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MOD > Immunology Part 2 Immunopathology > Flashcards

Immunology Part 2 Immunopathology Flashcards

1
Q

What are the four types of grafts?

A

Allograph–different individual same species
Autograph–same person
Xenograph–different individual different species
Syngenoic graph–genetically identical twins

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2
Q

What is graft rejection mediated by?

A

Adaptive immune response

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3
Q

What molecules are essential in organ transplants?

A

MHC/HLA in humans. Must recognize transplant as “self”

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4
Q

Type AA and OA blood antibodies and antigens?

A

Type A antigen, Anti-B antibodies

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5
Q

Type BB or BO blood antibodies and antigens?

A

Type B antigen, anti-A antibodies

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6
Q

Type AB blood antibodies and antigens?

A

A and B antigen, no antibodies

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7
Q

Type OO blood antibodies and antigens?

A

No antigens, Anti-A and Anti-B antibodies

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8
Q

What antigen do you have if you are Rh Positive?

A

D antigen

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9
Q

What Rh factor do we consider for blood transfusions?

A

RhD

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10
Q

What antigen do you have if you are Rh positive

A

You do not have the D antigen, but you use IgG antibody to fight D antigen.

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11
Q

When does agglutination occur to determine blood type?

A

When the antibody is used which will agglutinate with the corresponding antigen. EX: anti-B antibody with agglutinate with B antigen (BB or OB blood type).

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12
Q

When can you have a Rh factor exposure?

A

Pregnancy and transfusion.

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13
Q

What are the major antigen targets of rejection?

A

The MHC and HLA

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14
Q

What differentiates the two classes of HLA antigens?

A

Class I–found on all nucleated cells
Class II–found only on APC

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15
Q

What type of lymphocytes are the main reason for rejection?

A

Activation of T cells

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16
Q

What is suppressive therapy?

A

Drugs used to inhibit immune responses that contribute to rejection.

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17
Q

What are the three types of rejection?

A
  1. antibody-mediated (hyperacute and acute)
  2. cell-mediated (acute)
  3. chronic rejection (chronic)
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18
Q

What are the symptoms of rejection?

A

-General discomfort, uneasiness, or ill feeling
-flu-like symptoms including chills, body aches, nausea, cough, and shortness of breath
-symptoms depend on transplanted organ
ex: high blood sugar with pancreas transplant

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19
Q

How long does it take for antibody-mediated rejection to take place?

A

immediately–within minutes

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20
Q

Another name for antibody-mediated rejection

A

hyperacute rejection

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21
Q

What happens during antibody-mediated rejection?

A

-complement is activated
-cellular damage to endothelium and microvasculature
-vascular thrombosis

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22
Q

What type of reaction is seen with ABO blood type incompatability?

A

Hyperacute–antibody-mediated

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23
Q

How long does it take for acute rejection to take place?

A

Occurs within the first week and can last for several weeks

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24
Q

What is another name for acute rejection?

A

T cell mediated or antibody (B cell) mediated

25
Q

What is the most common type of acute rejection?

A

T cell mediated

26
Q

What happens during t cell mediated rejection?

A

APCs present donor alloantigens (foreign antigens on MHC molecules) to host T lymphocytes

27
Q

What is direct pathway T cell activation?

A

If the APCs are from the donor in t cell mediated rejection.

28
Q

What is indirect pathway T cell activation?

A

If APCs are from recipient in t cell mediated rejection. this one can last longer

29
Q

What happens to CD8+ t cells in t cell mediated rejection?

A

CD8+ recognized MHC I molecules then differentiate into mature CTLs and CTLs directly kill graft tissue.

30
Q

What happens to CD4+ t cells in t cell mediated rejection?

A

CD4+ recognize MHC II then differentiate into t-helper effector cells (TH1 or TH2). The effector cells secrete cytokines that influence other immune cells which all lead to graft injury.

31
Q

What is another name for antibody mediated acute rejection?

A

Humoral rejection

32
Q

What happens during antibody- mediated acute rejection?

A

Occurs as a result of B lymphocyte proliferation followed by differentiation into plasma cells. Plasma cells produce donor-specific antibodies (DSAs) NOT FINISHED

33
Q

How long does it take for immune-mediated inflammatory injury to take place?

A

Occurs over YEARS

34
Q

What is another name for chronic rejection?

A

Immune-mediated inflammatory injury

35
Q

Why does immune mediated inflammatory injury take place?

A

Inadequate immunosuppression

36
Q

What happens to the body as a result of immune mediated inflammatory injury?

A

Fibrosis, vascular injury, loss of graft function. Eventually results in endothelial smooth muscle thickening and arterial occlusion.

37
Q

What are the three fundamental requirements for development of GVHD (graft vs. host disease)?

A
  1. graft must contain immunologically competent cells
  2. Recipient cells must express antigens that are not present on donor cells
  3. recipient must be immunologically compromised and incapable of mounting an effective immune response.
38
Q

What percentage of graft recipients can develops signs of GVHD?

A

40%

39
Q

What types of rejection can occur as a result of GVHD?

A

acute and chronic

40
Q

Within how many days does GVHD typically occur?

A

the first 100 days of transplantation

41
Q

What three organ systems/organs does GVHD affect?

A
  1. GI
  2. Skin
  3. Liver
42
Q

How can we prevent graft rejection?

A

Immunosuppression drugs to inhibit T cell activation

43
Q

What type of rejection does not typically respond to immunosuppressive medications?

A

Chronic rejection

44
Q

What is autoimmunity?

A

The body’s immune system failing to differentiate from self and nonself

45
Q

What is self-tolerance?

A

The immune system differentiating self from nonself

46
Q

What are the two types of self tolerance?

A

Central and peripheral tolerance

47
Q

What is central tolerance?

A

eliminating autoreactive lymphocytes during maturation in the central lymphoid tissues

48
Q

What is peripheral tolerance?

A

functional suppression of autoreactive lymphocytes that escaped destruction in the thymus and are circulating in peripheral tissues.

49
Q

What contributes to autoimmune disorders?

A

loss of self-tolerance, genetic, and environmental factors

50
Q

What are said to be the principal factor of autoimmunity?

A

inheritance of susceptibility genes and environmental triggers, such as infections

51
Q

What is T-cell anergy?

A

an antigen-specific T cell cannot respond to an appropriate stimulus due to reduced function

52
Q

What is the release of sequestered antigens?

A

hidden self-antigens that are reintroduced to the immune system

53
Q

What is molecular mimicry?

A

similarities between foreign and self-antigens trigger an immune response against auto-antigens

54
Q

What are superantigen formations?

A

family of substances (staphylococcal and streptococcal exotoxins) that activate T lymphocytes leading to fever, shock, and death

55
Q

What are the two types of hypersensitivity reactions?

A

Aberrant (wrong) immune response and excessive immune response.

56
Q

What is the type I hypersensitivity reaction?

A

IgE mediated (allergy)

57
Q

What is the type II hypersensitivity reaction?

A

antibody-mediated (B cells)

58
Q

What is the type III hypersensitivity reaction?

A

complement-mediated (proteins and MHC)

59
Q

What is the type IV hypersensitivity reaction?

A

T cell mediated (CD8 or CD4 cells)

MOD (2 decks)

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