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Immuno-Sero > Hypersensitivity 2 (RVSP) > Flashcards

Hypersensitivity 2 (RVSP) Flashcards

1
Q

Enzyme allergen from the fecal pellets of the dust mite

A

Der P1

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2
Q

Scientific name of the common dust mite

A

Dermatophagoides pteronyssinus

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3
Q

Broken down by Der P1 that enables it to cross the mucosa

A

Occludin of the tight junction

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4
Q

Interleukins (ILs) for development of mast cells

A

IL-4

IL-9

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5
Q

ILs For development of eosinophils

A

IL-5

IL-9

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6
Q

ILs for differentiation of B cells

A

IL-4

IL-13

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7
Q

ILs to stimulate the overproduction of mucus

A

IL-4, 7, 9, 13

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8
Q

Term for the genetic trait to have a predisposition for localized anaphylaxis

A

Atopy

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9
Q

What do atopic individuals have higher levels of?

A

Higher levels of IgE and eosinophils

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10
Q

Mechanism of allergic response; attachment of IgE to Mast cells

A

Sensitization

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11
Q

Receptor of mast cells for IgE

A

Fc receptor

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12
Q

Effect of sensitization to IgE

A

Increase of IgE life span

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13
Q

Half-life of IgE in serum

A

2-3 days (sometimes up to 10)

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14
Q

When attached to the FceR (Fc epsilon Receptor), the half-life of IgE is increased to

A

Months

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15
Q

Cells that have high affinity for IgE
or
Cells that have high affinity IgE receptor

A

Mast cells
Basophils
Activated eosinophils

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16
Q

Triggers release of granules from cell (Type 1 hypersensitivity)

A

ALLERGEN binding to IgE attached to FcER

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17
Q

Condition of mast cells during secondary exposure to allergen

A

Mast cells are already primed with IgE on surface

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18
Q

During secondary exposure to allergen, the allergen binds IgE and cross-links to activate signal with ______________, ______________, ______________, and ______________

A
  • Tyrosine phosphorylation
  • Ca2+ influx
  • Degranulation
  • Release of mediators
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19
Q

Primary mediators in Type 1 H

A
  • Histamine
  • Cytokines (TNF-a, IL-1, IL-6)
  • Chemoattractants for neutrophils and eosinophils (NCF-A, ECF-A)
  • Enzymes (tryptase, chymase, cathepsin)
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20
Q

Secondary mediators in Type 2 H

A
  • platelet activating factors
  • Leukotrienes
  • Prostaglandins
  • TH2 cytokines (IL-4, 5, 13, GM-CSF)
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21
Q

Primary mediator; causes constriction of smooth muscles, vasodilation and activates enzymes for tissue breakdown

A

Histamine

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22
Q

Effect of bronchiole constriction by histamine

A

Wheezing

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23
Q

Effect of constriction of intestines by histamine

A

Cramps

Diarrhea

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24
Q

Effect of vasodilation by histamine

A
  • Increased fluid into tissues causing increased swelling

- fluid in mucosa

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25
Q

Pre-formed mediators in granules (Type 1 H)

A

Primary mediators

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26
Q

Mediators formed after activation (Type 1 H)

A

Secondary mediators

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27
Q

Most severe type of allergy; acute reaction that involves multiple organs

A

Anaphylaxis

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28
Q

Described anaphylaxis as “without protection”

A

Paul-Jules Portier

Charles Robert Richet

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29
Q

Researchers first to show that a serum factor was responsible for type 1 reactions

A

Carl Wilhelm Prausnitz

Heinz Kustner

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30
Q

Reaction described by Prausnitz and Kustner

A

Passive cutaneous anaphylaxis

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31
Q

What is the passive cutaneous anaphylaxis?

A

Serum from Kustner who was allergic to fish was injected to Prausnitz

A later exposure to fish antigen at the same site resulted in an allergic skin reaction.

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32
Q

Type of anaphylaxis; target organ responds to direct contact with allergen

A

Localized anaphylaxis

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33
Q

Effect of localized anaphylaxis in the digestive tract

A

Vomiting
Cramping
Diarrhea

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34
Q

Effect of localized anaphylaxis in the skin

A

Reddened, inflamed area resulting in itching

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35
Q

Effect of localized anaphylaxis in the airway

A

Sneezing and rhinitis OR wheezing and asthma

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36
Q

Effect of systemic anaphylaxis

A

Systemic vasodilation and smooth muscle contraction leading to severe bronchiole constriction, edema and shock

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37
Q

Systemic anaphylaxis is similar to __________

A

Systemic inflammation

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38
Q

Treatments for Type 1

A

Pharmacotherapy

Immunotherapy

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39
Q

Drugs used in pharmacotherapy to treat Type 1

A 
Antihistamines
Bronchodilators
Corticosteroids
Decongestants
Epinephrine

ABCDE

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40
Q

Drugs that block histamine receptors

A

Antihistamines

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41
Q

First line of defense against hypersensitivity

A

Avoidance of known allergens

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42
Q

AKA Immunotherapy

A

Desensitization/Hyposensitization/Allergy shots

43
Q

What happens in Desensitization?

A

Repeated injections of allergen to reduce the IgE on mast cells and produce IgG

44
Q

What is the mechanism in using anti-IgE monoclonal antibodies to treat Type 1 reactions?

A

The anti-IgE monoclonal antibody combines with IgE at the same site that IgE would normally use to bind to receptors on mast cells. Blocking of this site does not allow IgE to bind to mast cells, alleviating allergic symptoms.

45
Q

Tests for immediate hypersensitivity

A

In vivo test

In vitro test

46
Q

In vivo tests for immediate hypersensitivity

A

Direct skin testing
Cutaneous/Prick Test
Intradermal

47
Q

Most specific and least expensive in vivo test for type 1 reactions

A

Direct skin testing

48
Q

Positive for Cutaneous/Prick test for type 1 reactions

A

Greater than 3 mm in diameter

OR

3 mm higher than the control

49
Q

In vivo test for type 1 reactions; uses more concentration of allergen

A

Intradermal

50
Q

Positive for intradermal test for in vivo type 1 reactions

A

Wheal that is 3 mm higher than the control

51
Q

What is measured in the in vitro tests for type 1 reactions

A

Total IgE

Allergen-specific IgE

52
Q

Tests in the in vitro testing for type 1 reaction

A 
Radioimmunosorbent test (RIST)
Radioallergosorbent test (RAST)
53
Q

Test for total IgE

A

RIST

54
Q

Test for allergen-specific IgE

A

RAST

55
Q

In vitro test for Type 1 reactions; allows multiple allergens; diagnosis with a low sample volume

A

Microarray test

56
Q

AKA Antibody-mediated cytotoxicity

A

Type II Hypersensitivity

57
Q

What happens in drug reactions that causes Type II hypersensitivity

A

Drug binds to RBC surface and antibody against drug binds then causes lysis of RBC

58
Q

Blood group systems most commonly associated with transfusion reactions

A 
Duffy
ABO
Rh
Kell
Kidd

DARKK

59
Q

Mechanism involved in Goodpasteur’s syndrome

A

Ab reacts with basement membrane protein which triggers complement activation resulting to inflammation and deposition of IgG

60
Q

Tests for Type II

A

DAT

IAT

61
Q

Used in DAT for Type II testing

A
  • Polyspecific AHG (Abs to IgG, C3b, C3d)

- monospecific AHG

62
Q

Method used to detect transfusion reactions, HDN, and autoimmune hemolytic anemia

A

DAT

63
Q

Method used in crossmatching of blood to prevent a transfusion reaction

A

IAT

64
Q

Hypersensitivity where a large amount of SOLUBLE antigen and antibodies form complexes in blood

A

Type III/Immune Complex Disease

65
Q

Where can immune complexes be deposited of not eliminated?

A

Capillaries and joints where they can trigger inflammation

66
Q

Process of degranulation and triggering of inflammation of neutrophils and macrophages when they are unable to phagocytize the immune complexes

A

Frustrated phagocytosis

67
Q

Localized diseases caused by immune complexes

A

Arthritis

Glomerulonephritis

68
Q

Deposition of immune complexes in joints causing local inflammation

A

Arthritis

69
Q

Deposition of immune complexes in the kidneys cause __________

A

Glomerulonephritis

70
Q

Type III reaction caused by passive immunization with animal serum, usually horse or bovine

A

Serum sickness

71
Q

Type III reactions can be triggered by either ________ or ________ antigens

A

Autologous

Heterologous

72
Q

Autoimmune diseases that are Type III reactions

A
  • Systemic Lupus Erythematosus

- Rheumatoid arthritis

73
Q

Tests for Type III hypersensitivity

A
  • Fluorescent staining of tissue sections
  • Agglutination reactions
  • Measuring C’ levels
74
Q

First described Type 4 hypersensitivity

A

Robert Koch

75
Q

How did Robert Koch discover type IV hypersensitivity?

A

Patients with Mycobacterium tuberculosis developed a localized inflammatory response when injected intradermally with a filtrate from the organism

76
Q

Leukocyte associated with type 4 hypersensitivity

A

Sensitized T cells, specifically, Th1 cells

77
Q

True/False. Antibody and complement are directly involved in Type 4 Hypersensitivity

A

False

Ab and C’ are NOT directly involved

78
Q

True/False. Type 4 reactions can be transferred through the serum.

A

False

The reaction CANNOT be transferred by serum, only through TRANSFER OF T LYMPHOCYTES

79
Q

In delayed type hypersensitivity (DTH), ____ cells release _______ to activate ________ causing inflammation and tissue damage

A

Th1, cytokines, macrophages

80
Q

In DTH, continued macrophage activation can lead to

A

Chronic inflammation

81
Q

In DTH, chronic inflammation can lead to

A

Tissue lesions
Scarring
Granuloma formation

82
Q

How many hours until DTH response arises after exposure?

A

72 hours

83
Q

Generated by dendritic cells during sensitization stage against DTH antigens

A

Memory Th1 cells

84
Q

Cells that can activate macrophages and trigger inflammatory response in DTH

A

Memory Th1 cells

85
Q

When will DTH occur?

A

During the secondary contact

86
Q

Cytokines by memory Th1 cells that cause tissue destruction and inflammation

A

IFN-gamma
TNF-alpha
TNF-beta

87
Q

Cytokine by memory Th1 cells that activate cytotoxic T lymphocytes (CTLs)

A

IL-2

88
Q

Cytokine by memory Th1 cells for macrophage recruitment

A

Chemokines

89
Q

Cytokines by memory Th1 cells for increased monocyte/macrophage

A

IL-3

GM-CSF

90
Q

3 causes for Contact Dermatitis

A

Poison ivy
Poison oak
Poison sumac

iOS

91
Q

In contact dermatitis, small molecules acts as ______ and complex with skin proteins to be taken up by ___________, which is an APC, and presented to Th1 cells for sensitization

A

Haptens

Langerhans cell

92
Q

Type 4 reaction; due to inhaled allergens; allergic disease of the lung parenchyma

A

Hypersensitivity pneumonitis

93
Q

Other names for Hypersensitivity pneumonitis

A

Farmer’s Lung
Pigeon breeders disease
Humidifier lung disease

94
Q

Type 4 reaction; soluble antigens from Mtb induce a reaction in people who have or have had tuberculosis

A

Tuberculin-type Hypersensitivity

95
Q

What is the antigen in the tuberculin-type hypersensitivity?

A

Purified protein derivative (PPD) from the cell wall of the organism

96
Q 
DTH is a type of immune 
response classified by 
\_\_\_\_\_\_ and \_\_\_\_\_\_ 
activation that results in 
tissue damage.
A

Th1

Macrophage

97
Q

Tests for type 4 reactions

A

Patch test

Mantoux method

98
Q

Gold standard in testing contact dermatitis

A

Patch test

99
Q

How is the patch test done?

A

Non-absorbent pad wil allergen is applied on the patient’s back, reaction is checked over the next 48, 96, and 120 hours

100
Q

Amount of antigen injected intradermally in Mantoux method for type 4

A

0.1 mL

101
Q

Positive for Mantoux method

A

Induration of 5 mm or more

102
Q

At what time is the test site read in Mantoux method?

A

48 and 72 hours

103
Q

Antigens commonly used in Mantoux method

A
  • Candida albicans
  • Tetanus toxoid
  • Tuberculin
  • Fungal antigens (trichophyton & histoplasmin)

Immuno-Sero (6 decks)

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