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MB2:Dermatology > Immunology > Flashcards

Immunology Flashcards

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Dermatology Board Prep flashcards
1
Q

in what 3 ways does skin contribute to an effective immune system

A

barrier structure
immune cells in skin secreting cytokines/chemokines
genetics

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2
Q

how do keratinocytes contribute to immunity in the epidermis

A

sense pathogens by surface receptors
produce cytokines/chemokines
produce antimicrobial proteins

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3
Q

what cell does the birbeck granule characterise

A

langerhan cell

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4
Q

what lymphocytes are found in the epidermis

A

CD8+T cells

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5
Q

what lymphocytes are found in the epidermis

A

CD4 and CD8 T cells

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6
Q

how do TH2 T cells help B cells make antibodies

A

stimulation via IL4/IL5/IL13

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7
Q

what kind of CD4+T cells are found in atopic dermatitis

A

TH2 and TH17

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8
Q

what kind of CD4+T cells are found in psoriasis

A

TH1 and TH17

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9
Q

what immune cells, including lymphocytes, are found in the dermis

A 
CD4 and CD8 lymphocytes 
mast cells 
langerhans cells 
NK cells 
macrophges 
neutrophils, if acute immune response active
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10
Q

describe MHC I and its mechanism of action

A

found on all cells in the body and presents endogenous antigen to T cells

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11
Q

describe MHC II and mechanism of action

A

found on APC and presents exogenous antigen to T cells for activation of the acquired immune response

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12
Q

describe the immunological events occurring in psoriasis

A

environmental factor causes KC stress so stimulates DC to produce IFNa, DC activates TH1 and TH17 in skin lymph node which travel to skin and secrete IL17 to cause KC proliferation and attracts neutrophils
fibroblasts in dermis release epidermal growth factors

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13
Q

describe the immunological events occurring in atopic dermatitis

A

mutations in filaggrin gene lead to dry skin
KC becomes stressed by allergen invading dry skin and causes DC to activate TH2 cells that secrete IL4/IL5/IL13 to proliferate B cells secreting IgE
on second exposure IgE binds mast cells causing histamine and leukotriene release to promote inflammation causing rash on skijn

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14
Q

describe the rapid and late response of type I hypersensitivity

A

rapid - wheal and flare

delayed - cell infiltration and nodules

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15
Q

in what type of hypersensitivity would you find an arthus reaction and what does it mean

A

type III

skin reaction slower than type I, but faster than IV

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16
Q

what type of TH cell mediates type IV inflammation, and why is it delayed and how long by

A

TH1

delayed due to t cell response, usually 24-48 hours

17
Q

what is hypersensitivity

A

immune response causing collateral damage to self

18
Q

what is allergy

A

hypersensitivity of the immune system

19
Q

how fast does a type I allergy appear

A

a minute to 2 hours - fast

20
Q

common type I allergens

A 
nuts
pet dander
seafood
house dust mite 
pollen 
latex
bee sting 
medications
21
Q

describe pathophysiology of type I hypersensitivity

A

allergen exposed causes LC to travel to lymph node or dermis to activate TC. TH2 activates B cell to secrete IgE specific against allergen
second exposure - IgE binds and degranulates mast cells to cause proinflammatory mediators and cytokines

22
Q

what clinical features will you see with type I allergy

A

urticaria
angioedema
anaphylaxis

23
Q

investigation of type I allergy?

A 
history, history, history
IgE levels
Prick test 
Challenge test - only AFTER prick 
serum mast tryptase
24
Q

management of type I allergy?

A 
allergen avoidance 
antihistamines
topical steroid - if antihist not enough 
adrenaline autoinjector 
sodium chromoglycate 
inform/educate
medic alert
25
Q

non-allergic reactions appearing as such?

A

non-IgE - coeliac
Direct mas cell degranulation - NSAIDs, asp, morphine
metabolic - lactose intolerance
toxic - scombroid fish

26
Q

allergic contact dermatitis is?

A

type IV

27
Q

allergens in IV allergy?

A 
preservatives in cosmetics 
rubber accelerators 
fragrances
plant 
tattoo
nickel
garlic 
ivy 
surgical glue 
gold crowns
28
Q

pathophysiology of IV allergy?

A

Allergen presents to LC, migrates to lymph node to activate CD4/CD8, migrate to dermis/epidermis and cause keratinocyte apoptosis and cytokine secretion to cause leukocyte migration

29
Q

presentation of IV allergy?

A

eczema/dermatitis - contact and local

30
Q

investigation of IV allergy and how it works?

A

patch test

finn chambers with allergen placed on skin under occlusion for 48 hours, checked after 72-96 for reaction

31
Q

IV allergy may be mistaken for

A

contact dermatitis due to irritant
agents that abride, irritate and traumatise skin
nappy rash eg

32
Q

managing IV hypersensitivity

A 
allergen/irritant avoidance 
emollients 
topical steroids 
UV phototherapy 
immunosuppressants

MB2:Dermatology (11 decks)

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