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84 Cards in this Set
- Front
- Back
In the lymph node, what cells are in the follicle, medulla and paracortex?
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follicle - B cells
medulla cords - lymphocytes medulla sinuses - macrophages paracortex - T cells |
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What lymph nodes does the arm drain to?
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Axillary
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What lymph nodes does the sigmoid colon drain to?
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colic - inferior mesenteric
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What lymph nodes does the scrotum drain into?
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superficial inguinal
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What lymph nodes do the testes drain into?
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retroperitoneal AKA para-aortic
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What are the cells of acute and chronic inflammation?
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acute - PMNs
chronic - macro, baso |
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What are the main players in opsonization?
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IgG and C3b
(bring food to macrophages) |
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How does APCs present antigens?
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phagolysosome binds vesicle with MHC class 2 - chemicals digest the invariant chain, which free the MHC class 2 ptn - Ag binds to it
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Which MHC has a beta 2 microglobulin?
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MHC class 1
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What is the process of making free radicals and hydrogen peroxide?
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NADPH oxidase converts O2 to superoxide (resp burst.. positive NBT test)
superoxide dismutase converts superoxide to hydrogen peroxide myeloperoxidase converts hydrogen peroxide to bleach |
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What are the functions of red and white pulp?
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red - filters/kills old RBCs
white - make Ab, phago circulating pathogens |
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What do splenic macrophages do and why is it bad to not have a spleen?
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macrophages remove encapsulated bacteria and present to B/T cells
w/o spleen, low Ab, low complement activation, low opsonization and high susceptibility so encapsulated organisms |
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What kinds of special RBC things are seen in asplenic peeps?
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Howell-Jolly bodies
target cells |
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What are the different parts of the thymus and what happens there?
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cortex - immature T cells.
positive selection (make sure they recognice MHCs) medulla - mature T cells with epithelial reticular cells and Hassall's corpuscles negative selection - make sure T cells doesn't react to self Ag |
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What induces Th cells to become Th1 cells?
What do Th1 cells produce? |
IL-12... this is the cell mediated reponse
IL-2 and IFN gamma which activate macro and T cyt |
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What induces Th cells to become Th2 cells?
What do Th2 cells produce? |
IL-4... this is the humoral response
IL-4 and IL-5 which mediate class switching and IL-10 which inhib the cell mediated response. some of the B cells that are stim by Th2 produce antibodies, others go to germinal centers, switch classes and have somatic hypermutation |
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What are the HLA subtypes associated with ankylosing spondylitis?
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B27
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What are the HLA subtypes associated with multiple sclerosis?
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DR2
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What are the HLA subtypes associated with SLE?
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DR 2/3
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What are the HLA subtypes associated with diabetes mellitus type 1?
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DR 3/4
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What are the HLA subtypes associated with rheumatoid arthritis?
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DR 4
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What is a natural killer cell's function enhanced by?
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IL-12, IFN alpha and beta.
also induced to kill cells when they don't have MHC 1 (their function is to kill virally infected cells and tumor cells) |
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What do superantigens do?
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crosslink TCR and MHC class II.
Th1 cells release IFN-gamma macrophages release TNF, IL-1 and IL-6. |
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What are the co-stimulatory signals for Th?
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MHC II - TCR
B7 - CD 28 |
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What are the co-stimulatory signals for Tcyt?
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MHC I - TCR
IL2 from Th cell |
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What are the co-stimulatory signals for B cell class switching?
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IL-4, IL-5 from Th2
B cell has CD 40 receptor that's activated by CD 40 ligand on Th cell (class switching happens in germinal centers of lymph nodes) |
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What is ADCC used for and how does it work?
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defense against worms and viruses
target covered in IgG and IgE... NK, monocytes, eosino have Fc-rec and kill |
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IgG associations
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complement with IgM
opsonization with C3b cross placenta ADCC with IgE |
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IgA associations
deficiency? |
mucous membranes
secretions, breast milk dimer joined by J chain deficiency assoc with Giardia inf |
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IgM associations
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immediate response to antigen
pentamer joined by J chain complement |
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IgE associations
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hypersensitivity rxns - binds mast cells, allergen cross link Ab, mediates histamine release
worm immunity |
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What is a hapten?
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Ag that's too small to illicit immune reaction on it's own...
can combine with body ptn and ellicit type 1 HS |
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IL-1
IL-2 IL-3 |
IL-1 acute inflam and pyrogen
IL 2 Th and Tcyt growth IL 3 differentiation of bone marrow stem cells |
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IL-4
IL-5 IL 8 |
IL 4 switch to IgE and IgG
IL 5 switch to IgA, activate eosinophils (asthma) IL 8 PMN chemotaxis |
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INF-gamma
TNF.. and inhibited by... |
INF-gamma: by Th1, stim macro, activates Th1
TNF - by macro. mediates septic shock/ cachexia, WBC recruit inhib by infliximab, etanercept |
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IL-10
IL-12 |
IL 10 activate Th2, inhib Th1
IL 12 activates Th1 and NK |
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macrophage cell surface proteins
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CD 14, 40
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Th cell surface proteins
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CD3, 4, 40L
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Tcyt cell surface proteins
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CD3, 8,
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B cell surface proteins
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CD 19, 20, 21, 40
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NK cell surface proteins
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CD 16, 56
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What chemical mediators cause a decrease in inflammation?
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IL-10 and TGF beta
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What are the chemical mediators for systemic inflammation?
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TNF, IL 1, IL 6
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What are the chemical mediators for vasodilation?
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NO, histamine, PGI
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What are the chemical mediators for vasoconstriction?
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TXA2, leukotriene C/D/E
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What are the chemical mediators for increased permeability?
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histamine, bradykinin, leukotriene C/D/E, C3a, C5a
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What are the chemical mediators for pain?
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bradykinin, PGE
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What are the chemical mediators for fever?
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IL1, TNF, PGE
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What are the chemical mediators for chemotaxis?
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C5a, Leukotriene B4, IL8
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What part of complement helps with clearance of immune complexes?
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C3b
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What parts of complement help prevent activation on self?
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decay-accelerating factor and C1 esterase inhibitor
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What parts of complement mediate anaphylaxis?
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C3a, C5a
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What parts of complement mediate cytolysis by MAC?
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C5b - C9
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What does a deficiency in C1 esterase inhibitor cause?
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hereditary angioedema
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What does a deficiency of C3 cause?
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recurrent severe infections (cuz C3 involved in both alternative and classic pathways)
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What does a deficiency in C5-C8 cause?
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Neisseria infections
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What does a deficiency in decay accelerating factor cause?
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paraxysmal nocturnal hemoglobinuria
high complement activation.. usu pancytopenia |
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Symptoms of serum sickness
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fever, urticaria, arthralgias, proteinuria, lymphadenopathy
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What kind of hypersensitivity is multiple sclerosis?
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Type 4 (delayed T cell mediated)
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What is the autoantibody in primary biliary cirrhosis?
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anti-mitochondrial
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What disease has an anti-basement membrane antibody?
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Goodpastures..
Anti alpha 3 of collagen type 4 |
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What is the autoantibody in Pemphigus vulgaris?
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anti-desmoglein
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What is the autoantibody in polymyositis?
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anti-Jo
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What is the autoantibody in Sjogrens?
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anti SSa (Ro), anti SSb (La)
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What does a positive rxn to a Candida antigen test indicate?
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intact T cell function
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What is the defect in Bruton's agammaglobulinemia?
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defective tyr kinase - blocks B cell maturation.
No B cells in periphery, no germinal follicles.. recurrent BACTERIAL inf |
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What is the defect in Hyper-IgM syndrome?
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defective CD40L on Th ... can't class switch
recurrent BACTERIAL inf |
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What is the defect in selective Ig deficiency?
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can't class switch to specific types.
most common is IgA deficiency - get lots of URIs - giardia. - ANAPHYLAXIS on exposure to blood with IgA |
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What is the defect in Common Variable Immunodeficiency?
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ACQUIRED defect in B cell maturation
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Describe DiGeorge syndrome
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no thymus and PTH
high viral/fungal inf fish mouth tetany |
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In what immuno disease do you get lots of mycobacterial infections?
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IL-12 receptor deficiency.. so no Th1 activation.. see low IFN-gamma levels
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Describe SCID
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IL-2 rec defect
adenosine deaminase defect recurrent bacterial, viral, fungal, protozoal inf |
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Describe Ataxia-Telangiectasia
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defect in DNA repair enzymes - DNA sensitive to ionizing radiation
ataxia, telangiectasia and IgA def |
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Describe Wiscott-Aldrich syndrome
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progressive deletion of T/B cells
thrombocytopenic purpura, inf, eczema |
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In what disease do you see delayed separation of umbilicus?
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leukocyte adhesion deficiency
can't recruit WBC to inflam site - high bacterial inf, no pus |
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Describe Chediak Higashi syndrome
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defective phagosome-lysosome fusion
Staph/Strep inf, kinda albino, peripheral neuropathy, nystagmus |
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Describe Chronic Granulomatous disease
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no NADPH oxidase.
negative NBT test. susceptible to S aureus, E coli, Aspergillus and Pseudomonas cepacia, Serratia Marcescens, Nocardia |
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What/when is hyperacute rejection?
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preformed antidonor Ab
small vessel fibrinoid necrosis? MINUTES post transplant |
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What/when is acute rejection?
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Tcyt against foreign MHCs
WEEKS after transplant reversible with cyclosporine and tacrolimus (calcineurin inhib - prevent prod of IL2) |
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What/when is chronic rejection?
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T cell and antibody mediated
obliterative vascular fibrosis YEARS after transplant |
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What/when is graft versus host disease?
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Grafted T cells attack host MHC
cause rash, jaundice, hepatosplenomeg, diarrhea |
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What microorg show classic antigen variation?
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salmonella
borrelia (relapsing fever) N gonorrhea (pilus) influenza trypanosomes |
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What is the auto antibody in systemic scleroderma?
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anti-topoisomerase Ab also known as anti-Scl70
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What type of hypersensitivity is SLE?
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type 3 HS
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