Hypersensitivity Type II- Hunter Flashcards

1
Q

How can you get immunohemolytic anemias?

A

transfusion reations (ABO mismatch)
drug-induced (e.g. penicillin)
hemolytic disease of the newborn

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2
Q

What are four types of type II hypersensitivity?

A

Immunohemolytic anemias

Microbal cross-reactions with host tissues (e.g. rheumatic fever)

Autontibodies to self-proteins on cells or intracellular matrix

Autoantibodies that block or stimulate cell surface receptors

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3
Q

What is this:

you get opsonization and phagocytosis of red blood cells resulting in hemolysis and anemia.

A

autoimmune hemolytic anemia

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4
Q

What is this:

you get opsonization and phagocytosis of platelets resulting in bleeding.

A

autoimmune thrombocytopenic purpura

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5
Q

What is this, epidermal cadherin is targeted resulting in antibody-mediated activation of proteases, and disruption of intercellular adhesions. Patients show up with skin vesicles (Bullae)

A

pemphigus vulgaris

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6
Q

What is this:

Neutrophil granules proteins are targeted and then neutrophils degranulate which reuslts in inflammation and vasculitis

A

vasculitits caused by ANCA

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7
Q

What is this:
noncollagenous proteins in basement membranes of kidney glomeruli and lung alveoli are attacked and results in complement and Fc receptor mediated inflammation. THe clinical manifestation is nephritis, ung hemorrhage.

A

goodpasture syndrome

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8
Q

What is this:
strep cell wall antigen cross reacts with myocardial antigen resulting in inflammation and macrophage activation in the heart and body. The clinical manifestation is myocarditis and arthritis

A

Acute rheumatic fever

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9
Q

What is this:
acetycholine receptor is attacked resulting in antibodies that inhibit acetylcholine binding which down-modulates receptors and results in muscle weakness and paralysis.

A

myasthenia gravis

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10
Q

What is this:
TSH receptors are targeted which results in antibody-mediated stimulation of TSH receptors that results in hyperthyroidism.

A

graves disease (hyperthyroidism)

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11
Q

What is this:
insulin receptors are targeted and you get antibody inhibition binding of insulin so people become hyperglycemic and ketoacidodic.

A

insulin-resistant diabetes

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12
Q

What is this;
intrinsic factor of gastric parietal cells are neutralized and you get decreased absorption of vit B12 thus you have abnormal erythropoiesis and anemia.

A

pernicious anemia

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13
Q

How can you get antibody mediated pathology?

A

antibody can bind to self and cause C3b to bind leading to opsonization and phagocytosis. f phagocyte cnnot phagocytize the tissue, it gets frustrated and releases its products onto the tissues causing inflammation and tissue damage.

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14
Q

Mismatched transfusions wil result in what?

A

antibody-mediated RBC destruction

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15
Q

What are the 2 mechanisms of anti-mediated RBC destruction?

A

1: anti-RBC antibodies engage Fc receptors on macrophages and promote phagocytosis and kiling
2: anti-RBC antibodies can activate complement and promote RBC hemolysis

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16
Q

Explain how you can get immunohemolytic anemia via drug induction…. use penicilin for your example.

A

RBC surface protein gets modified with a penicillin hapten-> this RBC/pencilin complex meets up with CD4 T cell-> this tell B cells to produce anti-penicillin antibodies-> antibodies bound to penicllin modifed RBC cause their destrution either by phagocytosis or my complement-mediated hemolysis

17
Q

WHy is it scary to be a RH- mama with an RH+ fetus?

A

first pregnancy no big deal but the mom will see the positive RH+ and make antibodies to it. SOOO if she has another pregnancy with an RH+ baby the IgG antibodies will cross the placenta and cause hemolysis of fetal RBCs

18
Q

What can severe anemia in a fetus cause?

A

heart failure and massive edema (hydrops fetalis)

19
Q

If an anemic fetus survives, what are some complications that could develop?

A

brain damage due to heme metabolites (bilirubin)

20
Q

What is the direct coombs test?

A

you take babies blood and moms antibodies and then take a fluorescent anti-antibody and see if it binds-> then you know if you will have an RH problem

21
Q

What is the indirect coombs test?

A

take maternal serum, add Rh+ RBCs and wash out unbound antibody and then add anti-antibody and see if it binds

22
Q

How do you give a baby a blood transfusion?

A

through the umbilical vein in the placenta

23
Q

so how do you determine if Rh- mother has anti-Rh antibodies?

A

coombs test

24
Q

How do you fix it if Rh- mother has anti-Rh antibodies?

A

give her Rhogamat 28 weeks of gestation and within 72 hours of delivery to Rh- women.

25
Q

How does Rhogam work?

A

anti-Rh antibodies opsonize Rh+ fetal RBCs for phagocytosis and prevent alloimmunization

26
Q

antibodies to streptococcal M can cross react with antigens on the heart and cause what?

A

rheumatic fever

27
Q

How do you treat rheumatic fever?

A

NSAIDS, corticosteroids, antibiotics