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Intraocular Inflammation and Uveitis > Ocular Immunology > Flashcards

Ocular Immunology Flashcards

1
Q

name the compliment factor anaphylatoxins

A

C3a and C5a

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2
Q

What coats the pathogenic or antigenic cell surfaces to promote phagocytosis in the compliment pathway, and what is this called?

A

C3b. Opsonization

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3
Q

what is the membrane attack complex

A

complement-derrived complex that inserts into cell membranes to form pores inducing lysis

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4
Q

mechanism of action of corticosteroids

A

inhibit phospholipase A2, preventing the formation of arachidonic acid

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5
Q

mechanism of action of NSAIDs

A

inhibit cyclooxygenase, thereby preventing prostaglandin synthesis

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6
Q

what binds MHC class I molecules, and what types of pathology are generally controlled by this mechanism

A

CD8+ T-cells, which then kill tumor and virus-infected cells directly (cell-mediated immunity)

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7
Q

what binds MHC class II molecules, and what types of pathology are generally controlled by this mechanism

A

CD4+ T cells. phagocytosed bacterial and fungal components

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8
Q

role of CD4+ cells in humoral immunity

A

activation of B cells to switch from IgM to IgG, IgA, and IgE producing plasma cells

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9
Q

Types of hypersensitivity w/ examples

A

I: anaphylaxis / immediate hypersensitivity (allergic conjunctivitis)
II: cytotoxic antibodies (target antigens expressed on patient’s own cells; ex. myasthenia gravis, ABO incompatibility)
III: Immune complex reactions (SLE)
IV: delayed cell-mediated reactions (mediated by previously-primed CD4+ cells; PPD skin test, most uveitides)
V: stimulatory hyersensitivity (example = TED)

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10
Q

what differentiates the different subclasses of immunoglobulins

A

heavy chain moeties

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11
Q

Name the immunoglobulin(s) that:

  1. are strong compliment inducers
  2. is the primary immunoglobulin in mucosal secretions
  3. stimulates mast cell degranulation
A
  1. IgM and IgG3
  2. IgA
  3. IgE
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12
Q

what is a chronic Arthus reaction

A

antigenic persistence in tissues leading to chronic inflammatory reaction (may play a role in RA and other autoimmune diseases)

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13
Q

What is the Goldmann-Witmer coefficient? What value is significant?

A

ratio of antibody produced at a host site versus passively leaked from the blood. > 3 is significant

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14
Q

Antibodies to which virus have been indicated in Fuchs heterochromic uveitis?

A

Rubella

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15
Q

time frame for onset of Type IV hypersensitivity

A

12-48 hours

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16
Q

Uveitic example of Th1 and Th2 delayed hypersensitivity reactions?

A

Th1: sympathetic ophthalmia
Th2: toxocara (mediated by IL4, IL5, IgE)

17
Q

primary inflammatory cell in acute inflammation

18
Q

Inflammatory mediators most responsible for atopic keratoconjunctivitis?
For allergic conjunctivitis?

A

eosinophils

IgE and mast cells

19
Q

Is the compliment cascade is an example of innate or adaptive immunity?

20
Q

Most uveitis is cell-mediated or humoral?

A

cell mediated (mostly Th1)

21
Q

what subtype of inflammatory cells are Langerhans cells?

22
Q

Most common cause of hypopyon in general ophthalmology practice?

23
Q

Is Behcet’s uveitis classically a hot or a quiet eye?

24
Q

birdshot HLA?

25
Q

seronegative spondyloarthropathies HLA?

26
Q

predominant Th1 cell cytokines

A

IL2, IL6, TNF, IFN gamma

27
Q

IL 10 > IL 6 in vitreous tap?

A

lymphoma (not inflammation)

28
Q

predominant Th2 cell cytokines

A

IL4, IL5, IL10

29
Q

most abundant immunoglobulin in tear film?

30
Q

B cell maturation occurs in the ___

T cell “ “ “

A

bone marrow

thymus

31
Q

Immunoglobulin that:

  1. is largest
  2. represents the first immunoglobulin present in adaptive immune response
  3. crosses placenta
  4. is most abundant
A
  1. IgM
  2. IgM
  3. IgG (is smaller)
  4. IgG
32
Q

Where do conjunctival APCs migrate after being presented with a pathogenic antigen?

A

pre-auricular (lateral 2/3 of superior conj and lateral 1/3 inferior conj) and submandibular lymph nodes (medial 1/3 of superior and medial 2/3 of inferior conj)

33
Q

inflammatory mechanism for subepithelial infiltrates late in viral conjunctivitis?

A

delayed hypersensitivity response to viral antigens

34
Q

where are lymphatics in normal eye?

A

nowhere (immune privileged)

35
Q

What is anterior chamber associated immune deviation (ACAID)?

A

TGF-beta exposed, antigen-stimulated macrophages in iris migrate to the spleen and induce regulatory T lymphocytes to prevent delayed hypersensitivity in the eye (keeping it an immune privileged site)

36
Q

name the subtypes of the two major types of MHC families

A

MHC I: HLA-A, -B, and -C

MHC II: HLA-DR, -DP, -DQ

37
Q 
HLA associations for:
Birdshot
Seronegative spondyloarthropathies
TINU
Behcet
A

HLA-A29
HLA-B27
HLA-DRB1
HLA-B51

Intraocular Inflammation and Uveitis (7 decks)

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