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Immunology > TYPE II HYPERSENSITIVITY > Flashcards

TYPE II HYPERSENSITIVITY Flashcards

1
Q

Examples of type 2 hyper

A

Hemolytic anemia of newborns
Penicillin induced anemia.
Some autoimmune diseases
Blood transfusion reactions

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2
Q

Type 2 hyper is caused by

A

Type II: destruction of normal tissue (cells) by antibody (IgG or IgM)

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3
Q

When and why are transfusions performed?

A

When extreme blood loss is noted and a PCV is below 12

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4
Q

Risk of reaction to a first transfusion?

A

Species dependent
Many species minimal risk to FIRST transfusion

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5
Q

What may vet techs do for transfusions

A

Collect blood.
Minimize risk of reaction (blood type and cross match)
Administer the transfusion.
Monitor the transfusion

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6
Q

ACD solution is

A

Acid Citrate dextrose
This is an anticoagulant and energy source
Human blood collection packs (ready to go)
Sigma Chemical Co

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7
Q

Blood group antigens are

A

The molecules expressed on the surface of RBC’s are called blood group antigens.
Not involved in antigen processing
Name often starts with a species code and EA (Erythrocyte Antigen)
Followed by letter or number denoting order of discovery.

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8
Q

Transfusion reactions can happen because

A

Recipient may contain pre-existing antibodies as a result of previous exposure:
To blood- prior transfusions or pregnancies
To similar antigens through diet
Vaccinations – some contain animal tissue.
Dietary risk is species dependent.
Cattle

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9
Q

Mechanism by which blood transfusion reactions occur

A

Significant clinical signs if infused with large amounts of incompatible blood into a sensitized patient.
Mechanism: pre-existing antibody binds to erythrocyte antigens
Agglutination
Opsonization
Complement activation results in:
Hemolysis
Free hemoglobin can damage the kidneys.
Anaphylatoxin and mast cell degranulation

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10
Q

Prevention of transfusion reactions

A

Major and minor cross mach

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11
Q

Minor cross match uses

A

Donor serum and patient RBC

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12
Q

Major cross match is

A

Most important is donor RBCs with patients serum
Major cross match
Look for:
Lysis
Agglutination

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13
Q

Mild to moderate transfusion reaction

A

Sweating, salivating, diarrhea, vomiting
Increased RR or HR
Fever

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14
Q

Severe transfusion reaction

A

Shock
Weakness
Hypertension
Hypotension
Tachycardia
Bradycardia
Tachypnea
Dyspnea
DIC
Collapse
Death (Arrhythmia or apnea)

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15
Q

What to do if a transfusion reaction occurs

A

STOP the transfusion
ALERT the DVM
Maintain urine production.
IV fluids and diuretics
Medications
Diphenhydramine
+/- Epinephrine

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16
Q

Recovery phase after. a transfusion reactions

A

Hemoglobin eventually converted to bilirubin.
Icterus of mucosae and sclera
What color is icterus?
Yellow

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17
Q

Blood transfusion in cattle

A

MANY blood types.
Used to check parentage
Transfusions are usually incompatible.
So many different blood types
Some cattle have performed Ab against foreign RBC antigens.
Antibody seen in cattle that have had no previous blood transfusions.
Due to dietary antigens?
First transfusion last days to a week
Repeated transfusions – shorter life of RBCs

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18
Q

DEA 1 in dogs is

A

DEA 1 is a strong antigen.
Causes the most significant problems
Several laboratories make a card test to detect this Ag.
DEA 1.1 subgroup is the major concern within DEA 1 dogs.

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19
Q

Blood in dogs

A

No preformed antibody against foreign antigens
Many RBC antigens

20
Q

DEA 1.1 is what type of donor

A

So, DEA 1.1 positive dogs are Universal Recipients
DEA 1.1 negative dogs are Universal Donors

21
Q

Transfusing a DEA 1.1 negative dog with positive blood leads to:

A

First transfusion is “free”
Means no antibody present at first transfusion
Transfusion reactions on subsequent transfusions
Potential problems in puppies if pregnant (neonatal isoerythrolysis)
Recommended that always cross match on subsequent transfusions and in breeding bitches

22
Q

Problems on first transfusion prevented by testing for strong antigens

A

yes

23
Q

On subsequent transfusions prevented by testing for strong antigens

A

Yes
Small risk of incompatibilities form minor antigens

24
Q

Does cross matching first transfusion prevent problems on the first transfusion

A

Yes

25
Q

Does cross matching first transfusion prevent problems on subsequent transfusions

A

No
Maybe incompatible on second transfusion even though compatible first

26
Q

Transfusions in horses

A

Many blood groups but only 2 are important.
No preformed antibody
Unless previously exposed to antigenic RBCs
Sensitization through vaccination?

27
Q

Risk of reactions for blood transfusions in horses

A

Like dogs
Except multiparous pregnant mares have a higher risk

28
Q

Three blood types for cats

A

A, B and AB
99% of DSH and DLH cats in North America are type A
Type B is more prevalent in some Pure Breeds
Type AB is rare - <1-6%
Siamese and Burmese
All type A
Exotics, British Shorthair, Cornish Rex and Devon Rex
Up to 60% Type B
UK cats, 40% are Type A, 60% Type B

29
Q

What antibodies do type B cats posses

A

Most type B cats posses IgM against Type A antigens
Even though no previous transfusions
Why?
Alloantibodies

30
Q

Transfusions in cats

A

RBC half-life of 4-5 weeks with a donor and recipient match
If Type B blood is transfused into a Type A cat, RBC half-life is only a few days.
Type A blood to a Type B cat, RBC half-life of 1 hr
Low risk for north American domestic cats

31
Q

Neonatal Isoerythrolysis is

A

Also called hemolytic disease of newborn
Result of ingesting colostrum with antibody against neonate’s RBCs
Only a common problem in horses and mules
Occasional problem in cats, dogs, pigs, and sheep
Rare in cattle

32
Q

Neonatal Isoerythrolysis occurs when in horses

A

Stallion has different blood group (antigens) than mare - foal inherits some of these antigens.
Aa, Qa antigens cause most problems -90% of cases
Dam is sensitised
Leakage of foal blood due to placental bleeding or at parturition
Another possible cause?
Previous transfusion
Foal must ingest colostrum

33
Q

Who is most likley to get Neonatal Isoerythrolysis

A

Especially thoroughbred and standardbred mares that have had several foals
0.05-2% of foals affected
Mules

34
Q

Mules are

A

What is a mule?
An interspecies cross (Donkey stallion X Mare)
Large genetic differences
8-10% of foals affected with Neonatal Isoerythrolysis

35
Q

Signs of Neonatal Isoerythrolysis

A

The signs of hemolytic anemia
Mucous membranes
Pale (initial)
Icteric later
Possibly hemoglobinuria - diagnostic
Weakness, lethargy, possibly shock and death.

36
Q

Treatment of Neonatal Isoerythrolysis

A

Prevent or stop colostrum ingestion.
For at least 36h
Ideally, feed colostrum from another mare.
Alternative?
Can give serum from an unrelated horse
Oxygen, fluid and electrolytes, antimicrobials
Blood transfusion if PCV <15%
Convenient source is washed RBCs from dam
Can perform by letting RBC settle by gravity.

37
Q

Tests for Neonatal Isoerythrolysis

A

PCV Mild
-Hct = 0.15 to 0.24 L/L or PCV = 15-25%
PCV Severe <15%
Jaundiced Foal Agglutination Test
Mares’ colostrum is combined with foal’s RBCs.
Positive agglutination test
Test mares blood during pregnancy for rising titers of antibodies against Aa or Qa antigens

38
Q

Neonatal Isoerythrolysis in cats is Cats

A

One of the causes of “fading kitten syndrome”
Rare in north america
More common in the UK
Most likely to be seen when a blood Type B queen is mated with a blood Type A Tom

39
Q

Neonatal Isoerythrolysis in Cats is caused by what queen and tom blood types

A

Blood Type B Queen x Blood Type A Tom
Type A is dominant.
Queen will be genotype bb
Tom will be genotype aa or ab
So, offspring will be:
If Tom aa
All kittens will be ab (type A)
If Tom ab
Kittens will be ab (type A) or bb (type B)

40
Q

What cats would get Neonatal Isoerythrolysis

A

Blood group A offspring at risk of neonatal isoerythrolysis from anti-A antibody in the colostrum
Chance of disease is small if blood Type A Queen and Type B Tom
Blood type A cats have less preformed anti-B antibody

41
Q

Clinical signs of Neonatal Isoerythrolysis

A

Anemia, icterus, weakness, hemoglobinuria

42
Q

Type II drug hypersensitivities

A

Drug or its breakdown products bind to cells making them appear foreign (antigenic)
Example penicillin associated hemolytic anemia.
Rare, seen occasionally in horses.
Vaccines grown on tissue.
Cattle killed BVD vaccine grown on kidney cells
Contained potent adjuvant.
Stimulated anti-MHC Ab production.
Transferred to calves in colostrum and caused pancytopenia

43
Q

In which species is a first blood transfusion likely to be successful even if there is no cross matching?

A

Dogs, horses

44
Q

Define Type II hypersensitivity.

A

IgG/IgM antibody attacking normal tissue

45
Q

Why might a 1-day old foal be severely anemic?

A

Neonatal isoerythrolysis

46
Q

ACD solution has the following formula:

A

Trisodium citrate 22.0g
Citric acid (monohydrate) 8.0g
Dextrose (monohydrate) 24.6g
Distilled water to make up to IL
For each 100 ml of blood, need 15 ml of the ACD solution (pH 5.0)

47
Q

Jaundiced Foal Agglutination Test is

A

Mares colostrum is combined with foals RBCs
Positive agglutination test when neonatal isoerythrolysis

Immunology (21 decks)

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