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Final Immunology > hypersensitivity > Flashcards

hypersensitivity Flashcards

1
Q

triggers of hypersensitivity

A
  1. SELF ANTIGENS- autoimmunity 2. MICROBIAL ANTIGENS- excessive inflammation 3. ENVIRONMENTAL- allergy
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2
Q

persistent triggers of hypersensitivity can lead to

A

chronic disease

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3
Q

hypersensitivity

A

defect in regulation or targeting of the usually beneficial immune response

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4
Q

type I hypersensitivity

A
  • immediate, IgE-mediated, allergy - within minutes - involve antigen specific IgE on effector cells - vasoactive mediators, lipid mediators, cytokine - HISTAMINE
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5
Q

examples of type I hypersensitivity

A
  • allergic rhinitis (hay fever) - atopic asthma - anaphylaxis (food allergy, stinging insect allergy, drug allergy)
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6
Q

type I, II, and III hypersensitivity similarities

A

mediated by antibodies

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7
Q

type II and III hypersensitivity involve which antibodies

A

IgG and IgM

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8
Q

Type II hypersensitivity

A
  • injury related to antibody directly bing to target - minutes to hours - antigens are specific cells are extracellular matrix - local tissue/cell specific
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9
Q

Type III hypersensitivity

A
  • injury related to immune complex deposition - antigens are present in circulation - systemic
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10
Q

which class of immunoglobulin is most abundant in the bloodstream?

A

IgG

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11
Q

IgG

A
  • neutralization of microbes and toxins - most abundant in the bloodstream - opsonization of antigens for phagocytosis by macrophages and neutrophils - activation of the classical pathway of complement - neonatal immunity - activates NK cells
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12
Q

IgM

A

activation of the classical pathway of complement

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13
Q

IgA

A
  • mucosal immunity - neutralizations of toxins
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14
Q

IgE

A

eosinophils and mast cell mediated defense against helminths

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15
Q

type II hypersensitivity mechanism

A

antibodies causing 1. opsonization/phagocytosis 2. complement/Fc receptor inflammation 3. receptor activation

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16
Q

goodpasture syndrome

A
  • anti-glomelular basement membrane disease
  • antibodies against basement membrane in kidney and lung
  • fatigue, blood in the ling, bloody urine, kidney failure
17
Q
A

idiopathic thrombocytopenic purpure (ITP)

  • autoantibodies against platelets –> opsonization in the slpeen
18
Q
A

normal

19
Q
A

autoimmune hemolytic anemia

  • autoantibodies against RBC membrane proteins
20
Q

type II hypersensitivity

A
  • antibody stimulates the receptor without hormone
  • antibody inhibits binding of neurotransmitter to receptor
  • antibody binds antigen and attracts neutrophils and or complement which leads to inflammation
  • antibody coats outside of cells and then phagocytes come and eat them
21
Q

acute rheumatic fever, pemphigus vulgaris, pernicious anemia are clinical examples of type I or type II hypersensitivities

A

II

22
Q

timing of type III hypersensitivtiy

A

3-10 hours

23
Q

immune complex mediated hypersensitivity

A

Type III

24
Q

mechanism of Type III hypersensitivity

A

antibodies bind appropriate sized antigens and deposit in vessels or tissue cause complement/Fc receptor inflammation

  • causes vaculitis
25
Q

anti-diphtheria horse serum for diphtheria leading to fever, joint pain and symptoms with just horse serum; would take 1 week for onset od symptoms, subsequent injections decreased time of reaction is an exmaple of type I/II/III

A

type III hypersensitivity

26
Q

systemic lupus erythematosus

A
  • type III
  • usually women

SOAP BRAIN MD
- serositis

  • oral ulcers
  • arthritis
  • photosensitivity
  • blood (low WBC, RBC, and platelets)
  • renal
  • anti-nuclear antibodies
  • immunologic
  • neuroligic
  • malar rash
  • discoid rash
27
Q

poststreptococcal glomerulonephritis and polyarteritis nodosa are examples of type I/II/III/IV

A

III

28
Q

type IV hypersensitivity timing

A

1-3 dyas

29
Q

type IV mechanism

A
  • t-cells either through cytokines (CD4) or direct cytotoxic killing (CD8) cuase injurt
30
Q

type IV is mediated by t cells/antibodies

A

t cells

31
Q

type IV is/is not transferrable by serum

A

is not

32
Q

which of the following is a primary cytokine secreted by CD4+ t cells in type IV cytokine mediated hypersensitivity

A

IFN- gamma

33
Q

TB test is a an example of TYPE I/II/III/IV

A

IV

34
Q

poison ivy

A
  • contact dermatitis
  • low molecular weight and soluble so crosses cell membrane
  • modifies intracellular skin proteins, presented on MHC I cells
  • TYPE IV example
35
Q
  • In preparation for receiving a kidney transplant, a 32 y/o male is given rabbit-derived anti-thymocyte globulin (ATG). A little over 1 week after receiving his transplant, he develops fever, red rash and joint pain.
  • What type of hypersensitivity does this represent?

»A) Type I

»B) Type II

»C) Type III

»D) Type IV

A

»C) Type III

36
Q
  • Minutes after beginning a laparoscopic cholecystectomy on a 45 y/o female, the anesthesiologist notes hypotension and dropping SaO2. Under the drape, a red rash is noted on the patient.
  • What type of hypersensitivity does this represent?

»A) Type I

»B) Type II

»C) Type III

»D) Type IV

A

»A) Type I

37
Q
  • Over the past year, a 27 y/o male had 3 episodes of isolated hemoptysis and mildly progressive shortness of breath. He presented to the ED with the new concern for blood in his urine and was found to have antiglomerular basement antibodies.
  • What type of hypersensitivity does this represent?

»A) Type I

»B) Type II

»C) Type III

»D) Type IV

A

»C) Type III

38
Q

treatment options

A

steroids, epinephrine, plasmapheresis, steroids

Final Immunology (5 decks)

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