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B4W3 > HYPERSENSITIVITY AND AUTOIMMUNITY > Flashcards

HYPERSENSITIVITY AND AUTOIMMUNITY Flashcards

1
Q

what is an allergen?

A

an antigen which causes allergy. a low dose exposure can trigger hypersensitivity reactions

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2
Q

what type of immune response do most allergens promote?

A

T helper 2

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3
Q

what is an allergy?

A

the process by which an allergic reaction occurs. its an exaggerated immune response to a foreign antigen regardless of the mechanism

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4
Q

what is atopy?

A

the genetic tendency to develop allergic diseases

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5
Q

what cytokines do T helper 2 cells release to drive B cells to undergo class switching and produce IgE?

A

IL-4 and IL-13

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6
Q

why do mast cells secrete IL-4?

A

to activate Th2 cells

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7
Q

why do mast cells secrete IL-3 and IL-5?

A

to induce eosinophil activation

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8
Q

what are examples of type 1 hypersensitivity diseases?

A

allergic rhinitis, asthma, allergic eczema, urticaria and anaphylaxis

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9
Q

describe the key features of allergic rhinitis?

A

it is seasonal, also known as hay fever, causes red itchy watery eyes, a sensation of congestion, runny nose, sneezing, itchy or sore throat, post nasal drip, can cause allergic conjunctivas and allergic shiners

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10
Q

what is perennial allergic rhinitis?

A

when symptoms appear all year round, usually because the allergen is indoors

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11
Q

what is allergic conjunctivas?

A

red, watery, itchy eyes- inflammation due to exposure to antigen

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12
Q

what are allergic shiners?

A

Allergic shiners are dark circles under the eyes caused by congestion of the nose and sinuses. They’re usually described as dark, shadowy pigments that resemble bruises- caused by the accumulation of blood and other fluids

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13
Q

how do we treat allergic rhinitis?

A

reducing exposure to allergen, intranasal corticosteroids, anti-histamines, sometimes immunotherapy

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14
Q

what is immunotherapy?

A

Immunotherapy involves gradually introducing more and more of the allergen into your body to make your immune system less sensitive to it. The allergen is often injected under the skin of your upper arm. Injections are given at weekly intervals, with a slightly increased dose each time.

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15
Q

what are the key points about asthma?

A

asthma is the narrowing of the airway lumen and thickening of the bronchial wall. in an asthma attack air is trapped in the alveoli so air exchange is impaired

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16
Q

how can we treat asthma?

A

reliever inhalers (salbutamol), preventative inhalers (corticosteroids), leukotriene receptor antagonists and theophyllines (leukotriene inhibitors)

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17
Q

why would we use leukotriene receptor antagonists and leukotriene inhibitors to treat an asthma attack?

A

as leukotrienes are released by mast cells and are the primary cause of bronchoconstriction

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18
Q

what is the cause of allergic eczema?

A

a change in the protein filaggrin that codes for the epidermis of the skin means allergens can penetrate through the epidermal barrier which triggers an allergic response.

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19
Q

what are the signs of allergic eczema?

A

itchy, dry, red and cracked skin often in areas that flex a lot.

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20
Q

what perpetuates scratching in eczema? what is the problem with this?

A

keratinocytes in the skin produce a protein which encourages the person to itch as to remove the pathogen. it increases exposure to the allergen

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21
Q

what is the treatment of allergic eczema?

A

reduce scratching, emollients and topical corticosteroids

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22
Q

what are the main features of urticaria?

A

it is characterised by raised, red, itchy bumps in response to histamine release

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23
Q

what is the treatment for urticaria?

A

trigger avoidance, antihistamines, corticosteroids, leukotriene receptor antagonists, cyclosporin, anti IgE therapy

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24
Q

what are the main features of anaphylaxis?

A

a systemic response to an allergen characterised by rapid synthesis of prostaglandins and leukotrienes causing systemic vasodilation, increased vascular permeability, severe bronchoconstriction, oedema, shock and a fall in bp

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25
Q

what is the symptoms of anaphylaxis?

A

swollen eyes, lips, hands and feet. feeling lightheaded, narrowing of airways can cause difficulty breathing and wheezing, abdominal pain, nausea, vomiting and collapsing

26
Q

what is the treatment for anaphylaxis?

A

Epinephrine (adrenaline) to reduce your body’s allergic response.
Oxygen, to help you breathe.
Intravenous (IV) antihistamines and cortisone to reduce inflammation of your air passages and improve breathing.
A beta-agonist (such as albuterol) to relieve breathing symptoms.

27
Q

what are examples of type 2 hypersensitivity diseases?

A

Rhesus disease, drug-induce haemolytic anaemia, good pasture syndrome, myasthenia graves, graves disease

28
Q

explain the key features of Rhesus disease?

A

if a RhD- mother is exposed to RhD+ blood from a foetus then the mother will develop anti-D IgG antibodies so in subsequent pregnancies IgG can cross the placenta and induce haemolytic of foetal RBCs.

29
Q

what are the symptoms of rhesus disease?

A 
Yellow coloring of the skin and whites of the eyes (jaundice)
Pale-coloring because of anemia.
Fast heart rate (tachycardia)
Fast breathing (tachypnea)
Lack of energy.
Swelling under the skin.
Large abdomen.
30
Q

how do we prevent and treat rhesus disease?

A 
prevention= routine antenatal anti-D prophylaxis to reduce any RhD+ RBCs
treatment= blood transfusions
31
Q

explain the key features of drug-induced haemolytic anaemia?

A

binding of drugs to cells can induce an immune response and produce neoantigens on the surface of our RBCs and the body produces antibodies against them

32
Q

what are neoantigens?

A

mutated antigens specifically expressed by tumor tissue and are not expressed on the surface of normal cells.

33
Q

what is a hapten?

A

small molecules that elicit an immune response only when attached to a large carrier such as a protein- when a drug binds to a RBC and this causes production of neoantigens

34
Q

what is goodpasture syndrome?

A

rare autoimmune disease in which IgG antibodies attack the basement membrane in lungs and kidneys by activating the complement. leading to bleeding from the lungs, glomerulonephritis, and kidney failure.

35
Q

what is the treatment for goodpasture syndrome?

A

oral immunosuppressants

in severe cases sometimes plasmapheresis

36
Q

what is plasmapheresis?

A

when the plasma is separated from the blood cells.

37
Q

outline the key features of myasthenia gravis?

A

when antibodies attack the acetylcholine receptor at the neuromuscular junction which prevents nerve impulse transmission

38
Q

what are the clinical signs of myasthenia gravis?

A

muscle weakness

39
Q

what is the treatment for myasthenia gravis?

A 
pyridostigmine- blocks acetylcholinesterase
corticosteroids
immunosuppressants
thymectomy
B cell depleting therapy
40
Q

what are the key feature of Graves disease?

A

antibodes bind the thyroid hormone receptor causing increased thyroid hormone production- overactive thyroid

41
Q

what are the most distinguishable clinical signs of graves disease?

A

protruding eyes and development of goiter (visible enlargement of thyroid gland)

42
Q

what is the treatment for Graves disease?

A

thionamides
radioactive iodine therapy
surgery to remove thyroid

43
Q

what are the 3 ways in which immune complexes occur in response to?

A

autoantigens, environmental agents and infectious agents

44
Q

what are 3 types of type 3 hypersensititvity?

A

systemic lupus erythematosus, Arthus reaction and serum sickness

45
Q

what causes systemic lupus erythematosus?

A

autoantigens cause failure of clearance of apoptotic cells and this results in systemic damage to tissues

46
Q

what is the treatment for systemic lupus erythematosus?

A

alkylating agents, immunosuppressants and biological therapies (to reduce amount of antibody in the blood)

47
Q

what causes Arthus reaction?

A

a local vasculitis associated with deposition of immune complexes and activation of complement after giving a vaccine

48
Q

what causes serum sickness?

A

nonhuman proteins in certain medications and treatments that your body mistakes as being harmful, causing an immune reaction. One of the most common types is antivenom. antibodies bind to the antigens from the medication and immune complexes form

49
Q

how does serum sickness present?

A 
Fever
Hives
Itching
Joint pain
Rash
Swollen lymph nodes
50
Q

what type of hypersensitivity are autoimmune reactions?

A

type 4 (delayed)

51
Q

what is contact dermatitis?

A

a red, itchy rash caused by direct contact with a substance e.g. nickel or poison ivy.

52
Q

what is the treatment of contact dermatitis?

A

removal of trigger

53
Q

describe the tuberculin test?

A

antigen is injected into subcutaneous tissue and processed by local antigen-presenting cells, Th1 effector cells recognise the antigen and release cytokines which act on the vascular endothelium. recruitment of phagocytes and plasma to the site of antigen infection causes a visible lesion

54
Q

what is rheumatoid arthritis caused by?

A

dysregulation in cytokine production which causes immune cell mediated joint tissue destruction

55
Q

how can rheumatoid arthritis be diagnosed?

A

doctors look for the presence of Rheumatoid Factor (autoantibodies)

56
Q

what is the treatment of rheumatoid arthritis?

A

NSAIDs
corticosteroids
biological therapies

57
Q

what are biological therapies?

A

treatment designed to stimulate or restore the ability of the body’s immune system to fight infection and disease.

58
Q

what is the cause of multiple sclerosis?

A

immune cell mediated destruction of myelin that normally lines the nerve fibres to aid transmission. therefore this can lead to paralysis

59
Q

what is the treatment of multiple sclerosis?

A

immunosuppression
biological therapies
cell function modifying antibodies
haematopoietic stem cell transplants

60
Q

what is multiple sclerosis?

A

a condition that can affect the brain and spinal cord, causing a wide range of potential symptoms, including problems with vision, arm or leg movement, sensation or balance. It’s a lifelong condition that can sometimes cause serious disability, although it can occasionally be mild

61
Q

what is rheumatoid arthritis?

A

This means your immune system (which usually fights infection) attacks the cells that line your joints by mistake, making the joints swollen, stiff and painful.

B4W3 (7 decks)

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