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69 Cards in this Set
- Front
- Back
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What types of symptoms present with Thrombotic thrombocytopenic purpura?
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Platelet aggregation and deposition as thrombi causing hemolytic anemia, renal impairment and neurologic symptoms
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What is hemolytic uremic syndrome(HUS)?
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1. resembles TTP but in children. 2. Comes from E. coli or shigella 3. leads to renal failure
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What is basophilia?
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An elevation of the basophils that is linked to allergic hypersensitivity and chronic myeloproliferative syndromes
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Describe the 4 hypersensitivities as ACID?
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1. A-anaphylactic shock and Atopic(affects parts of body not in contact with allergen)
2. C-y-2-toxic rxn is direct 3. I-mmune complex type 3 4. D-elayed, cell mediated immunity is type 4 |
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What is chronic myelogenous leukemia aka chronic granulocytic leukemia?
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1. Mutation of the phili xsome 2. bone marrow to proliferate leukocytes and granulocytes abnormally.
3.The abnormal cells eventually crowd out the healthy cells and bone marrow damage occurs |
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What are the 3 main VasoD's
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Prostaglandins, NO and Histamine
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What 6 factors increase vascular permeability?
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1. Vasoactive amines
2. C3a and C5a 3. Bradykinin 4. Leukotriens C4, D4, and E4 5. PAF 6. Substance P |
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What chemicals increase leukocyte recruitment and activation?
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1. C5a
2. Leukotriene B4 3. Chemokines 4. Il-1 and TNF 5. Bacterial Products |
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What are the 3 main pyrogenic molecules?
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Il-1, TNF and prostaglandins
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What causes pain inflammation?
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Prostaglandins and bradykinins
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What cells do you associate granulomas with?
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TH1 cells, CD8 and Macrophages
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What is agammaglobulinemia?
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X-linked disorder of people who don't produce B-cells(Plasma cells)
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People with AR SCID have what problem?
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Inability to produce the lymphoid precursor and therefore no B or T cells. Patients would need a bone marrow transplant
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What is the problem with X-linked SCID?
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1. No Pre-T cells
2. can still produce B-cells. 3. Bone marrow transplant |
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What is aplastic anemia?
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A disorder of the stem cells that leads to bone marrow failure. Not plastic = not changing/growing
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What is megaloblastic anemia?
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A folate or B12 deficiency causing impaired DNA synthesis and RBCs aren't formed right
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Describe Type 1 hypersenstivity?
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1. First and fast
2. The free antigen touches IgE on a Mast or Basophil 3. Massive release of vasoactive amines causes anaphylaxis and atopic spread over the body |
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Which are the antibody mediated hypersensitivities
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1,2 and 3
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Describe Type 2 hypersensitivity?
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1. Cy-2-toxic
2. IgM or IgG bind the antigen normally, but here a self antigen has been recognized as foreign 3. Membrane attack complex(MAC) mac's down the pathogen(YOU!) |
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Describe a Type 3 hypersensitvity?
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1. IgM and IgG are in large quantities
2. Cause extensive crosslinking into large immune complex structures 3. Large complexs are cleared easily by macrophages 4. Smaller complexes escape clearance and cause destruction of endothelial vessels 5. Causes inflammation and destruction |
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Describe a type 4 hypersensitivity?
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1. Delayed 2-3 days
2. CD4 cells recognize the antigen complexed with a MHC from an APC 3. T- cells proliferate and macrophages become multinucleated giant cells |
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What are the 4 Ts of type 4?
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T-lymphocytes, Transplant rejection, TB skin tests, Touching contact dermatitis
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Name some Type 1 conditions?
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1. Asthma
2. Hay fever 3. Hives 4. Anaphylaxis |
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Name some type 2 conditions?
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1. Goodpastures
2. ITP 3. Graves 4. ANCA dzs 5. Hemolytic blood transfusions 6. Myasthenia |
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Name some Type 3 conditions?
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1. SLE
2. Serum sickness 3. Post-strep glomerulonephritis 4. Polyarteritis nodosum(hepB) |
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Name some type 4 conditions?
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1. Hashimotos
2. Poison Ivy 3. Sjorgrens 4. Contact dermatitis 5. TB |
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What do TH2 cells do?
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1. Initiate B cell production using IL-4 and IL-5
2. Produces IgE and IgG antibodies |
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What is IgG?
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The main, and most abundant, secondary response antibody. Only produced after an IgM has been produced. It fixes complement, opsonizes bacteria, neutralizes toxins and crosses the placenta
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What is IgM>
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The primary responder that is Mega big so it can't cross the palcenta
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What is IgE?
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The Ellergic responder, activates basophils and mast cells. Also reacts to worms. Lowest concentration
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What is IgA?
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Prevents the attachment of bacteria and viruses to the mucus membrane, does not fix complement
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How would you paradoxically treat a Rh+ woman with ITP?
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Give her Rhogam to induce hemolytic anemia, this ties up the macrophages and prevents them from destroying other cells
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What is Kernincterus?
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Damage to the brain centers of infants caused by increased levels of unconjugated-indirect bilirubin which is free (not bound to albumin).
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What happens to infants deficient in glucouronyl transferase?
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They have increased unconjugated bilirubin and could get cerebral palsy and jaundice. Tx this by putting them under bililights
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Describe Goodpasture's syndrome?
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A type 2 autoimmune that targets the BM in the glomeruli and alveoli. Causes nephritis and lung hemorrhage with an air bronchgram!
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What is a spherocyte?
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A sphere shaped RBC, happens in hemolytic anemia
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Describe hydrops fetalis?
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Hemolytic anemia causes high output cardiac failure in a newborn
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What is the Coomb's test?
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It looks for IgG in your blood that may destroy your RBC causing a hemolytic anemia
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What is the direct and indirect Coomb's test for?
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1. The direct will test a patient after drugs or a Dz that may lead to anemia, and the antibodies are already in your serum
2. The indirect tests whether or not the patient will create antibodies to new blood, for blood transfusions or a baby |
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What does an abnormal Coomb's indicate?
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1. A positive direct could be from autoimmune hemolytic anemia, chronic lymphocytic leukemia, mono, SLE, syphillis or erthyroblastosis fetalis
2. A positive indirect indicates your body will not accept new blood |
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What is erythrobastosis fetalis?(4)
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1. Hemolytic Dz of the new borns
2. D antigen from the first baby gives the mother an IgG 3. The second baby comes along and he is D+ 4. The mom's IgG will now cross the placenta and destroy the baby's RBC giving hemolytic anemia |
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What is IL-1?
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1. Secreted by a macrophage in acute inflammation
2. recruit leukocytes 3.pyrogen |
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What is IL-2?
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Secreted by Th1, it stimulates T-cells
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What is IL-3?
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Secreted by Th2 it stimulates bone marrow
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What is IL-4>
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Secreted by Th2 it stimulates IgE
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What is IL-5?
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Secreted by Th-2 it stimulates IgA. It also actives B cells and eosinophils
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What is IL-6?
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Secreted by Th and macrophages it stimulates Acute phase reactants and Ig's
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What is IL-8?
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Released from macrophages initiates neutrophil chemotaxis
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What is IL-10?
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From T-cells it inhibits T-cells
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What is IL-12?
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From B cells it activates Th1 and NK cells
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What is gamma interferons?
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From Th1 cells it stimulates macrophages
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How would you perform a direct and indirect Coombs test?
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1. Extract blood and add Coombs Reagent. If you see agglutination you have positive
2. Extract blood. Add to different blood types with Coombs reagent. Positive Coombs agglutinates |
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Name two antireceptor antibody dz?
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1. Graves anti-TSH-R
2. Myasthenia gravis anti-ACh-R |
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What is crescenteric glomerulonepthritis associated with?
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Goodpastures
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Which diabetes is considered to be autoimmune?
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Type 1 insulin dependent diabetes mellitus
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What causes micrscopic polyangitis?
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1. Anti-neutrophil cytoplasmic antibody (ANCA)
2. Type 2 hypersensitivity |
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What occurs during microscopic polyangitis?
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1. ANCA destroys the PMNs inside the vessels.
2. Proteases and hydrolytic enzymes release and cause the destruction of vascular walls of the kidney and lungs 3. Necrotizing and crescenteric glomerulonephritis |
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What does graves dz do to the throid follicles?
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It causes them to overgrow, since they can't go anywhere they grow papules
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What are 4 pulmonary/renal syndromes?
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1. Goodpastures
2. Microscopic polyangitis 3. Churg Strauss 4. Wegeners |
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Describe Post-step glomerulo nephritis?
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1. Begins with Beta hemolytic strep that causes a beta hematuria
2. An immunce complex will fall on a basement membrane 3. Destroys the wall and fibrinoid necrosis will occur |
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Describe the problem in polyarteritis nodosum?
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A type 3 where the body produces an antibody to Hep B. Immune complex falls onto vessel wall and causes an anneurysm
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How do the immune complexes form a rash in SLE?
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The IC precipitates onto the dermis/epidermis junction
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Where does the lumpy bumpy patter occur and how do you recognize it?
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It is elucidated by flourescence and forms around the BM of alveoli or glomeruli
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What is diffuse glomerulonephritis?
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A symptom where all of the glomeruli are attacked leading to renal failure. Treat by preventing the inflammation that will lead to irreversible scarring
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Describe Sjogren's Dz?
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A type 4 hypersensitivity, where the CD8 cells attack salivary and lacrimal glands. Usually in older females.
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What is the histology of hashimoto's?
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Askanazy hurthle cells
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Describe Hashimoto's?
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1. type 4 hypersensitivity
2. CD8 cells attack the thyroid. 3.thyroid tissue is replaced by lymphoid 4.hypothyroidism, no cold tolerance, and hypotension |
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Describe rheumatoid arthritis?
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1. type 4 where the CD8s and PMNs are infiltrating the synovial tissue.
2.They begin to form a pannus and destroy underlying cartilage, and eventaully get to the bone as well. Joint fusion will occur |
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What does antimitochondrial antibody indicate almost always?
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Primary biliary cirrhosis
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