Hypersensitivities Flashcards
(58 cards)
1
Q
Autoimmune Hemolytic Anemia
A
- Type II hypersensitivity
- Antigen: Erythrocyte membrane proteins (Rh, I)
- Mech: Opsonization and phagocytosis of erythrocytes
- Sym: Hemolysis, anemia
2
Q
Autoimmune thrombocytopenia purpura
A
- Type II hypersensitivity
- Antigen: Platelet membrane proteins (GP IIb/IIIa)
- Mech: Opsonization and phagocytosis of platelets
- Sym: Bleeding
3
Q
Pemphigus Vulgaris
A
- Type II hypersensitivity
- Antigen: epidermal cadherin
- Mech: antibody mediated activation of proteases, interruption of int cellular adhesions
- Sym: Bullae
4
Q
Vasculitis caused by ANCA
A
- Type II hypersensitivity
- Antigen: Neutrophil granule proteins
- Mech: degranulation of neutrophils and inflammation
- Sym: vasculitis
5
Q
Goodpasture syndrome
A
- Type II hypersensitivity
- Antigen: noncollagenous protein in basement membrane of kidney glomeruli and lung alveoli
- Mech: complement and Fc receptor mediated inflammation
- Sym: nephritis, lung hemorrhage
6
Q
Acute Rheumatic Fever
A
- Type II hypersensitivity
- Antigen: streptococcal cell wall antigen, antibody cross reacts with myocardial antigen
- Mech: Inflammation, macrophage activation
- Sym: Myocarditis, arthritis
7
Q
Myasthenia Gravis
A
- Type II hypersensitivity
- Antigen: Ach receptor
- Mech: antibody inhibits Ach binding, down regulated receptors
- Sym: muscle weakness, paralysis
8
Q
Graves disease
A
- Type II hypersensitivity
- Antigen: TSH receptor
- Mech: Antibody mediated stimulation of TSH receptors
- Sym: Hyperthyroidism
9
Q
Insulin resistant diabetes
A
- Type II hypersensitivity
- Antigen: insulin receptor
- Mech: Ab inhibits binding of insulin
- Sym: Hyperglycemia, ketoacidosis
10
Q
Pernicious Anemia
A
- Type II hypersensitivity
- Antigen: Intrinsic factor of gastric parietal cells
- Mech: Neutralization of intrinsic factor, decreased absorption of B12
- Sym: Abnormal erythropoiesis, anemia
11
Q
Systemic lupus erythematosus
A
- Type III hypersensitivity
- Antigen: DNA, nucleoproteins, others
- Sym: nephritis, arthritis, vasculitis
12
Q
Polyarteritis Nodosa
A
- Type III hypersensitivity
- Antigen: Hep B virus surface antigen
- Sym: Vasculitis
13
Q
Post-Streptococcal Glomerulonephritis
A
- Type III hypersensitivity
- Antigen: Streptococcal cell wall antigens, may be “planted” in glomerular basement membrane
- Sym: Nephritis
14
Q
Acute glomerulonephritis
A
- Type III hypersensitivity
- Antigen: bacterial (Treponema), parasite (malaria, schistosomes), tumor antigens
- Sym: Nephritis
15
Q
Reactive arthritis
A
- Type III hypersensitivity
- Antigen: Bacterial antigens (yersinia)
- Sym: acute arthritis
16
Q
Arthus Reaction
A
- Type III hypersensitivity
- Antigen: Various foreign proteins
- Sym: cutaneous vasculitis
17
Q
Serum Sickness
A
- Type III hypersensitivity
- Antigen: Various proteins (antisera, antibodies, viral antigens)
- Sym: Arthritis, vasculitis, nephritis
18
Q
Immunoglobulin
A
Endogenous antigen
Rheumatoid arthritis
19
Q
Tumor antigen
A
Endogenous antigen
Glomerulonephritis
20
Q
Aspergillus
A
Exogenous antigen
Farmers lung
21
Q
Quinidine
A
Exogenous antigen
Hemolytic anemia
22
Q
Heroin
A
Exogenous antigen
Glomerulonephritis
23
Q
Rheumatoid Arthritis
A
Type IV Hypersensitivity
- Inflammation mediated by Th17/Th1 cytokines, possible role of antibodies and immunize complexes
24
Q
Multiple Sclerosis
A
Type IV Hypersensitivity
- Inflammation mediated by Th17/Th1 cytokines, myelin destruction by activated macrophages
25
Type 1 Diabetes Mellitus
Type IV Hypersensitivity
| - T cell mediated inflammation, destruction of islet cells by CTLs
26
Hashimoto Thyroiditis
Type IV Hypersensitivity
| - Inflammation, CTL-mediated killing of thyroid epithelial cells
27
Inflammatory Bowel Disease
Type IV Hypersensitivity
| - inflammation mediated mainly by Th17 cytokines
28
Autoimmune myocarditis
Type IV Hypersensitivity
| - CTL-mediated killing of myocardial cells; inflammation mediated by Th1 cytokines
29
Contact sensitivity
Type IV Hypersensitivity
| - Inflammation mediated by Th1/Th17 cytokines
30
A RASH POINts MD
SLE criteria:
Arthritis, Renal Disease, ANA positive, Serositis, Hematologic disorders, Photosensitivity, Oral/nasopharyngeal ulcers, Immunologic disorders, Malar rash, Discoid rash
31
Anti-dsDNA
- SLE
- Formation of immune complexes
- diagnostic
32
Anti-Sm (ribonuclease core protein, Sm antigen)
- SLE
- Formation of immune complexes
- diagnostic
33
Anti-RNP U1 (Ribonucleoprotein)
- SLE, mixed connective tissue disease
| - Formation of immune complexes
34
Anti-SS-A (Ro), Anti-SS-B (La)
| Ribonucleoproteins
- Sjögren syndrome, SLE
| - Role in Sjögren syndrome not known
35
Anti-Scl-70
| DNA topoisomerase I
- Systemic Sclerosis
| - Unknown role in disease
36
Anti-Histones
| Histone proteins
- SLE
| - formation of immune complexes
37
Anti-centromere
| Centromere proteins
- Limited scleroderma, systemic sclerosis
- Unknown function
- Diagnostic
38
Antiphospholipid
| Phospholipid protein complexes involved in blood coagulation
- Antiphospholipid syndrome, SLE
| - Thrombotic episodes
39
Anti-Jo1
| Histidyl tRNA ligase
- Inflammatory myopathies
- Unknown role in disease
- Diagnostic
40
Anti-mitochondrial
- Primary biliary cirrhosis
| - Unknown role
41
Anti-eTg
| Transglutaminase
- Dermatitis herpetformis
| - Unknown role
42
Anti-Neutrophil cytoplasmic antibody (ANCA)
| Proteins in neutrophil cytoplasm
- Various vasculitides
- Possible formation of immune complexes
- diagnostic
43
Anti-Smooth muscle
- Chronic autoimmune hepatitis
| - Unknown role
44
Drug induced SLE
Procainamide, hydralazine
45
Diffuse Systemic Sclerosis
- Widespread Dermal involvement
- Early visceral involvement: Pulmonary interstitial fibrosis, pulmonary hypertension, renal damage, malignant hypertension, gastrointestinal (esophagus - difficulty swallowing, acid reflux), cardiac involvement
- Rapid progression
- ANAs
- DNA topoisomerase I (Scl-70) specific for diagnosis
46
Localized systemic sclerosis
- CREST: Calcinosis, Raynauds, Esophageal days motility, Sclerodactyly, Telangiectasia
- Anticentromere Ab
47
Hyperacute Rejection
- occurs when pre-formed antibodies to donor antigens (ABO, HLA) are present in recipient (Type II)
- Main target is vascular endothelium
- Complement fixation causes thrombosis of vessels and death of graft
- irreversible
48
Acute Rejection (Cellular)
- Edema and mononuclear infiltrate
- Endothelitis
- Type IV
- Reversible
49
Acute Rejection (Humoral)
- Rejection vasculitis
- Marked intimate thickening
- Anti-donor antibodies
- Type II
- Reversible
50
Chronic Rejection
- Most common cause of graft failure
- Better immunosuppression preventing acute rejection
- Chronic DTH (Type IV) of CD4 T cells
- Atherosclerosis of vessels
- Obliterative intimacy fibrosis of vessels (smooth muscle cells)
- Interstitial fibrosis
51
AL Amyloid
- immunoglobulin light chains (lambda)
| - plasma cell derived related to monoclonal B cell proliferation
52
AA amyloid
- Serum amyloid associated protein (SAA)
- non-immunoglobulin protein synthesized by liver
- Related to chronic inflammation
- Found in reactive systemic amyloidosis
53
AB amyloid
- Amyloid beta - amyloid precursor protein
| - Found in cerebral lesions of Alzheimer's disease
54
AB2M Amyloid
- B2 microglobulin
| - Long term hemodialysis patients
55
Transthyretin (TTR) amyloid
- Senile amyloidosis (heart)
| - Familial amyloidosis (mutated form of TTR)
56
Prion proteins
CNS Prion Disease
57
Systemic Amyloidoses
- Primary (immunocyte dyscrasias) - AL
- Secondary (Chronic inflammation) - AA
- Hemodialysis (AB2m)
- Systemic Senile (TTR)
- Hereditary/ Familial (Mutated forms of AA and TTR)
58
Localized Amyloidoses
- Senile cerebral (Alzheimer's - AB)
- Endocrine (Type 2 diabetes - islet amyloid peptide)
- Thyroid (medullary carcinoma - calcitonin)
