Immunology Flashcards

1
Q

describe the innate immune system

A

immediate
non-specific
no memory

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2
Q

describe the adaptive immune system

A

later
specific
memory

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3
Q

what are the main APC in the external eye

A

Langerhans cells

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4
Q

Langerhans cells have a lot of class I/II MHC molecules

A

class II

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5
Q

where in the eye are Langerhans cells found

A

corneo-scleral limbus

get less as you move to the centre of the cornea

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6
Q

the conjunctiva are the only part of the eye with lymphatic drainage, true or false

A

true

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7
Q

what APC are found in the conjunctiva

A

dendritic cells

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8
Q

what is MALT and where is it found

A

mucosal associated lymphatic tissue
conjunctiva
instead of lymph nodes

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9
Q

the cornea and sclera are a/vascular and don’t/have lymphoid tissue

A

avascular

don’t have lymphoid tissue

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10
Q

what immune mechanisms/cells does the lacrimal gland have

A

IgA and CD8+ T cells

MALT

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11
Q

where is the blood ocular barrier found

A

choroid and retina

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12
Q

which parts of the body have immune privilege

A

eyes
testes
brain
placenta/foetus

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13
Q

what is immune privilege

A

sites of the body with immune privilege are able to tolerate the introduction of an antigen without initiating an immune response

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14
Q

what does ACAID stand for

A

Anterior Chamber Associated Immune Deviation

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15
Q

what is ACAID

A

placement of a foreign material into the ocular microenvironment can induce a systemic form of tolerance to this material i.e. peripheral tolerance to ocular antigen

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16
Q

ACAID is an active/passive process

how does it work

A

active process
generation of CD4+ T cells and B cells to make non-complement fixing Ab
inhibits delayed type hypersensitivity
suppresses immune response to protect the eye

17
Q

what is a disadvantage of immune privilege in the eye

A

eye is physically and immunologically isolated from the rest of the body’s immune system

18
Q

what is sympathetic ophthalmia

A

rare BILATERAL granulomatous uveitis following trauma to ONE eye
thought to be a secondary autoimmune reaction to ocular antigens

19
Q

what immune cells are thought to mediate sympathetic ophthalmia

A

T cells

20
Q

in sympathetic ophthalmia, what are the following described as:
injured eye
fellow eye

A

injured eye - exciting eye

fellow eye - sympathising eye

21
Q

on examination of sympathetic ophthalmia, both eyes appear the same, true or false

A

true
you only know the exciting eye from the history
trauma may have happened years ago

22
Q

management of sympathetic ophthalmia

A

immediate surgery
steroids and immunosuppressants
if unsalvageable, take out exciting eye before sympathising eye becomes damaged too

23
Q

what increases the risk of sympathetic ophthalmia

A

many ocular surgeries

any more than 4-6 surgeries, would not operate any more

24
Q

hypersensitivity classifications

A

Type 1 - Acute, IgE mediated, mast cells, histamine
Type 2 - antiBody, direct cell killing by macrophages, NK cells, complement, MAC
Type 3 - immune Complex mediated
Type 4 - Delayed, T cell mediated

25
Q

example of Type 1 hypersensitivity and features

A

acute allergic conjunctivitis

- chemosis (oedema of conjunctiva)

26
Q

example of Type 2 hypersensitivity and features

A

ocular cicatricial pemphigoid

  • blistering and scarring of conjunctiva
  • entropion
  • cornea becomes hazy and vascularised
  • Tx: steroids
27
Q

example of Type 3 hypersensitivity and features

A

autoimmune corneal melting

  • perforation leading to open globe
  • Tx: intense high dose steroids
28
Q

example of Type 4 hypersensitivity and features

A

corneal graft rejection

  • vascularisation of host cornea reaching donor tissue
  • Tx: steroids
29
Q

ocular side effects of steroids

A

cataracts
steroid induced glaucoma
perforation if given for herpetic keratitis