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DEN 7102 Micro & Immuno Concepts > Exam 3 - Hypersensitivity and Autoimmunity Part 2 > Flashcards

Exam 3 - Hypersensitivity and Autoimmunity Part 2 Flashcards

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1
Q

Type II (cytotoxic) hypersensitivity is a ____ response

A

Humoral

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2
Q

Cytotoxic (Type II) Hypersensitivity is associated with what diseases?

A
  • hemolytic disease of the newborn (Rhesus incompatibility)
  • Rheumatic fever
  • Sympathetic opthalmia
  • Drug-induced hemolytic anemia
  • Autoimmunity
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3
Q

Type III hypersensitivity also known as:

A

Immune complex diseases

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4
Q

Type III hypersensitivity involves ____ bound to ____ which forms _____

A

IgG; soluble antigens; Antigen-antibody complex

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5
Q

Antigen-antibody complex is mostly cleared by ____, but sometimes are not cleared and leads to ____

A

innate mechanisms; Type III hypersensitivity

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6
Q

Type III hypersensitivity diseases

A
  • Systemic lupus erythematosus
  • Rheumatoid arthritis
  • Arthus reaction
  • Serum sickness
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7
Q

Anti-snRNP or anti-SmDNA antibodies are associated with what disease?

A

Systemic lupus erythematosus

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8
Q

Systemic lupus erythematosus - clinical presentation

A
  • malar rash (butterfly)
  • oral ulcers
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9
Q

Another name for antibodies against snRNPs

A

Anti-Smith antibodies

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10
Q

Complications of systemic lupus erythematosus include:

A
  • Non-infectious endocarditis (Libman-Sacks)
  • Membranous glomerulonephritis
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11
Q

What occurs in lupus-related non-infectious endocarditis?

A

Mitral/tricuspid valve has IgG-Sm (snRNP) complex buildup

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12
Q

What occurs in lupus-related membranous glomerulonephritis?

A

immune complex depositing in renal glomeruli (wire loop)

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13
Q

Lupus treatments are often:

A

Palliative (relieving symptoms without addressing cause of symptoms)

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14
Q

Lupus treatment includes:

A
  • NSAIDs
  • corticosteroids
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15
Q

Triggers for Lupus

A
  • UV light
  • vitamin D deficiency
  • infectious agents
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16
Q

Relative risk of lupus

A

Females 9:1

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17
Q

Rheumatoid arthritis

A
  • Chronic autoimmune disorder that affects joints
  • typically results in swollen, painful joints mainly linked with RF
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18
Q

What is Rheumatoid factor?

A

Autoantibody against IgG Fc portion

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19
Q

In rheumatoid arthritis, RF and IgG form ____ contributing to disease progression

A

Complexes

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20
Q

Rheumatoid factor is considered a:

A

Cryoglobulin - form solid or gel like complexes under 99F

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21
Q

Type 2 Rheumatoid arthritis

A

Monoclonal IgM against polyclonal IgG

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22
Q

Type 3 Rheumatoid arthritis

A

Polyclonal IgM against polyclonal IgG

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23
Q

In rheumatoid arthritis, immune complexes cluster in ____, leading to ____

A

Joints; synovial damage

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24
Q

____ occurs at synovial lining of joint mainly due to inflammation

A

Granulation

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25
Granulation in rheumatoid arthritis consists of:
Immune complexes and inflammation
26
Granulation in rheumatoid arthritis is also called:
Pannus
27
Granulation at joints leads to:
- bone loss - calcification - loss of joint space - ankylosis
28
Ankylosis
Stiffening of joint
29
Arthus reaction is a Type ___ hypersensitivity involving ____
3; vaccine administration
30
Rare complication of some types of immunization
Arthus reaction
31
Arthus reaction is infrequently reported with:
Diphtheria and tetanus (toxoid vaccines)
32
Serum sickness is a major treatment risk with:
Xenogeneic anti-toxin
33
Serum sickness can induce:
- inflammation - fever - urticaria (hives) for days/weeks
34
Serum sickness - easy or hard to clear?
Hard to clear
35
Type IV hypersensitivity is also called:
delayed-type hypersensitivity (DTH)
36
True or false: Type IV hypersensitivity involves antibodies/antibody complexes
False - does not
37
Type IV hypersensitivity is associated with ___ response
Th1 (macrophages)
38
Type IV hypersensitivity occurs after:
48-72 hours
39
Contact sensitivity is type ____
Type IV hypersensitivity
40
Contact hypersensitivity occurs in contact with:
- poison ivy or poison oak - hair dyes - latex protein - nickel (small metal ions)
41
Contact hypersensitivity with nickel results in:
Inflammation
42
Examples of Type IV hypersensitivity
- contact hypersensitivity - tuberculin hypersensitivity - granulomatous hypersensitivity
43
Tuberculin hypersensitivity occurs with:
PPD tuberculin test
44
The Mantoux skin test (PPD) is read after ____ which is a classic ____ response
48-72 hours; DTH
45
What is measured after PPD skin test
Induration
46
Mycobacterium tuberculosis has mycolic acids in the cell wall which are ____ and inhibits ____ formation. This allows for replication in ____
anti-phagocytic; phagolysosome; macrophages
47
Granuloma formation from tuberculosis infection occurs as a result of:
Failure of acute inflammation resolution
48
End stage macrophages
Epithelioid cells
49
Autoimmunity appears to preferentially affect _____ due to _____
Females; increase of age-associated B cells (AABCs)
50
Age associated B cells express surface markers ___
CD11c
51
Age associated B cells express transcription factor:
T-bet
52
Age associated B cells have a robust response to ____ which bind ____
TLR7 and TL9; bind bacterial or viral DNA
53
Relative risk for autoimmune diseases are greater among ____. What is the exception?
Females; Ankylosing spondylitis is higher among males
54
Ankylosing spondylitis RR
1:3 (males affected more)
55
What is ankylosing spondylitis?
Type of arthritis in the joints of the spine
56
Over 90% of ankylosing spondylitis patients have:
HLA-B27
57
Lichen planus is mediated by:
Cytotoxic T cells (CD8+)
58
Lichen planus commonly affects ____ of the oral mucosa
Basal keratinocytes
59
Lichen planus looks a lot like:
Pemphigus/pemphigoid
60
Patients with lichen planus are usually taking ____
Immunosuppressants (more oral and viral diseases)
61
Oral lichen planus commonly presents as:
- bilateral white lesions of buccal mucosa (reticular white lacy lines) - confluent white papules on dorsal tongue
62
Systemic sclerosis is also known as
Scleroderma
63
What is systemic sclerosis?
- autoimmune disease of connective tissue - thickening of skin (collagen accumulation) - frequent damage to small arteries
64
Systemic sclerosis may result in
Disfiguring disease, auto-amputation of phalanges
65
Common feature of systemic sclerosis
Narrowing of esophagus
66
Main oral symptom of systemic sclerosis
Dysphagia (difficulty swallowing) Also incomplete mouth closure, sclerosis of frenulum
67
Multiple sclerosis is a ____ disease
Demyelinating
68
In multiple sclerosis, autoreactive ____ can cause damage and inflammation
T-lymphocytes
69
Multiple sclerosis involves:
- T-lymphocytes - CNS macrophages
70
Initial infection with _____ may trigger multiple sclerosis response
Epstein Barr virus
71
There is a ____ risk of multiple sclerosis after EBV infection
EBV infection
72
Type I diabetes is also known as
Insulin dependent diabetes mellitus
73
Type I diabetes is caused by
Autoimmune damage to insulin-producing pancreatic beta cells
74
What allelic variations are associated with type 1 diabetes?
- HLA-DR3 plus HLA-DR4 (highest risk) - HLA-DQ*B1 (associated)
75
Type 1 diabetes can lead to what oral manifestations?
- periodontitis - hyperplastic gingivitis another reason why kids may have periodontitis
76
Addison's disease is also known as
Primary adrenal insufficiency
77
Addison's disease involves antibodies against
21-hydroxylase in adrenal cortex
78
Addison's disease results in
Endocrine disorder - hypocortisolism
79
Addison's disease causes ____ in oral mucosa
Hyperpigmentation

DEN 7102 Micro & Immuno Concepts (26 decks)

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