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Pathology > Immunity 2 > Flashcards

Immunity 2 Flashcards

1
Q 
All of the following are mediators released by mast cells upon an antigen binding to IgE on their surface, except\_\_\_?\_\_\_ .
A Prostaglandins
B Histamine
C Leukotrienes
D Cytokines
E Antibodies
A

Antibodies

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2
Q
  • Type I Immune Mediated Disease
  • Unexplained periodic swelling –may involve lip or be around the eye
  • “Quincke disease”, “angioneurotic edema”
  • Rapid, recurring, diffuse, edematous swelling of subcutaneous or submucosal soft tissues –frequently the lips
  • May involve gastrointestinal or respiratory tract mucosa
  • The common clinical presentation of a group of conditions with different pathogenesis
A

Angioedema

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3
Q
  • IgE-mediated hypersensitivity–Type I hypersensitivity reaction–Mast cell degranulation and histamine release
  • Physical stimuli
  • Contact allergy
  • Responds to antihistamines
A

Allergic angioedema

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4
Q

Which T helper cell is involved in hypersensitivities?

A

Th2

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5
Q

•High prevalence of atopic disease in developed countries (20%) compared to developing countries
•Individuals living in a more “hygienic” (Western) environment
–Precludes early and extensive antigen exposure
–Leads to a higher likelihood of a Th2 response to antigens

A

Hygiene hypothesis

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6
Q

•Type __Hypersensitivity Reaction:
Antibody-Mediated Hypersensitivity
•Tissue damage mediated by antibodies IgG, IgM

A

Type II

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7
Q

What 2 cells are the targets of type 2 hypersensitivity reactions?

A

Erythrocytes

Platelets

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8
Q

What is the cell surface receptor that is the target of Type 2 hypersensitivity rxns?

A

Acetylcholine receptor

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9
Q

What are the 2 ECM materials that are the targets of type 2 hypersensitivity reactions?

A

Laminin

Desmoglein

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10
Q

ABO mismatch leads to ______

A

Intravascular hemolysis

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11
Q 
An individual who has blood Type O has:
A The ability to be a universal donor
B The ability to be a universal recipient
C Type A and B antigens
D Antibodies to Type O blood
A

The ability to be a universal donor

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12
Q
  • Antibody blocks acetylcholine receptor

* Antibody mediated inhibition of cell function

A

Myasthenia gravis

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13
Q

•Antibody-mediated stimulation of cell function
•Antibody stimulates TSH receptor
Antibody mediated stimulation of cell function

A

Graves disease

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14
Q
  • Autoantibodies to basement membrane antigens–BP180–Laminin5 (epiligrin)
  • Nikolsky sign
  • Hemidesmosomes
  • Sub-epithelial splitting process
A

Mucous membrane pemphigoid

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15
Q
  • Autoantibodies against desmosomal proteins
  • Desmoglein-3, a glycoprotein component of desmosomes
  • Nikolsky sign
A

Pemphigus Vulgaris

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16
Q

Myasthenia gravis is an example of:
A Antibody mediated stimulation of cell function
B Antibody mediated inhibition of cell function
C A Type I immune reaction
D Immediate hypersensitivity

A

Antibody mediated inhibition of cell function

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17
Q

What antibodies are seen in type 2 and 3 hypersensitivities?

A

IgM and IgG

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18
Q

•Type ____ hypersensitivity: antibodies are directed against antigens and get phagocytosed or lysed

A

Type II

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19
Q

•Type ____ hypersensitivity: Antigen-antibody complexes that circulate and activate complement
Tissue damage in multiple organ systems in both mild and severe forms

A

Type III

20
Q

Type ____ hypersensitivity:
–Immediate onset
–IgE
–Rash, cough, difficulty breathing happens immediately

A

Type 1

21
Q

Type ____ hypersensitivity:
–Delayed onset
–Antibody independent
–Takes days

A

Type 4

22
Q
  • Pharyngitis caused by certain strains of Streptococci (“Strep throat”) –exogenous antigen
  • Antigen excess Immune complexes
  • Immune complexes filter out in renal glomeruliComplement
  • Glomerulonephritis –proteinuria, hematuria, hypertension, fever, lower back pain
A

Post-streptococcal glomerulonephritis

23
Q

•A multisystem autoimmune disease most common in adult women in child-bearing years
•Type III Hypersensitivity
-Immune Complex Disease
•Autoantibodies–anti-nuclear antibodies (ANA)
•Butterfly rash

A

Lupus Erythematosus

24
Q 
The following organs are involved in \_\_\_\_\_\_
•Skin
•Joints
•Kidney
•Heart: Libman-Sacks endocarditis
•Pericarditis, pleuritis
•Central nervous system
•Arthritis, arthralgia, anemia, bone marrow depression, vasculitis, skin rashes
A

Systemic lupus erythematosus

25
Q
  • Most common form of lupus
  • Highest morbidity–Glomerulonephritis renal failure
  • Butterfly rash 50%–Malar area and nose, aggravated by sunlight
  • Libman-Sacks endocarditis
  • Arthritis, arthralgia, heart and lung involvement, anemia, bone marrow depression, vasculitis, skin rashes
A

Systemic lupus erythematosus

26
Q
  • Non-bacterial endocarditis
  • Systemic lupus erythematosus
  • Mitral valve
  • Small, sterile vegetations
  • Risk for infective endocarditis
A

Libman-Sacks Endocarditis

27
Q

If you have four or more of the following, you have _____
•Facial erythema (especially butterfly rash)
•Skin rash
•Raynaud phenomenon (cold sensitivity in hands and feet)
•Alopecia (loss of hair)•
Photosensitivity
•Anemia, leukopenia, thrombocytopenia
•Arthritis
•Oral, nasal or pharyngeal ulcers

A

Lupus

28
Q

•Type III Hypersensitivity -Immune Complex Disease
•Sometimes follows infections or drugs
-Only mucosal surfaces
•An immunologically mediated self-limited, mucocutaneous disease
•Young adults
•Sudden onset of widespread, painful superficial mucosal ulcers and target lesions of skin
•Hemhorragic crusted ulcers on lips
•Targetoid“bullseye” lesions on skin
•May be recurrent
•May follow infection -herpes simplex, mycoplasma pneumoniae
•May follow drug exposure –antibiotics, analgesics
•“Drugs and Bugs”
•Prodromal symptoms
•Sudden onset of mucocutaneous lesions
•Self-limiting disease–Lasts 2-6 weeks–Avoid dehydration
•Recurrent episodes
•Lesions may be limited to oral mucosa

A

Erythema Multiforme

29
Q

What type of lesion is a tell-tale sign of erythema multiforme?

A

Bullseye lesion

30
Q
  • Type III Hypersensitivity -Immune Complex Disease
  • Reaction to proteins in antiserum derived from a non-human animal source–occurs 5–10 days after exposure–Immunization with vaccine developed from horse/mouse serum
  • Immune complexes form and settle out in tissues
  • Synovial membranes –arthritis, fever, rash, arthralgia
A

Serum sickness

31
Q
  • Type III Hypersensitivity -Immune Complex Disease
  • Local reaction
  • Antigen-antibody complexes trigger complement cascade and sterile vasculitis at site of injection
A

Arthus reaction

32
Q

The following autoimmune diseases involve _____ organs:
•Autoimmune thyroiditis (Hashimoto disease)
•Autoimmune thyroiditis (Graves disease)
•Autoimmune (Idiopathic) thrombocytopenic purpura (ITP)
•Myasthenia gravis
•Autoimmune atrophic gastritis in pernicious anemia

A

Single Organs

33
Q 
The following autoimmune diseases involve \_\_\_\_\_ organs:
•Systemic lupus erythematosus
•Systemic sclerosis (scleroderma)
•Rheumatoid arthritis
•Sjogren syndrome
A

Multiple organs

34
Q

•Type IV delayed hypersensitivity reaction to protein from M. tuberculosis
•Intracutaneous tuberculin injection
•T-cells sensitized by prior infection recruited to area
induration

A

Mantoux Tuberculin Skin Test

35
Q

____ immunological tolerance
–Developing T cells
•deletion of self-reacting T cells in the thymus–Developing B cells
•receptor editing or deletion of self-reacting B cells in the bone marrow

A

•Central tolerance

36
Q

____ immunological tolerance
Peripheral tolerance–Anergy= functional inactivation
–Suppression by regulatory T cells
–Deletion by activation-induced cell death

A

Peripheral tolerance

37
Q
  • Chronic, systemic inflammatory disease–joints, skin, blood vessels, lungs, muscles–Vs. Osteoarthritis(degenerative joint disease –DJD)
  • not a systemic disease
  • Genetic susceptibility
  • Environmental arthritogen
  • white blood cells attack synovium–membrane the body uses to protect and line the joints.
A

Rheumatoid Arthritis

38
Q

________ is an autoantibody–Antibody against an antibody
•IgM autoantibody to the Fc portion of IgG
•+ in 80% with rheumatoid arthritis

A

Rheumatoid factor

39
Q

–Not diagnostically specific

–Associated with other autoimmune diseases

A

•Antinuclear Antibodies (ANAs)

40
Q

–Also non-specific

–Useful in monitoring disease activity

A

•Erythrocyte Sedimentation Rate (ESR)

41
Q

•Autoimmune disease of adults, predominately females –excessive fibrosis
•May be limited to the skin or be widespread affecting various organ systems
•May be associated with other autoimmune diseases
-Fibrosis stiffness deformity
-Ischemia atrophy and ulceration

A

Systemic sclerosis

42
Q 
The following are oral findings in \_\_\_\_\_\_\_\_\_
•Microstomia
•Ankyloglossia
•Xerostomia
•Generalized widening of PDL space
•Mandibular resorption
A

Systemic sclerosis

43
Q
  • Arterial spasm in response to cold or emotional stress •Pallor, cyanosis and then erythema
  • Numbness, tingling or pain on recovery
A

Raynaud Phenomenon

44
Q

What are the 5 components of the CREST SYNDROME

A 
Calcinosis cutis
Raynaud Phenomenon
Esophageal dysfunction
Sclerodactly
Telangiecstasia
45
Q

•Chronic, systemic autoimmune disease–may be associated with other autoimmune diseases
•Middle-aged females (9:1)
•Benign lymphoepithelial lesion (BLEL)salivary gland enlargement
•Dry eyes and dry mouth (sicca syndrome
•Increased risk of lymphoma
•Autoantibodies to ribonucleoproteins
–Anti-SS-A (anti-Ro)–Anti-SS-B (anti-La)
•Rheumatoid factor (RF) –IgM autoantibody to the Fc portion of IgG–70%
•Anti-nuclear antibodies (ANA)–50-70%
•Anti-salivary duct antibodies

A

Sjogren syndrome

46
Q

CREST syndrome is associated with all of the following except:
A Systemic Sclerosis
B Reynaud phenomenon
C Telangiectasias on the skin
D Autoimmune destruction of beta cells of the pancreas

A

Autoimmune destruction of beta cells of the pancreas

Pathology (26 decks)

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