hypersensitivity reaction - type 2

Question 1

what is type 2 hypersensitivity disorder

.

Answer 1

IgG or IgM

react with cell or matrix associated self-ag

->

• tissue damage
• receptor blockade/activation

Question 2

Haemolytic disease of the newborn antigen

Answer 2

Antigens on
neonatal erythrocytes

Question 3

Haemolytic disease of the newborn pathology

Answer 3

Maternal IgG
mediated
reticulocytosis
and anaemia

Question 4

Haemolytic disease of the newborn dx

Answer 4

Positive Direct Coombs Test

Question 5

Haemolytic disease of the newborn rx

Answer 5

Maternal Plasma Exchange

exchange transfusion

Question 6

Autoimmune
Haemolytic
Anaemia (+ ITP
= Evan’s
Syndrome) antigen

Answer 6

Numerous
autoantigens e.g.
Rh blood group
Ag

Question 7

Autoimmune
Haemolytic
Anaemia (+ ITP
= Evan’s
Syndrome) path

Answer 7

Destruction of
red blood cells by
auto antibody +
complement +
FcR+
phagocytes,
anaemia

Question 8

Autoimmune
Haemolytic
Anaemia (+ ITP
= Evan’s
Syndrome) dx

Answer 8

Positive Direct
Coombs Test,
Anti Red Cell Ab

Question 9

Autoimmune
Haemolytic
Anaemia (+ ITP
= Evan’s
Syndrome) rx

Answer 9

Steroids

Question 10

Autoimmune
Thrombocytope
nic Purpura

Answer 10

Glycoprotein
IIb/IIIa on
platelets

Question 11

Autoimmune
Thrombocytope
nic Purpura path

Answer 11

Bruising/
Bleeding
(Purpura)

Question 12

Autoimmune
Thrombocytope
nic Purpura dx

Answer 12

Anti-Platelet Antibody

Question 13

Autoimmune
Thrombocytope
nic Purpura rx

Answer 13

Steroids, IVIG,
Anti-D Antibody,
splenectomy

Question 14

Goodpasture’s
Syndrome antigen

Answer 14

Non-collagenous
domain of
basement
membrane
collagen type IV

Question 15

Goodpasture’s
Syndrome path

Answer 15

Glomerulonephritis, pulmonary
haemorrhage

Question 16

Goodpasture’s
Syndrome dx

Answer 16

Anti GBM Ab
Linear Smooth IF staining of IgG
deposits on BM

Question 17

Goodpasture’s
Syndrome rx

Answer 17

Corticosteroids
and
Immunosuppression

Question 18

Pemphigus
Vulgaris antigen

Answer 18

Epidermal
Cadherin

Question 19

Pemphigus
Vulgaris path

Answer 19

Non-tense
blistering of skin
and Bullae

Question 20

Pemphigus
Vulgaris dx

Answer 20

Direct Immunofluorescence
showing IgG
deposition

Question 21

Pemphigus
Vulgaris rx

Answer 21

Corticosteroids
and
Immunosuppress
ion

Question 22

graves ag

Answer 22

TSH receptor

Question 23

graves path

Answer 23

Hyperthyroidism

Question 24

graves dx

Answer 24

Anti TSH-R Ab

Question 25

graves rx

Answer 25

Carbimazole and Propylthiouracil

Question 26

myasthenia gravis ag

Answer 26

Acetylcholine receptor

Question 27

myasthenia gravis path

Answer 27

Fatigable muscle weakness, Double Vision

Question 28

myasthenia gravis dx

Answer 28

Anti Ach-R Ab Abnormal EMG Tensilon Test

Question 29

myasthenia gravis rx

Answer 29

Neostigmine, Pyridostigmine, (If serious use IVIG and Plasmapheresis)

Question 30

acute rheumatic fever ag

Answer 30

M proteins on Group A strep

Question 31

acute rheumatic fever path

Answer 31

Myocarditis, Arthritis, Sydenham’s Chorea

Question 32

acute rheumatic fever dx

Answer 32

Clinical, based on Jones Criteria

Question 33

acute rheumatic fever rx

Answer 33

Aspirin, Steroids and Penicillin

Question 34

pernicious anaemia ag

Answer 34

Intrinsic Factor and Gastric Parietal Cells

Question 35

pernicious anaemia path

Answer 35

↓Hb ↓B12

Question 36

pernicious anaemia dx

Answer 36

Anti-Gastric Parietal Cell Ab, Anti-IF Ab, Schilling Test

Question 37

pernicious anaemia mx

Answer 37

Dietary B12 or IM B12

Question 38

churg-strauss syndrome ag

Answer 38

Medium and Small Vessel Vasculitis

Question 39

churg-strauss syndrome path

Answer 39

Allergy →Asthma→ Systemic Disease (Male predominance)

Question 40

churg-strauss syndrome dx

Answer 40

p-ANCA (against myeloperoxidase ), Granulomas, Eosinophil Granulocytes

Question 41

churg-strauss syndrome rx

Answer 41

Prednisolone, Azathioprine, Cyclophosphamide

Question 42

Wegener's granulomatosis (GPA) ag

Answer 42

Medium and Small Vessel Vasculitis

Question 43

Wegener's granulomatosis (GPA) path

Answer 43

Sinus Problems, Lung Cavitations + haemorrhage, Crescentic Glomerulonephritis

Question 44

Wegener's granulomatosis (GPA) dx

Answer 44

c-ANCA (against Proteinase 3) granulomas

Question 45

Wegener's granulomatosis (GPA) rx

Answer 45

Corticosteroids, cyclophosphamide, co-trimoxazole

Question 46

microscopic polyangitis ag

Answer 46

Pauci-immune necrotizing, small vessel vasculitis

Question 47

microscopic polyangitis path

Answer 47

Purpura, livedo, many different organs affected

Question 48

microscopic polyangitis dx

Answer 48

p-ANCA (against myeloperoxidas)

Question 49

microscopic polyangitis rx

Answer 49

Prednisolone, Cyclophosphamide or Azathioprine, plasmapheresis

Question 50

chronic urticaria ag

Answer 50

Medications (NSAIDS) Cold, Food, Pressure, Sun, Exercise, Insect Stings, Bites and Idiopathic

Question 51

chronic urticaria path

Answer 51

Persistent Itchy Wheals Lasting > 6 Weeks. Associated with Angioedema in 50% of cases. IgG against FceR1 or IgG against IgE (Exclude Urticarial Vasculitis in those who respond poorly to Antihistamine)

Question 52

chronic urticaria dx

Answer 52

Challenge Test, ESR (Raised in Urticarial Vasculitis), Skin Prick Testing

Question 53

chronic urticaria rx

Answer 53

Avoid precipitants, Check for thyroid disease, Preventative antihistamine, IM adrenaline for pharyngeal angioedema, 1% Menthol in Aqueous Cream for pruritis (Also Doxepin and Cyclosporin)