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ESA 4 missing > Immune Not On Brainscape > Flashcards

Immune Not On Brainscape Flashcards

1
Q

Which food allergy diagnoses screen for IgE

A
  • serum specific IgE
  • skin pin prick test

Correlate with likely hood of allergy

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2
Q

Hypersensitivity type 2 reactions caused by complement activation

A
  • haemolytic disease of newborn

- transfusion reactions

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3
Q

Antigen HDN

A

Rhesus D

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4
Q

Antigen transfusion reaction

A

ABO

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5
Q

Antigen

  • autoimmune haemolytic anemia
  • immune thrombobytopenic purpura
  • goodpastures
A
  • red blood cells
  • platelets
  • collagen in GBM of lung and kidney
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6
Q

Examples of type 2 hypersensitivity caused by antibody dependent cell cytotoxicity

A
  • autoimmune haemolytic anemia
  • immune thrombobytopenic purpura
  • goodpastures
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7
Q

Concequences HDN

A

Hydrops fetalis
Liver/splenomegaly
Severe hyperbilirubinemia
Kernicterus

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8
Q

What is given to prevent HDN

A

RhoGAM- solution of rhesus positive proteins that prevent the immune system from making Rh- antibodies

Or

Anti-D prophylaxis to neutralise RhD antigens from first babys’ RBC so the mother doesn’t produce RhD-

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9
Q

How to test for HDN

A

Indirect Coombs- tests for Anti-D antibody in plasma of mother and needs RhD antigen and Coombs reagent to be added

Direct coombs- looks at RBC from baby for Anti-D. Needs RhD antigens and Coombs reagent

+ve test = agglutination of RBCs

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10
Q

II disease caused by

  • receptor stimulation
  • receptor blockage
  • protein blockade
A

Stimulation - graves
Receptor Blockade- MG
Protein blockade- pernicious anaemia

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11
Q

Antigen pernicious anemia

A

Intrinsic factor in gastric parietal cell

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12
Q

How to correct metabolism and give replacement therapy

A

Correct metabolism (graves)

  • anti thyroid drugs
  • thyroidectomy

Replacement therapy (MG/P anemia)

  • pyridotygmine
  • Vit B12
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13
Q

What is plasmapheresis used for

A

MG, goodpastures, graves

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14
Q

Type III immune mechanism

A
  • intermediate size complex deposited
  • complement activated
  • neutrophil chemotaxis
  • neutrophil adherence and degranulation
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15
Q

What is antigen rheumatoid arthritis, Lupus and glomerulonephtiris

A

RA- Fc portion of IgG
GN- infectious microbes
SLE- Ds DNA

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16
Q

3 subtypes of granulomatous inflammation

A
  • contact
  • tuberculin
  • granulomatous
17
Q

Diseases caused by type Iv

A

Hashimotis, diabetes mellitus

18
Q

Antigen hashimotis and DM

A

H- thyroid gland

DM- pancreatic island cell

19
Q

How is anaphylaxis treated

A

Adrenaline

  • reverses peripheral vasodilation and reduces oedema
  • reversed airway obstruction
  • inhibits mast cell activation
20
Q

Mechanism type 1 hypersensitivity

A
  • TH2 response
  • IgE production
  • causes mast cell activation and degranulation
21
Q

4 chemical mediators for anaphylaxis

A

tryptase-remodel connective tissue matrix
histamine- increase vascular permeability
leukotrieone- increase vascular permability
platelet activating factor- activate neutrophils/eosinohils and platelets

22
Q

key points epi pen

A 
Properly remove the safety cap
• Place device against mid-anterolateral thigh
• Correct injection with a click heard
• Hold device in place for 10 seconds
• Massage injection site for 10 seconds
23
Q

systemic anaphylaxis symptoms

A 
RESPIRATORY:
• Upper airway obstruction with Stridor
• Lower airway obstruction with wheeze
• Cyanosis
CVS:
• Palpitations, tachycardia, bradycardia
CNS:
• Dizzy, Confusion, unconscious
ABDOMEN:
• nausea and vomiting,
• Abdominal pain
24
Q

RA xray signs

A

Narrowing of joint space
osteoporosis localized at the MCP joints of both hands (Periarticular osteopenia}

small erosions (proximal phalanges)

Juxta-articular bony erosions (in non-cartilage protected bone)

soft tissue swelling involving all fingers,

In severe and advanced cases you will see Subluxation and gross deformity

25
Q

antibodies RA

A

Fc portion IgG (rheumatod factor)

ACPA

26
Q

extra articular features RA

A

dry eyes, pericarditis, splenomegaly, renal inbolvement

27
Q

autoimmune pathophysiologu SLE

A
  • Self antigens and failure of the immune system to inactivate B cells and T cells that recognize these self antigens (i.e. a breakdown of tolerance)
  • Development of autoantibodies that either form circulating complexes or deposit by binding directly to tissues.
  • Activation of complement
  • Influx of neutrophils, causing inflammation in those tissues.
  • Abnormal cytokine production
28
Q

4 key points SLE diagnosis

A

joint problems, renal problems, malar rash, ANA antibodis

29
Q

treatment SLE

A

DMARDS- azathioprine
education- suncream use
steroids- prednisolone

30
Q

symptoms anaphylaxis

A 
Angioedema
Urticaria
Loss of consciousness
Confusion
Abdo pain/vomiting/diarrhoea
31
Q

mechanism anaphylaxis

A

Type 1 hypersensitivity reaction
A sensitized individual is re-exposed to an antigen
The antigen binds to IgE bound to mast cells – cross-linking of IgE
This leads to mast cell degranulation & release of granular contents and synthesis of new mediators

32
Q

Give two differences between IgE mediated and Non-IgE mediated food allergy (2 marks):

A

Onset for Ige = immediate, onset for Non-IgE = delayed

Age for IgE is variable & depends on age of contact, Non IgE = infancy & early childhood

Non-IgE tends to resolve much sooner than IgE mediated (which may never resolve)

33
Q

Explain the underlying pathology causing rheumatoid arthritis (4 marks)

A

Type 3 hypersensitivity reaction
Antibodies bind to the antigen (often Fc portion of IgG) forming immune complexes
Immune complexes (intermediate sized) deposit in the joints
Complement system is activated recruiting neutrophils to the area
There is neutrophil adherence to the tissue and degranulation leading to destruction of the tissue causing pain and inflammation

34
Q

what pescribed alongside methotrexate

A

folic acid

35
Q

Briefly describe the mechanism of the type IV hypersensitivity reaction (2 marks):

A

Sensitization phase APCs present the antigen to TH1 cells.

Effector phase TH1 cells bind with resting macrophages to activate them leading to an inflammatory response

36
Q

Give 4 side effects of long-term steroid use (2 marks):

A 
Skin thinning 
Immunosuppression 
Water retention 
Osteoporosis 
Cushing syndrome

ESA 4 missing (5 decks)

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