10.04 Immunology, immune disorder and hypersensitivity disorder

Question 1

immunology overview

Answer 1

histocompatibility genes: inherited

transplant antigen: rejects transplant (HLA)

antigens and lymphocyte DNAs are developed after birth through genetic rearrangement

specificty of genes is inherited

Question 2

hypersensitivity type I

Answer 2

aka allergies

IgE: antibodies that increase vascular permeability to allow cells to enter the interstitium

especially mast cells (aka basophi in circulation) which secrete serotonin which in turn increase vascular permeability even more

Question 3

hypersensitivity type II

Answer 3

aka autoimmune or antibody-mediated

when antibody develops which attacks the body

sometimes, one’s own antigen is recognized as harmful

sometimes, imflammation stimulates it

if something foreign is deposited on the surface of cells or tissues, the immune response may damage the whole thing

hemolytic anemia: RBCs attacked because antigens attached to them

glomerulonephritis: base.memb is attacked. susceptible because of much filtering activities.

Question 4

hypersensitivity type III

Answer 4

aka immune complex-mediated

happens in mid-stage of infection

• when there is neither too much or too little antigens and antibodies >> forms immune complex
• moderately sized structure escape phgocytosis and deposit on glomerulus (glomerulonephritis) or circulate
• water-soluble so can be filtered but WBCs can’t be filtered.

Question 5

hypersensitivity type IV and V

Answer 5

Type IV (T-cell mediated)

Type V (making too much antibodies; e.g., thyroid autoimmune disease)

Question 6

immune deficiency overview

Answer 6

primary: inherited or innate
secondary: after birth of acquired

Question 7

DiGeorge syndrome

Answer 7

no t-cells

failure of thyroid development

parathyroid: regulate calcium level >> Ca decrease in DiGeorge >>bone problems and tetanic contraction (maximal muscle contraction; painful) >> problem with heart contraction (fatal)

Question 8

autoimmune and immune deficiency

Answer 8

if one part of immune system is missing or damaged, other parts try to make up for it, leading to over-activity

Question 9

amyloid

• definition
• plasma cytoma
• type II diabetes
• other dz
• systemic amyloid

Answer 9

• an abnormal protein structure produced when same sequence of polypeptides are overproduced
• plasma cytoma: produced by cancer cell. substance P (stabilizing protein) makes it worse. causes inflammation
• type II diabetes: increased insulin resistance >> insulin production increased >> amyloid
• anemia associated with amyloid deposits
• systemic: lots in blood >> filtered in kidney >> precipitates in urine when cooled (Bence-Jones proteins)

Question 10

Collagen vascular diseases

Answer 10

aka autoimmune or connective tissue disease

not disease of collagen, vasculature or connective tissue

Braverman signs: dilated blood vessels on nail beds

Question 11

Lupus Erythematous types

Answer 11

cutaneous

biscoid: scarring on scalp

systemic

Question 12

systemic LE signs

Answer 12

skin: “butterfly” eruption/rash on face (sensitivity to light)

joints, pericadium, pleura: serous membrane damaged

kidney: “wire loop” on glomerulus b/c of immunoglobin deposits

Telangiectasia: dilated blood vessels on hands and wrists

Libman-Sack endocarditis: sterile deposits on heart valve

retinal inflammation

“onion skin” on spleen

• serum on frozen animal spleen produce concentric ring-shaped deposits

Question 13

systemic LE and anti-nuclear antibodies

Answer 13

anti-nuclear antibodies (ANA) attack DNA, histones, non-histone proteins and nuclear antigens

test for LE includes looking for ANA around the cell nucleus

Hematoxylin body (LE body) is a blob in blood produced by ANA attacking DNA from dead cell

LE cell: LE body + leukocyte

Question 14

Rheumatoid arthritis

Answer 14

joints: systemic arthritis (primarily attacks small joints like fingers and toes)

Pannus formation: abnormal layer of fibrovascular tissue or granulation tissue which ultimately cause cartilage destruction and bone erosion

IgM attacks IgG

Question 15

Sjogren syndrome

Answer 15

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A. <!--[endif]-->Destruction of lacrimal and salivary glands (tear and saliva production disrupted)

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B. <!--[endif]-->Dry mouth (xerostomia), lack of tears (keratoconjunctivitis sicca),

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C. <!--[endif]-->Often associated with other autoimmune diseases such as RA.

Question 16

Scleroderma (systemic sclerosis)

Answer 16

scarring of skin + visceral membrane (GI track, lung, kidneys, muscles and heart)

sclerotic atrophy of the skin, begining at the fingertips then up the arm and rest of the body

Sclerodactylyl: skin is bound down below the fat tissue (leather-like texture)

pitting at fingertips: necrosis at fingertips due to blood flow loss

Question 17

CREST syndrome

Answer 17

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1. <!--[endif]-->Those who survive SS have CREST syndrome

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2. <!--[endif]-->NOT isolated scleroderma (which is called morphea)

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3. <!--[endif]-->Raymaud Phenomenon: fingers turn white in cold weather due to decreased blood flow

Question 18

polymyositis aka dermatomyositis

Answer 18

inflamed muscle: begin as systemic muscle weakness (initially affecting large muscles of trunk, neck and limbs)

can inflame upper eye (eye lids)

in children, it’s a strong sign of internal cancer

Question 19

polyarteritis nodosa

Answer 19

necrotizing inflammation of the walls of blood vessels