Disorders of the Immune Response

Question 1

what are the different types of hypersensitivity

Answer 1

• Type I: allergic reaction
• Type II: antibody (IgG) mediated
• Type II: immune complex hypersensitivity
• Type IV: cell mediated and cell mediated delayed hypersensitivity

Question 2

allergic reaction s/s

Answer 2

• urticaria
• rhinitis
• atopic dermatitis
• bronchial asthma

Question 3

causative mechanism of allergic reaction

Answer 3

allergen causes formation of IgE antibodies from B lymphocytes. They attach to mast cells upon re-exposure to the allergen, the allergen attaches to the IgE on the mast cells sausing the release of histamine. Histamine causes an inflammatory response

Question 4

what is the exaggerated type I hypersensitivity reaction

Answer 4

Anaphylactic shock

Question 5

Anaphylaxis

Answer 5

severe hypersensitivity reaction. Due to large amounts of chemical mediators released from mast cells into general circulation quickly

Question 6

s/s of anaphylaxis

Answer 6

• Edema in mucosa
• Constriction of the bronchioles occurs obstructing airflow
• Hives
• Itching
• Skin erythema
• Vomiting
• Abdominal cramping

Question 7

treatment of anaphylaxis

Answer 7

injection of epinephrine

Question 8

what does injection of epinephrine do

Answer 8

• Causes vasoconstriction
• Increase the rate and strength of heartbeat
• Relaxes the bronchiole smooth muscle

Question 9

type II hypersensitivity reaction

Answer 9

antibody (IgG) mediated

Question 10

how many types of type II hypersensitivity reactions are there

Answer 10

3

Question 11

type 1 of type II hypersensitivity reaction

Answer 11

complement and antibody mediated cell destruction

Question 12

what are the examples of type 1 of type II

Answer 12

• drug reactionL hemolytic anemia from penicillin
• incompatible blood transfusion

Question 13

type 2 of type II hypersensitivity reaction

Answer 13

complement and antibody mediated inflammation

Question 14

what are the examples of type 2 of type II

Answer 14

rejecting organs

Question 15

type 3 of type II hypersensitivity reaction

Answer 15

antibody mediated cellular activation or destruction

Question 16

what are the examples of type 3 of type II

Answer 16

• graves disease: produce antibodies, they attach to receptors in thyroid gland, and thyroid gland releases large amounts of T3 and T4
• Myastenia gravis: binds to Ach receptor destroying the receptor

Question 17

type III hypersensitivity reactions

Answer 17

immune complex hypersensitivity

Question 18

what is immune complex hypersensitivity

Answer 18

antigen and antibody complex being deposited in the walls of blood vessels that causes an inflammation and damage to blood vessels

Question 19

examples of immune complex hypersensitivity

Answer 19

• glomerulonephritis
• autoimmune vasculitis

Question 20

s/s of immune complex hypersensitivity

Answer 20

• urticaria
• patchy or generalized rash
• extensive edema
• fever

Question 21

type IV hypersensitivity reactions

Answer 21

cell mediated delayed hypersensitivity

Question 22

cell mediated delayed hypersensitivity:

Answer 22

• cell mediated
• direct cell mediated cytotoxicity
• delayed type hypersensitivity

Question 23

cell mediated

Answer 23

t lymphocytes attack antigen

Question 24

direct cell mediated cytotoxicity

Answer 24

cytotoxic t cells directly kill antigen containing cell

Question 25

Delayed type hypersensitivity

Answer 25

- takes a couple days for inflammation and adverse effect to happen - response to soluble protein antigen - macrophages, t helper cells

Question 26

4 general category of transplant:

Answer 26

- allograft - isograft - autograft - xenograft

Question 27

allograft

Answer 27

same species

Question 28

isograft

Answer 28

identical twins

Question 29

autograft

Answer 29

one part of the body to another

Question 30

xenograft

Answer 30

between different species

Question 31

does allograft need immunosuppressive drugs and matching HLA/MHC’s

Answer 31

you have to match between 7-10 of the HLA and MHC - if someone is a good match it means their HLA are closely matched - they also have to be on immunosuprresive drugs

Question 32

does isograft need immunosuppressive drugs and matching HLA/MHC’s

Answer 32

they have identical HLA/MHC, that is automatically a compatible transplant so there is no need for immunosuprressive drugs

Question 33

does autograft need immunosuppressive drugs and matching HLA/MHC’s

Answer 33

identical HLA/MHC - no immunosuprresive drugs

Question 34

does xenograft need immunosuppressive drugs and matching HLA/MHC’s

Answer 34

immunosuprresive drugs are needed

Question 35

what are the different types of rejection in host vs graft disease

Answer 35

- hyperacute - acute - chronic

Question 36

hyperacute reaction

Answer 36

occurs immediately after transplantation when blood flow is reestablished. Due to preexisting antibodies in the host. The blood vessels are affected and consequently blood flow to the transplanted organ is compromised

Question 37

acute reaction

Answer 37

occurs several weeks after transplantation when unmatched antigens cause a reaction → generation of T cells, antibodies against the graft

Question 38

Chronic reaction

Answer 38

occurs several months or years after transplantation. Blood vessels in the graft are gradually damaged

Question 39

what is the process of graft vs. host disease

Answer 39

Occur when there are some T-lymphocytes in the graft that attack the host (host is immunologically compromised)

Question 40

what are the three things you need for a graft vs host disease to occur

Answer 40

- Transplant must have a functional cellular immune component - Recipient tissue must have antigens foreign to the donor T-lymphocytes - Recipient immune system must be compromised to the point where it can’t destroy the transplanted T-cells

Question 41

immunodeficiency

Answer 41

loss of part or all the function of immune system

Question 42

Primary immunodeficiency

Answer 42

- Humoral (B-cell deficiencies) → hypogammaglobulinemia - Cellular (T-cell) deficiencies →thymic aplasia - Severe combined immunodeficiency disorder (SCID): deficient B and T cell due to non-functional T-helper cells → bubble boy disease - Wiskott aldrich syndrome: production of abnormal or non functional immune cells → decreased antibody production

Question 43

Secondary immunodeficiency

Answer 43

- Malnutrition - Immunosuppressant drugs - AIDS - Kidney disease - Hodgkin lymphoma - Chemotherapy

Question 44

What is the difference between being diagnosed HIV positive and being diagnosed with AIDS?

Answer 44

The difference between being HIV+ or AIDS has to do with the number of T helper cells. If it's below 200 you have AIDS and not HIV.

Question 45

AIDS-Associated illnesses

Answer 45

- respiratory: pneumocytosis pneumonia, pulmonary TB - gastrointestinal: esophageal candidiasis, CMV, herpes simplex