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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
Type II Hypersensitivity: | 1) complement-mediated lysis
- 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
Type II Hypersensitivity: | 2) opsonization and phagocytosis
- C3b (product of complement system) opsonizes self-cell | - cell is phagocytosed
27
Type II Hypersensitivity: | 3) neutrophil-mediated damage
- antigen deposits in tissue - antibody binds - complement activated - neutrophil chemotaxis - neutrophil adherence and degranulation - result: some tissue damage and cell death
28
Type II Hypersensitivity: | 4) antibody dependent cell mediated cytotoxicity
- 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
Type II Hypersensitivity: | 5) induced cell malfunction
- 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
Type II Hypersensitivity: | 5) induced cell malfunction examples
- Myasthenia gravis | - Grave's disease
31
Myasthenia gravis
- 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
Grave's disease
- 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
Type III Hypersensitivity: - _____ mediated - _____ complexes - _____ antibodies - complexes formed ____ and _____ in vessel walls or extravascular tissues
``` immune complex; antigen-antibody; IgG, IgM; in the circulation; deposited ```
34
``` Type III Hypersensitivity: immune complex clearance: large: _____ small: _____ intermediate: _____ ```
macrophages; renal clearance; deposit in tissues
35
Type III Hypersensitivity: | systemic
- serum sickness | - Raynaud's phenomenon
36
Type III Hypersensitivity: | localized
-arthus reaction (usually from an injection)
37
Type III Hypersensitivity: | immune complex-mediated diseases
- infectious (poststreptococcal glomerulonephritis, polyarteritis nodosa, reactive arthritis) - autoimmune (lupus, rheumatoid arthritis, Sjogren's, reactive arthritis)
38
Type III Hypersensitivity: | ocular manifestations of immune complex-mediated autoimmune diseases
- uveitis - retinal vasculitis - ischemic optic neuropathy - scleritis - peripheral ulcerative keratitis - keratoconjunctivitis sicca
39
Type IV Hypersensitivity: - mediated by _____ - direct action= _____ - indirect action= _____ - _____ response - cells _____
``` T lymphocytes; cytotoxic T-cells; Th1 helper T-cells via activation of phagocytes (macrophages)- "coordinating the attack"; delayed; killing cells ```
40
Type IV Hypersensitivity: - PPD skin test (TB skin test) - read ____ - positive presents _____ - reaction caused by ____, NOT ____
between 48 and 75 hours; a number of ways based on risk factors; T-cells; TB antibodies (although you may have them)
41
Type IV Hypersensitivity: | cell-mediated diseases
- environmental (contact dermatitis, Stevens-Johnson syndrome) - TB-type (PPD reaction) - autoimmune (Crohn's, MS, T1 diabetes)
42
Type IV Hypersensitivity: | ocular manifestations
- uveitis, episcleritis, scleritis (Crohn's) - optic neuritis (MS) - hemorrhagic conjunctivitis (Stevens-Johnson syndrome)
43
allergy: - ____ antigens - requires _____
environmental; | sensitization
44
most allergies are Type ___
I
45
allergy Type I: - _____ hypersensitivity - symptoms match _____ - higher ____ in general in people who are "atopic" - genetically _____
immediate; site of exposure (inhaled, ingested, exposed); IgE titers and mast cells; predisposed
46
allergic conjunctivitis: - most exposed _____ - most densely ____ - ____ mediated - type ___
mucous membrane; mast cell populated areas; IgE; I
47
allergy Type II: - usually against ____ - elicit ____ response - example: ____
haptens that bind to the surface of cells; IgG or IgM; penicillin allergy
48
allergy Type III: - ____ formation in response to environmental, soluble antigens - example: _____
immune complex; | farmer's lung
49
allergy Type IV: - mostly ____, which need ____ - _____ mediated response - example: _____
haptens; carrier (usually proteins found in skin); cell; contact dermatitis

Basic Pathology (21 decks)

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