Immunopathology I Mechanisms- Friedlander

Question 1

what is the one thing that seems to help older folks’ immune responses?

Answer 1

physical exercise

Question 2

what are haptens?

Answer 2

atoms or little molecules that bind to some body protein

Question 3

what cells are the basis of adaptive immunity?

Answer 3

B and T lymphocytes, specific and diverse receptors to deal with a particular antigen we may encounter

Question 4

what kind of stain identifies NK cells?

Answer 4

CD 57

Question 5

what is the architecture of a lymph node?

Answer 5

cortex: B cells
medulla: T cells

Question 6

Where do B cells mature?

Answer 6

germinal follicles of lymph nodes

Question 7

what does it mean when a lymph node is swollen in our necks?

Answer 7

B cells are proliferating

Question 8

where are plasma cells most often found?

Answer 8

mostly in tissues rather than blood

Question 9

what is the appearance of plasma cells?

Answer 9

soccer ball nucleus

Question 10

what does the term hypersensitivity mean?

Answer 10

disease caused by the immune system itself harming the body

Question 11

type 1 hypersensitivity is an inappropriate function of what system?

Answer 11

Th2/IgE/mast cell/eosinophil system

Question 12

what chemical(s) play a role in type 1 IMMEDIATE immune injury? fxn?

Answer 12

*histamine: vasodilation and leakage (this is what Kenna talked about)
leukotrienes: contract smooth m. and leakage
PGD2: bronchospasm and mucus production

Question 13

what is the most important eosinophil attractant/activator?

Answer 13

IL-5

Question 14

what is Urticaria and what is often due to?

Answer 14

hives due to IgE/type 1 immune injury

Question 15

what chemical causes DELAYED Type 1 HS?

Answer 15

Leukotrienes

Question 16

what is allergic rhinitis?

Answer 16

“hay fever” sneezing, itchy, due to airborne antigens (pollen, dust, mites, animal dander)

Question 17

what is allergic asthma?

Answer 17

bronchoconstriction from inhaled allergen; IgE, lots of Eosinophils, plugs airways and remodels them

Question 18

what is anaphylaxis?

Answer 18

life threatening emergency (massive IgE response)

Question 19

What is anaphylactic shock? tx?

Answer 19

entire vascular bed opens and leaks, BP drops catastrophically; Tx= Epi

Question 20

what should you think with eosinophilic gastroenteritis?

Answer 20

food allergy

Question 21

what is atopic dermatitis? looks like (where)? due to? tx?

Answer 21

Eczema, cracks and red spots in creases of elbows, knees; d/t: food allergies, Fc linkage on dendritic macrophages; tx= corticosteroids

Question 22

what are the 3 kinds of urticaria?

Answer 22

1. cold: decrease temp causes degranulation
2. chronic: autoimmunity, food, unknown
3. cholinergic: heat-induced post shower or exercise

Question 23

what type of rxn is Type 2 HS?

Answer 23

antibody mediated IgG or IgM bind to Ag on cells/within tissue and cause cell destruction

Question 24

what are the 3 mechanisms that destroy anti-body coated cell?

Answer 24

1. opsonization: IgG coated cells phagocytosed
2. complement mediated lysis
3. Ab dependent cell mediated cytotoxicity (Thelper cells)

Question 25

how do you test for a type 2 rxn?

Answer 25

Direct Coomb's test; pt's blood with anti-IgG Coomb's reagent, will agglutinate for positive Abs

Question 26

what is goodpasture's dz caused by?

Answer 26

Abs against basement membrane of lung and kidney

Question 27

what is Issac's dz?

Answer 27

Abs keep nerves firing m. all the time

Question 28

what is type 3 HS rxn?

Answer 28

deposition of circulating Ab-Ag complexes into tissue

Question 29

what are the conditions needed for complexes to occur?

Answer 29

Ag must equal Ab

Question 30

where do complexes most often deposit? pathophysiology that follows?

Answer 30

intima of blood vessels; activates complement, attracts neutrophils, release lysosomal enzymes

Question 31

what does type 3 HS produce?

Answer 31

vasculitis, artritis, and/or glomerulonephritis

Question 32

what is an Arthus rxn? example?

Answer 32

local formation of Ab-Ag complexes after intradermal injection of Ag; vaccine booster

Question 33

what is serum sickness?

Answer 33

rxn to proteins in antiserum derived from animal source; immune complexes form in which Ab to foreign proteins are produced

Question 34

what causes most serum sickness now?

Answer 34

drugs (not serum)

Question 35

SXS of Serum sickness?

Answer 35

5-10 days after exposure: fever, urticaria, arthralgias, proteinuria, lymphadenopathy

Question 36

what is the worst type of Type 3 HS rxn? looks like?

Answer 36

hyperacute transplant rejection: pt already has Ab against donor HLA, complexes plug blood supply to organ, turns white before surgeon's eyes

Question 37

what is a type 4 HS rxn?

Answer 37

t-helper mediated "delayed"; Th cells recognize "altered self" Ag, release cytokines, activate macrophages; cell-mediated, no Ab involved

Question 38

What is a true Type 4?

Answer 38

TB skin test

Question 39

what is the anergy test?

Answer 39

lots of little needs on a white thing, failure of skin to mount response, Th cells don't work

Question 40

what is an example of type 4 HS rxn?

Answer 40

contact dermatitis: happens change body protein, immune system reacts to change= allergy

Question 41

what are some of the autoimmune disorders caused by type 4 rxns?

Answer 41

MS, G-B Syndrome, Hashimoto's, vitiligo, halo nevus

Question 42

acute transplant reject occurs when? mediated how?

Answer 42

weeks to months; mediated cellularly (t cell) or humorally (b cells)

Question 43

chronic transplant reject occurs when?

Answer 43

in every transplant eventually but slowly, months to years,

Question 44

what happens in chronic rejection?

Answer 44

vessels narrow, initima is thickened, fibrosis

Question 45

when does graft v host dz most often occur (what kind of transplant)?

Answer 45

BMT OR immunosuppressed and has blood transfusion OR liver transplant

Question 46

what are the early signs of GVHD?

Answer 46

loss of epidermis, generalized rash, starts on palms, GI ulcers

Question 47

what are the later stages of GVHD? SXS?

Answer 47

after 100+ days, more fibrosis and less obvious necrosis | SXS: organ dysfxn, maculopaular rash, hemolysis/jaundice, HSM, diarrhea, N/V/abd. pain

Question 48

when someone has a viral infection what kind of HS rxn are they having?

Answer 48

Type 3; think flu

Question 49

what should we think of with anergy?

Answer 49

sarcoidosis, lymphoma, CA, HIV, measles, really bad disseminated infetions