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Respiratory Pathology and Immunology > Hypersensitivity II (IMMUNOLOGY) > Flashcards

Hypersensitivity II (IMMUNOLOGY) Flashcards

1
Q

What is the pathophysiology behind a type II hypersensitivity reaction?

A

Antibody binds to cell-surface antigen resulting in activation of complement and opsonisation leading to cell lysis and antibody-mediated phagocytosis

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2
Q

What are the 4 effects of complement activation?

A

Chemotaxis
Solubilisation of immune complexes
Direct killing via membrane attack complex
Opsonisation

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3
Q

In a type II hypersensitivity reaction B cells produce …

A

antibody directed against cell membrane protein

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4
Q

What does binding of antibody to cell surface antigen result in?

A

complement activation
NK and Eosinophil activation and ADCC
Act as opsonin for phagocytes

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5
Q

What are examples of type II hypersensitivity in blood cells and to what do the antibodies bind?

A

Transfusion reactions
Autoimmune haemolytic anaemia (bind to red cells)
Idiopathic thrombocytopaenic purport (antibodies bind to platelets)

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6
Q

What is an example of a type II hypersensitivity in the kidneys and what do the antibodies bind to?

A

Good pasture’s syndrome

bind to glomerular basement membrane

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7
Q

What are examples of type II hypersensitivity in the nervous system and what do the antibodies bind to ?

A 
Myasthenia graves (bid to acetyl choline receptor) 
Gillan-Barre-Syndrome (bind to peripheral nerve glycoprotein)
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8
Q

What is an example of type II hypersensitivity in the endocrine system and what do the antibodies bind to?

A

Grave’s disease (antibodies bind to TSH receptors)

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9
Q

What is an example of type II hypersensitivity in the skin and what do the antibodies bind to?

A

Pemphigus vulgaris (antibodies bind to epithelial cell cement)

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10
Q

What happens as a result of an incorrect blood transfusion?

A

Complement-mediated lysis of transfused red blood cells will begin after as little as 1 ml of blood is transfused

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11
Q

What are the clinical features of transfusion reactions?

A 
Pyrexia 
Rigors
Tachycardia
Tachypnoea
Hypotension
Dizziness
Headaches
Chest or lumber pain
Possibly fatal
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12
Q

What is the consequence of Grave’s disease?

A

Hyperthyroidism

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13
Q

What released TSH (thyroid stimulating hormone)?

A

Pituitary gland

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14
Q

Many type II hypersensitivity reactions are mediated by ….?

A

auto-antibodies

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15
Q

What are the two management methods of type II hypersensitivity?

A

Plasmapheresis

Immunosuppression

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16
Q

What does plasmapheresis aim to do?

A

Remove all pathogenic antibodies

17
Q

How does plasmapheresis work?

A

Remove patient blood via cell separator

Replace cellular contents (plasma replaced by someone else’s)

18
Q

What limits the efficacy of plasmapheresis?

A

rebound antibody production

19
Q

Immunosuppressants switch off …?

A

B cell production of antibody

20
Q

What is the pathophysiology behind a type III hypersensitivity reaction?

A

If there’s excess soluble antigen, antibody binds & forms small immune complexes that are trapped in small blood vessels, joints & glomeruli

21
Q

Farmer’s lung is an example of which type of hypersensitivity reaction?

A

III

22
Q

Which organisms cause Farmer’s lung?

A 
Aspergillus fumigatus
Micropolyspora faeni
Avian serum proteins
Aspergillus clavatus
A
23
Q

Which agent causes Bird fancier’s lung?

A

Avian serum proteins

24
Q

Which organism causes Malt worker’s lung?

A

Aspergillus clavatus

25
Q

Which organism causes Cheese worker’s lung?

A

Apergillus cravats

Penicillin casei

26
Q

Which organism causes Maple bark stripper’s lung?

A

Cryptostroma cotricale

27
Q

What occurs in acute hypersensitivity pneumonitis?

A

Immune complexes deposited in the walls alveoli and bronchioles causing leukocyte accumulation and inflammation within alveoli

28
Q

What are the symptoms associated acute hypersensitivity pneumonitis`

A

Wheezing and malaise after 4-8 hours after exposure to antigen
May be associated with dry cough, pyrexia, breathlessness
O/E often normal

29
Q

How can type II hypersensitivity reactions be diagnosed?

A

Specific IgG antibody testing that are reactive to putative antigens

30
Q

How can type III hypersensitivity reactions be managed?

A

(Avoidance)
Corticosteroids
Immunosuppressants

31
Q

What is the pathophysiology behind type IV hypersensitivity reactions?

A

Initial sensitisation to antigen generates primed effector TH1 cells
Second exposure - activation of primed T cells - recruitment of macrophages, neutrophils and other lymphocytes - release of proteolytic enzymes - persistent inflammation

32
Q

Poison ivy and sarcoidosis are examples of which type of hypersensitivity reaction?

A

Type IV

33
Q

Why is sarcoidosis treated with systemic corticosteroids?

A

Block T cell activation & macrophage activation

Respiratory Pathology and Immunology (7 decks)

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