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114 Cards in this Set

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  • Back
What are inappropriate immune responses called?
What is characterized by immune mechanisms that initiate inflammation and result in the destruction of healthy tissue
T/F The inappropriate reaction to an antigen takes place after re-exposure (not immediately).
T/F All hypersensitivities are not life threatening
False - they may all be life threatening.
What may all hypersensitivities be?
Immediate or Delayed
What kind of hypersensitivity occurs in minutes to a few hours?
Immediate hypersensitivity
What type of hypersensitivity takes several hours and are at maximum severity days after re-exposure?
Delayed Hypersensitivity
What is a exaggerated immune responses against environmental antigens?
What kind of hypersensitivity is most common and least threatening?
What are either haptens or small-molecular-weight proteins?
What are the following:
-Pollens (tree, grass, and weed)
– Molds and fungi
– Foods (milk, egg, fish, wheat)
– Animals (cat and dog dander)
– Cigarette smoke
– Components of house dust (dust mites)
– Medications (penicillin, sulfa)
What is a misdirected immune responses against the host’s own cells?
What is a disturbance in the immunologic tolerance of self-antigens?
What is it when the immune system reacts against self-antigens and destroys host tissues
What are produced during autoimmunity?
What is commonly found in older people?
What is part of the aging process may be a deterioration of tolerance to self-antigens?
What is immune responses directed against beneficial foreign tissue?
What is the immune system produces a reaction against cells and tissues of another individual
The following are a type of what:
1. Blood transfusion
2. Organ transplantation and grafted tissue
3. Fetus during pregnancy
The most severe immediate hypersensitivity reaction is called what?
What is a rapid response, occurring within minutes of re-exposure?
What are the types of anaphylaxis?
Localized or systemic
The following is an example of what: cutaneous anaphylaxis includes erythema (reddish skin), hives, edema.
Localized anaphylaxis
The following are examples of what:
-Itching and erythema (reddish skin)
– Vomiting, abdominal cramps, diarrhea
– Laryngeal edema, breathing difficulties, respiratory distress
– Anaphylactic shock: widespread edema causes decreased blood volume and blood pressure, which may result in vascular collapse, shock and eventually death
Systemic anaphylaxis
The following are examples of what:
– Generalized itching
– Numbness & tingling, commonly around face and mouth
– Hive-type skin irritation
– Difficulty breathing
– Tightening of the chest
– Weakness/dizziness
– Abdominal cramps, diarrhea, vomiting
– Rapid, weak pulse
Anaphylactic Shock
How many types of hypersensitivity reactions are there?
What are Types I, II, and III hypersensitivity mediated by?
What is type IV hypersensitivity mediated by?
T/F Types I, II, and III are delayed, while type IV is immediate.
False - Types I, II, and III are immediate, while type IV is delayed.
Allergic rhinitis (mast cells)is an example of what type of hypersensitivity?
Type I: IgE mediated Reactions
What type of reaction is the most common?
Type I Hypersensitivity
What is produced by B-cells after exposure to an allergen (environmental antigen)?
IgE Antibody
T/F Repeated exposure to large doses of allergen elicit enough IgE to “sensitize” the person.
In a sensitized person, re-exposure causes IgE to initiate what?
Mast Cell Degranulation
What do mast cells release?
What mediates the allergic response?
Histamine Receptors
What causes:
-Contraction of bronchial smooth muscles resulting in bronchial constriction and breathing difficulties
– Increased vasodilatation and vascular permeability resulting in edema
The interaction of histamine with histamine receptors.
Which tissues respond the most to histamine?
- Skin: itching, swelling, hives
– GI tract: cramping
– Respiratory tract: constriction of airways
– Other tissue: conjunctivitis, rhinitis, edema of the larynx
What is the general manifestation of a type I hypersensitivity?
– Hypotension
– Irregular heart beat
– Anaphylactic shock
What are examples of Type I hypersensitivity?
- Hay fever
– Asthma
– Eczema
– Local anaphylaxis
– Systemic anaphylaxis
Genetic predisposition: some individuals appear to be prone to allergies and are called what?
What type of individuals:
– Produce higher concentration of IgE
– Their airways and skin are more responsive to stimuli
Atopic Individuals
If one parent has an allergy, what percent of the offspring develop allergies?
If two parents have an allergy, what percent of the offspring develop allergies?
T/F is higher in children of atopic mothers than fathers.
T/F Because allergic reactions can be life threatening, sensitized individuals can try to be in contact with the specific allergens.
False - they should try to avoid the allergens.
T/F Tests of IgE mediated allergy are available to determine the specific allergen.
What kinds of tests can be performed to determine specific allergens?
Blood and Skin tests
What are the following examples of:
– Injections of minute amounts of allergen in increasing doses over a prolonged period
– May reduce the severity of the allergic reaction in treated individuals
What is also known as antibody-mediated cytotoxic hypersensitivity?
Type II: Tissue-specific Reactions
What is a type of disease that is tissue-specific?
– Graves disease
– Blood transfusion reactions
– Haemolytic disease of the newborn
– Autoimmune Haemolytic anaemia
– Drug reactions
How are tissue specific antigens expressed?
the plasma membrane of cells in specific tissues
What begins with antibodies binding to tissue-specific antigens?
Type II Hypersensitivity: Tissue Specific Reactions
What end in the destruction of the target (host) cell by macrophages (or by NK Cells)?
Type II Hypersensitivity: Tissue Specific Reactions
What is caused by antigen-antibody (immune) complexes?
Type III: Immune Complex mediated Reactions
The mechanism of this includes:
1. Large quantities of antigen-antibody complexes (IgG and IgM) form in the blood
2. They are deposited in the capillaries’ walls (between the endothelial cells and the basement membrane)
3. The antigen-antibody complexes activate the complement system
4. Complement proteins and the antigen-antibody complexes attract leukocytes to the area, mostly neutrophils
5. The neutrophils attempt to ingest the immune complexes, but cannot because the complexes are bound to the tissue (capillary wall)
6. The neutrophils discharge their lysosomal enzymes (killing agents) into the tissue
7. This promotes massive inflammation which causes tissue damage
8. This leads to tissue death and hemo
Type III: Immune Complex mediated Reactions
What type of reactions are not organ-specific but occur mostly in the blood vessels of the skin, joints, and kidneys
Type III: Immune Complex mediated Reactions
Examples of this are:
– Systemic lupus erythematosus
– Skin lesions of syphilis and leprosy
Type III: Immune Complex mediated Reactions
What type of hypersensitivity is mediated by specifically sensitized T cells, does not involve antibodies?
Type IV: Cell-mediated tissue destruction
What kind of hypersensitivity is always a delayed reaction?
Type IV: Cell-mediated Tissue Destruction
What are the types of Type IV: Cell-mediated Tissue Destruction?
Cytotoxic T cells (Tc) and Lymphokine-producing cells (Td)
What attack and destroy target cells directly (by toxins)?
Cytotoxic T Cells
What produce lymphokines that recruit macrophages to phagocytose target cells
Lymphokine-producing cells (Td)
What are clinical examples of Type IV Cell-mediated tissue destruction?
- Graft and transplant rejection
– Tumor rejection
– Autoimmune diseases
- contact with poison ivy and metals
– Interaction with certain drugs such as sulfa and penicillin
What types of autoimmune diseases are Type IV?
Rheumatoid arthritis &
Insulin-dependent diabetes mellitus
The following is an example of what:
- Poison ivy or poison oak causes a delayed hypersensitivity reaction with lesions only at the site of contact
– The allergen is a plant resin, too small to induce an immune response (a hapten)
Allergic Contact Dermatitis
The following is an example of what:
- Drugs such as penicillin and sulfa are haptens
• Penicillin may cause anemia by binding to proteins on erythrocytes
Interaction with certain drugs such as sulfa and penicillin causing Type IV hypersensitivity.
What is the mechanism of type IV hypersensitivity?
The allergen a hapten: a molecule that is too small to induce an immune response
– Haptens bind to a protein in host cells and only then the immune response is initiated
– When binding with host cell proteins, haptens become a neo-antigen (new antigenic determinant), which is recognized as foreign
– The immune system attacks the neo-antigen on the host cell’s membrane and destroys the cell
What is a breakdown of tolerance, in which the body’s immune system begins to recognize self-antigens as foreign?
– Immunologic tolerance to self antigens develops during what period of gestation?
Embyronic Period
T/F The original insult that caused the autoimmunity response may be either apparent or not.
Apparent original insults include what?
include drug-induced anemia and virus induced changes (such as rubella infection)
Unnapparent original insults include what?
include rheumatoid arthritis and systemic lupus erythematosus (SLE)
T/F Most autoimmune diseases happen after preexisting infections that leave no trace.
What disease is the only autoimmune disease that has been associated conclusively with a preceding infection (group A streptococcal infection)?
rheumatic heart disease
What sex is autoimmune disease more prevalent in?
Are autoimmune diseases more prevalent in whites or blacks?
What age group are most autoimmune diseases found in?
20-40 years old
T/F There is a decreased incidence of autoimmune diseases in twins.
False - there is an increased incidence.
T/F In most autoimmune diseases there are only exacerbations.
False - There are remissions and exacerbations.
What disease does the following describe: TSH receptors are bound (Dr. S’s notes say ‘destroyed’ but they are actually bound) causing hyperthyroidism (the antibodies stimulate the
thyroid to produce hormone).
Graves Disease
What type of disease occurs when the acetylcholine receptors on muscle cells are destroyed causing muscular weakness?
Myasthenia Gravis
What type of disease is characterized when myelin cells, which surround and insulate axons of nerve cells are destroyed, leading to decreased nerve conduction?
Multiple Sclerosis
What type of autoimmune disease occurs when multiple tissues are attacked and destroyed?
Systemic lupus erythematosus (SLE)
What type of disease is a chronic, multisystem, inflammatory disease
and is one of the most common, complex, and serious autoimmune disorders?
Systemic lupus erythematosus (SLE)
What type of disease occurs when a large variety of auto-antibodies are produced against many self-components including Nucleic acids (DNA), phospholipids (cell membranes)and Erythrocytes, lymphocytes, platelets, clotting proteins?
Systemic lupus erythematosus (SLE)
What disease occurs when Circulating immune complexes composed of DNA and antibody are deposited and cause inflammatory lesions (tissue damage) in the kidneys, brain, heart, spleen, lung, GI tract and skin (type III hypersensitivity)?
Systemic lupus erythematosus (SLE)
What are the clinical manifestations of lupus?
– Arthritis (90% of individuals with SLE)
– Rash (70-80%)
– Renal disease (40-50%)
– Hematological abnormalities such as anemia (50%)
– Cardiovascular disease (30-50%)
Why is it extremely difficult to diagnose SLE?
Because the signs and symptoms affect almost every system in the body and tend to come and go.
What are the eleven clinical findings of SLE?
1. Facial rash confined to the cheeks (wolf like face-lupus)
2. A scaling rash with raised patches
3. Photosensitivity: skin rash in sunlight
4. Oral or nasopharyngeal ulcers
5. Arthritis of at least two peripheral joints
6. Inflammation of serous membranes such as pleurisy and pericarditis
7. Renal disorders such as protein-uria
8. Neurologic disorders such as seizures or psychosis
9. Hematologic disorders such as hemolytic anemia, leukopenia or thrombocytopenia
10.Immunologic disorders
11.Presence of antinuclear antibody
How many of the eleven clinical findings of SLE must be found simultaneously for diagnosis?
Four of the eleven
What occurs when an individual’s immune system reacts against antigen on tissue of other members of the same species?
What are two examples of alloimmunity?
Transient neonatal disease & Transplant rejection and transfusion reactions
What disease occurs when the maternal immune system becomes sensitized against antigens expressed by the fetus?
Transient neonatal disease
What disease occurs when the fetus is a hybrid between the mother and father and expresses paternal antigens that are not found in the mother, and occasionally, the fetal antigens cross the placenta and elicit an immune response in the mother?
Transient neonatal disease
What disease occurs when maternal antibodies may be transported to the fetal circulation to produce alloimmne disease in the fetus, and although the symptoms may be manifested immediately after birth (and may be fatal), the source of these antibodies (mother) is removed at birth, so if the symptoms are treated the disease will disappear?
Transient neonatal disease
What are examples of transient neonatal disease?
Rh and ABO: maternal antibodies against erythrocyte antigens induce anemia in the child
What disease is a common problem among infants immediately after birth. It is the result of the inability of the neonatal liver to clear bilirubin, a breakdown product of blood cells, from the blood. Neonatal jaundice is usually a self-limiting, mild disorder. The most commonly used treatment is ultraviolet light exposure, in which the infant is placed under an ultraviolet lamp for a few hours each day. The ultraviolet light breaks down bilirubin into a form which the infant liver can process and excrete.
What occurs when the immune system of a recipient (of either an organ transplant or a blood transfusion) reacts against antigens on the donor’s cells?
Transplant rejection and transfusion reactions
What occurs when with organ transplantation there is often an immune response of the recipient against HLA-antigens on the donated tissue
and this is a type IV, cell-mediated reaction?
Graft Rejection
What are methods to decrease the rejections of the graft?
HLA matching of donor and recipient and the use of immunosuppressive drugs
Without immunosuppressive drugs, an organ will be rejected how quickly?
Within 2 weeks
Depending on the amount of time that passed between transplantation and rejection, graft rejection is classified how?
As hyperacute, acute, or chronic
T/F Hyperacute rejections are common.
False - they are rare.
What kind of rejection is the following:
- Antibodies bind to the graft tissue immediately when blood returns to the area
• The graft turns white immediately, due to inflammatory responses including the clotting cascade, which result in stoppage of blood flow to the graft
• Usually occur in recipients with preexisting antibodies to the antigens in the graft
What type of rejection is the following:
– A type IV, cell-mediated immune response
– Occurs about 2 weeks after transplantation
– The recipient develops an immune response against the unmatched HLA antigens
– Immunosuppressive drugs may delay or lessen the intensity of acute rejection
What type of rejection is the following:
– May occur after months or years of normal function
– Characterized by a slow and progressive organ failure due to inflammatory damage to endothelial cells lining blood vessels
– As a result of a weak immune reaction against minor histocompatibility (HLA) antigens on the grafted tissue
What type of reaction is IgE-mediated allergic reactions and is always allergens?
Type I
What type of reaction is tissue-specific reactions; autoimmune disease and blood transfusion (alloimmunity)?
Type II
What type of reaction is an autoimmune disease?
Type III
What type of reaction is cell -mediated reactions; allergens (contact dermatitis) and alloimmunity (transplant rejection)?
Type IV
How many types of stimuli for reactions are there?
What are the three different types of stimuli?
Allergy, autoimmunity, and alloimmunity