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Immunology > Hypersensitivity > Flashcards

Hypersensitivity Flashcards

1
Q

Mast cell , basophils , eosinophils role in immunity

A

Inflammation in mucosa
Have a role in hypersensitivity

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2
Q

What is hypersensitivity?

A

Excess or uncontrolled reaction produced by normal immune system causes tissue damage

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3
Q

What cuse hypersensitivity?

A

Foreign Ag
1. Harmless environment Ags like food ,drug(hapten)
2. Infectious organism

Self Ag
Due to failure of tolerance–> autoimmune disease like self reactive clones

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4
Q

Factor determining clinical & pathological consequences

A
  1. Type of immune response
  2. Nature & location of the causative Ag , RT or GIT
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5
Q

Hypersensitivity is classified according to ______ ________ causing tissue damage
Type 1,2,3 is ____
Type 4 ____

A

Effort mechanism
Ab mediated
T cell mediated

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6
Q

Type 1 hypersensitivity is also called _____ or _____

A

Immediate
Anaphylctic type ( lgE mediated)

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7
Q

1st exposure to allergen cause

A

Sensitization

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8
Q

What are the allergen that cause hypersensitivity

A

Certain food
Pollen
Drugs ( penicillin )
Insect bit like bee venom
Animal serum protein

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9
Q

During the first exposure in hypersensitivity, allergen is taken by APCs to be presented to

A

Th2

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10
Q

In type 1 hypersensitivity why th2 is highly secreted ( هذا أفضل وصف عندي) ?

A

Genetic predisposition that run in families

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11
Q

After APCs bind with its MHC2 (that contain allergen) to TCR on th2 , what will happen

A

Th2 secrete lL4,13,10 that + B cell to produce lgE secretion
And lL5 to run as ADCC

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12
Q

After 1st exposure, Sensitization requires _____ , during that period millions of _____ molecules are synthesized, these molecules attach to ____ on thousands of mast cells and basophils

A

1 week
IgE
Fc epsilon receptor

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13
Q

In 1st exposure, mast cell and basophils secrets histamine

A

False , in second exposure

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14
Q

2nd exposure to allergen cause

A

Degranulation

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15
Q

In hypersensitivity type 1 , how Degranulation occurs?

A

When mast cells and basophils is attached to lgE , and FAB of lgE do crosslinking action degranulation of mast cells in tissue and basophils in blood

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16
Q

What are the early phase reactions to allergen
On set on 2nd exposure to Ag :
Mediators ( what is synthesis) :
Effects :

A

Within minutes
Physiological preformed mediators
Histamine , pAF , ECF-A (حبا في العلم جيب الفلفورم لوحدك)

1.Increase VD and capillary permeability which cause wheal and flare reaction
2. Smooth muscles contraction and Increase mucus secretion (in trachea دي جدعنة بس غالبا صح)
3. + of nerve ending in skin cause itching

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17
Q

Late phase reactions onset on 2nd exposure to Ag

A

Within hours

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18
Q

Late phase reactions midators

A

Cytokines TNF alpha , lL4,5,13
Recruitment of neutrophils , eosinophils and th2

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19
Q

Late phase reactions effects

A

Neutrophils and eosinophils that release proteases cause tissue damage

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20
Q

Where is clinical presentation is absorbed in hypersensitivity type 1 and name its 2 kinds

A

In RT , intestinal wall , skin ( site of mast cell

Systemic anaphylaxis
Localized anaphylaxis (atopy) or atopia=extraordinary

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21
Q

In Systemic anaphylaxis type of allergen is

A

Injection like penicillin, animal antitoxin
Bee venom

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22
Q

Mechanism of Systemic anaphylaxis

A

Degranulation of mast cell and basophils in blood

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23
Q

What are the symptoms of Systemic anaphylaxis

A

Edema and hypotension
Urticarial rash احمرار جلدي
Difficulties in breathing
Fatal within minutes

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24
Q

Localized anaphylaxis differentiate into

A

Airborne allergens (inhalation)استنشاق

Food drag allergens (ingestion)ابتلاع

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25
Q

Airborne kinds

A

Allergic rhinitis ( hay fever) التهاب الأنف التحسسي
Bronchial asthma الربو القصبي

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26
Q

Allergens of hay fever and broncil asthma is

A

Plant pollen
Animal dander
Fungal spores حويصلات الفطريات

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27
Q

Allergic rhinitis (التهاب الأنف التحسسي)
Bronchial asthma الربو القصبي
Name there mechanism

A

Allergic rhinitis
Degranulation of mast cells in eyes and upper RT or trachea

Bronchial asthma
Degranulation of mast cells in lower RT or lungs

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28
Q

Symptoms of allergic rhinitis

A

Red eyes
Coughing and sneezing

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29
Q

Symptoms of Bronchial asthma

A

Difficulty in breathing

30
Q

كيف يسبب Degranulation of blood صعوبة في التنفس

A
31
Q

Food and drug allergens (___) affect GIT causing _____& ______
Absorbed in blood , reach skin cause _____ , reach lung cause ____

A

Ingestion
Vomiting , diarrhea
Urticarial , asthmatic attack نوبة ربو

32
Q

Diagnosis of type 1 hypersensitivity are 2 kinds ,name them and mechanism

A
  1. Allergy skin test –> determine causative allergen
  2. Allergy blood tests –> measurement of lgE in serum
33
Q

Allergy skin test is a diagnosis processe that test allergen of ___,____,_____

A

Penicillin يستخدم قبل ما اعطي المريض الحقنه ، أتأكد اذا عنده حساسية ولا لأ

Pollens , food

34
Q

Metod of allergy skin test

A

Pricking the skin in forearm or back with sterile lancet containing drop of allergen
يارب ما تكون نسيت شو نوع allergen إلي نحطه على المريض في حالة allergy skin test

35
Q

+ve result of allergy skin test

A

Wheal and flare reaction within 15 to 20 min

36
Q

Allergy blood tests measure lgE in serum by two ways name them

A

Total lgE by RIA : high in some allergic patients

Specific lgE by RAST : يستخدم ضد certain allergen

جيب الفلفورم تبعها ، والله مو صعب

37
Q

Management of type 1 hypersensitivity

A

Identify and avoiding allergen if possible
Drugs
Immunotherapy

38
Q

Name drugs that prevent release or effect of chemical mediator in type 1 hypersensitivity

A
  1. Epinephrine ( best immediate treatment for anaphylactic shock )
  2. Corticosteroids
  3. Mast cell stabilize ( prevent Degranulation)
39
Q

Example for mast cell stabilizer

A

Na cromoglycate

40
Q

العلاج بالمناعة هو

A

Immunotherapy

41
Q

Bind to Fc of lgE prevent lgE from binding to mast cell

A

Monoclonal Ab or anti lgE , by this way we can prevent 1st exposure

42
Q

What is the goal of allergy specific immunotherapy or desensitization

A

Decrease lgE and increase lgG titers

43
Q

When we use desensitization?

A

Failure of medication to control allergy symptoms
مثل شخص كل ما يجي فصل الربيع تزيد حساسيته من pollen

44
Q

Method of allergy specific immunotherapy

A

Repeated injection of small doses of allergen
1. Decreases th2 domination that decreases lL4,5 that decreases lgE

  1. Increases th1 response that increase IFN GAMA that lgG( blocking Ab)
  2. Increases t reg response that inhibit th2
  3. Tolerance in t cell specific to allergen هبد
45
Q

Type 2 hypersensitivity is also called

A

Cytotoxic or cytolytic type (lgG,lgM mediated)

46
Q

What are the mechanism of type 2 hypersensitivity

A

A. Formation of lgG and lgM against Ag on cell surface

B. Ab binds to Ag on cell surface

C. Mechanism of tissue damage

47
Q

In type 2 hypersensitivity mechanism, Formation of lgG or IgM against Ag on self or foreign cells

Ag of self cells _____ or ______(___)
Due to failure of tolerance
_____(attach drug) or ______(exogenous)

Ag of Foreign cell (exogenous)
_______ &_______

A

Self protein , receptor (endogenous)
Hapten ( attach drug)
Organism

Allogenic RBC Ags
“ graft cells

48
Q

Mechanism of tissue damage are _______&______

A

Lysis of cell by cytotoxic Abs
Interference with cell functions ومثال على ذلك Graves disease
Myasthenia Gravis

49
Q

tissue damage occur in type 2 hypersensitivity
Lysis of cell by cytotoxic Abs by 3 ways name them

A

Complement activation , killing by Mac (c5b6789) اي الشطارة دي

Opsonization

ADCC

مش لازم اكتب امثله لأنها واضحة ومتكررة

50
Q

Tissue damage in type 2 hypersensitivity is interference with cell functions , what is that ?

A

Binding of Ab to cellular receptors –> stimulation or blocking of receptor
في مثال جميل على دا هو Graves disease و myasthenia Gravis

51
Q

Clinical presentation of type 2 hypersensitivity are

A

Allohemolysis
Autoimmune hemolysis , thrombocytopenia, granulocytopenia

52
Q

How Interference with cell functions occur ?

A

Binding of Ab to cellular receptors causing stimulation or blocking of receptors

53
Q

What is the meaning of allogenic ?

A

Different Ag from an individual in the same species , his Ag could be blood or even stem cells

54
Q

Allohemolysis is a clinical presentation of type 2 hypersensitivity, name its kinds

A

ABO incompatibility

Rh incompatibility(Rh factor or D Ag)

55
Q

What is ABO incompatibility?

A

Comments why for transfusion reaction
If a person with A+ve is tranfused(نقل إليه) with B+ve RBCs preexisting (natural) antiB lgM rapidly hemolyse( تقتل او انحلال الدم) RBCs in circulation by complement activation

56
Q

What is the mechanism of Rh incompatibility?

A

Fetal Rh +ve( ليش البيبي عنده ار اش موجب ، لأن ورثه من ابوه) leak into Rh -ve mother circulation(قصدو الدورة الدموية) during birth of 1st child —> this reaction sensitive mother to produce lgG ام شريرة

–> ln second pregnancies lgG that was produced in first pregnancy cross placenta and destroy fetal RBCs

–> still birth or erythroblastosis or jaundice

57
Q

How we prevent lgG killing RBCs of fetal?

A

Anti D or anti RH+ve injection is given to the mother within 72 hour of 1st delivery of Rh+ baby (الممرضة البطلة رح تعطي الجرعة للأم أو ما تولد البيبي)

–> neutralize or destroy any leaking fetal RBCs in mother circulation during baby delivery

–> no + of mother immune system

58
Q

How we can treat a mother with rh-ve and her fetal with rh+ve RBCs

A

By exchange transfusion ( it also may happen in uterus)

59
Q

Autoimmune hemolysis destruction of

A

Hemolysis of self RBCs

60
Q

Throm’bo-cyto-penia is the destruction of

A

Self platelets

61
Q

Granu-lo-cyto-penia I the destruction of

A

Self granulocytes

62
Q

How auto immune against RBCs , platelets, granules (وهذه كلها self cells) occur ?

A

Abs called acto Abs attack patient own Ags

63
Q

Autoimmune hemolysis , thrombocytopenia, granulocytopenia , e.g for drug(happten)

A

Drags like penicillin may bind to Ags on RBCs or platelets –> production of cytotoxic Abs to cell-frug complex

E.g hemolytic anemia by penicillin

64
Q

Name other clinical presentation of type 2 hypersensitivity

A

Disease due to affection of cell receptor [ type 5 hypersensitivity]

Good pasture syndrome

Rheumatic fever

Hyperacute & acute graft rejection

65
Q

E.g for disease due to affection of cell receptor

A

+ of receptor Graves disease
- of receptor Myasthenia Gravis

66
Q

What is Graves disease?

A

When pituitary gland produces TSH to stimulate thyroid gland , thyroid gland associated with TSH receptor will coat with TSH and the thyroid gland will be + and secrete T3 and T4

But when immune system produces Abs in excess way (بطريقة مفرطة) that bind to TSH receptor that + thyroid gland to produce more and more T3,T4

—> hyperthyroidism إفراط الغدة الدرقية

67
Q

What is Myasthenia Gravis الوهن العضلي?

A

At nerve ending, nerve produce ACh(اسيتاي كولين) that bind to receptors on muscles called ACh receptors .
But when immune system produce lgG that bind to ACh receptors and - it paralysis الشلل occur

68
Q

When lgG and lgM is non cytotoxic Abs ?

A

وهن العضلات القاتل و Gravis disease

69
Q

good pasture مثال على مريض

A

يتعذب في دنيتو بسبب Renal failur and RT failure

70
Q

What is good pasture syndrome

A

IgG auto Abs ( failure of tolerance) bind to non collagenous proteins(dr: لازم تكونوا اخذتوه في الفسيولوجي) in basement members ( احفظو كده) of lung alveoli and kidney glomeruli ( شوف الشعر ده)

71
Q

What is heterophile Abs ?

A

Specific for one or epitope on different Ags

Immunology (5 decks)

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