lect 15.2

Question 1

when would an oral food challenge be administered?

Answer 1

Clinical suspicion of food allergy but diagnosis uncertain based on SPT and / or
serum specific IgE

helps detemine if a patient has outgrown an allergy

Question 2

what allergy is most and least common to outgrow

Answer 2

diary

shellfish

Question 3

what kind of reaction occurs from biting not venomous insects

Answer 3

local reaction

extremely rare for systemic reaction

Question 4

what kind of reaction comes froms stinging insects

Answer 4

type 1 hypersensitivity

Question 5

what are the clinical interventions for type 1

Answer 5

enviroental interventino
- avoidance and masks

pharmacological intervention

immunological intervention

Question 6

what are the pharmocological interventions for type 1

Answer 6

epinepherine- relxes SM, dec cAMP (prevent degranualation), inc vardiac output, reduces vascular permeability

anti histamins

cortisone- acts on first phase symptoms

Question 7

what is hyposensitixation

Answer 7

immunological intervention for type 1 hypersensitivity

shifting from TH2 igE respnose to TH1 igG4 response

Question 8

what does shifting from igE to igG lead to

Answer 8

turning on the inhibitory mast cell FcR to prvent degranulation

desensitization leading to inc igG4,
dec igE
dec basophil and mast cell activation

Question 9

what is the function of T reg cells

Answer 9

they operate at the site of the immune response and are non specific

NOT SYSTEMICALLY

Question 10

what are some other immunological interventions for typr 1

Answer 10

anti igE monoclonal antibody that binds to CIRCULATING igE

cytokines and anti cytokines and cytokine receptor antagonists

adhesion molecule antagonists

Question 11

what are the adhesion molecule antagonsits used in typr 1 treatment

Answer 11

anti ICAM 1 treatment for asthma

Question 12

what cytokines are ysed fro type 1 treatment

Answer 12

il 12

il 10

Question 13

what are the anti cytokines used in type 1

Answer 13

anti il 4

Question 14

what are the anti igE monoclinal antibodies drugs used

Answer 14

omalizumab

xolair

approved for asthma and food allergies

Question 15

explain protective role of IgE

Answer 15

igE on mast cell binds to worm/ helminth antigen

leads to degranulation

extraceuular killing of the helminth

Question 16

what antibodies used in type 2

Answer 16

igM - primary respsone

igG - secondary - class switch

Question 17

what does type 2 hypersensitivity depend on

Answer 17

Ab binding on self antigen on cell

Question 18

exposure requirements of tye2

Answer 18

previous exposure not required but increaes the change of reaction the more you are exposed

Question 19

what type 2 reaction occurs if you have a tranfusion that isnt matched to your blood type

Answer 19

compliment medated hemolysiswh

Question 20

why dont you react toyour own blood type or Rh

Answer 20

bc you have microbes in your gut that have the same antigens as in your blood, you wont produce Abs against these antigens

Question 21

what is the result of Ag:Ab bidning of your own antigens in type 2

Answer 21

• Complement-mediated hemolysis
• Ab dependent cell-mediated
  cytotoxicity (ADCC)
• Anti-receptor Ab’s
• Hemolytic anemia

Question 22

Ab dependent cell-mediated cytotoxicity (ADCC) in type 2

Answer 22

drug induced reactions

drug acts as a hapten on your cell that is then targetted by Abs

The FcR binds to NK cells leading to target cell apoptosis

Question 23

what disease is implicated in anti-receptor antibodies

Answer 23

myasthenia gravis

Question 24

explain myasthenia gravis

Answer 24

Antibodies develop that bind
to the acetylcholine receptor
on muscle cells
- prevents muscle activation
by ACh
- leads to muscle weakness

Question 25

explain hemolytic disease of the newborn

Answer 25

fetal antigens normally go into the mothers blood and they incerase during delivery

if the kid has a Rh that doenst match mom, shell make antibodies against it that will bind to the RBC in the second pregnancy and clear the RBC of the kid by the spleen

BY HEMOLYSIS BY COMPLEMENT OR ABO incompatibitlity

maternal antibodies cirulate in the newborn for up to 6 mo and lead ot mild to severese anemia in the baby

bilirubin builds up form Hb rememnants and leadsot brain damage

Question 26

what is used to treat hemolytic disease of newborn

Answer 26

Rhogam that binds to kids antigens perventing mom ab from binding and preventing B cell activation and memory cell formation

Question 27

what is rheumatic fever

Answer 27

type 2

infection w step bact

lead to fomation of Ab against step but also against cardiac Ag (molecular mimmickery)

Ab deposition

rheumatic fever