Hypersensitivity Ii

Front 1

What is the use of epinephrine?

Back 1

1. Anaphylactic shock

Front 2

What is the use of omalizumab?

Back 2

1. Antibody to IgE used to tx refractory asthma

Front 3

What mediate type II hypersensitivity reactions?

Back 3

1. IgG or IgM

2. +/- complement

3. Frustrated phagocytosis by PMNs

Front 4

What occurs in transfusion reactions?

Back 4

1. Elicited by contact with food or microbial antigens that cross--react with RBC antigens

2. Incompatible blood transfusion leads to IgM binding to RBC lysis, initiating complement cascade

Front 5

How do you blood type?

Back 5

Front 6

When do isohemagluttinins develop?

Back 6

1. 8 mos.

Front 7

What are some examples of ABO antibody cross-reactions?

Back 7

1. Anti-A w/ influenza virus

2. Anti-B with E. coli

Front 8

What is the presentation of a transfusion reaction?

Back 8

1. Fever

2. Hypotension

3. Lower back pain

4. Chest compression feeling

5. N/V

Front 9

What occurs in HDNB?

Back 9

1. Maternal IgG antibodies cross placenta and bind to the Rh(D) antigen on baby's RBCs

Front 10

What are the ssx of HDNB?

Back 10

1. Anemia

2. CRF

3. Kernicterus

4. Jaundice

5. Hydrops fetalis

6. Hepatomegaly

Front 11

How do you tx HDNB?

Back 11

1. Rhogam tx

Front 12

How does rhogam tx work?

Back 12

1. Anti-Rh antibody injected immediately postpartum to eliminate the Rh+ cells and prevent sensitization

2. IgG-mediated negative feedback

Front 13

When should an unsensitized Rh- woman receive RhoGam tx?

Back 13

1. 28-29 weeks AND

2. 72 hours after delivery

Front 14

What is the likelihood than an Rh- mother will become sensitized to her baby's RH+ RBCs?

Back 14

1. Rh- nulliparous mother has 16% chance if ABO compatible with baby

2. 2% if ABO incompatible

Front 15

What mating is most likely to result in HDNB in the 2nd child?

Back 15

1. Mom O- x Dad AB+

Front 16

What are the two types of autoimmune hemolytic anemias?

Back 16

1. Warm-reactive

2. Cold-reactive

Front 17

What occurs in warm-reactive AHA? How do you detect it?

Back 17

1. IgG-coated RBCs removed by splenic and liver macrophages

2. Occurs at 37 C

3. Detect by Coomb's test

Front 18

In what disorders is warm-reactive AHA seen?

Back 18

1. SLE

2. Lymphocytic leukemia

Front 19

What occurs in cold-reactive AHA?

Back 19

1. React with RBCs below 37 C

2. Complement-activating IgM

Front 20

What agent elicits cold agglutinins? How?

Back 20

1. M. pneumoniae

2. IgM antibodies directed toward i/l antigen on RBC

Front 21

What drugs can induced AHA?

Back 21

1. Haptens--- adsorb to RBC surface

2. Induces IgG production--- complement activation leads to cell lysis

3. **Penicillin, quinine, sulfonamides**

Front 22

What happens in drug-induced thrombocytopenia?

Back 22

1. Drugs attach to platelets, which induce antibodies

Front 23

What do the antibodies cause in drug-induced thrombocytopenia?

Back 23

1. Platelet lysis

2. Opsonization of platelets for phagocytosis

3. ADCC

Front 24

Wha tis idiopathic thrombocytopenia purpura?

Back 24

1. Antibodies to platelets arise for unknown reasons

Front 25

What causes the issues in rheumatic fever?

Back 25

1. M protein cross-reacts with cardiac myosin

2. Leads to rheumatic heart disease and myocarditis

Front 26

What occurs in hyperacute graft rejection?

Back 26

1. Transplant recipient has pre-formed antibodies to ABO antigens

2. Antibodies attack vascular endothelium of allogenic graft

Front 27

What occurs in type II hypersensitivity?

Back 27

1. Immune complexes form in serum or ECF

2. Lodge in tissues

3. IgM or IgG, antigen, and complement involved

4. Leads to tissue damage

Front 28

What is the IC in PSGN?

Back 28

1. GAS+Ab+complement

Front 29

What occurs in PSGN?

Back 29

1. ICs lodge in glomeruli

Front 30

What occurs in serum sickness?

Back 30

1. Patient forms Ab to passively transferred xenogenic immunoglobulins----

2. ICs lodge in kidneys and joints--- glomerulonephritis and arthritis

Front 31

What are the MCC of drug-induced serum sickness?

Back 31

1. Penicillin

2. NSAIDs

Front 32

What are the MCC of serum sickness?

Back 32

1. Horse sera to tx snake-bites, respiratory diphtheria

2. Murine monoclonal Ab to tx cancer and suppress graft rejections

Front 33

What happens in an arthus reaction?

Back 33

1. Seen when boosters are administered to persons with high Ab titers

2. Area of edema+hemorrhage >50 mm

3. 5-12 hours after subQ or intradermal antigen injection

Front 34

What is in the lesion of an arthus reaction?

Back 34

1. ICs

2. WBCs

3. Platelets

Front 35

What occurs in extrinsic allergic alveolitis? What type of hypersensitivity reaction is it?

Back 35

1. Inhaled antigens from olds, plants, and animals complex to specific IgG in alveoli of lungs, fix complement, and induce inflammation

2. TYPE III/IV

Front 36

What happens in PAN?

Back 36

1. ICs between Hep B and complement

2. Livedo reticularis

Front 37

What will a deficiency in C1, C2, or C4 lead to?

Back 37

1. Immune complexes remain large and bind poorly to RBCs that would carry them to liver or spleen to be eliminated

3. Immune complexes cannot be destroyed

Front 38

How can you detect ICs in type III hypersensitivity reactions?

Back 38

1. Precipitation with 2-4% PEG

2. RIA using C1q as ligand

3. Immunofluorescence