Hypersensitivity Reactions

Question 1

Type I Hypersensitivity reactions are mediated by ___________ antibodies

Answer 1

IgE

Question 2

How are IgE levels increased in a type I hypersensitivity reaction?

Answer 2

Exposure to antigen, ie. Bee stings, pollen, and shellfish

Question 3

What cells does IgE bind to to cause degranulation in a type I hypersensitivity reaction?

Answer 3

Basophils and mast cells

Question 4

What cell-derived mediators of inflammation are released when IgE antibodies bind to basophils and mast cells?

Answer 4

Histamine, leukotrienes, and eosinophilic chemotactic factor

Question 5

What does the release of histamine cause in a type I hypersensitivity reaction at the vascular level?

Answer 5

Vascular leakage in venules and arteriole dilation leading to hypotension

Question 6

A type I hypersensitivity reaction causes (Bronchodilation/Bronchoconstriction) via leukotrienes?

Answer 6

Bronchoconstriction

Question 7

What pathologies are associated with a type I hypersensitivity reaction?

Answer 7

Hay fever, asthma, hives, anaphylactic shock, physical urticaria

Question 8

What is a type I hypersensitivity reaction also called?

Answer 8

Immediate, IgE mediated, or anaphylactic

Question 9

What is an emergency treatment for a type I hypersensitivity reaction?

Answer 9

Epipen (Epinephrine)

Question 10

What are the effects of an epipen on a patient suffering from anaphylactic shock?

Answer 10

Vasoconstriction, bronchodilation, increased blood pressure, and increased heart rate

Question 11

A type II hypersensitivity reaction involved ______ and ______ antibodies?

Answer 11

IgG, IgM

Question 12

What do IgM and IgG antibodies bind to in a type II hypersensitivity reaction?

Answer 12

Self antigens

Question 13

What occurs when IgM and IgG antibodies bind to “self” antigens?

Answer 13

Triggering of the complement system via classic pathway and tissue damage
- Infiltration of WBC via chemotaxis
- Opsonization via C3b
- Lysis via C5b-C9

Question 14

What are type II hypersensitivity reactions also called?

Answer 14

Cytotoxic reactions

Question 15

What pathologies are associated with a type II hypersensitivity reaction?

Answer 15

Goodpasture syndrome
Hemolytic anemia
Myasthenia gravis
Graves’ disease
Hachimoto’s thyroiditis
Rheumatic fever
Hyperacute graft rejection
Erythroblastalis fetalis

Question 16

What is the etiology and pathogenesis of Goodpasture syndrome?

Answer 16

Autoimmune type II hypersensitivity reaction where the body produces anti-glomerular basement membrane (kidney) antibodies

Question 17

What are the symptoms of Goodpasture syndrome?

Answer 17

Hematuria, hemoptysis, kidney failure

Question 18

What is the etiology of myasthenia gravis?

Answer 18

Autoimmune type II hypersensitivity reaction where the body produces antibodies against acetylcholine receptors on muscles (LMNs)

Question 19

What are the symptoms of myasthenia gravis?

Answer 19

Flaccid paralysis beginning with small muscles of the face, muscle fatigue, lid lag of eyes, winded stair walking

Question 20

What is the etiology of Grave’s disease?

Answer 20

Autoimmune type II hypersensitivity reaction where the body produces antibodies against thyroid stimulating hormone (TSH)

Question 21

Graves’ disease is (Hypothyroid/Hyperthyroid)?

Answer 21

Hyperthyroid

Question 22

What type II hypersensitivity pathology is unique in that it binds to a receptor and increases its productivity?

Answer 22

Grave’s disease

Question 23

Hachimoto’s thyroiditis is (Hypothyroid/Hyperthyroid)?

Answer 23

Hypothyroid

Question 24

What is the etiology of Hachimoto’s thyroiditis?

Answer 24

Autoimmune type II hypersensitivity reaction where the body produces antibodies against thyroglobulin and thyroid peroxidase (TPO)

Question 25

What is the etiology of rheumatic fever?

Answer 25

Autoimmune type II hypersensitivity reaction where the body produces antibodies against streptococcus M proteins

Question 26

What can untreated streptococcus infection lead to?

Answer 26

Rheumatic fever or heart disease

Question 27

What is the etiology of a hyperacute graft rejection?

Answer 27

Autoimmune type II hypersensitivity reaction where the body produces antibodies in the host against a skin graft post surgery

Question 28

What is erythroblastalis fetalis also known as?

Answer 28

Rh disease

Question 29

What occurs in erythroblastalis fetalis?

Answer 29

Antibodies against fetal Rh+ blood made by the birthing mother due to differences in blood type

Question 30

What type of hypersensitivity reaction is erythroblastalis fetalis?

Answer 30

Type II

Question 31

In a type III hypersensitivity reaction the antibodies involved are ______ and ______

Answer 31

IgG, IgM

Question 32

What unique structure forms when IgG and IgM bind to a circulating antigen in a type III hypersensitivity reaction?

Answer 32

Immune complex

Question 33

A type III hypersensitivity reaction is when an antibody is made against a _________________ in _________________?

Answer 33

Soluble antigen, blood plasma

Question 34

What is activated when an immune complex gets stuck in a capillary bed during a type III hypersensitivity reaction?

Answer 34

Complement system

Question 35

What pathologies are associated with a type III hypersensitivity reaction?

Answer 35

Local Arthus reaction Systemic Lupus Erythematosus Serum Sickness Glomerulonephritis

Question 36

What is an arthus reaction?

Answer 36

Localized type III hypersensitivity reaction that occurs after a vaccine or injection where the toxoid generates an immune complex to bring in WBCs

Question 37

What are the most commonly affected tissues in systemic lupus erythematosus? Why?

Answer 37

Kidneys, skin, and liver due to larger populations of capillary beds

Question 38

What are symptoms of systemic lupus erythematosus?

Answer 38

Butterfly rash on the face, fatigue, joint pain, anemia

Question 39

What is serum sickness?

Answer 39

Type III hypersensitivity reaction to a horse serum injection where the body forms immune complexes against horse proteins

Question 40

What is glomerulonephritis?

Answer 40

Type III hypersensitivity reaction where the body forms immune complexes in the glomerulus of the kidney leading to inflammation and filtration issues

Question 41

What are type III hypersensitivity reactions also called?

Answer 41

Immune complex mediated reactions

Question 42

What are symptoms of glomerulonephritis?

Answer 42

Proteinuria, hematuria, hypertension, fever, low back pain; Increased BUN (blood urea nitrogen) and blood creatinine, decreased GFR

Question 43

What hypersensitivity reaction does not require the presence of antibodies?

Answer 43

Type IV

Question 44

What lymphocyte is primarily involved in a type IV hypersensitivity reaction?

Answer 44

CD4+ Helper T cells

Question 45

What cell mediated cytokines are involved in a type IV hypersensitivity reaction?

Answer 45

IL-1, IL-6, IL-12

Question 46

What causes the release of cytokines from CD4+ helper T cells in a type IV hypersensitivity reaction?

Answer 46

Presence of a foreign antigen

Question 47

A type IV hypersensitivity reaction is (Instant/Delayed)?

Answer 47

Delayed

Question 48

A type IV hypersensitivity reaction requires at least __________ exposures to an antigen?

Answer 48

Two

Question 49

What pathologies are associated with a type IV hypersensitivity reaction?

Answer 49

Allergic sensitivities to cosmetics and detergents Poison ivy and sumac Granulomatous diseases such as tuberculosis, leprosy, sarcoidosis, and Crohn's disease Treponema pallidum spirochete diseases such as syphilis Deep fungal infections such as histoplasmosis

Question 50

What are type IV hypersensitivity reactions called?

Answer 50

Delayed type/ T cell mediated reaction

Question 51

What type of hypersensitivity reaction is tuberculosis, leprosy, sarcoidosis, and Crohn's disease?

Answer 51

Type IV

Question 52

What type of hypersensitivity reaction is syphilis?

Answer 52

Type IV