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53 Cards in this Set
- Front
- Back
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6 Types of Immediate Hypersensitivity
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1. Anaphylaxis
2. Urticaria (Hives) 3. Angioedema 4. Rhinoconjunctivits 5. Asthma 6. GI symptoms (cramps, diarrhea, vomiting) |
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Describe Type I Hypersensitivity
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-Immune Reactant: IgE
-Antigen: Soluble antigen -Effect mechanism: Mast Cell activation -Examples of hypersensitivity reaction: allergic, rhinitis, asthma, systematic anaphylaxis |
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What areas are affected by mast cell activation and granule release?
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-GI Tract
-Airways -Blood Vessels |
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What changes are made in the GI tract because of mast cell activation and granule release during Type I hypersensitivity?
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-Increased fluid secretions
-Increased peristalsis RESULTING IN...expulsion of GI tract contents (diarrhea, vomiting) |
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What changes are made in the airway because of mast cell activation and granule release during Type I hypersensitivity?
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-Decreased Diameter
-Increased mucus secretion RESULTING IN... 1. congestion and blockage of airways (wheezing, coughing, phlegm) 2. Swelling and mucus secretion in nasal passages |
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What changes are made in the Blood vessels because of mast cell activation and granule release during Type I hypersensitivity?
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-Increased blood flow
-Increased permeability RESULTING IN... 1. increased fluid in tissues causing increased flow of lymph to lymph nodes 2. increased cells and protein in tissues 3. increased effector responses in tissues |
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What effect does histamine have on the body?
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-Toxic to parasites
-INcreases vascular permeability -Causes smooth muscle contraction |
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What effect do leukotrienes have on the body? Which leukotrienes are involved?
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(Leukotrines B4 and C4)
-Cause smooth muscle contraction -Increases vascular permeability -Stimulate mucus secretion |
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What forms do the major allergens come in?
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-Airborne
-Injected -Ingested -Skin contact |
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What are examples of airborne allergens?
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-Pollen
-Mold spores -Housedust mite (feces) -Cockroach -Animal "dander" |
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What are some examples of major allergens that are injected?
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-Drugs (haptens)
-Stinging insect venom |
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What are some examples of ingested major allergens?
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-Drugs (haptens)
-Foods (nuts, shellfish, eggs, cows milk) |
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What are some examples of major allergens that present themselves through skin contact?
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Latex protein
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What type of hypersensitivity is anaphylaxis? How should you treat it?
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-Type I immediate hypersensitive
-Epinephrine |
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What are the clinical manifestations of anaphylaxis?
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-Bronchoconstriction-asthma
-GI cramping -Urticaria -Vasodilation-hypotension |
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What are the most frequent signs and symptoms of anaphylaxis?
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1. Urticaria/angioedema
2. Upper airway edema 3. Dyspnea/wheeze 4. Flush 5. Hypotension 6. GI |
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What are the most common causes of death with anaphylaxis?
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-70%=respiratory compromise (from asthma or angioedema of the airway)
-24%=Cardiovascular failure (vasodilation, extravasation--low blood volume) |
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What does epinephrine do when used to treat anaphylaxis?
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-Stabilizes mast cells preventing release of mediators
-Bronchodilator -Increases vascular resistance -Increased heart rate and myocardial contractility |
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What are some types of atopic diseases?
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-Rhinitis,
-Conjunctivitis -Asthma -Atopic dermatitis -Food Allergy |
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Type I reactions are...
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Immediate hypersensitivity and anaphylaxis
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How does a Type I reaction due to hypersensitivity come to being?
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-Involves interaction between allergen and preformed complementary IgE antibodies bound to FcE receptors on mast cells and basophils
-Cross-linking triggers degranulation and release of histamine =immediate reaction |
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What leads to late phase reaction in Type I hypersensitivity? How long until this happens?
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-Release of leukotrienes and other cytokines
-Within several hours |
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After late phase, what occurs in type I hypersensitivity?
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-Recruitment and accumulation of eosinophils, basophils, neutrophils, and lymphocytes (mediate local tissue damage)
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How do genetic roles play in ones Type I hypersensitivity?
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-Related to development of skewed Th2 response (promotes increased IgE response)
-IL-4 polymorphisms: induces B cell maturation to increased IgE expression and producing plasma cells |
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What kind of tests can IgE?
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-Skin test
-Radio allergosobent test (RAST) |
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Describe a skin test. When is this used?
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-Small doses of several suspected allergens are separately injected or scratched or pricked into the patient's skin in small doses
-Wheal-and-flare will develop 30 min-1hr on the site where the allergen was deposited if the pt has mast cells with allergen-specific IgE boudn to FcE Receptors |
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What is the treatment for Type I Hypersensitivity?
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-Avoidance of allergen
-Therapy: Specific Immunotherapy (SIT)=allergy shots (Used for Type I hypersensitivity) |
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Tell me about allergy shots.
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-Pt given increasing does of allergen or immunodominant synthetic peptides (represent hypersensitivity-causing, TCR-binding epitopes)
-Mechanism: skew the T cells response to the allergen away from a Th2 response toward a Th1 response |
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What are Th1 responses typically mediated by?
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IgG
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What look similar to anaphylaxis but is not a type I hypersensitivity reaction?
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-Pseudo-allergic reactions (ex: vancomycin-red man disease)
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Tell me Type IV (Th2 cells)
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-Immune reactant: Th2 cells
-Antigen: Soluble antigen -Effector mechanism: IgE production, eosinophil activation, mastocytosis -Example: Chronic asthma, chronic allergic rhinitis |
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CD8-cytotoxic T-cells
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-Main function in adaptive immune system response: kill virus-infected cells
-Pathogens targeted: Some intracellular bacteria, Viruses (e.g. influenza, rabies, vaccinia) |
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CD4 Th1 cells
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-Main function in adaptive immune response:
1)Activate infected macrophages 2) Provide help to B cells from antibody production -Pathogens targeted: 1) Extracellular bacteria 2) Microbes that persist in macrophage vesicles (e.g.mycobacteria, Listeria_ |
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CD4 Th2 cells
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-Main functions in adaptive immune response: Provide help to B cells for antibody production, especially switching to IgE
-Pathogen targeted: Helminth parasites |
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CD4Th17
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-Main function in adaptive immune response: Enhance neutrophil response
-Pathogens targeted: Extracellular bacteria (i.e. Salmonella, enterica) |
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CD4 regulatory T-cells
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-Main function in adaptive immune response: Suppress T-cell responses
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What is another way describe asthma?
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Reversible expiratory obstruction
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What is the treatment for asthma?
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-Acute: inhaled beta adrenergic agents (albuterol): reverse bronchospasm
-Chronic: inhaled or oral steroids-reduce inflammation -Late phase responses are also blocked by steroids |
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What causes immediate action to food allergies? What are some examples of what occurs with this response?
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-IgE
-Diarrhea, cramping, vomiting -Urticaria and angioedema -Anaphylaxis |
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What causes chronic food allergies? What are some examples of what occurs with this response?
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-Th2
-Eosinophilic esophagitis -Eosinophilic gastroenteritis |
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What types of Type I reactions are mast cells involved?
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-Acute:
1. Anaphylaxis: ++++ 2. Asthma and rhinitis: ++ 3. Atopic Dermatitis: + 4. Food Allergy: +++ |
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What types of Type I reaction are Th2 and eosinophils involved?
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-Chronic:
1. Asthma and rhinitis: +++ 2. Atopic dermatitis: ++++ 3. Food Allergy: + |
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What causes asthma?
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-Hygiene
-Allergens -Micronutrients |
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IFN- a /ß
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1.Induce macrophage activation
2. anti-viral activity 3. stimulates cytokine production 4. increases expression of FcR and class I and II MHC antigens (Also called Type I interferons) (Principal cell sources = leukocytes and fibroblasts, respectively) |
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IFN-gamma
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1. Upregulates MHC class I & II antigen expression
2. Induces macrophage and NK cell activation 3. Induces Ig class switching; has anti-viral activity 4. Inhibits activities of IL-4 on B-cells 5. Enhances Fc receptor expression on B-cells. (Also called Type II interferon) (primary cell sources = T cells and NK cells) |
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IL-1
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1. Induces IL-2 receptor expression
2. Effects differentiation of hematopoietic cells 3. Induces slow wave sleep 4. Induces fever via PGE release in the hypothalamus 5. Growth factor for fibroblasts 6. Induces prostaglandin and collagenase production; 7. Stimulates hepatocyte production of acute phase protein (Formerly LAF and endogenous pyrogen) (Principal cell sources = macrophages & monocytes, Langerhans cells, keratinocytes, B-cell lines, microglial cells) Polypeptide with Mr 12,000-17,000 depending on species. Receptor: An 80 kD Mr molecule, member of the Ig superfamily. |
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IL-2
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1. Induces growth (late G1-S transition) of antigen- (or mitogen-) activated T cells
2. Promotes production of cytokines. 3. Stimulates growth of NK cells and B cells as well as T cells. Mr of 15,000-17,000; 133 amino acids. (formerly TCGF). (principal cell source = T cells). Receptor: A low affinity cell surface receptor (p55 subunit/Tac antigen/IL-2R chain) noncovalently interacts with other chains to generate a high affinity IL-2R. |
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IL-3
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Stimulates growth/differentiation of hematopoietic precursors and mast cells (principal cell source = T cells)
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IL-4
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1. Induces B cell activation (formerly BSF-1, BCGF-I);
2. Induces Ig class switching; 3. Induces T-cell growth; 4. induces mast cell growth; 5. macrophage activator; 6. stimulates growth & differentiation of hematopoietic progenitors (principal cell source = TH 2 cells) |
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IL-5
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1. Induces B cell growth;
2. Promotes IgA switch; 3. Promotes eosinophilia (formerly TRF, BCGF II) (principal cell source = Th2 cells) |
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IL-6
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1. Promotes plasmacyte growth;
2. Induces Ig secretion; 3.T cell growth; 4. acute phase proteins (formerly BSF-2) (principal cell source - Th2 cells, fibroblasts) |
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IL-7
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1. Induces pre-B-cell and pre-T-cell growth and thymocyte proliferation. (principal cell source = stromal cells)
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IL-8
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1. Chemoattracts neutrophils and T cells;
2. Regulates lymphocyte homing and neutrophil infiltration. (principal cell source = macrophages) |
