Immunology II (pg 208+) Flashcards
What is type I hypersensitivity rxn?
Free antigen cross linking on IgE on mast cells and basophils
What causes the delayed type I hypersensitivity rxn?
Production of arachidonic acid metabolites
What is the type II hypersensitivity rxn?
Cytotoxic = IgM and IgG bind to fixed antigen on other cells, leading to cellular destruction
What are the two types of C regions on the light chains of abs?
Kappa and lambda
What are the C regions of the heavy chain of Abs?
Part for specificity of IgA, IgG etc.
What are the 3 MOA of type II hypersensitivity?
- Opsonization leading to phagocytosis
- Complement mediated lysis
- Antibody-dependent, cell mediated cytotoxicity
What is the direct Coomb’s test?
detects antibodies that have adhered to patient’s RBCs (e/g/ test an Rh + infant of an Rh - mother)
What is the indirect Coomb’s test?
Detects antibodies that can adhere to other RBCs (e.g. test an Rh - woman for Rh + abs)
What is the MOA of papain on abs? Pepsin?
Papain = breaks Fc from variable region and light chains apart Pepsin = breaks Fc from variable region
What is the Arthus rxn?
a local subacute antibody mediated type III reaction
What is type IV hypersensitivity rxn?
Delayed type–sensitized T lymphocytes encounter antigen, and then release lymphokines–no ab involved
What are the four T’s of type IV hypersensitivity rxns?
T lymphocytes
Transplant rejections
TB skin test
Touching (contact dermatitis)
What are the components of the ACID mnemonic that describes that four types of hypersensitivity rxns?
- Anaphylactic and atopic
- Cytotoxic (antibody mediated)
- Immune complexes
- Delayed
Name the type of hypersensitivity reaction involved: autoimmune hemolytic anemia
II
Name the type of hypersensitivity reaction involved: SLE
III
Name the type of hypersensitivity reaction involved: MS
IV
Name the type of hypersensitivity reaction involved: ITP
II
Name the type of hypersensitivity reaction involved: polyarteritis nodosa
III
Name the type of hypersensitivity reaction involved: Guillian barre
Iv
Name the type of hypersensitivity reaction involved: erythroblastosis fetalis
II
Name the type of hypersensitivity reaction involved: post streptococcal GMN
III
Name the type of hypersensitivity reaction involved: serum sickness
III
Name the type of hypersensitivity reaction involved: arthus rxn
III
Name the type of hypersensitivity reaction involved: goodpasture
II
Name the type of hypersensitivity reaction involved: Bullous pemphigoid
II
Name the type of hypersensitivity reaction involved: pemphigus vulgaris
II
Name the type of hypersensitivity reaction involved: GVHD
IV
Name the type of hypersensitivity reaction involved: PPD test
IV
Name the type of hypersensitivity reaction involved: contact dermatitis
IV
Name the type of hypersensitivity reaction involved: rhinitis
I
What is the pathogenesis and presentation of allergic transfusion rxns?
- type I hypersensitivity rxn against plasma proteins in transfused blood
- Urticaria, pruritus, wheezing, fever
What is the pathogenesis and presentation of anaphylactic transfusion rxns?
- Severe allergic rxn, usually d/t IgA deficiency
- Dyspnea, bronchospasm, hypotension, shock
What is the pathogenesis and presentation of febrile, nonhemolytic transfusion rxns?
- Type II hypersensitivity rxn; host abs against donor HLA antigens and leukocytes
- Fever, HA, chills, flushing
What is the pathogenesis and presentation of acute hemolytic transfusion rxns?
- Type II hypersensitivity rxn that causes intravascular hemolysis. D/t ABO blood group incompatibility.
- Fever, hypotension, tachypnea, tachycardia, flank pain, jaundice
What does the Fab determine? Fc?
Fab = Idiotype Fc = isotype
What are the two antibodies that can bind antibodies?
IgG and IgM
True or false: antibodies are glycoproteins, and their carbs moieties are attached to the CH2 domain
True
How does isotype switching occur?
V(D)J rearrangement
What are the autoantibodies in: MG?
anti-ACh receptor
What are the autoantibodies in: goodpasture
Anti BM
What are the autoantibodies in: SLE, antiphospholipid syndrome
Anti-cardiolipin
Lupus anticoagulant
What are the autoantibodies in: CREST (limited scleroderma)
Anticentromere
What are the autoantibodies in: SLE
Anti smith
Anti dsDNA
ANA
What are the autoantibodies in: DM I
Anti glutamate decarboxylate
What are the autoantibodies in: Bullous pemiphgoid
Anti hemidesmosome
What are the autoantibodies in: drug induced lupus
anti-histone
What are the autoantibodies in: polymyositis and dermatomyositis
Anti Jo
Anti-SRP
Anti-Mi-2
What are the autoantibodies in: Hashimoto’s thyroiditis
Antimicrosomal
Antithyroglobulin
What are the autoantibodies in: primary biliary cirrhosis
Antimitochondrial
What are the autoantibodies in: Diffuse scleroderma
Anti SCL-70 (anti DNA topoisomerase I)
What are the autoantibodies in: Autoimmune hepatitis
Anti-smooth mucle
What are the autoantibodies in: Sjogren’s syndrome?
Anti-SSA (ro)
Anti-SSB (la)
What are the autoantibodies in: Grave’s disease?
Anti TSH
What are the autoantibodies in: mixed CT disease?
Anti U1 RNP
What are the autoantibodies in: GPA (Wegener’s)
c-ANCA
What are the autoantibodies in: celiac disease
IgA antiendomysial
IgA anti tissue transglutaminase
Which has D chain, light or heavy
Only heavy
What are the three segments of the light chain ab?
V
J
C
What are the autoantibodies in: microscopic polyangiitis
p-ANCA
What are the auto-antibodies in: Churg Strauss syndrome
p-ANCA
True or false; light chains have both kappa and lambda light chains
False–either or
What is the most abundant light chain?
Kappa chain
The variable domain of the light chains is encoded by random recombination of which light chain exon?
V and J
What are the autoantibodies in: RA?
Rheumatoid factor
Anti CCP
What chromosome has the heavy chain of Abs?
14
The first recombination event in heavy chain rearrangement is what?
Between D and J
What is the first step of B cell maturation?
Development of heavy chain
Which comes first: pro B cells, or Pre B cells?
Pro
B cell receptors are membrane bound Ig that are composed of what?
Two heavy and two light chains
What is the peaks of serum electrophoresis? (5)
1 = albumin 2 = alpha 1 3 = alpha 2 4 = beta 5 = gamma
What are the protein components of MHC class I and II?
I = long alpha and short beta chain II = Two similar lengths alpha and bet chains (both are membrane spanning)
B cells express what CD molecules?
CD 5
What is the CD protein that is found on all T cells?
CD3
What is the MOA and use of muromonab?
- ANti CD3 ab to prevent T cell activation
- Used for heart and renal transplants