Robbins Chapter 6 Tables Flashcards by Stephanie Wehbe

Immediate (Type I) hypersens. immune mechanism

Production of IgE to release vasoactive amines and mast cells

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Immediate (Type I) hypersens. histopathologic lesions (6)

vascular dilation, edema, smooth muscle contraction, mucus production, tissue injury, inflammation

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Immediate (Type I) hypersens. prototypical disorders (3)

anaphylaxis, allergies, bronchial asthma

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Antibody-mediates (Type II) hypersens. immune mechanism

production of IgG and IgM
binds to antigen on cell or tissue
phagocytosis or lysis of target cell by complement or Fc receptor
recruit leukocytes

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Antibody-mediates (Type II) hypersens. histopathologic lesions (4)

phagocytosis, lysis of cells, inflammation, potentially no tissue injury

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Antibody-mediates (Type II) hypersens. prototypical disorders (2)

autoimmune hemolytic anemia, goodpasture syndrome

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Immune complex-mediated (type III) hypersens. immune mechanism

deposition of antigen-antibody complexes
complement activation
recruitment of leukocytes by complement products
release enzymes and toxic molecules

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Antibody-mediated (Type II) hypersens. histopathologic lesions (2)

inflammation, necrotizing vasculitis (fibrinoid necrosis)

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Antibody-mediates (Type II) hypersens. prototypical disorders (3)

systemic lupus erythematosus, serum sickness, arthus reaction

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Cell-mediated (Type IV) hypersens. immune mechanism

activated T lymphocytes
release of cytokines
inflammation and macrophage activation
T cell-mediated cytotoxicity

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Cell-mediated (Type IV) hypersens. histopathologic lesion (4)

perivascular cellular infiltrates, edema, granuloma formation, cell destruction

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Cell-mediated (Type IV) hypersens. prototypical disorders (4)

contact dermatitis, multiple sclerosis, type 1 diabetes, tuberculosis

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Immediate Hypersensitivity Examples (4)

Anaphylaxis, bronchial asthma, allergic rhinitis, food allergies

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Clinical and Pathologic Manifestations of Anaphylaxis

fall in blood pressure (shock) caused by vascular dilation, airway obstruction due to laryngeal edema

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Clinical and Pathologic Manifestations of bronchial asthma

airway obstruction caused by bronchial smooth muscle hyperactivity, inflammations and tissue injury caused by late-phase reaction

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Clinical and Pathologic Manifestations of allergic rhinitis, sinusitis (hay fever)

increased mucus secretion, inflammation of upper airways, sinuses

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Clinical and Pathologic Manifestations of Food allergies

increased peristalsis due to contraction of intestinal muscles

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Autoimmune hemolytic anemia

target antigen: red cell membrane proteins
mechanism of disease: opsonization and phagocytosis of red cells
manifestation: hemolysis, anemia

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Autoimmune thrombocytopenia purpura

target antigen: platelet membrane proteins
mechanism of disease: opsonization and phagocytosis of platelets
manifestation: bleeding

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Pemphigus vulgaris

target antigen: proteins in intercellular junctions of epidermal cells
mechanism of disease: antibody-mediated activation of proteases, disruption of intercellular adhesions
manifestation: skin vesicles (bullae)

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Vasculitis cause by ANCA

target antigen: neutrophil granule proteins
mechanism of disease: neutrophil degranulation and inflammation
manifestation: vasculitis

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Goodpasture syndrome

target antigen: noncollagenous protein in basement membrane of kidney and lung
mechanism of disease: complement and Fc receptor mediated inflammation
manifestation: nephritis, lung hemorrhage

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Acute Rheumatic fever

target antigen: streptococcal cell wall antigen
mechanism of disease: inflammation, macrophage activation
manifestation: myocarditis, arthritis

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Myasthenia gravis

target antigen: Ach receptor
mechanism of disease: antibody inhibits Ach binding, down modulates receptors
manifestation: muscle weakness, paralysis

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Graves disease (hyperthyroidism)

target antigen: TSH receptor mechanism of disease: antibody-mediated stimulation of TSH receptors manifestation: Hyperthyroidism

Insulin-resistant diabetes

target antigen: insulin receptor mechanism of disease: antibody inhibits binding of insulin manifestation: hyperglycemia, ketoacidosis

Pernicious anemia

target antigen: intrinsic factor of gastric parietal cells mechanism of disease: neutralization of intrinsic factor manifestation: anemia and abnormal erythropoiesis

Systemic Lupus Erythematosus

antigen involved: nuclear antigens | manifestations: nephritis, skin lesions, arthritis

Poststreptococcal glomerulonephritis

antigen involved: streptococcal cell wall antigens | manifestations: nephritis

Polyarteritis nodosa

antigen involved: Hepatitis B virus | manifestations: systemic vasculitis

Reactive arthritis

antigen involved: bacterial antigen | manifestations: acute arthritis

Serum Sickness

antigen involved: proteins | manifestations: arthritis, vasculitis, nephritis

T Cell-Mediated Diseases (6)

``` Rheumatoid arthritis Multiple Sclerosis Type 1 Diabetes Mellitus Inflammatory Bowel Disease Psoriasis Contact Sensitivity ```

Rheumatoid arthritis

Specificity: collagen Mechanism of tissue injury: Th17 Manifestations: chronic arthritis with inflammation

Multiple Sclerosis

Specificity: myelin Mechanism of tissue injury: Th1 and Th17 Manifestations: demyelination in CNS and paralysis

Type 1 Diabetes

Specificity: panceatic islet b cells Mechanism of tissue injury: T cell mediated inflammation, destruction by CTLs Manifestations: Insulitis

Inflammatory Bowel Disease

Specificity: enteric bacteria Mechanism of tissue injury: Th1 and Th17 Manifestations: chronic intestinal inflammation and obstruction

Psoriasis

Mechanism of tissue injury: Th17 | Manifestations: destructive plaques in the skin

Contact sensitivity

Specificity: environmental chemicals ex. urushiol from poison ivy Mechanism of tissue injury: Th1 Manifestations: epidermal necrosis, dermal inflammation causing rash and blisters

Organ Specific Diseases Mediated by Antibodies (6)

``` Autoimmune hemolytic anemia Autoimmune thrombocytopenia Autoimmune atrophic gastritis of pernicious anemia Myasthenia gravis Graves Disease Goodpasture syndrome ```

Systemic Diseases Mediated by Antibodies (1)

Systemic Lupus Erythematosus

Organ Specific Diseases Mediated by T Cells (2)

Type 1 Diabetes | Multiple Sclerosis

Systemic Diseases Mediated by T cells (2)

Rheumatoid Arthritis | Systemic Sclerosis

Organ Specific Diseases Autoimmune (1)

Inflammatory Bowel Diseases (Crohns)

Criteria for Classification of Systemic Lupus Erythematosus (11)

``` Malar rash Discoid rash Photosensitivity Oral Ulcers Arthritis Serositis Renal Disorder Neurologic disorder Hematologic disorder Immunologic disorder Antinuclear antibody ```

Leukocyte adhesion deficiency 1

defective leukocyte adhesion | mutation in b chain of CD11/CD18 integrins

Leukocyte adhesion deficiency 2

defective leukocyte adhesion | mutation in fucosyl transferase required for sialyl-lewis-X

What is the defect in Chediak-Higashi syndrome

decreased leukocyte functions | mutations affecting protein involved in lysosomal membrane traffic

What is the defect in chronic granulomatous disease

decreased oxidative burst

X linked defect in leukocyte function

phaogocyte oxidase (membrane component)

Autosomal recessive defect in leukocyte function

phagocyte oxidase (cytoplasmic component)

Myeloperoxidase deficiency defect in leukocyte function

decreased microbial killing because of defect MPO-H2O2 system

C2 and C4 deficiency

defective classical pathway activation reduced resistance to infection reduced clearance of immune complexes

C3 deficiency

defects in all complement functions

Deficiency of complement regulatory proteins

excessive complement activation

Human immunodeficiency virus infection

secondary (acquired) immunodeficiency | depletion of CD4+ helper T cells

Irradiation and chemotherapy treatments for cancer

secondary (acquired) immunodeficiency | decreased bone marrow precursors for all leukocytes

Involvement of bone marrow by cancers

secondary (acquired) immunodeficiency | reduced site of leukocyte development

Protein-calorie malnutrition

secondary (acquired) immunodeficiency | metabolic derangements inhibit lymphocyte maturation and function

Removal of Spleen

secondary (acquired) immunodeficiency | decreased phagocytosis of microbes