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112 Cards in this Set
- Front
- Back
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what are the four classifications of hypersensitivty reactions
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I immediate hypersensitivity
II anitody dependent cytotoxicity III immune complex mediated hypersensitivity IV cell mediated |
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what antibody does type I hypersensitivity involve
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IgE o mast cells of basophils
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what happesn when IgG bind to their specific antigen?
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vasocactive amines are released
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what are the mediators of type I
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histamine
leukotrienes C4 and D4 cytokins IL1 and TNF |
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what do histamine, leukotrines, and cytokines cause
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vaosdialtion, vasuclar leakage, smooth muscle spasm
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what are exampels of type I
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rhinitis
astham anaphylaxis hives itching pulmonary bronchocontrisction systemic vaosdilatoin |
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what is type II hypersensitivity
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antibody dependent cytotoxicty
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what triggers type II
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when antibodies attach to surfaces of individiual cells like RBCs or to surfaces associated with solid tissue like glomerular BM of the kidney
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what is the resutl of antibody dependent cytotoxicity
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activated complement
cell lysis by MAC cell opsonizaiton and phagocytosis |
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what are five examples of type II
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transfusion reactions
hemolytic disease of the newborn Rh incompatability autoimmune hemolytic anemia thrombocytopenia drug reactions like PCN pemphigus vulgaris |
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what are examples of what happens in antibody mediated cellular dysfunction and what type of hypersense is this
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II
mysathenia gravis anti ACh receptors on muscle cause muscle weakness graves' disease antiTSH receptor stimualte thyroid production |
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what is type IIi
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immune complex mediated hypersensitivty
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is thype three normal? if yes, when?
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yes, in infections there is a good balance between the antigen conc and the antibodies. when antibodies are in excess, smaller complexes are formed and deposition tends to occur in tissue
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where does deposition tned to occur
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joints leading to arthritis
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what is an example of III
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arthritis
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what is type IV
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cell mediated
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____ _______ ______ is the principle defense to a number of microbes including tb, viruses, fungi, protoza, and parasites
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cell mediated immunity
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what happens in cell mediated
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injury mediated by sensitzed t cells
contact dermatitis delayed type hypersensitivty mediated by cytotoxic t cells |
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what are examples of type IV
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tuberculin
poison ivy or oak transplant rejection |
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what are the types of rejection
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hyepractue
actue chronic |
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which hypersensitivity do we take advantage of during a PDT test
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type IV for tb
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what are two autoimmune diseases that we covered in depth
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SLE
rheumatoid arthritis |
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what is the fundamental defect in SLE
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failur to maintian self tolerance
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in SLE what do you form Ab against
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cell nuclear and cytoplasmic components
cell surface Ag of blood elements prfotein phospholipid components |
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what are the contributing factors of SLE
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genetic
environmental |
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what are examples of genetic contributory factors of SLE
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high rate of concordance in twins 25%
HLA-DQ |
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what are exampels of environemtnal risks for sLE
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female sex hormones
drugs procainamide and hydralazine UV light |
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what are the main targets of SLE
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skin
kidneys serosal membranes joints heart |
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what are the five main clinical manifestations of SLE
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hematologic
arthritis skin fever fatigue |
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in order to diagnose SLE, __ of ___ criteria must be met
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4
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list several of the diagnostic criteria for SLE
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malar rash
discoid rash photosensitivity oral ulces arthritis serositis renal disorder neurolobic disorder blood disorder immunolgoic disorder antinuclear antibody |
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what are the two treamtnents for SLE
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corticosteroids
immunossuppressive therapies |
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what are some of the side effects of corticosteroids
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acne
hairy hirsuitism thin skin osteoporosis muscle wasting buffalo hump cataracts glaucoma DM electrolyte abnormalities menstrual disorders impotence moon face opportunistic infections |
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is RA symmetric?
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yes
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what does RA principally affect
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small joitns of hangds and feet especially the metcarpophalangeal and proximal itnerphalangeal joints
ankels knees wrists elbows shoulders |
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what are the four main symptoms of RA
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arthritis
general malaise, weakness, low grade fever raynaud's phenomenon extaarticular manifestations |
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what is raynaud's phenomenon
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epidosdic digictal ischemia with glanching then darkening of iners and toes dut to vasopasm of digital arteries
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what are the extraarticular manifestations of RA
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rheumatoid nodules over extensor rsurfaces like shines and forearms
muscle atrophy pleuritis and pleural nodules vasculitis affectin glung, ehart, bowel, liver, spleen, pancrease testes |
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what is the pathogensis of RA
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HLA DR4
cross reaction to epstein barr cytomegalo or mycoplasma see inflammatory response of the activated T cll, macrophages, and fibrobalsts attacking the synovial linign fo the joints presense of RA IgM and occasionally IgG binding to IgG effector molecules including IL1 2 TNF and interferon |
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in diagnosing RA _ of _ criteria must be met
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4 of 7
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what are the seven criteria for diagnosing RA
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SRRAMA
serum RF rheumatoid nodules radiographic x ray changes that show bondy erosions arthritis in 3 or more joints morning stiffness lasting one hour before improvement arthritis of hand joints |
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what are the treatments for RA
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corticosteroids
immunosuppressive therapies |
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what is the change in life expectancy with RA
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reduced by 3 to seven years
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superantigens are most closely associated with diseases caused by
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staph
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chronic inflammation is most often associated with all except
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staph aureus skin infections
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chronic inflammation would most likely icnlude what cells?
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lymphocytes and monocytes
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risk factors for SLE include all except
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HpV
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inflammation can be initiated by all except
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contact with normal epithelial tissue
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the most circulating antibody is
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IgG
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several biopsies show granulomatous inflammation in the liver,skin, lugns, and lymph nodes of a 25 year old black female. what are you most concerned about
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sarcoidosis
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diseases associated with an HLA type include
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all of the above
DM I RA chronic active hepatitis myasthenia gravis |
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hageman factor is activated by...
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exposure to certain bacterial componenets
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hageman factor is synonymous with
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12
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superantigens are most closely associated with diseases caused by
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staph
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chronic inflammation is most often associated with all except
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staph aureus skin infections
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chronic inflammation would most likely icnlude what cells?
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lymphocytes and monocytes
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risk factors for SLE include all except
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HpV
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inflammation can be initiated by all except
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contact with normal epithelial tissue
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the most circulating antibody is
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IgG
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several biopsies show granulomatous inflammation in the liver,skin, lugns, and lymph nodes of a 25 year old black female. what are you most concerned about
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sarcoidosis
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diseases associated with an HLA type include
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all of the above
DM I RA chronic active hepatitis myasthenia gravis |
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hageman factor is activated by...
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exposure to certain bacterial componenets
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hageman factor is synonymous with
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12
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DMI is most closely asosciated with what HLA factors
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HLA DQ or DR MHC
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arachidonic acid derivatives include....
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cycloxy lipxoy protsaglandins
leukotrines 1 and 3 |
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cytokines include
interferons leukotrienes bradykinin histamine none of the above |
interferons
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in a smoker, the normal respiratory epithelium of the airways has been replaced by the types of epithelium that you find normally on the skin. the transition from one tyep of epithelium to another differnetiated epithelium is called
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metaplasia
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what are the benefits of exudation
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increases pain
allows the release of circulating antibodies facilitates phagocytses dilutes toxin |
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the membrane attack comples is made of C what
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5 to 9
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the appearance of granluation tissue is most closely associated with
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angiogensis
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risk factors for RA include what
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preveious infection with mycoplasma EB or cytomegalo
certain HLA 30 to 50 being female ALL OF THE ABOVE |
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the tissues/cells that are most frequently affected by SLE include all except..
joints pancreas blood skin kidneys |
no pancreas
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hyperplasia is always a pathologic situation t or f
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false
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an exmaple of type II is
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hemolytic disease of the newborn
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the cell most cloesly associated with antibody production are
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B cells
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rheumatoid factor is
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IgM IgG complexes
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antibodies producted against DNA despecially dsDNA is most associated with
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SLE
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class I MHCs include all except with HLA complex
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D
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all of the following are true about raynauds phenomenon except
it always associated with RA it is due to vasopasm reults in blanching of digits can be triggered by cold hurts |
A it is always associated with ra
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most body water is
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intracellular
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true statements about aging include
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it is a consequence of civilization
it is not a disease process it is reduced ability to adapt to environemtnal stress ALL OF THE ABOVE |
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asprin and nsaids relieve inflammation by inhibiting the formation of...
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prostaglandins
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cytokines such as IL1 and TNF will cause all of the following excpet
fever increased sleep decreased appetites lead to increased cortisol increase all of the above |
all
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obesity is a risk factor for...
ovarian cancer cancer of the colon cancer of the breat all none |
all
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tissue rejection is a type __
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IV
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SLE most frequently manifests where...
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in the blood
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risk factors for SLE include
youth hla DQ genetic factors all fo the above only A and C |
only A and C
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what are teh Cs for opsonin
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C2b
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what are C for MAC
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C3b C3a and C5a
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what are C that activates the lipoxygenase pathway and leukocytes
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C5a
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where does coagulation necrosis occur
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heart
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where does liquefaction necrosis occur
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brain
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where does caseous necrosis occur
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tb in lungs
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where does fat necrosis occur
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pancreas
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what bacti has exotoxin that kills leukocytes
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strep
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what has cell wallglycolipids that resist free radicals
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tb
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waht has a slimy capusle tha tresists phagocytosis
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strep pneumoniae
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what are plasma cells
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make antibodies
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what do Nk cells do
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nonspecific kilers of the cells lakcing the self password
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what are neutrophils
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first line of acut inflammatory response
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what do monocytes do
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differentaite into macrophages to help clear infectious agents
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what do mast cells do
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major cells of inflammatory response taht initate a greater inflammatory response
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what do fibroblasts do
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deposit collagen
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what do endothelial cells do
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shrink to release WBCs into vascular space
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what do APCs do
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antigen presenting cells that are a source of IL1
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what do giant cells do
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lead to chronic inflammation
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what do platelets do
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aggregate to form clots
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what are seven complications of corticosteroids
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moon face
buffalo hump acne impotence arthritis osteoporosis thin skin |
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what are four of the diagnosing for RA
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SSRAMA
serum rheumatoid factor morning stiffness taht requires at least one hour to lessen rheumatoid nodules espcially on shins and forearms arthritis especially in the joints of the hand ankels elbows shoulders knees and wrists |
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describe how persistnat cellular stress can ldea to cancer
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persistant cellular stress will lead to metaplasia in which one differnetiated cell type is replaced with another differentitaed cell type like calluses. If stress persists, teh new cell will be dysplastic cells which implies derragnged growth in which new bad differentaited cellsa re produced. this is the start ofcarcinoma in situ and may metasticize into adjacent tissues
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distinguish between ischemia and hypoxia. give examples
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ischemia the loss of blood supply
hypoxia lack of oxygen supply in ishcemia the loss of blood supply woudl also imply a lack of oxygen and nutrietns to teh cell ischemia ex MI hypoxia ex high altitude |
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distinguish between hyperplasia and hypertrophy. give examples
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hyperplasia increase in the number of cells
physiologic endometrial cells funciton RBCs in high altitude constant irritation calluses hypertrophy increase in cell size physiologic sex organs abnromal anaebolic steroids increase muscle size physical demand exercise increase muscle size |
