Type III Immunopathology Flashcards Preview

Blood and Lymph Unit 2 > Type III Immunopathology > Flashcards

Flashcards in Type III Immunopathology Deck (30):
1

What three requirements must be met in order to see a type III immunopathology?

The immune complex must...
1. Be to small to removed by RED
2. Large enough to activate complement
3. Too large to readily pass through basement membrane

2

What components of complement recruit neutrophils?

C3a and C5a

3

Name somethings that neutrophils release upon arrival to immune complexes stuck in a basement membrane.

Inflammatory factors like proteases cathepsin G and elastase and hydrogen peroxide

4

What activates metalloproteinases?

Hydrogen peroxide

5

What three things contribute to degradation of the basement membrane?

Proteases cathepsin G (produced by neutrophils)
Elastase (produced by neutophils)
Metalloproteinases

6

What helps release histamine from mast cells?

C3a and C5a

7

Type III immunopathology causes what?

Widespread small vessel vasculitis

8

Polyarteritis nodosa can be caused by what virus?

Hepatitis B and C
-Viral proteins + antibodies embed in medium sized arteries

9

Can an antigen that is quickly cleared by the body cause Type III?

No. The antigen needs to be given in a high enough quantity so it can be around when the antibody is finally made by the B cells

10

What is the onset of serum sickness?

10-14 days after exposure. Need time for the antibodies to be released. 10-14 is the time it takes for the antigen to still be in a little bit of excess of the antibody -

11

What are the symptoms of serum sickness?

Fever
malaise
rash + itch
arthraligia

12

True or Flase
Serum sickness can happen after treatment with murine, chimeric, or humanized monoclonal antibodies

True

13

How can penicillin cause a type III reaction?

Penicillin can be know to bind to human peptides.

Complex taken up by B cells and digested and presented to T cells

T cells recognize penicillin + chewed up protein and activates B cell switching

B cell creates anti-penicillin antibodies

Complexes form

14

True or False:
Serum sickness-like symptoms can be seen in patients with viral infections like hepatitis

True.
Lower-leg rash
Malaise
Fever
Arthralgias

15

An 8 year old boy comes into the emergency room complaining of nausea, vomiting, fever, malaise, hypertension. reduced urine output,hematuria, and joint pain. What should be your next question?

Have you had a soar throat lately because it sounds like acute post-streptococcal glomerulonephritis.

16

What is the treatment for someone with acute post-streptococcal glomerulonephritis?

Antibiotics and supportive care

17

What would you see on the labs of a patient with acute post-streptococcal glomerulonephritis?

Hematuria
Decreased complement levels

18

A farmer comes in with a dry cough, malaise, fever and tachycardia. It has been raining lately What should be on your differential?

Hypersensitivity pneumonitis. caused by thermophilic Actinomycetes found in moldy hair. Aerosolized spores are inhaled complexes form in the lunges

19

What is the treatment of hypersensitivity pneumonitis?

Systemic glucocorticoids and avoidance

20

A booster immunization is given to a child. The injection site becomes inflammed. What has just occured?

Arthus reaction. Pre-existing antibody to immunogen complexes immediately begin to form locally.

21

Can antigens be endogenous?

Yes

22

Rheumatoid factor is an IgM anti-IgG, but it is just big enough to deposit in the BM. So what type of reaction it this?

Type III

23

Describe the pathogenesis of systemic lupus erythematosus.

Antibodies to double stranded DNA
HIstones H2, H3, and H4.

The antibody---dsDNA preferentially deposit in kidneys

24

Why do SLE patients develop facial butterfly rashes?

Sun-damaged DNA-releasing skin cells + reactive antibodies

25

What is the leading reason for kidney transplatation?

IgA Nephropathy.

26

What causes IgA nephropathy?

Terminal sugars of the carbohydrate chains in the hinge of an IgA are missing creating a new epitope that looks like those found in bacteria and viruses.

Antibodies bind and the complexes deposit in the basement membranes of kidneys

27

What are some causes of IgA nephropathy?

Chronic tonsillitis and maybe some genetic causes

28

How can you diagnose Type III?

1. Low total hemolytic complement
2. Cryoglobulins
3. Rheumatoid factor
4. Renal biopsy

29

What are cryoglobulins?

Fluffy precipitate when the serum is kept 24 hours in the rerigerator (immune complexes which are less soluble in the cold)

30

Visualizing a renal biopsy with fluorescein-labeled goat antibodies to human immunoglobulin would show what type of pattern if the pathology was Type III?

Lumpy bumpy