Hypersensitivity and autoimmune disease

Question 1

Types of hypersensitivity

Answer 1

Immediate (type 1)
Antibody-mediated (type II)
Immune complex-mediated (type III)
Delayed-type hypersensitivity (type IV)

Question 2

Immune mechanism of type I hypersensitivity

Answer 2

Activation ot Th2 cells resulting in the production of IgE which in turn binds to FCER on mast cell, basophils and eosinophils

Question 3

Immune mechanism of type II hypersensitivity

Answer 3

IgM and IgG against surface

Question 4

Immune mechanism of type III hypersensitivity

Answer 4

Deposition of immune complexes comprised of IgM or IgG and soluble antigen

Question 5

Immune mechanism of type IV hypersensitivity

Answer 5

Inflammatory cytokines, IFN-Y and IL-17, produced by CD4+ Th1 and Th17 cells

Question 6

Mechanisms of tissue injury in type I hypersentivity

Answer 6

Immediate reaction - degranulation and release of vasoactive amines and proteases
Late-phase reaction - Synthesis and secretion of prostaglandins and leukotrienes
cytokine-induce inflammation and leukocyte recruitment

Question 7

Mechanisms of tissue injury in type II hypersensitivity

Answer 7

Opsonization and enhaces phagocytosis

recruitment and activation of inflammatory cells

Question 8

Mechanisms of tissue injury in type IV hypersensitivity

Answer 8

IFN-y activation of macrophage
IL-17 recruitment and activation of neutrophil
CTL-mediated cellular death

Question 9

Only hypersensitivity mediated by IgE

Answer 9

Type I

Question 10

Mast cell mediators - Mediators stored and released

Answer 10

histamine
heparin
eosinophil chemotactic factor A

Question 11

Mediators newly synthesized from arachidonic acid

Answer 11

prostaglandin D2, E2, F2a
Leukotrienes C4, D4, E4 (lipoxygenase pathway)
Leukotriene B4

Question 12

Target antigen of acute rheumatic fever

Answer 12

streptococcal cell-wall Ag; Ab cross-reacts with myocardial Ag

Question 13

Target antigen for Goodpasture syndrome

Answer 13

Type IV collagen in basement membranes of kidney glomeruli and lung alveoli

Question 14

Target antigen in transfusion reaction

Answer 14

ABO blood glycoproteins

Question 15

Target antigen for myasthenia gravis

Answer 15

Acetylcholine receptor

Question 16

Target antigen for Graves disease

Answer 16

TSH receptor

Question 17

Target antigen for pernicious anemia

Answer 17

instrinsic factor of gastric parietal cells

Question 18

Type of hypersensitivity of HDNB

Answer 18

type II

Question 19

Antigen involved in systemic lupus erythematosus

Answer 19

dsDNA, Sm, other nucleo-proteins

Question 20

Clinical manifestations of systemic lupus erythematosus

Answer 20

nephritis, arthritis, vasculitis, butterfly facial rash

Question 21

Antigen involved in poststreptococcal glomerulonephritis

Answer 21

streptococcal cell wall Ags

Question 22

HLA genes

Answer 22

Among the strongest genetic associations with the development of autoimmmune disease

Question 23

HLA allele for rheumatoid arthritis

Answer 23

DR4

Question 24

HLA allele for insulin-dependent diabetes mellitus

Answer 24

DR3/DR4

Question 25

HLA allele for multiple sclerosis, goodpasture’s

Answer 25

DR2

Question 26

HLA allele for systemic lupus erythematosus

Answer 26

DR2/DR3

Question 27

HLA allele for celiac disease

Answer 27

DQ2 or DQ8

Question 28

HLA allele for Graves disease

Answer 28

B8

Question 29

HLA allele for ankylosing spondylitis, psoriasis, inflammatory bowel disease, reactive arthritis

Answer 29

B27

Question 30

Infection with what is at the highest risk for Guillain-Barré syndrome?

Answer 30

Campylobacter