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75 Cards in this Set

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anaphylactic Reaction/Anaphylaxis

IgE
Involves ____ antibodies which bind to Basophils/Mast cells.
1st exposure to the allergen

Fc
IgE is formed and binds to Mast cells by ___ portion. No symptoms at this point.
2nd exposure to the allergen
Degranulation
(Histamine, Leukotriene and Prostagladins released)
1. Dilates blood vessels
2. Increased permeability of capillary vessels
3. Contraction of smooth muscles
4. Increased mucus secretion
5. Increased secretion of HCI in stomach (heart burn)
Type I
Immediate Hypersensitivity

systemic anaphylaxis
Localized Anaphylaxis/Atopic disease
Asthma
Systemic anaphylaxis
Severe->sometimes fatal

Develops rapidly after antigen/allergen is introduced to a sensitized individual.

e.g. Bee Sting: Shock and asphyxia
Signs/Symptoms of type I anaphylaxis
Flushing of skin
Shortness of breath
Shock
Constriction of smooth muscle in the lungs
Asphyxia
Asphyxia
death due to respiratory failure
Adrenaline/Epinephrine
What is the treatment that is used in treating type I allergic reaction?
Localized Anaphylaxis/Atopic Disease
More common
e.g. Hayfever, asthma, hives
Ags: plant pollen, fungal spores
Dust, animal dander, dust mites
Foods (peanuts)
IgE
What class of antibody is involved in hayfever?
Hayfever
Involves IgE
Allergic Rxn of upper respiratory system.

Signs/symptoms: Itch, tearing eyes, congested nasal passages, runny nose and sneezing.

Treatment: Antihistamine
Antihistamine
What is used to treat hayfever?
Asthma
Allergic Rxn of the lower respiratory system.

signs/symptoms: wheezing and shortness of breath; smooth muscle contraction

treatment: Adrenaline/Epinephrine (leukotrienes NOT histamines)
caffenie
Skin test to identify allergen
Desensitization
What is used to prevent anaphylactic reactions?
Desensitization
Carefully injecting small, repeated doses of the allergen into the skin. Patient produces IgG antibody rather than IgE. IgG acts as "blocking" Ab.
Prevents binding of allergen to IgE on Mast cells->No release of histamine->no symptoms.
Type II (cytotoxic) reactions
Involves IgG and IgM antibodies and complement. Complement activation causes cell lysis or damage by macrophages. Transfusion Rxns and Rh Incompatibility.

ABO blood groups
Rh Incompatibility
Drug-induced Thrombocytopenic purpura
ABO blood groups
carbohydrate
Four major types based on ___________ antigens on surface of RBCs.

Incompatible blood types will cause clumping (hemoagglutination) of RBCs.
Drug-induced Thrombocytopenic purpura
involves haptens

Ab bind w/hapten and result in hapten-platelet complexes
Rh Incompatibility
D Ag (De-antigen)
Erythroblastosis Fetalis/Hemolytic Disease of the Newborn (HDN)

Results from Rh negative mother exposed to Rh positive cells by prior birth or transfusion. (Sensitized)
-> Produce anti-Rh antibodies (IgG) which can cross the placenta.
-> Reacts with fetal RBCs -> Lysis of RBCs. Results in release of toxins (Bilirubin) and anemia.
hemoagglutination
Incompatible blood types will cause clumping (_________________) of RBCs.
(Rh incompatability)

Lysis
-> Reacts with fetal RBCs -> _______ of RBCs. Results in release of toxins (Bilirubin) and anemia.
(Rh incompatability)
IgG
-> Produce anti-Rh antibodies (___) which can cross the placenta.
Exchange transfusion: Removal of fetal Rh+ cells and transfusion with Rh- blood.
What would the treatment be for Rh incompatibility?
RhoGam
Prevention of Rh incompatibility

Passinve immunization of Rh- mother with anti-Rh antibodies (blocking Ab) coats Rh+ cells and prevents sensitization.
Rhogammaglobulin
What does RhoGam stand for?
Type III
Immune complex hypersensitivity
Type III
Excess immune complexes are deposited in tissues -> localized inflammation and tissue damage.
Non-self Ag
self-Ag
Rheumatoid Arthritis
Systemic Lupus Eruthematosus
Glomerulophritis
immune complexes
Excess _______ ________ are deposited in tissues -> localized inflammation and tissue damage.
Non-self Ag
Serum sickness
self-Ag
Autoimmune Disease
Rheumatoid Arthritis
immune complexes deposited in the joints
Systemic Lupus Erythematosus
An example of immune complex reactions
Glomerulophritis
an immune complex condition usually resulting from an infection, that causes inflammatory damage to the kidney glomeruli, which are sites of blood filtration.
Type IV Delayed Hypersensitivity
TD cells- this is not an Ab response
Contact dermatitis

mediated by T cells
Contact Dermatitis

cytokines
T-cell mediated response
Allergen binds to some of your own cells - most of these are haptens
e.g. Poison Oaks, Poison Ivy

T-cells infiltrate tissue -> release _________ -> activate inflammatory cells -> destroy target cells.
Autoimmune Disorders
Production of Autoantibodies or self-reactive T-cells
Autoantibodies
antibodies against one own tissue or chemical substances
Paul Ehrlich
Horror Autotoxicus

The need not to react to self. Deliberately attempted to immunize animals against their own tissues.

father of autoimmunity
Type I
Due to antibodies against pathogens
Type II
Antibodies reacts with cell-surface antigens

clonal deletion
Type III
Immune Complex

IgM, IgG, complement immune complexes deposit in tissues
Type IV
Mediated by T cells
Rheumatic Fever and Acute Glomerulonephritis
An example of type I

Follows infection with group A strep.
Cross-reactive Antibody can bind to heart, cartilage, muscle, and kidney tissue.
(RF ~ 15,000 deaths/yr US)
Graves Disease
Example of Type II

Attachment of AutoAbs to receptors for Thyroid-Stimulating Hormone (TSH) on follicle cells of the thyroid gland.

Stimulation of follicle cells->overproduction of thyroxin.

Bypass of feedback control

Hyperthyroidism can result from too much TSH
Thyroid-Stimulating Hormone (TSH)
Attachment of AutoAbs to receptors for ____________ ________ on follicle cells of the thyroid gland.
Hyperthyroidism
goiter, increased metabolic rate, nervousness, tremor, difficulty concentrating, heat intolerance, diarrhea, and palpitations.
Myasthenia Gravis
AutoAbs bind to acetylcholine receptors at neuromuscular junctions -> causes degradadation of receptors -> muscle weakness and fatigue -> loss of muscle function -> paralysis -> respiratory failure and death
Systemic Lupus Erythromatosis

SLE or lupus
Ex. of type 3

Disease involved with AutoAbs produced against a variety of tissues and DNA.

Most involved: kidneys, bone marrow, skin, nervous system, joints, muscles, heart and G.I. tract.

sometimes caused by UV light
symptoms of Lupus
Fever, skin rashes, arthritis, effusions (fluid build up) and inflammation in plueral, pericardial, peritoneal cavities and CNS.

Can cause a life-threatening, progressive, immune complex-mediated glomerulonephritis.

90% of cases are women of childbearing age

Rare in males (klinefelter's syndrome XXY)
Rheumatoid Arthritis
Example of type III

Associated with advanced age (80% of population)

Characterized by chronic inflammation of the joints.

AutoAbs (rheumatic factor) form immune complexes with IgG -> bind to synovial membrane of joints -> activates complement -> scar tissue and joint destruction.
IgG
activates
Rheumatoid Arthritis

AutoAbs (rheumatic factor) form immune complexes with ___ -> bind to synovial membrane of joints -> __________ complement -> scar tissue and joint destruction.
Hashimoto's/Autoimmune Thyroditis
An example of type 4

T-cells destroy the follicle cells that produce thyroxin.

Hypothyroidism: Malaise, lethargy, pain, fever, and increased risk of pyogenic infection.

immune system is sluggish also
thyroxin
Hashimoto's/Autoimmune Thyroditis

T-cells destroy the follicle cells that produce ________.
Diabetes Mellitus
Type I (juvenile onset/insulin dependent)
Diabetes Mellitus
Type I
T-cells attack islet cells of the pancreas -> inflammatory reaction -> cell lyses -> decreased insulin secretion.
islet cells


(Diabetes Mellitus)
T-cells attack ______ _____ of the pancreas -> inflammatory reaction -> cell lyses -> decreased insulin secretion.
Acquired immune deficiency syndrome
What does AIDS stand for?
HIV

reverse transcriptase
(retroviridae)

Envelope with transmembrane spikes.

gp120 spikes enable ____ to attach to host cells with the CD4 receptor: T cells, macrophages, dendritic cells, and monocytes.

Upon entering a cell viral RNA is transcribed into DNA by the enzyme __________ ___________.
Provirus
Viral DNA becomes integrated into the host cell chromosome. Integrated DNA may be active or latent.
Catergory A
Category B
Category C
What are the clinical categories for HIV infection?
Category A
Asymptomatic or lymphadenopathy (swollen lymph nodes)

CD4 count 500/mm3 or above
Category B
Various symptoms and persistent infections (oral candidiasis)

CD4 count btwn 200-499/mm3
Category C
Clinical AIDS.

Various opportunistic infections

Less than 14% of T-cells present are CD4 cells.

CD4 count below 200/mm3
Transmission of HIV/AIDS
Direct contact with body fluids

Blood
Semen
Saliva
Blood
Transmission of HIV

10-1000 IP (infectious particles)/ml
Semen
Transmission of HIV

10-50 IP/ml
Saliva
Transmission of HIV

generally < 1 IP/ml
No ideal animal model

Virus targets the immune system itself

Mutation rate of HIV

Needs both antibody and killer T-cell response
What are the problems that we can't make a vaccine yet?
mucosal immune response
Effective vaccine will also have to stimulate a _______ ________ _________ (IgA).
Cross reactive antibodies.
Human immunodeficiency virus
What does HIV stand for?
gp120

HIV
_______ spikes enable ____ to attach to host cells with the CD4 receptor: T cells, macrophages, dendritic cells, and monocytes.
T cells
macrophages
dendritic cells
monocytes
What are the names of the CD4 receptors involved in HIV?
Signs/symptoms: Itch, tearing eyes, congested nasal passages, runny nose and sneezing.
What are the symptoms of hayfever?
Multiple Sclerosis
Damage to the myelin sheath (demyelination) of CNS (Brain and Spinal cord) T-cells attack myelin -> decreased ability to conduct nerve impulses -> musclular weakness, tremors, difficulties in speech and vision -> paralysis
(Multiple Sclerosis)

myelin sheath
nerve
paralysis
Damage to the ________ ______(demyelination) of CNS (Brain and Spinal cord) T-cells attack myelin -> decreased ability to conduct ______ impulses -> musclular weakness, tremors, difficulties in speech and vision -> _________.