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Phase 2 > Immunology 2 > Flashcards

Immunology 2 Flashcards

1
Q

Describe the 4 types of hypersensitivity reactions

A

Type 1 – IgE mediated drug hypersensitivity
Type 2 – IgG mediated cytotoxicity
Type 3 – Immune complex deposition
Type 4 – T cell mediated

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2
Q

Describe the process Type 1 Hypersensitivity reaction

A

Needs prior exposure to antigen/drug
IgE antibodies formed after exposure to molecule
IgE becomes attached to mast cells/leucocytes, expressed as cell surface receptors

Re-exposure cause mast-cell degranulation and releases inflammatory tings like histamine, prostaglandins, leukotrienes, platelet activating factor

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3
Q

Describe some signs/symptoms of Anaphylaxis

A

Rapid onset
Breathing difficulty, wheeze, cough, SOB
Hypotension
Circulation problems - low BP, high HR
Rash/Hives (itchiness)
Swelling of lips, tongue, throat
Loss of consciousness
Cyanosis

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4
Q

How common is it to have a biphasic response with anaphylaxis?

A

1-20% of people have biphasic response

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5
Q

Describe the process of a Type 2 Hypersensitivity reaction

A

Antibody dependent
Drug/Metabolite combines w/ protein
Body treats it as foreign and forms antibodies (IgG, IgM)

Antibodies combine w/ antigens
Complement system activates, damages cells

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6
Q

Describe the process of a Type 3 Hypersensitivity reaction

A

Immune complex mediated
Antigen/antibody forms large complex and activates complement system
Small blood vessels damaged/blocked

Leucocytes attracted to site of reaction
They release inflammatory substances

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7
Q

Example of a Type 3 Hypersensitivity reaction

A

Glomerulonephritis
Vasculitis

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8
Q

Example of Type 1 H reaction

A

Anaphylaxis

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9
Q

Example of Type 2 H reaction

A

Haemolytic anaemia
MS
Pemphigus

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10
Q

KEY symptoms of Anaphylaxis?

A

ABC PROBLEMS
AIRWAY
BREATHING
CIRCULATION

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11
Q

Describe the process of Type 4 Hypersensitivity reaction

A

Lymphocyte mediated
Antigen specific receptors develop on T lymphocytes
Leads to local/tissue allergic reaction

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12
Q

Example of Type 4 H reaction

A

Contact dermatitis
Stevens Johnson syndrome

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13
Q

Treatment of Anaphylaxis

A

Basic life support (ABCDE!!)
Stop drug if infusion

IM ADRENALINE 500MG
(300mg in epipen)

High flow O2
IV fluids - to ↑ BP

If no response after 5 mins, do IM again

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14
Q

What blood test can you do to confirm anaphylaxis?
When would this test be done?

A

Mast cell tryptase
AFTER treatment, otherwise Px will die

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15
Q

Difference between Immune and Non-immune anaphylaxis

A

NON-immune is due to direct mast cell degranulatin
No prior exposure
but clinically identical

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16
Q

What does adrenaline do?

A

Vasoconstriction - ↑ Peripheral vascular resistance, ↑ BP, ↑ Coronary perfusion
VIA alpha-1

Stimulates Beta-1 positive ionotropic and chronotropic effects on heart

↓ Oedema and bronchodilates VIA beta-2

Releases further mediators from mast cells and basophils by ↑ Intracellular c-AMP
∴ ↓ Release of inflammatory mediators

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17
Q

RF for hypersensitivity reaction

A

F
EBV, HIV
Prev drug reactions
Uncontrolled asthma
Medication (w/ macro molecules)
Certain HLA groups
Acetylator status

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18
Q

What are the clinical criteria for an allergy to drug

A

No correlation with pharmacological properties of drug
No linear relation w/ dose (Even a tiny amount will cause anaphylaxis)
Has a primary exposure
Small number of patients
Happens on re-exposure

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19
Q

Give examples of polymorphonuclear leukocytes

A

Neutrophils
Eosinophils
Basophils

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20
Q

Give examples of mononuclear leukocytes

A

Monocytes
T-cells
B-cells

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21
Q

What is the key role of monocytes?

A

Plays important role in innate and adaptive immunity (phago and Ag presentation)
Removes foreign or dead bodies

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22
Q

What are the 2 main intracellular granules in neutrophils?

A

Primary - kills microbes by secreting toxic substances
&
Secondary

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23
Q

What are neutrophils involved in?

A

Play important role in innate immunity (phagocytosis)

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24
Q

Where do macrophages reside?

A

Reside in tissues
e.g. Kupffer cells in liver, microglia in brain

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25
Q

What is the approx lifespan of macrophages?

A

Months/years

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26
Q

Main role of macrophages?

A

Remove foreign bodies and self (dead/tumour cells)
Presents Ag to T-cells

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27
Q

Approx lifespan of eosinophils

A

8-12 days

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28
Q

What dye is used to stain eosinophil granules?

A

Acidic dyes (eosin)

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29
Q

Main role of eosinophils?

A

Activates neutrophils
Induces histamine release from mast cells and provokes bronchospasms
Mainly associated with parasitic infections and allergic reactions

30
Q

Lifespan of basophils?

A

~2 days

31
Q

How are basophils involved in allergic reactions?

A

IgE binds to receptors
Causes de-granulation releasing histamine

32
Q

What type of dye is used to stain basophil?

A

Basophil granules stain with basic dyes

33
Q

Basophils are very similar to?

A

Mast cells

34
Q

Where are mast cells found?
Where is their precursor found?

A

Only in tissues
Precursor in blood

35
Q

How are mast cells involved in allergic reactions?

A

IgE binds to receptors
Causes de-granulation releasing histamine

36
Q

T-cells play a major role in

A

Adaptive immunity

37
Q

Lifespan of T-cells

A

Hours-years

38
Q

Where do T-cells mature?

A

Thymus

39
Q

Where can T-cells be found?

A

Blood, lymph nodes and spleen

40
Q

What are the 4 types of T-cells?
Brief description of their function

A

T helper 1 - CD4 - helps immune response for intracellular pathogens

T helper 2 - CD4 - helps produce antibodies against extracellular pathogens

Cytotoxic T cell - CD8 - kills cells directly

T regulator - regulates immune response

41
Q

Lifespan of B-cells?

A

Hours-years

42
Q

Where do B-cells mature?

A

Bone marrow

43
Q

B-cells recognise

A

Antigens presented by antigen presenting cells (APC)

44
Q

B-cells differentiate into

A

Plasma cells that make antibodies

45
Q

Where are B-cells found?

A

Blood, lymph nodes and spleen

46
Q

Natural killer cells account for ___ of __

A

15% of lymphocytes

47
Q

Where are Natural killer cells found?

A

Spleen, Tissues

48
Q

How do natural killer cells kill?

A

Via apoptosis

49
Q

What do natural killer cells kill?

A

Virus infected cells
Tumour cells

50
Q

Are Immunoglobulin’s soluble?

A

Yes

51
Q

Name the 5 classes of Igs

A

IgG
IgA
IgM
IgD
IgE

52
Q

Describe the characteristics of IgG

A

Predominant in human serum
70-75% of IgG in serum
Crosses placenta

53
Q

Difference between mast cells and basophils

A

Mast cells are fixed in tissue
Basophils can circulate in blood around body

54
Q

Mast cells express ____

A

High affinity IgE receptors

55
Q

Describe the characteristics of IgA

A

15% of Ig in serum
Predominant in mucous secretions e.g. saliva, milk, bronchiolar secretions

56
Q

Describe the characteristics of IgM

A

10% of Ig in serum
Mainly found in blood
Mainly primary response, initial contact w Ag

57
Q

Why can’t IgM cross the endothelium?

A

Too big

58
Q

Describe the characteristics of IgD

A

1% of Ig in serum
Transmembrane monomeric form present on mature B cells

59
Q

What is IgE associated with?

A

Allergic response and defence against parasitic infections

60
Q

Define epitope

A

The part of antigen that binds to antibody/receptor binding site

61
Q

Define affinity

A

Measure of binding strength between an epitope and an antibody binding site.
Higher the affinity, the better

62
Q

What do interferons (IFN) do?

A

Induce a state of antiviral resistance in uninfected cells and limits spread of viral infection

63
Q

What do interleukins (IL) do?

A

Cause cells to divide, to differentiate and to secrete factors
Over 30 types

64
Q

What do colony stimulating factors (CSF) do?

A

Involved in directing division and differentiation on bone marrow stem cells (precursors of leukocytes)

65
Q

What does tumour necrosis factor do?

A

Mediate inflammation and cytotoxic reactions

66
Q

Describe innate defence mechanisms

A

1st line of defence
Provides a barrier to antigens
Present from birth
No memory
DOES NOT require lymphocytes

67
Q

Describe adaptive (specific) defence mechanisms

A

Response is specific to antigen
Quicker response
MEMORY to specific antigen
REQUIRES lymphocytes

68
Q

Give some examples of physiological barriers

A

Temperature
Fever response (inhibits micro-organism growth)
pH
Gastric acidity

69
Q

Why are neonates more susceptible to infection than adults? (gastric acidity)

A

Neonates have a less acidic stomach
∴ more susceptible

70
Q
A

Phase 2 (24 decks)

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