23 - Skin Inflammation Flashcards

(29 cards)

1
Q

Cardinal signs of inflammatin

A

Heat
Redness
Swelling
Pain

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2
Q

Langerhans cells

A

In the epidermis
Dendritic cells - spine like projections
Pick up antigens that enter the skin and transport to the lymph nodes

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3
Q

What type of sensitivity is Mast Cell Mediated Inflammation

A

Type 1 hypersensitivity

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4
Q

What are the steps in Mast Cell mediated inflammation

A

1) Allergen ingested by APCs which present to allergen to cells
2) TH2 T cells recognise and produce 1L-4
3) IL-4 promotes B-cells –> plasma cells
4) Plasma cells release IgE antibodies
5) IgE antibodies bind to Fc receptor on mast cell
6) 2nd exposure - allergen binds to IgE
7) Mast cell degranulates when all binds

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5
Q

What is released from a mast cell in mast cell degranulation

A
Histamines
Cytokines
Enzymes
Prostaglandins 
Leukotrienes
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6
Q

Function of histamine

A

Smooth muscle contraction
Bronchoconstriction
Intestinal hypermotility
Arteriole dilation - hypotension + headache

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7
Q

What is Der P1

A

Enzyme allergen from faecal pellets of dust mites

Breaks down the components of tight junctions

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8
Q

What is mast cell degranulation responsible for

A

Urticaria
Asthma
Hay fever

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9
Q

What causes anaphylaxis

A

Antigen into blood stream
binds to IgE on basophils
Release of inflammatory mediators
Bronchospasm and circulatory collapse

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10
Q

What is omalizumab

A

Treatment for resistant urticaria and asthma

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11
Q

MoA of omalizumab

A

Binds to circulating IgE to decrease cell bound IgE
Decreases expression of high affinity receptors
Decreases tissue infiltration + mediator release

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12
Q

What type of sensitivity is antibody mediated inflammation

A

T2 hypersensitivity

where antibodies bind to bodies own tissues

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13
Q

What is the mechanism of antibody mediated inflammation in pemphigus vulgaris

A

Antibodies are formed against desmosomes

Lack of cohesion between keratinocytes and epidermiss

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14
Q

How do you treat pemphigus Vulgaris

A

Oral steroids

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15
Q

MoA of Rituximab

A

Targets CD20 on B cells

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16
Q

What type of sensitivity is immune complex mediated

A

Type 3 hypersensitivity

17
Q

How does immune complex mediated work

A

1) Accumulation of immune complexes (antigen-antibody) that havent been cleared
2) Gives rise to inflammatory response and leukocyte accumulation

18
Q

Where do the immune complexes insert themselves (in type 3 hs)

A

Blood vessels
Joints
- this causes symptoms

19
Q

Symptoms of early vasculitis

A

Erythema + oedema

20
Q

Symptoms of established vasculitis

A

Palpable purpura

21
Q

Severe vasculitis

A

Ulceration + necrosis

22
Q

What antingen and antibody complex in SLE

23
Q

What antigen and antibody complex in Polyarteritis Nodosa

A

HbsAg

Anti-HBsAb

24
Q

Type of sensitivity is Delayed hypersensitivity

A

Type 4 hypersensitivity

25
What is the pathophysiology of Allergic Contact Dermatitis
1) Contact allergens can cross the stratum corneum + form a conjugate with a protein 2) Conjugate recognised by langerhans cells as foreign 3) Transported to lymph nodes 4) if meet the allergen again - allergic reaction
26
What is the role of IL-2 and IFN-gamma in ACD
Promote Th1 response- secrease IL2, IL3, GM-CSF, IFN and TNF Promotes macrophage response Causes inflammation
27
Examples of contact allergens
Nickel rubber topical antibiotics
28
What is granuloma formation
Collection of macrophages (aka histiocytes)
29
Causes of granuloma formation
TB Sarcoidosis foreign body granuloma