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PHA 520 - Foundations > Immuno II > Flashcards

Immuno II Flashcards

1
Q

Exaggerated, inappropriate immunologic rxns that are harmful to the host

A

Hypersensitivity reactions

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2
Q

Sensitization

A

first exposure to antigen with an immune response (antibody)

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3
Q

Subsequent exposures to an antigen:

A

cause a hypersensitivity reaction

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4
Q

Four types of hypersensitivity reactions:

A

Type I - allergy/anaphylaxis
Type II - antibody-dependent/cytotoxic
Type III - immuno-complex
Type IV - T-cell mediated/delayed

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5
Q

Which hypersensitivity reactions are mediated by antibodies and what antibodies are they?

A

I (IgE)

II and III (IgG)

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6
Q

Biggest chemical mediator in a type I rxn?

A

histamine

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7
Q

What is a type I reaction?

A

Immediate anaphylactic (IgE)

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8
Q

What is a type II rxn?

A

antibody-mediated cytotoxic reaction to antigens (IgG)

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9
Q

T/F: type II rxns are complement-dependent.

A

True - MACs destroy the foreign cell membrane and cause lysis

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10
Q

Examples of type I rxns:

A 
Systemic anaphylaxis
Urticaria
Asthma
Hay Fever
Allergic rhinitis/conjunctivitis
Food or drug allergies
Atopic dermatitis (eczema)
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11
Q

Examples of type II rxns:

A 
Transfusion rxns
Rh incompatibility
Hemolytic dx of the newborn
Rheumatic fever
Autoimmune hemolytic anemia
Goodpasture syndrome
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12
Q

What is the onset timing of a type I rxn?

A

minutes

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13
Q

What is the onset timing of a type II rxn?

A

hours to days

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14
Q

What is a type III rxn?

A

1) Ag-Ab immune complexes form and deposit in tissues
2) Inflammatory response is induced in the tissues
3) Activates complement, causing tissue damage and lysosomal enzyme release

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15
Q

Onset time of a type III rxn?

A

2 to 3 weeks

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16
Q

Examples of type III rxns:

A 
SLE (lupus)
Rheumatoid arthritis
Poststreptococcal glomerulonephritis
IgA nephropathy
Serum sickness
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17
Q

A patient with SLE forms what kind of auto-antibodies?

A

antinuclear antibodies (ANAs)

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18
Q

Complement activation in type III rxns (i.e. SLE) produces what complement protein that attracts neutrophils?

A

C5a

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19
Q

Body fluids of pts with RA contain what factor and where does it bind?

A

Rheumatoid factor (IgM and IgG) that binds to the Fc fragment of normal host IgG

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20
Q

Patients with RA have ___ titers of RF and ___ titers of complement in serum when their disease is active.

A

High RF

Low complement

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21
Q

What is a type IV rxn?

A

Delayed cell-mediated rxn where:

1) Macrophage ingests and presents the foreign antigen on a MHC-II complex
2) T cells are activated and produce IFN-gamma –> activates macrophages and cause inflammation

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22
Q

What kinds of cells mediate type IV reactions?

A

CD4 (helper) and CD8 (cytotoxic)

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23
Q

Examples of type IV rxns:

A 
Contact dermatitis
Poison oak/ivy
TB skin test rxn
Drug rash
Steven-Johnson syndrome
Toxic epidermal necrolysis
Erythema multiforme
24
Q

Pathologic features of type IV rxns using CD4 and macros:

A

ex: TB, cocci
Disease produces granuloma
Skin test produce an induration

25
Pathologic features of type IV rxns using CD8 cells:
ex: contact dermatitis (pruritic vesicular rash) | EM, SJS, TEN: target lesion
26
Time of onset for type IV rxns:
2-3 days
27
Hereditary angioedema (HAE)
congenital immunodeficiency of C1 protease inhibitor (complement cascade can't be turned off)
28
What complement proteins does a person with HAE have in excess?
C3a, C4a, C5a
29
What are the main symptoms of HAE?
Episodic local significant capillary permeability and subcutaneous and submucosal edema (usually GI and UR tracts)
30
How do you differentiate between a type I HS reaction and HAE?
HAE lacks itchiness and urticaria
31
Biggest red flag symptom for HAE:
recurrent abdominal colic
32
Treatment for HAE
Replace the missing C1 esterase inhibitor
33
What the surface proteins that are markers of "self" on cells?
MHC I and MHC II
34
What are the non-self substances that trigger the immune system?
Epitope (trigger area on the antigen)
35
Autoimmunity mechanisms for avoiding damage to self-cells:
1) Sequestration 2) Tolerance 3) Regulation
36
What autoimmunity mechanism has the body keeping bad cells from being released into the bloodstream before destroying them?
sequestration
37
What autoimmunity mechanism involves the body not reacting to self-reactive B and T cells?
tolerance
38
What autoimmunity mechanism involves regulatory cells preventing self-reactive cells from being activated?
regulation
39
Exogenous autoimmune triggers:
bacterial or viral infections T1D Medications Smoking/toxins
40
Endogenous autoimmune triggers:
autoantibodies
41
Example of molecular mimicry autoimmune triggers:
Strep antigen is similar to the body's own and the body attacks cardiac tissue because it looks similar
42
Criteria for autoimmune disease diagnosis
1) autoantibodies 2) self-reactive T cells 3) Imbalance between T and B cell pathogenic factors and regulatory factors that control immune response
43
T/F: people only have autoantibodies if they have an autoimmune dx?
False
44
What dx is characterized by autoantibody stimulation (thyroid stimulating immunoglobulin [TSI]) of the TSH receptor?
Graves disease
45
What disease is an autoimmune reaction to infection with GAS?
Rheumatic fever
46
What disease involves autoantibody blocking and inactivation (anti-AcHR) of the alpha-chain of the nicotinic AcH receptors in neuromuscular jxns?
Myasthenia gravis
47
What disease has immune complex formation that targets dsDNA?
SLE
48
What are the autoantibodies associated with SLE?
anti-dsDNA | anti-Smith
49
What disease is characterized by insulin and islet cell autoantibodies, as well as T cell cytokine production and cellular toxicity?
Type I diabetes
50
What disease is characterized by RF and anti-CCP?
Rheumatoid arthritis
51
What disease is characterized by a pro-inflammatory autoimmune response causing destruction of CNS myelin?
Multiple sclerosis
52
Immunizations exploit the _____ immune response.
adaptive
53
A vaccine that contains the weakened form of the virus.
live attenuated
54
A vaccine that contains killed pathogens.
inactivated
55
A vaccine that uses a component of the pathogen as a vaccine antigen to mimic exposure.
Subunit
56
A vaccine where the polysaccharide from the bacterial capsule is bound to a carrier protein.
conjugate subunit vaccine

PHA 520 - Foundations (7 decks)

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