Hypersensitivity (Davies + Schaefer)

Question 1

Allergic rhinitis is a Type ____ hypersensitivity and is mediated by Ig____.

Answer 1

I, IgE

Question 2

Drug allergies are a type ____ hypersensitivity, mediated by Ig__.

Answer 2

II, IgG

Question 3

Graft rejection is a type ____ hypersensitivity and is mediated by ______.

Answer 3

4, CTL

Question 4

What cell type is primarily responsible for degranulation and the release of histamine in a type I hypersensitivity?

Answer 4

Mast cell

Question 5

What is the cytokine released from mast cells that is responsible for promoting inflammation and endothelial activation?

Answer 5

TNF-a

Question 6

What leukotrienes are released from mast cells and promote smooth muscle contraction, increased vascular permeability and mucus secretions (3)?

Answer 6

C4, D4, and E4

Question 7

TH2 cells release _____ to activate IgE production and ____ to activate Eosinophils against parasites.

Answer 7

IL-4, IL-5

Question 8

What is the primary cell type targeted during penicillin allergy?

Answer 8

Erythrocyte

Question 9

______ from a naive T cell will bind with ____ on an APC for co-stimulation.

Answer 9

CD28, B7

Question 10

What type of selection takes place in bone marrow (cell and name of selection)?

Answer 10

B-cell negative selection

Question 11

What is the selection process of T cells and where does it take place?

Answer 11

Positive selection in the cortex (CD 4 and CD 8)

Negative selection in the thymic medulla (CD 4 or CD 8)

Question 12

What are the three immunologically privileged sites in the body?

Answer 12

Brain, eye, testes

Question 13

What cell type is responsible for suppression of T cells?

Answer 13

T reg cells

Question 14

What is the fate of a T cell that does not get a B7 costimulation from an APC?

Answer 14

Anergy

Question 15

T reg cells use IL-___, IL-___, and TNF-___ to suppress activation of CD4 T cells.

Answer 15

10, 35, Beta

Question 16

What role does Group A Strep play in rheumatic fever (a Type II Hypersensitivity)?

Answer 16

Molecular mimicry induces carditis and polyarthritis

Question 17

Ankylosing spodylitis is associated with HLA-___.

Answer 17

B27

Question 18

Birdshot chorioretinopathy is associated with HLA-___.

Answer 18

A29

Question 19

Type I DM is strongly associated with HLA-___ and ___.

Answer 19

DQ2 and DQ8

Question 20

What Ig mediates Type I HS?

Answer 20

IgE

Question 21

What are the mediators of Type II HS?

Answer 21

IgG or IgM and complement

Question 22

What are the mediators of Type III HS?

Answer 22

IgG and complement

Question 23

What are the mediators of Type IV HS?

Answer 23

T cells, Macrophages, histiocytes

Question 24

What is the difference between Types II and III HS?

Answer 24

Type II is antibody mediated

Type III is immune complex mediated

Question 25

Autoimmune hemolytic anemia is an example of Type __ HS?

Answer 25

II

Question 26

Grave's disease is an example of Type ___ HS?

Answer 26

II

Question 27

What are the three primary consequences of HS in SLE?

Answer 27

Glomerulonephritis, vasculitis, and arthritis

Question 28

Type I DM is an example of Type ___ HS?

Answer 28

IV

Question 29

What is the pathophysiology of Type I DM?

Answer 29

Anti-beta cell CTLs kill Beta cells, preventing insulin production

Question 30

What blood type is the universal donor? What is the universal recipient?

Answer 30

Donor: O neg Recipient: AB pos

Question 31

What protein is used to identify compatible recipient-donor?

Answer 31

HLA

Question 32

Hyperacute rejection is an example of Type ___ HS.

Answer 32

II

Question 33

How can a hyper acute rejection be rescued?

Answer 33

Trick question - It can't

Question 34

What mediates acute rejection?

Answer 34

Host T cells against HLA alleles

Question 35

Acute rejection is a Type ___ HS.

Answer 35

IV

Question 36

Chronic rejection is a Type ___ HS.

Answer 36

III

Question 37

What is the pathophysiology of chronic rejection?

Answer 37

Immune complex depositions in the vasculature of the graft recruit inflammatory cells --> Immune effects enter the graft tissue --> Increasing immunity causes rejection of tissue

Question 38

How are acute and chronic rejection prevented and treated?

Answer 38

Immunosuppression

Question 39

What is the mechanism of Belatacept in immune suppression?

Answer 39

Block B7 on APC, preventing T cell activation

Question 40

What is the mechanism of cyclosporine and FK-506?

Answer 40

Block NFAT transcription --> Inhibit IL-2 production --> reduced T cell activation

Question 41

What is the strategy behind long term maintenance of immunosuppressive drugs in organ transplant?

Answer 41

Interfere with T cell activation

Question 42

Bone marrow transplant rejection is an example of ______ (Graft/Host) vs. ______ (Graft/Host) and is mediated by _____ (Donor/Host) _____ cells.

Answer 42

Graft vs. Host, Donor T-cells