hypersensitivity

Question 1

triggers of hypersensitivity

Answer 1

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

Question 2

persistent triggers of hypersensitivity can lead to

Answer 2

chronic disease

Question 3

hypersensitivity

Answer 3

defect in regulation or targeting of the usually beneficial immune response

Question 4

type I hypersensitivity

Answer 4

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

Question 5

examples of type I hypersensitivity

Answer 5

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

Question 6

type I, II, and III hypersensitivity similarities

Answer 6

mediated by antibodies

Question 7

type II and III hypersensitivity involve which antibodies

Answer 7

IgG and IgM

Question 8

Type II hypersensitivity

Answer 8

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

Question 9

Type III hypersensitivity

Answer 9

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

Question 10

which class of immunoglobulin is most abundant in the bloodstream?

Answer 10

IgG

Question 11

IgG

Answer 11

• 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

Question 12

IgM

Answer 12

activation of the classical pathway of complement

Question 13

IgA

Answer 13

• mucosal immunity - neutralizations of toxins

Question 14

IgE

Answer 14

eosinophils and mast cell mediated defense against helminths

Question 15

type II hypersensitivity mechanism

Answer 15

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

Question 16

goodpasture syndrome

Answer 16

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

Question 17

Answer 17

idiopathic thrombocytopenic purpure (ITP)

• autoantibodies against platelets –> opsonization in the slpeen

Question 18

Answer 18

normal

Question 19

Answer 19

autoimmune hemolytic anemia

• autoantibodies against RBC membrane proteins

Question 20

type II hypersensitivity

Answer 20

• 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

Question 21

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

Answer 21

II

Question 22

timing of type III hypersensitivtiy

Answer 22

3-10 hours

Question 23

immune complex mediated hypersensitivity

Answer 23

Type III

Question 24

mechanism of Type III hypersensitivity

Answer 24

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

• causes vaculitis

Question 25

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

Answer 25

type III hypersensitivity

Question 26

systemic lupus erythematosus

Answer 26

- 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

Question 27

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

Answer 27

III

Question 28

type IV hypersensitivity timing

Answer 28

1-3 dyas

Question 29

type IV mechanism

Answer 29

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

Question 30

type IV is mediated by t cells/antibodies

Answer 30

t cells

Question 31

type IV is/is not transferrable by serum

Answer 31

is not

Question 32

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

Answer 32

IFN- gamma

Question 33

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

Answer 33

IV

Question 34

poison ivy

Answer 34

- contact dermatitis - low molecular weight and soluble so crosses cell membrane - modifies intracellular skin proteins, presented on MHC I cells - TYPE IV example

Question 35

* 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

Answer 35

»C) Type III

Question 36

* 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

Answer 36

»A) Type I

Question 37

* 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

Answer 37

»C) Type III

Question 38

treatment options

Answer 38

steroids, epinephrine, plasmapheresis, steroids