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Immunology Exam 4 > Hypersensitivity 1 > Flashcards

Hypersensitivity 1 Flashcards

1
Q

Hypersensitivity disorders are _

A

Diseases caused by the immune system

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2
Q

The 3 main ways that the immune system can cause tissue damage are by _

A

Rxn against microbes
Rxn against environment
Rxn against self

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3
Q

When immune rxns are mounted against microbes, there are 3 ways the rxn can damage the host. They are _

A

excessive / unusually persistent response
antibodies deposit in tissues
antibodies cross react

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4
Q

An example of an unusually excessive / persistent disease is _

A

Granuloma formation in tissues

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5
Q

An example of a case where antibodies deposit in tissues is _

A

post-streptococcal glomerulonephritis

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6
Q

An example of a case where antibodies cross react with normal tissues is _

A

Rheumatic fever

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7
Q

About what percentage of the population react to environmental substances?

A

20%

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8
Q

Auto-immune disease arises because _

A

The nomal self tolerance mechanisms fail

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9
Q

What percentage of the population suffers from autoimmune disease? What is the age group?

A

5%

20 - 40 yrs old

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10
Q

The mechanisms of autoimmunity are different from the mechanisms of host defense against pathogens. T or F

A

False. The same mechanisms

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11
Q

Type 1 hypersensitivity is also known as _. It is mediated by what type of antibody?

A

Immediate

IgE

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12
Q

What is the mechanism of type 1 hypersensitivity?

A

Mast cells and their mediators. Think allergic

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13
Q

What are the antibody mediators of type 2 hypersensitivity?

A

IgM and IgG against self tissues

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14
Q

What is the mechanism of type 2 hypersensitivity?

A

Opsonization / phagocytosis, complement, recruitment of leukocytes

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15
Q

What are the antibodies that mediate type 3 hypersensitivity?

A

IgM and IgG

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16
Q

What is the mechanism of type 3 hypersensitivity?

A

Immune complexes deposit in tissues. Complement and Fc recruitment of leukocytes

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17
Q

What are the immune mediators of type 4 hypersensitivity?

A

CD4 - cytokine mediated inflammation

CD8 - Cell mediated autolysis

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18
Q

What is the mechanism if type 4 hypersensitivity?

A

Leukocyte activation and recruitment, cytokine inflammation, cell killing

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19
Q

What 2 types of hypersensitivity are mediated by antibodies?

A

Types 2 and 3

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20
Q

What type of hypersensitivity doesn’t depend on leukocyte recruitment?

A

Type 1

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21
Q

Types 2 and 3 hypersensitivity are both antibody mediated. What is the difference?

A

In type 2, the antibody is directed against the tissue. In type 3, the antibody accumulated in the area of the tissue

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22
Q

When examined by immuno-fluorescence, what would you expect to see when comparing antibody deposition between type 2 and 3 reactions?

A

Deposition is smooth in type 2 rxns

Deposition is coarse in type 3 rxns

23
Q

An example of a type 2 rxn where antibodies directed against RBCs destroy the cells is _.

A

Autolytic hemolytic anemia

24
Q

Antibodies against CD20 would be expected to _

A

Destroy B cells

25
Q

What is the Coomb’s test?

A

It is a test to detect the presence of anti-RBC antibodies

26
Q

Would you expect a type 2 rxn to yield systemic or non-systemic disease?

A

Non-systemic, tissue targeted / specific

27
Q

What are the 3 mechanisms by which a type 2 rxn can cause tissue injury?

A

Opsonization
Damage to tissue proteins
Antibody deposition in tissues

28
Q

3 examples where antibodies bind to cells to mediate autoimmune rxns (phagocytosis) are _. What type of hypersensitivity is this?

A

Autoimmune hemolytic anemia
Autoimmune thrombocytopenic purpura
Hemolysis following blood transfusion
Type 2

29
Q

3 examples where antibodies bind to tissues to mediate autoimmune reactions are _. What type of reaction is this?

A

Good pastures syndrome
Glomerulonephritis
Acute rheumatic fever
Type 2

30
Q

What are myesthenia gravis and graves disease? What type of hypersensitivity is this?

A

Myesthenia - The antibodies block receptor function
Graves - Antibody stimulates the thyroid
Type 2 hypersensitivities

31
Q

What is the manifestation of autoimmune thrombocytopenic purpura?

A

Bleeding

32
Q

What is Goodpasture’s syndrome?

A

Abs target NC1 in basement membrane of glomerulus and lungs. Leads to nephritis, lung hemmorhage

33
Q

What is pemphigus vulgaris?

A

Antibodies against intercellular desmoglein in epidermis. Leads to skin vesicles (blisters)

34
Q

Glomerulo-nephritis is not the same as post-streptococcal glomerulonephritis. In post-streptococcal, _

A

Group A strep antibodies and their antigen deposit in glomeruli, leading to inflammation

35
Q

Type 3 rxn are more likely to be [systemic/non-systemic]

A

Systemic, the complex can deposit anywhere

36
Q

The mechanism of damage in type 3 rxns is _

A

Immune complexes activate Fc-mediated inflammation and complement to damage blood vessels and surrounding tissues

37
Q

Areas susceptible to type 3 rxn are areas where plasma ultra-filtration occur. These are _ (3)

A

Kidney
Joints
Vasculature

38
Q

Are larger or smaller complexes more likely to form deposits in vessel walls?

A

Smaller. Larger complexes attract complement, cleared by phagocytosis

39
Q

What is Arthus reaction?

A

This is where a previously immunized animal is adminstered a local bolus of antigen (subQ). This results in a localized inflammation mediated by antibody, causing local cutaneous vasculitis and necrosis

40
Q

What is serum sickness?

A

It is observed when people are innoculated with horse antibody. Occurs 7-10 days later (igG response time). Fever, chills, rash, arthritis, glomerulonephritis

41
Q

Systemic Lupus Erythematosus (SLE) is the prototype immune complex disease. Antibodies are targeted towards _

A

DNA
Nucleoproteins
Others

42
Q

What are the 2 major means by which Type 4 rxns cause tissue damage?

A

Triggering inflammation

Direct tissue killing

43
Q

CD4 cells can recruit macrophages and neutrophils. What are the subtypes responsible and what is the major cytokine?

A

Macrophages - Th1 - IFN-gamma

Neutrophils - Th17 - IL-17

44
Q

The classical T-cell mediated inflammation is _

A

Delayed type hypersensitivity

45
Q

What is the timeline for delayed type hypersensitivity? What are 2 examples provided?

A

24-48 hrs

PPD test, contact dermatitis

46
Q

In DTH, what is occuring at 4 hrs? 12 hrs? When is peak induration occuring?

A

4 hrs - Neutrophils around post-cap. venules
12 hrs - T cells and monocytes around venules
Peak induration - 24-48 hrs

47
Q

Delayed type hypersensitivity requires prior exposure to antigen. True or false

A

True

48
Q

A example of chronic type DTH is _. What is a characteristic finding?

A

Tuberculosis

Granulomas (nodules of inflammatory cells), Fused macrophages to form multinucleate giant cells

49
Q

Difficulty breathing following prolonged TB infection is due to _

A

Fibrotic tissue from inflammation, not the microbe itself

50
Q

The major CD4 subtype involved in granuloma formation and its cytokine is _

A

TH1, IFN-gamma

51
Q

What do RA, MS, Type 1 diabetes and IBS have in common?

A

All type 4 hypersensitivity reactions.

52
Q

Poison Ivy dermatitis is an example of _. The allergen here is Urushiol

A

Type 4

53
Q

Treatment of poison ivy can be done with _

A

Corticosteroids (topical or systemic, depending on severity)

54
Q

What is the patch test?

A

Allergy panel test

Immunology Exam 4 (7 decks)

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