Immunopathology I

Question 1

type I hypersensitivity

Answer 1

immediate. the injury is caused by TH2 cells, IgE antibodies, mast cells and other leukocytes

Question 2

type II hypersensitivity

Answer 2

antibody-mediated disorders, secreted IgG and IgM antibodies injure cells by promoting their phagocytosis or lysis and injure tissues by inducing inflammation

Question 3

Type III hypersensitivity

Answer 3

immune complex-mediated disorders, IgG and IgM antibodies bind antigens usually in circulation and antigen-antibody complexes deposit in tissues and induce inflammation

Question 4

Type IV

Answer 4

in cell mediated immune disorders sensitized T lymphocytes (TH1, TH17, and CTLs) are the cause of tissue injury

Question 5

systemic lupus is an example what what type of sensitivity

Answer 5

type III

Question 6

what antigen is involved in lupus

Answer 6

nuclear antigens

Question 7

thematoid arthiritis is an example of what type of hypersensitiviy

Answer 7

type IV

Question 8

isograft

Answer 8

from identical twin

Question 9

transplant rejection

Answer 9

immune damage resulting from recipient response to allograft HLA antigens

Question 10

direct pathway

Answer 10

reaction to donor APC

Question 11

indirect pathway

Answer 11

reaction to self APC

Question 12

cell mediated cytotxicity

Answer 12

host cytotoxic lymphocytes destroy graft cells

Question 13

delayed type hypersensitivy

Answer 13

helper lymphocytes secrete cytokines, recuit mononuclear cells which release inflammatory mediators which cause tissue damge

Question 14

what does kidney rejection most often affect

Answer 14

epithelial and vascular cells

Question 15

type II hypersensity reaction to target graft vascular

Answer 15

Ab bind to HLA moecules in graft endothelium, activate complement causing acute inflammation or basculitis

Question 16

type III hypersensitivity reaction to target graft vasculature

Answer 16

Ag-Ab complexes fix complement causing necrotizign, immune complex vasculitis

Question 17

what are the patterns of rejection

Answer 17

hyperacute, acute, chronic

Question 18

hyperacutre rejection

Answer 18

the recipienct has already encountered the donor materal and body views it as foreign.

Question 19

how can you prevent hyperacute rejection

Answer 19

cross-matching recipient serum with donor lymphocytes to determine presence of cytotoxin Ab to donor MHC I and II antigens

Question 20

what is acute rejection mediated by

Answer 20

cellular, humoral, or combined/overlapping mechanisms

Question 21

when does acute rejection occur

Answer 21

days-months post transplant or after withdrawal of immunosuppressive therapy

Question 22

morphology of acute rejection

Answer 22

lymphocytic infilitrates and tubular necrosis

Question 23

what cells predominant in acute cellular rejection

Answer 23

lymphocytes

Question 24

what cells predominant in acute cellular rejection

Answer 24

lymphocytes

Question 25

how do cytotoxin (CD8+) lymphocytes help with acute cellular rejection

Answer 25

infiltrates tubular and bascular basement membranes cause tubular damage and endothelitis

Question 26

how do hylper T cells (CD4+) help with acute cellular rejection

Answer 26

produce cytokines which cause extensive interstitial inflammation

Question 27

how does acute humoral rejection affect vascularture

Answer 27

necrotizing vasculitis | intimal thickening due to accumulation of fibroblasts, foamy macrophages, myocytes

Question 28

humoral injury of chronic rejection

Answer 28

proliferative vascular lesions

Question 29

cellular injury of chronic rejection

Answer 29

cytokine induced proliferation of bascular smooth muscle and production of collagen in extracellular matrix

Question 30

morphology of chronic rejection

Answer 30

vascular changes, interstitial fibrosis, tubular atrophy, chronic inflammation

Question 31

when does acute liver rejection occur

Answer 31

within 3 months after transplant

Question 32

what is teh triad of freatures of acute liver rejection

Answer 32

portal tract inflammation bile duct epithelial damage endothelitis of protal vein and hepatic a

Question 33

chronic liver rejection

Answer 33

progressive disappearnace of bile ducts due to direct immunologic destruction or loss of blood supply

Question 34

what is the end results of chronic liver rejection

Answer 34

portal and heptaic fibrosis

Question 35

what is heart transplant treatment for

Answer 35

advanced, irreversible myocardial disease

Question 36

what is a major complication of heart transplant

Answer 36

diffuse intimal proliferation, coronary artery disease silent MI infection maligancies

Question 37

what maligancies are assocaited with heart transplant

Answer 37

epstein-barr virus associated B cell lyphmoa

Question 38

what do steroids suppress

Answer 38

macrophage activity and inflammation

Question 39

how does cyclosporine work

Answer 39

block nuclear factor of activated T cell (NFAT)

Question 40

function of NFAT

Answer 40

necessary for IL-2 stimulation of T cells

Question 41

complications of transplantation

Answer 41

infections recurrence of origal disease maligancy MI due to steroids

Question 42

what maligancies are associated with transplant pts

Answer 42

lymphoma and kaposi's sarcoma

Question 43

why does transplantation of hematopoietic cells treat

Answer 43

hematologic disorders non-hematologic malignancies immunodefiences

Question 44

what are complications of transplantation of hematopoietic cells

Answer 44

graft versus host disesea infection immunodeficiency

Question 45

what has to happen to teh hematopoietic transplant pt

Answer 45

you have to completely destroy their bone marrow - very immunosuppresed

Question 46

graft v host disease

Answer 46

donot t cells recognize host HLA antigens as form and mount a type IV reaction against graft elements and tissues

Question 47

what are the targets of graft v. host disease

Answer 47

epithelia of skin, GI, liver