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Immunology > Hypersensitivity diseases > Flashcards

Hypersensitivity diseases Flashcards

1
Q

Type I sensitivity also known as:

A

anaphylaxis

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2
Q

Type I associated with which antibody?

A

IgE

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3
Q

What are the IgE complex-induced mediators in anaphylactic shock?

A
  • histamine
  • leukotrienes
  • TNF-alpha
  • IL-1
  • IL-6
  • serotonin
  • bradykinin
  • platelet activating factor (PAF)
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4
Q

What do IgE complex-induced mediators do?

A
  • contract smooth muscle
  • increase vascular permeability
  • ## induce hypotension
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5
Q

Common inducers of IgE and anaphylactic shock:

A
  • venom
  • foods
  • drugs
  • antibiotics like penicillin
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6
Q

Urticaria is associated with which type of hypersensitivity?

A

Type I

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7
Q

What is urticaria?

A
  • cutaneous form of type I
  • IgE mediated
  • wheal and flare lesion and pruritis
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8
Q

asthma is associated with which type of hypersensitivity?

A

Type I

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9
Q

Cells involved in asthma inflammation:

A
  • mast cells
  • Th2 CD4+ cells
  • basophils
  • eosinophils
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10
Q

Asthma - important mediators

A
  • leukotrienes
  • PAF
  • eosinophil chemotactic factor (ECF)
  • histamine
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11
Q

Asthma - important triggers

A
  • resp infections
  • environmental pollutants
  • aspirin
  • NSAIDs
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12
Q

extrinsic vs intrinsic asthma

A

extrinsic - associated with allergens and pollutants

intrinsic - can be non-immunologic (cold, exercise)

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13
Q

rhinitis associated with which type of hypersensitivity?

A

Type I

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14
Q

rhinitis associated with which antibody type?

A

IgE

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15
Q

cytokine mediators associated with rhinitis:

A
  • histamine
  • leukotrienes
  • prostaglandin D2
  • ECF
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16
Q

Explain the therapeutic induction of a hyposensitive state in an allergic individual

A
  • repeated injection of the agent in subliminal doses

- Increased IgG blocks IgE binding and reduces reaction-associated mediator release

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17
Q

Type II hypersensitivity is also known as:

A

Cellular antigen-antibody cytotoxicity

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18
Q

briefly explain type II hypersensitivity:

A

antibodies are directed against epitopes that occur on the cellular surface membranes of organs and tissues

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19
Q

Explain how damage occurs in type II hypersensitivity:

A

1) lytic action of complement
2) opsonization by phagocytic cells
3) killing by ADCC
4) killing of target cell by Tc cells or NK cells or both via perforins and serine proteases (granzymes)

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20
Q

transfusion reactions are associated with which type of hypersensitivity?

A

Type II

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21
Q

What is the most common type of transfusion reaction?

A

ABO reaction

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22
Q

What is the most severe type of transfusion reaction?

A

Rh reaction

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23
Q

What test can be used to test for the presence of anti-Rh IgG antibody in mother’s circulation or in fetal cells?

A

Coombs test

24
Q

Those with an O blood phenotype have antibodies against:

Can accept:

A

against: A and B blood

can accept: O only

25
Q

Those with an A blood phenotype have antibodies against:

Can accept:

A

against: B blood

can accept: AA or AO

26
Q

Those with B blood phenotype have antibodies against:

Can accept:

A

against: A blood

Can accept: BB or BO

27
Q

Those with AB blood phenotype have antibodies against:

Can accept:

A

against: neither

Can accept: Anything

28
Q

What does the + or - stand for in A- or A+ blood?

A

+ means presence of Rh protein

29
Q

Erythroblastic fetalis is associated with which type of hypersensitivity?

30
Q

autoimmune reactions are associated with which type of hypersensitivity?

31
Q

Goodpasture’s syndrome is an example of:

A

autoimmune reaction (type II)

32
Q

What is the mechanism of Goodpasture’s syndrome?

A
  • reactivity against self glycoprotein present on glomerular basement membrane
  • IgG binds antigenic glycoprotein, activates complement
  • C5a attracts neutrophils which release lysosomal enzymes and kill glomeruli
33
Q

What does most of the damage in Type III hypersensitivity reactions?

A

Neutrophils attracted by C5a release lysosomal enzymes that destroy tissue

34
Q

Type III hypersensitivity reactions are also known as:

A

antigen-antibody complex reactions

35
Q

What do antigen-antibody complexes secrete?

A

C5a, anaphylatoxins, clotting factors

36
Q

Briefly explain type III hypersensitivity reactions:

A

antibody binds antigen in complexes and evades phagocytosis. Deposits in tissues or on blood vessel surfaces and secretes chemotactic mediators leading to neutrophil destruction of tissues.

37
Q

Serum sickness is associated with which type of hypersensitivity reaction?

38
Q

Polyarteritis nodosa (PAN) is associated with which type of hypersensitivity reaction?

39
Q

Describe polyarteritis nodosa:

A
  • constant insult to arterial walls by circulating ag-ab complexes
  • thrombosis common
40
Q

Systemic lupus erythematosus (SLE) is associated with which type of hypersensitivity reaction?

41
Q

If lupus involves loss of self tolerance, why isn’t it considered an autoimmune disease classified as type II?

A

The expected initiator of lupus is an antibody response against bacterial or viral DNA. The mechanism for loss of self-tolerance is unknown.

42
Q

What distinguishes Masugi (Goodpasture’s) glomerulonephritis from lupus glomerulonephritis?

A

In fluorescent test, Masugi ag-ab complexes are uniformly dispersed, indicating a reaction to a host antigen with genetic origin. In lupus, ag-ab complexes are clumped, indicating they collected in certain locations from circulation.

43
Q

Rheumatoid arthritis is associated with which type of hypersensitivity reaction?

44
Q

Briefly describe the mechanism of rheumatoid arthritis:

A

Normal Ab interaction with a currently unidentified Ag causes a conformational change in the Ag revealing a new “foreign” epitope. New IgM antibody appears as a result and reacts against pre-existing IgG, forming IgM-IgG complexes in synovial fluid. This activates complement, and then neutrophils. The neutrophils destroy cartilage with lysosomal enzymes.

45
Q

Type IV hypersensitivity reactions are also known as:

A

Delayed-type

46
Q

Which type of hypersensitivity reaction does not involve antibody?

47
Q

What cells are involved in type IV hypersensitivity reactions?

A
  • sensitized T cells
  • macrophages
  • NK cells
48
Q

Briefly describe the mechanism of a type IV hypersensitivity reaction:

A

An inflammatory response induced by activated macrophages, Tc cells, and NK cells to intracellular microorganisms and/or molecular chemical irritants

49
Q

Examples of type IV reactions:

A
  • tuberculin skin test
  • granulomatous reactions
  • contact dermatitis
50
Q

What is an epithelioid cell granuloma?

A

a fusion of monocytes as a result of increased IL-4 and IFN-gamma upon the persistence of microbial antigens in tissues (granulomatous reaction/type IV)

51
Q

What are some drugs that treat asthma?

A
  • Zileuton
  • Montelukast
  • Omalizumab/Xolair
52
Q

What do Zileuton and Montelukast do?

A
  • asthma treatment

- block luekotriene synthesis

53
Q

What does Omalizumab/Xolair do?

A
  • inhibits IgE arming of mast cells

- reduces serum IgE by 95%

54
Q

In subcutaneous immunotherapy, how does increased IgG help?

A

1) intercepts allergen before it reaches mast cell
2) increases clearance of allergen by macrophages
3) blocks allergen epitopes from binding IgE
4) triggers inhibitory B cell receptors
5) triggers inhibitor mast cell receptors

55
Q

Some examples of type II reactions:

A
  • hemolytic disease of newborn
  • autoimmune blood dyscrasias
  • hyperacute graft rejection
  • myasthenia gravis

Immunology (13 decks)

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