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Immunology MLS > Test 2 > Flashcards

Test 2 Flashcards

1
Q

Hypersensitivity

A

Normal exaggerated immune response to an antigen

Produces inflammation, cell destruction, and/or tissue damage

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2
Q

Hypersensitivity types:

A

Humoral (antibody) response
(Immediate hypersensitivity )

Cell mediated response
(Delayed hypersensitivity)

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3
Q

Allergen

A

Molecule that triggers a hypersensitivity reaction

Ex: animal dander, pollen, food, molds, drugs

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4
Q

Atopy

A

Immediate hypersensitivity mediated by igE antibodies

*Used as allergy interchangeably *

Ex: hay fever, food allergies, latex sensitivity ,

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5
Q

Types of hypersensitivity reactions :

A

Types I - III are humoral mediated(immediate)

Type IV - cell mediated [delayed]

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6
Q

Environmental substances

A

Immediate hypersensitivity reaction (humoral) associated w/ igE such as Rhinitis or asthma happens

If dust stimulated igG antibody production, farmers lung can be triggered

If diffuse into skin and act as a hapten, contact dermatitis (delayed hypersensitivity ) occurs

Eosinophil levels in blood and nasal secretions elevated = igE normal /elevated

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7
Q

Drugs

A

Can provoke hypersensitivity reaction mediated by IgG, IgE, T lymphocytes

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8
Q

Metals

Ex: nickel , chemicals

A

Cause type I hypersensitivity [humoral (immediate)]

Chemicals act as a hapten and bind to proteins/MHC

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9
Q

Infectious agents

A

Influenza , cause cytokines storm (high secretions of cytokine) & dam age to epithelial cells in RT

Streptococci , cause immune complex disease

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10
Q

Food allergies

A

LEAST COMMON FORM OF TYPE I HYPERSENSITIVITY

ANAPHYLAXIS - systemic type 1 reaction ; can cause shock/edema

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11
Q

Types of type I hypersensitivity

A 
Metals 
Environmental substances 
Food allergies 
Drugs 
Infectious agents
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12
Q

Anaphylaxis reaction 3 stages :

A
  1. Antigen attaches to igE antibody on mast cells/basophiles
  2. Activated mast and basophils release mediators
  3. Effects of mediator release produce vascular changes and activation of platelets , eosinophils, neutrophils, and coagulation cascade
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13
Q

Anaphylactoid Reactions :

A

Not antigen-antibody mediated : substances act directly on mast cells or tissues, like anaphylotoxins of complement cascade [ C3a, C5a]

Direct chemical degranulation of mast cells may be cause [ infusion of macromolecules like proteins )

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14
Q

Atopic reaction

A

Exposure of skin,nose, or airway to an allergen produces specific ig antibodies

Exaggerated response by production of igE antibodies

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15
Q

The hallmark allergic disease

A

Infiltration of affected tissue by Th2 cells

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16
Q

Hypersensitivity reactions defined by

A

Principal mechanism responsible for cell tissue injury that occurs during immune response

17
Q

Type 1 hypersensitivity:

A

-immediate hypersensitivity (anaphylactic)
-Mast cells (tissue basophiles ) cellular receptors for igE ; contain HEPARIN IN 1:6 RATIO W/ HISTAMINE
- basis of an allergic reactions caused by molecules released by mast cells when an allergen interacts with MEMBRANE BOUND IGE
- SYMPTOMS SKIN REDNESS, SNEEZING , WHEEZING WITHIN MINUTES
- localized reaction - immediate response to mediators from mast cell degranulation
-Generalized reaction : mediators like cytokines and vasoactive amines (histamines ]
- atopic food allergy March in children : most SES @ 2 YEARS , decrease after 3 years
- testing : skin puncture test (SPT),
Increase in igE in serum indicates allergy disorder
Greater the igE antibody value, greater chance of symptoms

18
Q

IMUNNOCAP

A

Gold standard for allergen specific igE detection (in vitro)

19
Q

Treatments:

A

Immunotherapy (hyposensitization) : allergy shots 3-: montelukast for asthma airway inflammation

Desensitization: best for one allergy

20
Q

Mediators

A

Mediators of asthma and allergy formed by basophiles and released largely after stimulation w/ interleukin 3

Ex: Histamine
Leukotriene C4
Interleukin-4 & 13

Basophiles granulocytes(IL-3) are key effector cells in type 2 helper T (th2) cell responses ;

21
Q

Histamine

A

Contraction of blood vessels and increase capillary permeability and mucus secretion in airway

22
Q

Prostaglandins

A

Vasodilation and increased vascular permeability

23
Q

Leukotriens

A

Erythema and wheal formation

24
Q

Type 2 hypersensitivity

A
  • cytotoxic reactions due to IgG or igM antibodies directed to cell surface antigens
    3 Mechanisms :
    1.antibody dependent , complement mediated cytotoxic reactions - destruction of cell CYTOLYSIS
  • transfusion reactions
  • hemolytic Reactions
    2.ANTIBODY DEPENDENT , CELL MEIDATED CYTOTOXICTY
    3. Antireceptor antibodies - disturb natural function of receptors EX: HYPERACUTE GRAFT REJECTION
25
Q

Transfusion reactions

A

hemolytic reactions after antibody dependent , complement mediated cytotoxic reactions

Hemolytic - infusion of incompatible erythrocytes; (acute- immediate & most dangerous ) or 1 of 2 delayed reactions ( 7 to 10 days later, low RBC, anamnestic antibody response ) & associated w/ decreased RBC survival & anamnestic antibody response

Reactions occur w/ as little as 10 to 15 ml of incompatible blood ;

Symptoms:
fever and chills ; release of thromboplastic substances into circulation and induce disseminated vascular coagulation and acute renal failure

26
Q

Hemolytic disease of the fetus and newborn ( HDFN)

A

Excessive destruction of fetal RBCs by maternal antibodies ; jaundice or anemia

Most frequently ABO Incompatibility when mother is O and baby Is type a , sometime b

IgG, only immunoglobulin transported to fetus

*Transplacental hemorrhage TPH *
All RH negative pregnancies should receive rh IgG

27
Q

Autoimmune hemolytic anemia

A

Type 2 hypersensitivity reaction directed against self antigen on rbcs
Cold autoimmune hemolytic anemia(cold autoagglutinatins): usually igM ; 1/3 rd of cases ; best @ room temp.

Warm autoimmune hemolytic anemia:
IgG, most cases of autoimmune anemia; react best at 37 C

28
Q

Autoantibodies

A

Damage solid tissue components
Ex: Good pastures syndrome
Graves’ disease
Wegeners granulomatosis

29
Q

Type II hypersensitivity and antibodies

A

Antibodies stimulate target organ functions without causing organ damage
Wegeners granulomatosis - stimulation of cells lead to tissue damage
Prevention : check donor and recipient & immunization
Plasmapheresis - reduce # of antibody in patients circulating blood

30
Q

Type II reaction testing :

A

DAT ( direct antiglobulin test ) : detects AHG , IF POSITIVE repeated using monospecific anti IgG and anti C3 reagents

If there’s an autoimmune hemolytic anemia caused by igM , only C3d assay would be positive

Platlet agglutination if thrombocytopenic purpura suspected

31
Q

Type III Reactions

A

Immunecomplex reactions deposition of immune complexes into blood vessels walls/tissues

Circulating immune complexes ACTIVATE COMPLEMENT
Ex: glomerulonephritis n systemic lupus (SLE)

heart valves and renal glomeruli two sites where immune complexes are deposited

32
Q

Type III Reactions :

A 
Farmers Lung and Arthus reaction 
Glomerulonephritis 
SLE (systemic lupus erythematosus) - autoimmune disorder characterized by autoantibodies (glomerulonephritis develops) 
Serum sickness  
Autoimmune diseases
33
Q

Type III Reaction testing & treatment :

A

Specific assays
- quantitation of complement C3 and C4 components

Treatment : Avoidance of antigen and corticosteroids

34
Q

Type IV Reactions : DTH

A 
Cell mediated ( Delayed hypersensitivity )
Caused by soluble factors and lymphokines NOT antibody and complement
35
Q

DTH : Delayed type hypersensitivity

A

Can be a Physiological reaction to pathogens that are difficult to clear m most extreme DTH Reactions
Ex: mycobacterium tuberculosis & hepatitis B virus

Tumor necrosis factor-alpha (TNF-A) - STIMULATES MOST OF DANAGE IN DTH REACTIONS

HALLMARK EXAMPLE OF OCCUPATIONAL TYPE 4 HYPERSENSITIVITY = ALLERGIC CONTACT DERMATITIS

TUBERCULIN TYPE HYPERSENSITIVITY

36
Q

Type 4 Testing :

A

Skin test for TB
Reaction in people exposed or acquired TB microorganism. Doesn’t mean you have it

Tb antigen is injected intradermally ; obs. 48 - 72 hours

TREATMENT: AVOIDING ANTIGEN & ANTI-INFLAMMATORY DRUGS / corticosteroid

37
Q

HYPSERNSITIVTY : A.C.I.D.

A 
ACID 
A - ANAPHYLAXIS
C - cytotoxic
I- immunecomplex 
D- Delayed type hypersensitivity

Immunology MLS (1 decks)

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