Patho-Immune Flashcards
TYPE OF HYPERSENSITIVITY
Anaphylaxis
Bronchial asthma
Hay fever
Food allergies
I
Eosinophils
IL-5 fron TH2
TYPE OF HYPERSENSITIVITY
Myasthenia Gravis
Graves Disease
Acute Rheumatic fever
Goodpastures syndrome
II
C3b opsonization
NK cells and macrophage phagocytosis
C3a and C5a inflammation (anaphylatoxins)
TYPE OF HYPERSENSITIVITY
Pernicious anemia
ITP
Autoimmunoe hemolytic anemia
ANCA vasculitis
II
TYPE OF HYPERSENSITIVITY
Pemphigus vulgaris
Insulin resistant DN
II
TYPE OF HYPERSENSITIVITY
Arthus reaction
Reactive arthritis
III
Immune complex
Kidneys, joints, small blood vessels
TYPE OF HYPERSENSITIVITY
SLE
Serum sickness
III
TYPE OF HYPERSENSITIVITY
PSAGN
Polyarteritis nodosa
III
TYPE OF HYPERSENSITIVITY
Rheumatoid arthritis Psoriasis Multiple aclerosis Type I DM Inflammatory bowel disease Contact sensitivity
IV
CD4
IFNy from TH1
IL17 from TH17
CD8
Perforins>granzymes, cytotoxic t cells
Hallmark of SLE:
Best screening test:
Specific for SLE:
Lupus nephritis class:
Mesangial - I, II
Subendothelial- III (focal <50), IV (diffuse >50)
Subepithelial: V, VI (>90, sclerosis)
Autoantibodies
ANA
Anti-Sm and Anti-dsDNA
TRIAD
Keratoconjunctivitis sicca
Xerostomia
Arthritis
Most important and most commin autoantibodies detected?
Diagnostic:
Type of reaction:
SJOGREN SYNDROME
Tcell CD4
Lip biopsy
Anti-ro (ss-a) and Anti-la (ss-b)
Lymphocytic infiltration in glands > atrophy, fibrosis, hyalinization > may transform to lymphoma
Tx: pilocarpine, cevimeline
CREST Syndrome
Autoimmunity > chronic inflammation > damage to small blood vessels > perivascular fibrosis in skin and organs
Most notable antibodies:
SYSTEMIC SCLEROSIS / SCLERODERMA
Calcinosis Raynaud phenomenon Esophageal dysmotility Sclerodactyly Telangiectasia
diffuse: early visceral involvement, anti-DNA topoisomerase I (anti Scl70)
limited: late, anti centromere
Most common cause of death in scleroderma
Effecf in esophagus
Interstitial fibrosis
Rubber-hose-like inflexibility in esophagus
ALLORECOGNITION PATHWAYS
CD8 > Cytotoxic T cells
MHC Class I
Direct: Donor to recipient
ALLORECOGNITION PATHWAYS
CD4 > TH1 and TH17
MHC Class II
Direct
ALLORECOGNITION PATHWAYS
Recipient APC to donor organ
Indirect
ALLORECOGNITION
T cell mediated
Acute cellular rejection - tubules
Chronic rejection - interstitial fibrosis
Antibody mediated
Hyperacute rejection - bloody urine
Acute humoral rejection - glomerulous
Insufficient INTEGRINS
Leukocytes Stuck in vascular walls
Leukocyte Adhesion Deficiency
Impaired phagolysosome function
Neutrophils cannot merge with lysosome
Chediak-Higashi syndrome
Inherited defect jn microbicidal activity
Absent NADPH oxidase
Chronic granulomatous disease
TRIAD
Thrombocytopenia
Infections (Immunodeficiency)
Eczema
Depleted T cells in peripheral organs
WISKOTT-ALDRICH SYNDROME
Tx: HSC transplantation
Deletion of Ch22 or TBX1
Failure of development of 3rd and 4th pharyngeal pouches
Absent thymus
Decreased T cell lymphocytes
Susceptible to viral and fungal infections
CATCH 22
DIGEORGE SYNDROME
Cardiac anomalies Abnormal facies Thymic hypoplasia Cleft lip/palate Hypocalcemia Chromosome 22
X linked recessive
Poor maturation if B cells
Decreased immunoglobulins
Absent germinal centers in lymph nodes, peyer patches, tonsils, appendix, absent plasma cells
Common infections: H. Influenza, S. Pneumonia, S. Aureus, enterovirus, giardia
BRUTON AGAMMAGLOBULINEMIA
Ig replacement
Starch like misfolded proteins
Pressure atrophy on adjacent cells
Congo red on ordinary light
Apple green birefringence under polarized light (B sheet conformation)
AMYLOIDOSIS
most common and seriously affected organ: kidney
