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MT2 > HYPERSENSITIVITY REACTIONS > Flashcards

HYPERSENSITIVITY REACTIONS Flashcards

1
Q
  • normal but exaggerated or uncontrolled immune response to an antigen
  • Can produce inflammation, cell destruction, or tissue injury
A

Hypersensitivity

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2
Q

1967: _____ was discovered which can be specific for hundreds of different allergens

A

IgE

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3
Q

any altered reaction to external substances

A

Allergy

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4
Q

refers to immediate hypersensitivity mediated by IgE antibodies

A

Atopy

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5
Q

Ag that trigger allergic reactions

A

Allergens

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6
Q

HYPERSENSITIVITY OF REACTION..

Reaction: Anaphylactic
Antibody: IgE
Complement Involved: No
Cells involved: Mast cells, basophils, granules
Cytokines involved: Yes
Comparative description: Antibody mediated, immediate
Mechanism of tissue injury: Allergic and anaphylactic reactions
Examples: Anaphylaxis, Hay Fever, Asthma, Food Allergy

A

Type 1

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7
Q

Reaction: Cytoxic
Antibody: IgG, possibly other immunoglobulins
Complement Involved: Yes
Cells involved: Effector cells (macrophages, polymorphonuclear leukocytes)
Cytokines involved: No
Comparative description: Antibody dependent: complement or cell mediated
Mechanism of tissue injury: Target cell lysis; cell-mediated cytotoxicity
Examples: Transfusion reactions, Hemolytic disease of newborn, Thrombocytopenia

A

Type II

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8
Q

Reaction: Immune complex
Antibody: Antigen-antibody complexes (IgG, IgM)
Complement Involved: Yes
Cells involved: Macrophages, Mast Cells
Cytokines involved: Yes
Comparative description: Immune complex mediated (immune complex disease)
Mechanism of tissue injury: Immune complex deposition, inflammation
Examples: Arthus reaction, Serum sickness, Systemic lupus erythematosus

A

Type III

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9
Q

Reaction: T cell-dependent
Antibody: None
Complement Involved: No
Cells involved: Antigen-specific T cells
Cytokines involved: Yes (T cell cytokines)
Comparative description: T cell-mediated, delayed type
Mechanism of tissue injury: Inflammation, cellular infiltration
Examples: Allergy or infection, Contact dermatitis

A

Type IV

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10
Q

TYPE 1 REACTIONS…

life threatening ________

A

anaphylactic reactions

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11
Q

TYPE 1 REACTIONS…

allergies

A

food allergies

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12
Q

TYPE 1 REACTIONS…

Demonstrates a ___________ tendency

A

strong familial or genetic

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13
Q

TYPE 1 REACTIONS…

acute allergic reactions caused by molecules released by mast cells/basophils when an allergen interacts with membrane-bound IgE

A

Immediate hypersensitivity

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14
Q

Acute allergic reactions result from the release of _______, _______, _______, and _______ when an allergen interacts with IgE that is bound to mast cells or basophils

A

preformed granule-associated mediators, membrane-derived lipids, cytokines, and chemokines

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15
Q

granules contain a complex of heparin, histamine, and zinc ions

A

mast cells

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16
Q

Histamine, leukotriene C4, IL-4, and IL-13 major mediators of allergy and asthma which are all formed by ____ which are release quantities after stimulation with _______

A

Basophils ; IL-3

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17
Q

IL-3 strongly induces messenger ribonucleic acid (mRNA) for _______, a major effector of granule-mediated cytotoxicity.

A

granzyme B

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18
Q

clinical response to immunologic formation and fixation between a specific antigen and a tissue-fixing antibody.

A

Anaphylaxis

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19
Q

anaphylaxis is mediated _____ antibody

A

IgE

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20
Q

clinically similar to anaphylaxis and can result from immunologically inert materials that activate serum and tissue proteases and the alternate pathway of the complement system.

A

Anaphylactoid reactions (anaphylaxis like):

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21
Q

Anaphylactoid reactions are not mediated by __________; instead, offending substances act directly on the _______

A

antigen-antibody interaction ; mast cells

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22
Q

exposure (skin, nose, or airway) to an allergen produces allergen-specific IgG antibodies

A

Atopic Reaction

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23
Q

hallmark of allergic disease (Atopic Reaction)

A

infiltration of affected tissue by Th2 cells

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24
Q

Type I Reactions: Signs & Symptoms

A

Localized Reaction
Generalized Reaction

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25
Q

occurs as an immediate response to mediators released from mast cell degranulation

A

Localized Reaction

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26
Q

Local reactions can consist of _____ and ______ at the site of antigen exposure or angioedema of the bowel after ingestion of certain foods.

A

urticaria and angioedema

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27
Q

Skin reactions are characterized be the appearance of ____ and ____ at the site of the introduction of the allergen. This phenomenon is the _____ of the skin test to diagnose an allergy or confirm sensitivity to a specific antigen.

A

redness and itching; basic principle

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28
Q

produced by mediators (cytokines and vasoactive amines (e.g., histamine)) from mast cells

A

Generalized Reaction

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29
Q

Anaphylactic reactions in generalized reaction are ____ in onset (also dramatic)

A

rapid

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30
Q

______ release leads to constriction of bronchial smooth muscle, edema of the trachea and larynx, and stimulation of smooth muscle in the GI tract (causes vomiting and diarrhea).

A

Histamine

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31
Q

In generalized reaction, the resulting breakdown of cutaneous vascular integrity results in ________ and ______; _____ causes a reduction of circulating blood volume and a progressive fall in blood pressure, leading to shock.

A

urticaria and angioedema ; vasodilation

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32
Q

Progression of allergic disease experienced by atopic children

A

Allergy March

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33
Q

In allergy march the formation of IgE antibodies begins _____

A

early in life

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34
Q

TYPE 1 REACTIONS TESTING

A

SKIN TESTING
PATCH TEST
IMMUNOCAP

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35
Q
  • performed by a skin puncture test (SPT)
  • assist in the identification of foods that may provoke IgE-mediated, food-induced allergic reactions or a patch test.
  • cannot be considered diagnostic of FA
A

Skin Testing

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36
Q

in skin testing, placing a drop of a solution containing a possible allergen on the skin. Then a series of ______ or _____ allows the solution to enter the skin.

A

scratches or needle pricks

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37
Q

positive reaction in skin testing

A

red, raised and itchy area on the skin

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38
Q

used for the evaluation of contact food allergiesv

A

patch test

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39
Q

patch test is used to detect ________

A

contact dermatitis

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40
Q

In patch test, taping a patch that has been soaked in the allergen solution to the skin for _______

A

24 to 72 hours.

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41
Q

in vitro quantitative measurement of IgE in human serum

A

ImmunoCAP

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42
Q

considered to be the gold standard for the analysis of allergen- specific IgE.

A

ImmunoCAP

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43
Q

Antibody-Dependent, Complement-Mediated Cytotoxic Reactions

A

Type II Reactions

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44
Q
  • interaction of IgG or IgM antibody with cell-bound antigen
  • result in the activation of complement and destruction of the cell (cytolysis) to which the antigen is bound
A

Type II Reactions: Antibody-Dependent, Complement-Mediated Cytotoxic Reactions

45
Q

refers to the adverse consequences of incompatibility between patient and donor erythrocytes.

A

Transfusion Reactions

46
Q

most common cause of immediate hemolytic reactions

A

transfusion of ABO group–incompatible blood

47
Q

most serious and potentially lethal transfusion reactions

A

Immediate Hemolytic Reactions

48
Q

In Immediate Hemolytic Reactions, reactions can occur with the infusion of as little as ________ of incompatible blood

A

10 to 15 mL

49
Q

Immediate Hemolytic Reactions, occur during _____ or immediately after blood has been ____

A

infusion ; infused

50
Q

Immediate Hemolytic Reactions demonstrate _____ and ____ hemolysis

A

extravascular and intravascular hemolysis

51
Q

delayed hemolytic reaction manifests ____ days after transfusion

A

7 to 10 days

52
Q

delayed hemolytic reaction occurs in the _____ spaces

A

extravascular spaces

53
Q

In delayed hemolytic reaction, ________; does not activate complement or activates it very slowly, ______ occurs

A

IgG antibody–coated erythrocytes ; extravascular hemolysis

54
Q

from excessive destruction of fetal RBCs by maternal antibodies

A

Hemolytic Disease of the Fetus and Newborn

55
Q

Hemolytic Disease of the Fetus and Newborn is characterized by ____ and _____

A

anemia and jaundice

56
Q

In HDFN, most frequent form of ABO incompatibility occurs when the mother is type ____ and the baby is type __ or type __, usually type ____

A

O ; A or B ; A.

57
Q

directed against self antigens on RBCs

A

Autoimmune Hemolytic Anemia

58
Q

Cold autoagglutinins (IgM) react best at room temperature or lower.

A

Cold Autoimmune Hemolytic Anemia.

59
Q

warm autoagglutinins (IgG) represent most cases of autoimmune hemolytic anemia

A

Warm Autoimmune Hemolytic Anemia

60
Q

In Autoimmune Hemolytic Anemia, source of antigen exposure may be _____, antibodies can be formed to _____ or _____

A

unknown ; microorganisms or drugs

61
Q

Autoimmune Hemolytic Anemia reacts best at ____ temperature

A

37 degree celsius

62
Q

Autoantibodies can attack and damage components of solid tissues, as in _________.

A

Goodpasture’s syndrome

63
Q

In Goodpasture’s syndrome, ___ autoantibodies bind a glycoprotein in the ______ of the kidney’s glomeruli and the lungs

A

IgG ; basement membrane

64
Q

___________ activates complement that can trigger an inflammatory response.

A

Anti–basement membrane antibody

65
Q

Type II Hypersensitivity and Antibodies That Affect Cell Function

A
  • antibodies bind to cells and affect their function
  • stimulate the target organ function without causing organ damage.
  • Wegener’s granulomatosis: stimulation of cells by autoantibody leads to tissue damage
66
Q

stimulation of cells by autoantibody leads to tissue damagev

A

Wegener’s granulomatosis

67
Q

performed to detect transfusion reactions, HDFN, and autoimmune hemolytic anemia

A

direct antiglobulin test (DAT)

68
Q

In DAT, If there is an __________ caused by IgM, only the C3d assay would be positive.

A

autoimmune hemolytic anemia

69
Q

used to determine the presence of an unexpected antibody

A

indirect AHG assay

70
Q

Goodpasture’s syndrome can be diagnosed by finding antibodies to glomerular basement membrane in patient serum on _______ or ______ examination of a _____ biopsy

A

indirect immunofluorescence or direct fluorescent ; renal tissue

71
Q

caused by the deposition of immune complexes in blood vessel walls and tissues (repeated exposure)

A

Type III Reactions

72
Q

Repeated antigen exposure leads to _______ with the production of an ____________.

A

sensitization ; insoluble antigen-antibody complex

73
Q

As these complexes (insoluble antigen-antibody complex) are deposited in tissues, the complement system is _____, macrophages and leukocytes are _____, and _________ occurs.

A

activated ; attracted ; immune-mediated damage

74
Q

skin conditions in type III reactions

A

allergic vasculitis; erythema nodosum

75
Q

Pulmonary reactions

A

Farmer’s Lung
Bathtub Refinisher’s Lung
Epoxy Resin Lung
Plastic Worker’s Lung

76
Q

hypersensitivity pneumonitis which is a reaction to thermophilic actinomycetes found in moldy hay

A

farmer’s lung

77
Q

Toluene diisocyanate cause ________

A

bathtub refinisher’s lung

78
Q

phthalic anhydride causes ________

A

epoxy resin lung

79
Q

trimetallic anhydride causes _________

A

plastic worker’s lung

80
Q

local immune complex diseases in type III reactions

A

Farmer’s lung, Arthus reaction

81
Q

circulating immune complex disease in type III reactions ______

A

Poststreptococcal glomerulonephritis; SLE

82
Q

other reactions that may occur in type III reactios

A

Serum Sickness

83
Q

Immune complexes (in type III reactions) usually cleared by mechanisms involving _____

A

complement

84
Q

Type III reactions are caused by ____, ____ and possibly other antibody types.

A

IgG, IgM

85
Q

_________ develops within 1 to 2 weeks after initial exposure or repeated exposure by injection of heterologous serum protein

A

Acute serum sickness

86
Q

hallmark of serum sickness

A

protracted interaction between antigen and antibody in the circulation, with the formation of antigen-antibody complexes in an environment of antigen excess.

87
Q

autoimmune disorder characterized by autoantibodies that form immune complexes with autoantigens

A

SLE

88
Q

SLE is deposited in the _________

A

renal glomeruli

89
Q

In SLE, _____ (inflammation of capillary vessels in the glomeruli) develops.

A

glomerulonephritis

90
Q

inflammation of capillary vessels in the glomeruli

A

glomerulonephritis

91
Q

Type III Reactions: Testing

______ of tissue biopsy specimens can be used to observe the deposition of immune complexes in tissues

A

Fluorescent staining

92
Q

quantitation of complement (____ and ____ components) is also a Type III Reactions Testing

A

C3 and C4

93
Q

moderated by the link between T lymphocytes and phagocytic cells

A

Type IV Cell-Mediated Reactions

94
Q

involves antigen-sensitized T cells or particles that remain phagocytized in a macrophage and are encountered by previously activated T cells for a second or subsequent time

A

Delayed-type hypersensitivity

95
Q

in Delayed-type hypersensitivity…

T cells respond _____, or by the release of______, to exhibit _______ and ________

A

directly ; lymphokine ; contact dermatitis and allergies of infection

96
Q

in Delayed-type hypersensitivity…

immunologic mechanisms ________

A

contact sensitivity

97
Q

in Delayed-type hypersensitivity…

Rejection of ________

A

foreign tissue grafts

98
Q

in Delayed-type hypersensitivity…

elimination of tumor cells bearing _______

A

neoantigens

99
Q

____ can be a physiologic reaction to pathogens that are difficult to clear, such as _____ and _____. This triggers the most extreme _____

A

DTH ; hepatitis B virus and Mycobacterium tuberculosis ; DTH reactions

100
Q

DTH reactions also take place against _______. In insulin-dependent (type 1) diabetes, T cells respond to ________, damaging the islets and eventually preventing insulin secretion.

A

autoantigens ; pancreatic islet cell antigens

101
Q

________ is secreted by macrophages and T cells and stimulates much of the damage in DTH reactions.

A

Tumor necrosis factor-α (TNF-α)

102
Q

The hallmark of occupational type IV hypersensitivity is
_____ caused by _____

A

allergic contact dermatitis ; metals

103
Q

Latex contains low-molecular-weight soluble proteins that cause IgE-mediated allergic reactions

A

Latex Sensitivity

104
Q
  • Latex allergy can give rise to a broad range of symptoms. Glove wearers may experience _____ or _____, contact dermatitis that ranges from nonspecific pruritus to _____, _____, _____.
  • These symptoms and the irritant contact dermatitis are caused by the _______ and _______ used in glove manufacturing, not by the latex itself.
A
  • type IV, or delayed hypersensitivity ; nonspecific pruritus ; eczematous, red, weepy skin.
  • accelerators and chemicals
105
Q

skin test for testing of exposure to tuberculosis (TB) is a classic example of a _________

A

delayed hypersensitivity reaction

106
Q

Testing for Delayed Hypersensitivity..

small amount of antigen is injected under the skin (intradermally) with a fine-needle syringe. Site is observed at ____ and. _____ hours for the presence of _____ (lesion ≥10 mm in diameter)

A

48 and 72 ; induration

107
Q

The test is based on the principle that soluble antigens from M. tuberculosis induce a reaction in individuals who have acquired or been exposed to the tuberculosis microorganism or a related organism at some time but It does not mean that _____

A

the person has tuberculosis.

108
Q

In cases of persistent dermatitis, a ______ may be performed. An _____ containing the suspected allergen is applied to the skin. The skin is checked for redness with ____ or _____, indicating a positive test result, over _____.

A

patch test ; adhesive patch ; papules or tiny blisters ; 48 hours

MT2 (45 decks)

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