersensitivity:

1) complement-mediated lysis

A
  • complement system classical pathway is activated
  • IgM or IgG bind to antibodies and membrane attack complex attack self cells
  • ex: hemolytic disease of the newborn
26
Q

Type II Hypersensitivity:

2) opsonization and phagocytosis

A
  • C3b (product of complement system) opsonizes self-cell

- cell is phagocytosed

27
Q

Type II Hypersensitivity:

3) neutrophil-mediated damage

A
  • antigen deposits in tissue
  • antibody binds
  • complement activated
  • neutrophil chemotaxis
  • neutrophil adherence and degranulation
  • result: some tissue damage and cell death
28
Q

Type II Hypersensitivity:

4) antibody dependent cell mediated cytotoxicity

A
  • natural killer cells have crystalline fragment receptors on them to recognize antibodies on cells
  • natural killer cells release perforin and granzymes to destroy target cell\
  • can play a role in transplant rejection
29
Q

Type II Hypersensitivity:

5) induced cell malfunction

A
  • causes increase or decrease in normal cell activity
  • antibodies attack self = change the function
  • problematic for cells that need to turn on and off or have feedback loop (ex: muscle cells, thyroid glands)
  • this process is NOT cytotoxic
30
Q

Type II Hypersensitivity:

5) induced cell malfunction examples

A
  • Myasthenia gravis

- Grave’s disease

31
Q

Myasthenia gravis

A
  • antibodies block ACh receptors on muscle cell at neuromuscular junction
  • prevents ACh released at motor end plate from activating muscle cell
  • lid droop, double vision, weak grip, trouble swallowing/speaking, easily fatigued
32
Q

Grave’s disease

A
  • antibodies stimulate thyroid cells to overproduce thyroid hormone
  • hyperthyroid
  • goiter, increased metabolism, CNS effects (irritability), weight loss
  • lid retraction - “thyroid stare”
  • increased sympathetic activity
33
Q

Type III Hypersensitivity:

  • _____ mediated
  • _____ complexes
  • _____ antibodies
  • complexes formed ____ and _____ in vessel walls or extravascular tissues
A 
immune complex;
antigen-antibody;
IgG, IgM;
in the circulation;
deposited
34
Q 
Type III Hypersensitivity:
immune complex clearance:
large: \_\_\_\_\_
small: \_\_\_\_\_
intermediate: \_\_\_\_\_
A

macrophages;
renal clearance;
deposit in tissues

35
Q

Type III Hypersensitivity:

systemic

A
  • serum sickness

- Raynaud’s phenomenon

36
Q

Type III Hypersensitivity:

localized

A

-arthus reaction (usually from an injection)

37
Q

Type III Hypersensitivity:

immune complex-mediated diseases

A
  • infectious (poststreptococcal glomerulonephritis, polyarteritis nodosa, reactive arthritis)
  • autoimmune (lupus, rheumatoid arthritis, Sjogren’s, reactive arthritis)
38
Q

Type III Hypersensitivity:

ocular manifestations of immune complex-mediated autoimmune diseases

A
  • uveitis
  • retinal vasculitis
  • ischemic optic neuropathy
  • scleritis
  • peripheral ulcerative keratitis
  • keratoconjunctivitis sicca
39
Q

Type IV Hypersensitivity:

  • mediated by _____
  • direct action= _____
  • indirect action= _____
  • _____ response
  • cells _____
A 
T lymphocytes;
cytotoxic T-cells;
Th1 helper T-cells via activation of phagocytes (macrophages)- "coordinating the attack";
delayed;
killing cells
40
Q

Type IV Hypersensitivity:

  • PPD skin test (TB skin test)
  • read ____
  • positive presents _____
  • reaction caused by ____, NOT ____
A

between 48 and 75 hours;
a number of ways based on risk factors;
T-cells;
TB antibodies (although you may have them)

41
Q

Type IV Hypersensitivity:

cell-mediated diseases

A
  • environmental (contact dermatitis, Stevens-Johnson syndrome)
  • TB-type (PPD reaction)
  • autoimmune (Crohn’s, MS, T1 diabetes)
42
Q

Type IV Hypersensitivity:

ocular manifestations

A
  • uveitis, episcleritis, scleritis (Crohn’s)
  • optic neuritis (MS)
  • hemorrhagic conjunctivitis (Stevens-Johnson syndrome)
43
Q

allergy:

  • ____ antigens
  • requires _____
A

environmental;

sensitization

44
Q

most allergies are Type ___

A

I

45
Q

allergy Type I:

  • _____ hypersensitivity
  • symptoms match _____
  • higher ____ in general in people who are “atopic”
  • genetically _____
A

immediate;
site of exposure (inhaled, ingested, exposed);
IgE titers and mast cells;
predisposed

46
Q

allergic conjunctivitis:

  • most exposed _____
  • most densely ____
  • ____ mediated
  • type ___
A

mucous membrane;
mast cell populated areas;
IgE;
I

47
Q

allergy Type II:

  • usually against ____
  • elicit ____ response
  • example: ____
A

haptens that bind to the surface of cells;
IgG or IgM;
penicillin allergy

48
Q

allergy Type III:

  • ____ formation in response to environmental, soluble antigens
  • example: _____
A

immune complex;

farmer’s lung

49
Q

allergy Type IV:

  • mostly ____, which need ____
  • _____ mediated response
  • example: _____
A

haptens;
carrier (usually proteins found in skin);
cell;
contact dermatitis

Basic Pathology (21 decks)

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