Exam 3 - Hypersensitivity and Autoimmunity Part 1 Flashcards
(119 cards)
1
Q
Helminthic infection
A
Worm/parasite infection
2
Q
True or false: eosinophils are PMN
A
True
3
Q
Eosinophils stain with
A
Eosin
4
Q
Helminthic infections stimulate ___ in the GI
A
Th2 response
5
Q
In a helminthic infection, ____ can coat eggs and helminths to prevent _____
A
IgA and IgM; Prevent new adherence and further colonization
6
Q
___ produces distinct response to adherent helminths that break the mucosal barrier
A
IgE
7
Q
IgE is associated with
A
Atopic, allergic response
8
Q
IgE ___ domain binds to ____ on basophils and mast cells
A
CH4 (extra CH domain); Fce receptors
9
Q
FceRI receptor on eosinophils is ____
A
High affinity
10
Q
FceRII receptor on eosinophils is ____
A
Low affinity
11
Q
FceRI receptor on basophils and mast cells is ____
A
High affinity
12
Q
Eosinophils, basophils, and mast cells are found in high concentrations in:
A
- skin
- respiratory tract
- GI tract
13
Q
FceRI degranulation releases _____ which are toxic to ____
A
major basic protein and eosinophil cationic protein; helminths
14
Q
In addition to major basic protein and eosinophil cationic protein, eosinophils also contain:
A
- histamine
- lactoferrin
- lysozyme
15
Q
What is associated with atopic (allergic) response?
A
- Type I hypersensitivity
- Anaphylaxis
- Elevated IgE levels
16
Q
Type I hypersensitivity is ___ mediated
A
IgE
17
Q
Routes of allergen encounter
A
- inhalation
- contact
- ingestion
- injection
18
Q
Type I hypersensitivity may include:
A
Anaphylaxis
19
Q
Common contact allergens
A
- latex gloves
- dental dam
- condoms
20
Q
Common ingested allergen
A
Antibiotics
21
Q
Sensitization
A
process of coating mast cell with IgE, becoming sensitive to activation by subsequent encounter of that antigen
22
Q
IgE is bound to mast cells for how long?
A
12-14 days
23
Q
Antibodies that bind to cells like mast cells are known as
A
Cytotrophic antibodies
24
Q
When the IgE + Mast Cell complex encounters the antigen again it causes:
A
Immediate degranulation (overwhelming and inappropriate response)
25
Immediate phase response during Type I hypersensitivity includes
- rapid degranulation
- histamine
- heparin
26
Delayed phase response in Type I hypersensitivity includes
- lipid mediators (arachidonic acid metabolites PGE2, PGD2, LB4)
- cytokines
27
Immediate phase Type I hypersensitivity occurs ___ after exposure
5-30 min
28
What happens during immediate phase Type I hypersensitivity
- mast cell (tissue) degranulation
- may cause anaphylaxis if systemic degranulation (basophil)
29
Delayed phase Type I hypersensitivity occurs after ____
- 8-12 hours (lipid mediators)
- days to weeks (cytokines)
30
What happens during delayed phase Type I hypersensitivity
- inflammatory cell infiltration
- continual symptoms
31
Vasoactive amines
- histamines
- blood vessel dilation
- vascular permeability
32
Histamines have what receptors
H1-H4
33
Chemotactic factors
- Eosinophil chemotactic factor
- neutrophil chemotactic factor
34
Heparin, Vasoactive amines, and chemotactic factors are examples of
Immediate (acute) mediators
35
H1R (histamine receptor) is located on:
- smooth muscle
- endothelium
36
Activation of H1R causes:
- vasodilation and mucosal secretion
- venule, capillary permeability
- bronchial, gut constriction
37
H4R histamine receptor is located on
Basophils and mast cells
38
Activation of H4R causes:
mediation of chemotaxis and inflammation
39
Prostaglandin E2/PGD2
Increases vasodilation
40
Leukotriene B4
Chemoattraction of PMN
41
Lipoxin A4
Inhibits inflammation and chemotaxis
42
Type I hypersensitivity produces a ____ response to a _____ and an abnormally high response to an ____
abnormal; non-allergen; allergen
43
Type I hypersensitivity - mechanism
- overproduction of IgE
- priming of mast cells via FceRI
- increases IgE half life
- Degranulation releases histamine
- causes inflammation
- leads to production of arachidonic acid metabolites
44
Clinical manifestation of Type I Hypersensitivity
- Urticaria
- Edema
- Erythema
- Rhinorrhea
- Bronchoconstriction
45
Urticaria
Hives (intraoral or dermal)
46
Edema
Swelling
47
Erythema
Redness
48
Rhinorrhea
Runny nose
49
Bronchoconstriction
Shortness of breath
50
Clinical diagnosis of allergies
- Immunologic testing: skin test involves wheal and flare
- Abnormal IgE serum levels
- abnormal eosinophil count
- Eosinophils in sputum
51
Wheal
Granular response (histamine)
52
Flare
Inflammatory response (PGE2, LB4)
53
OTC antihistamines - name
Diphenhydramine
54
Diphenhydramine is commonly used for ____ and competes with histamine for ____
hay fever and nasal allergies; H1 receptor
55
Prescription anti-inflammatory medications
- leukotriene receptor antagonists (Singulair)
- Epinephrine or bronchodilators (Primatene mist)
- Cromolyn sodium (blocks calcium influx, mast cells)
- Asthma inhaler (inhibits degranulation)
56
Hyposensitization
Repeated administration of sub-clinical allergen dose
57
Type II hypersensitivity is ____ mediated
Antibody (IgG)
58
Type II hypersensitivity is often called:
Cytotoxic hypersensitivity
59
Rhesus disease is also called
Erythroblastosis fetalis; hydrops fetalis
60
Most common cause of Rhesus disease is:
Rhesus incompatibility
61
In Rhesus disease during pregnancy, mother is ____ and baby is ____
Rh -; Rh +
62
Can Rhesus disease be prevented?
Yes - Rhogam
63
Rhesus disease - subsequent children
IgG can be transferred to fetus
64
Rhesus disease diagnosis via:
Coombs test
65
Rheumatic fever involves:
Group A Strep
66
Rheumatic fever is associated with antibody response to ____ which has structural similarity to some ____
protein M; cardiac antigens
| molecular mimicry
67
Some people with rheumatic fever develop immune response against
Cardiac antigens
68
Diseases related to Type II hypersensitivity
- Hemolytic disease of the newborn (Rhesus disease)
- Rheumatic fever
- Sympathetic Opthalmia
- Drug-induced hemolytic anemia
69
Sympathetic opthalmia is a form of
Uveitis
70
What causes sympathetic opthalmia
- Penetrating injury to the eye that releases sequestered antigens
- ocular antigens stimulate conjunctival lymphatics
- IgG and lymphocytes return via blood vessels
- can damage eye, cause blindness
71
Drug-induced hemolytic anemia includes what drugs
- a-methyldopa
- ibuprofen
- pencillin
- cephalosporins
- quinine
72
Drug-induced hemolytic anemia can modify or bind:
- modify Rhesus antigens
- bind erythrocytes
73
What happens to RBC in drug-induced hemolytic anemia?
antibodies destroy RBC in presence of drug
74
Treatment of drug-induced hemolytic anemia
- removal of causative agent (drug)
- treatment with prednisone (corticosteroid) if needed
75
Gra'es disease, also known as ____, affects the ____
Toxic diffuse goiter; affects thyroid
76
Grave's disease - agonist
Thyroid stimulating immunoglobulin (TSI) to TSH receptor
77
Most common cause of hyperthyroidism in the US
Grave's disease (50-80% cases)
78
Grave's disease RR for female:male
7:1
79
Most common symptoms of Grave's disease
- elevated levels of T3 and T4; low TSH
- Exopthalmos (periorbital edma, bulding eyes)
80
Hashimoto's disease also known as
Hashimoto's thyroiditis
81
Most common cause of hypo-thyroidism in the US
Hashimoto's disease
82
Hashimoto's disease - most common symptoms include:
- weight gain
- fatigue
- depression
- cold intolerance
- constipation
83
Goodpasture syndrome is known as ____ disease
Anti-globular basement membrane disease
84
Goodpasture syndrome - most auto-antibodies are to:
alpba-3 subunit of Type IV collagen
85
Goodpasture syndrome antibodies against:
Basement membrane in lung and kidneys
May lead to permanent lung, kidney damage, or death
86
Pernicious anemia is a form of
Vitamin B12 deficiency
87
In pernicious anemia, antibodies are formed against:
Gastric intrinsic factor (GIF) which is needed for B12 absorption
88
Pernicious anemia can lead to
Macrolytic or megaloblastic anemia
89
Common symptoms of pernicious anemia
- pallor, low grade fever, weight loss, tingling, numbness
- Glossitis (inflammation and depapillation of tongue)
90
Pernicious anemia prevalence
400,000 in US; age-associated (>50)
91
Myasthenia gravis is a
Long term neuromuscular disease
92
Myasthenia gravis: autoimmune antibodies against
Nicotinic Ach receptors; prevents nerve impulses from triggering muscle contractions
93
Myasthenia gravis symptoms
- ptosis (drooping upper eyelid)
- dysphagia (swallowing difficulties)
- hanging jaw/facial weakness
94
Myasthenia gravis is more common in:
women; ages 50-70
95
Sjogren's syndrome
Autoimmune disorder or moisture producing glands
96
What is affected in Sjogren's syndrome
- Sjogren syndrome autoantibodies (SSA)
- salivary and lachrymal (exocrine) glands
97
Primary manifestation of Sjogren's syndrome
- xerostomia: dry mouth
- keratoconjunctivitis sicca (KCS): dry eyes
98
Tx for Sjogren's syndrome
- artificial tears/saliva
- Pilocarpine may be used
99
Sjogren's syndrome characterized by:
CD4+ T cell and B cell infiltrate
100
Lymphocytic infiltrate associated with:
Exocrine glands (salivary, lachrymal)
101
Xerostomia increases:
Caries risk (500,000-2,000,000)
102
Linear IgA disease
Linear IgA deposition in basement membrane zone (BMZ)
103
True or false: Linear IgA is a type of Type II hypersensitivity
True even though it's IgA and not IgG
104
Linear IgA may present similar to
EBA
105
There is a drug induced form of Linear IgA disease, called
vancomycin-induced Stevens-Johnson syndrome
106
EBA antibodies against:
Auto-immunity IgG against type 7 collagen
107
EBA disorder characterized by
- blisters in skin or mucosa
- can be spontaneous or trauma induced
- occurs in areas of high contact (feet, hand, mouth)
108
Pemphigus is:
Group of rare autoimmune blistering diseases
109
Pemphigus antibodies against
Autoantibodies IgG against desmoglein - causes separation between cells
110
Pemphigus vulgaris against:
Desmoglein 3
111
Pemphigus foliaceus against:
Desmoglein-1
112
Pemphigus vulgaris mostly affects desmosomes of
stratified squamous epithelium
113
Pemphigus vulgaris - lesions may form on
Tongue and palate
114
Pemphigoid
Antibodies are to BP-1 hemidesmosome in basement membrane
115
____ can have cicatricial presentation (no skin involved)
Pemphigoid
116
_____ rarely affects the mouth - mostly the skin
Bullous pemphigoid
117
Bullous pemphigoid and Cicatricial pemphigoid can both be classified as
Type II hypersensitivity
118
Cicatricial pemphigoid commonly presents in the ___ and can cause ____
mouth; desquamative gingivitis
119
Bullous pemphigoid most commonly manifests in:
Skin lesions
