Hypersensitivity Flashcards

1
Q

true allergy or atopy

A

Type 1 Hypersensitivity

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2
Q

IgE antibody-mast cell mediated in response to antigen

A

Type 1 Hypersensitivity

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3
Q

sensitization phase

A

Type 1 Hypersensitivity
first exposure to allergen protein that binds haptens

no reaction

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4
Q

IgE to the allergen is produced long term by the plasma cells and binds to ______ on mast cells

A

Fc epsilon R1 IgE receptors

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5
Q

elicitation phase

A

hypersensitivity reaction upon repeat exposure

occurs only after sensitization

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6
Q

allergen cross links the IgE on the mast cell _______

A

Fc epsilon R1

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7
Q

immediate hypersensitivity is mediated by

A

vasoactive amines and lipid mediators

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8
Q

late phase hypersensitivity is mediated by

A

cytokines

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9
Q

mast cells are located in

A

all connective tissue

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10
Q

Fc epsilon R1

A

high affinity receptor on mast cells and basophils

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11
Q

ITAM phosphorylation causes

A

release of preformed mediators
arachidonic acid metabolism secreting lipid mediatiors
activation of cytokine transcription genes to secrete cytokines

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12
Q

histamine is released

A

upon mast cell degranulation

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13
Q

effect: histamine

A

vasodilation, increased vascular permeability, smooth muscle contraction, mucous production

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14
Q

proteases are released upon

A

degranulation

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15
Q

proteases cause

A

tissue damage

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16
Q

prostaglandins are released

A

arachidonic acid metabolism

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17
Q

prostaglandins cause

A

vasodilation

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18
Q

leukotrienes are released

A

arachidonic acid metabolism

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19
Q

leukotrienes cause

A

prolonged smooth muscle contraction

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20
Q

synthesized THF-a causes

A

endothelial cell activation
inflammation
neutrophil activation

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21
Q

synthesized IL-4 causes

A

IgE class switching by B cells

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22
Q

synthesized IL-5 causes

A

eosinophil generation and activation

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23
Q

antihistamines

A

reduce the potential for histamine to bind and cause symptoms

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24
Q

H1 antagonists: first gen

A

antihistamines that cause sedation, short acting

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25
Q

first gen H1 antagonists: drug names

A

diphenhydramine, hydroxyzine, doxepin, cyproheptadine

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26
Q

H1 antagonists: 2nd gen

A

antihistamines that are long acting, little to no sedation

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27
Q

H1 antagonists: 2nd gen drug names

A

cetrirzine, levocetirizine, loratadine, desloratadine, fexofenadine

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28
Q

H2 antagonists

A

receptors mostly in gut
indigestion/heartburn

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29
Q

H2 antagonists: drug names

A

ranitidine and famotidine

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30
Q

1st line in anaphylaxis

A

epinephrine

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31
Q

montelukast, zafirlukast

A

leukotriene receptor antagonists
relax bronchial smooth muscle

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32
Q

administration: corticosteroids

A

inhaled, topical, oral, IV, IM

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33
Q

allergy shots are

A

desensitization

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34
Q

repeated increasing dose of allergens to help the system overcome the allergy

A

desensitization

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35
Q

cromolyn

A

inhibits mast cell degranulation

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36
Q

mepolizumab
reslizumab
benralizumab

A

anti IL-5 therapy

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37
Q

duplimab

A

anti IL-4, IL-13 therapy

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38
Q

clinical use: duplimab

A

atopic dermatitis in adults
asthma

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39
Q

antibodies can be directed against cells or extracellular matrix components

A

Type II

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40
Q

antibodies/antigens can bind and be directly deposited in blood vessels

A

Type III

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41
Q

complement and Tc mediated recruitment and activation of leukocytes

A

Type II

42
Q

opsonization and phagocytosis of cells

A

Type II

43
Q

cell function abnormalities by competitive inhibition or activation

A

Type II

44
Q

complement activation released C3a and C5a

A

Type II

45
Q

Type II activates

A

neutrophils

46
Q

neutrophils generate ______ through ROS and lysosomal enzymes

A

inflammation/injury

47
Q

associated with strep infection

A

Type II

48
Q

mycarditis

A

Type II

49
Q

anemia/thrombocytopenia

A

Type II

50
Q

autoimmune hemolytic anemia: target

A

erythrocyte membrane proteins

51
Q

autoimmune hemolytic anemia: pathophys

A

opsonization and phagocytosis of erythrocytes

52
Q

autoimmune hemolytic anemia: effect

A

hemolytic anemia

53
Q

autoimmune (idiopathic) thrombocytopenia purpura: target

A

platelet membrane proteins

54
Q

autoimmune (idiopathic) thrombocytopenia purpura: pathophy

A

opsonization and phagocytosis of platelets

55
Q

autoimmune (idiopathic) thrombocytopenia purpura: effect

A

bleeding

56
Q

goodpasture syndrome: target

A

NC protein in kidney glomeruli and lung alveolar basement membranes

57
Q

goodpasture syndrome: pathophys

A

complements and Fc receptor mediated inflammation

58
Q

goodpasture syndrome: effect

A

nephritis
lung hemorrhage

59
Q

grave’s disease: target

A

TSH receptor

60
Q

grave’s disease: pathophy

A

antibody mediated stimulation of TSH receptors

61
Q

grave’s disease: effect

A

hyperthyroidism

62
Q

myasthenia gravis: target

A

Ach receptor

63
Q

myasthenia gravis: pathophys

A

antibody competitively inhibits Ach binding which leads to down regulation of receptors

64
Q

myasthenia gravis: effects

A

muscle weakness
paralysis

65
Q

pemphigus vulgaris: target

A

desmoglein- protein in intercellular junction of epidermal cells which holds cells together

66
Q

pemphigus vulgaris: pathophys

A

antibody mediated activation of proteases cause disruption of intercellular adhesions

67
Q

pemphigus vulgaris: effect

A

bullae (large fluid filled blisters)

68
Q

pernicious anemia: target

A

intrinsic factor of gastric parietal cells

69
Q

pernicious anemia: pathophys

A

neutralization of intrinsic factor leads to decreased absorption of vitamin B12

70
Q

pernicious anemia: effect

A

anemia

71
Q

rheumatic fever: target

A

streptococcal cell wall antigen; antibody cross reacts with myocardium

72
Q

rheumatic fever: pathophys

A

inflammation
macrophage activation

73
Q

rheumatic fever: effect

A

myocardities
arthritis

74
Q

Type III hypersensitivity diseases

A

SLE
polyarteritis nodosa
post-streptococcal glomerulonephritis
serum sickness
arthus reaction

75
Q

antibody specificity: SLE

A

DNA, nucleoproteins, other

76
Q

manifestation: SLE

A

nephritis, arthritis, vasculitis

77
Q

antibody specificity: polyarteritis nodosa

A

mostly unknown, hep B surface antigen

78
Q

manifestation: polyarteritis nodosa

A

vasculitis

79
Q

antibody specificity: post-streptococcal glomerulonephritis

A

streptococcal cell wall antigens

80
Q

manifestation: post-streptococcal glomerulonephritis

A

nephritis

81
Q

antibody specificity: serum sickness

A

protein antigens

82
Q

manifestation: serum sickness

A

systemic vasculitis
nephritis
arthritis

83
Q

antibody specificity: arthus reaction

A

protein antigens

84
Q

manifestation: arthus reaction

A

cutaneous vasculitis

85
Q

arthus reaction

A

formation of complexes at the site of antigen injection

86
Q

disease caused by deposition of circulating antibody/antigen complexes in blood vessels

A

Type III

87
Q

activation of complement and inflammatory cascade by circulating complexes

A

Type III

88
Q

Type II and III treatment

A

corticosteroids
plasmapheresis
IVIg
Anti CD20 antibody (rituximab)

89
Q

local autoimmune reaction with T cells directed against cellular antigens within that local tissue

A

Type IV

90
Q

persistent reaction to chemicals
poison ivy, chemicals, metals, triggers

A

Type IV

91
Q

response to superantigens

A

Type IV

92
Q

Type IV hypersensitivity disease

myelin proteins

demyelination in the CNS, sensory and motor dysfunction

A

multiple sclerosis

93
Q

Type IV hypersensitivity disease

unknown antigens

inflammation of synovium and erosion of cartilage and bone in joints

A

rheumatoid arthritis

94
Q

Type IV hypersensitivity disease

pancreatic islet antigens

impaired glucose metabolism, vascular diseaase

A

Type 1 DM

95
Q

Type IV hypersensitivity disease

unknown

inflammation of the bowel wall; abdominal pain, diarrhea, intestinal bloating

A

IBD
chron’s

96
Q

Type IV hypersensitivity disease

modified skin proteins

delayed type hypersensitivity rash

A

contact sensitivity
poison ivy
metal allergy

97
Q

Type IV hypersensitivity disease

microbial proteins

chronic granulomatous inflammation

A

tuberculosis

98
Q

Type IV hypersensitivity disease

viral. encoded proteins

cytotoxic T cells cause death, hepatic dysfunction, fibrosis

A

hep B and C

99
Q

Type IV hypersensitivity disease

microbial super antigens

cytokine release causing fever and shock

A

Type IV hypersensitivity disease

100
Q

Type IV hypersensitivity disease treatment

A

anti-inflammatories: corticosteroids

Decrease T cell response of effects: TNF-a, IL receptor antagonists, anti-CD20