Unit 4 sections 1-2

Question 1

Anaphylaxis

Answer 1

Most severe type of allergic response; systemic release of histamine; depends on route of exposure, dosage and frequency of exposure

Question 2

What intercellular changes occur when IgE binds to antigen? What are 3 mediators?

Answer 2

Degranulation of mast cell with IgE on surface, release of histamine and other mediators; histamine, heparin, Eosinophil chemotactic factor of anaphylaxis (ECF-A), Neutrophil chemotactic factor, proteases, Platelet activating factor (PAF), Prostaglandin D2 (PGD2), Leukotrienes and cytokines

Question 3

What is the difference between immediate and delayed sensitivity?

Answer 3

seconds to minutes between exposure to antigen and onset of clinical symptoms

several hours to develop symptoms

Question 4

What are the most common testing for immediate hypersensitivity?

Answer 4

Direct skin testing
Microarray

Screening tests-RIST and RAST
AB ID
Direct/Indirect Coombs for Type 2
Agglutination runs for Type 3

Question 5

Category 1 Immunodeficiency name and general defect

Answer 5

Combined immunodeficiency; defect in cellular AND humoral

Question 6

Category 2 Immunodeficiency name and general defect

Answer 6

Combined Immunodeficiencies with associated or syndromic features; Defects in cell mediated immunity with effects on humoral and nonimmunologic problems

Question 7

Category 3 Immunodeficiency name and general defect

Answer 7

Predominantly Ab deficiencies; Antibody defects

Question 8

Category 5 Immunodeficiency name and general defect

Answer 8

Congenital defects of phagocytic number and/or function; phagocyte ability defect

Question 9

Category 8 Immunodeficiency name and general defect

Answer 9

Compelement deficiencies; defects affecting complement pathway

Question 10

Ataxia-Telangiectasia: Defect and lab findings

Answer 10

2; Gene defect 11q22 (AR); IgM inc, T cells dec; variable dec: IgG2 IgA and IgE

Question 11

Bruton’s tyrosine kinase deficiency: Defect and lab findings

Answer 11

3; Tyrosine kinase deficiency in pro-B cell stage leads to lack of mature B cells (XL); No B cells or immunoglobulins

Question 12

Chronic Granulomatous Disease: Defect and lab findings

Answer 12

5: abnormal neutrophil phagocytosis due to NADPH oxidase issue; immunoglobulin, neutrophil and WBC inc, sometime RBC dec

Question 13

Common variable Immunodeficiency (CVI): Defect and lab findings

Answer 13

3; B cells can’t produce IgA/G enough; IgA and IgG dec.

Question 14

Complement Deficiencies: Defect and lab findings

Answer 14

8; Deficiencies in C1q, C4 and C2*, C5-9 (AR); Complement dec.

Question 15

DiGeorge anomoly: Defect and lab findings

Answer 15

2; Thymic problems during embryo development leads to low T cells; Low T cell count

Question 16

Glucose-6-Phosphate Dehydrogenase Deficiency: Defect and lab findings

Answer 16

5; Inability to generate enough NADPH leads to defect in hydrogen peroxide production (Enzyme deficiency); G6P Dehydrogenase dec, anemia

Question 17

Graft vs. Host Disease: Defect and lab findings

Answer 17

2; defect in T cell system allows donor lymphocytes to take over; CBC (WBC) inc, liver function test, serum electrolytes

Question 18

IgA deficiency: Defect and lab findings

Answer 18

3: Low number of B cells that can’t produce IgA; B cell and IgA dec.

Question 19

IgG subclass deficiency: Defect and lab findings

Answer 19

3; abnormal distribution of IgG subclasses; IgG dec or specific subclass dec. only

Question 20

Myeloperoxidase deficiency: Defect and lab findings

Answer 20

5; Deficiency of myeloperoxidase; Enzyme dec., In MP stain, no red in neutrophils

Question 21

Severe Combined Immunodeficiency (SCID): Defect and lab findings

Answer 21

1; No T cells with some w/B some w/o B; T-B+-NK+-, if no B cells, degreased Ig

Question 22

Wiskott-Aldrich syndrome (WAS): Defect and lab findings

Answer 22

2; Antigen processing defect (XL) WAS protein CD43; IgM and T cells dec. , small/low number of platelets

Question 23

Type 1 Hypersensitivity: Mediator and Immune mechanism

Answer 23

IgE; cell bound IgE due to sensitization reacts with antigen then release cytokines and other chemicals

Question 24

Type 1 Hypersensitivity: Disease example and tests to ID

Answer 24

Food allergies; Direct skin testing, Total IgE or Ag specific measurement, Screening test: total-RIST and specific-RAST, Microarray

Question 25

Type 2 Hypersensitivity: Mediator and Immune mechanism

Answer 25

IgG/IgM; free antibody reacts Ag on cell surface

Question 26

Type 2 Hypersensitivity: Disease example and tests to ID

Answer 26

Transfusion run, Hemolytic disease, Hashimotos, Graves, Type 1 Diabetes; Direct/Indirect Coombs, Ab ID:TPO and anti-MuSK

Question 27

Type 3 Hypersensitivity: Mediator and Immune mechanism

Answer 27

IgG/IgM; Ab and Ag react to form complexes that precipitate in the tissues, bind complement

Question 28

Type 3 Hypersensitivity: Disease example and tests to ID

Answer 28

SLE, RA; Agglutination rxns (RBC/latex), EIA (Ab ID), Histologic, Complement levels

Question 29

Type 4 Hypersensitivity: Mediator and Immune mechanism

Answer 29

T cell; Hapten binds to carrier protein, the complex is engulfed by APC, MHC II receptor produced to react with T cell, subsequent exposure cause T cell to release cytokines

Question 30

Type 4 Hypersensitivity: Disease example and tests to ID

Answer 30

Poison ivy/oak, TB, Herpes, allograft rejection; Skin test, PPD test (TB), chest Xray (TB), Biopsy