Pathology

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what are the four type so fimmunologis disorders

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hypersensitivity reactions, autoimmune disease, immunologic deficiency syndromes, amyloidosis

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hypersensitivty reactions can be initiated by

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interactions of antigen with humoral antibody or cell mediated immune mechanism

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Type I hypersensitivity

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anaphylactic type-anaphylaxis, some forms of bronchial asthmas

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Type II hypersensitivity

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cytoxic type-autoimmune hemolytic anemia, Goodpasture syndrome

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Type III hypersensitivity

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immune complex disease-arthus reaction, serum sickness, systemic lupus erythematosus

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Type IV hypersensitivity

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cell mediated-tuberculosis, contact dermatitis, transplant rejection

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4 primary mediators of anaphylactic hypersensitivity

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biogenic amines, chemotactic mediators, enzymes, proteoglycans

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4 secondary mediator of anaphylactic hypersensitivity

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leukotrines, prostaglandin D2, platelet activating factor, cytokines

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common inciting agents to systemic anaphylaxis and give some clinical sypmtoms of this reaction

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inciting agents-heterologous proteins, hormones, enzymes, polysaccharides and drugs. symptoms-itiching, hives, laryngeal edema, vomiting, abdominal cramps

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atopy

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genetically determined predisposition to develop localized anaphylactic reactions to inhaled or ingested allergens

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inciting agents of atopy

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pollen, animal dander, house dust, fish

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symptoms of atopy

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urticaria, angioedema, allergic rhinitis, some forms of asthma

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immune complex reaction

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mediated hypersensitiivty reactions is induced by antigen-antibody complexes that produce tissue damage as a result of their capacity to activate that complement system

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3 phases of systemic immune complex disease

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formation of antigen antibody complexes in circulation, deposition of the immune comples in various tissues, inflammatory reaction in dispersed sites throughout body

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Arthus reaction

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defined as localized areas of tissue necrosis resulting from acute immune complex vasculities

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cell mediated hypersensitivity

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initiated by specifically sensitized T lymphocytes, it includes classic delayed type hypersensitivity reaction initiated by CD4 cells and direct cell cytotoxity mediated by CD8 T Cells

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two major types of cell mediated hypersensitivity

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delayed type hypersensitivity, Tcell mediated cytotoxicity

Front 18

what are the two mechanisms involved in transplant rejection

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T-cell mediated reactions, antibody-mediated reactions

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hyperacute rejection

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occurs within minutes or hours after transplantation and can sometimes be recognized by surgeon just after the graft vasculature is anastomozed to the recipients

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acute rejection

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occurs within days of transplantation in the untreated recipient or may appear suddenly months or even years later after immunosuppression has been employed and terminated

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acute cellular rejection

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most commonly seen within the initial months after transplantation and is heraleded by an elevation or serum creatinine levels followed by clincial signs or renal failure

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acute rejection vasculitis

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mediated primarily by antidonor antibodies and hence it is manifested by damage to blood vessels

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chronic rejection

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present clincially with a progressive rise in serum creatinine level over a period of 4-6months dominated by vascular changes, interstial fibrosis and loss of renal parenchyma

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describe mechanism behind graft vs host disease

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gaft vs host disease occurs in any situation in which immunologically competent cells or their precursors are transplanted into immunological crippled recipients

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Systemic Lupus Erthyematosus

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SLE is classic prototype of they multisystem disease of autoimmune origin, characterized by an array of autoantibodies particualarly antinuclear antibodies

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Sjorgens syndrome

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clinicopathologic entity characterized by dry eyes, and dry mouth, resulting from immunologicallly mediated destruction of the lacrimal and salivary glands

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systemic sclerosis

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excessive deposition of collagen, the hallmark of systemic sclerosis results from multiple factorsthat ultimatley lead to production of variety of firborblast growth factors

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inflammatory myopathy

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comprimes uncommon heterogeneous groups of disorders characterized by immunolgical mediated injury and inflammation of mainly skeletal muscles

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3 types of inflammatory myopathies

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dermatomyositis, polymyositis, inclusion-body myositis

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polyarterites nodosa

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belongs to a group of disease characterized by nercotizing inflammation of the walls of blood vessels and showing strong evidence of an immunologic pahtogeneic mechanism

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DiGeorge Syndrdome

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example of T cell deficiency that derives from failure of development of the 3rd and 4th pharyngeal pouches leading to thymic hypoplasia

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Wiskott-Aldrich Syndrom

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X-linked recessive disease characterized by thrombocytopenia, eczema and a marked vulnerability to recurrent infection ending in early death

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Acquired immunodeficiency syndrome

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retroviral disease characterized by profound immunosuppression that leads to opportunistic infections, seocndary neoplasms and neurologic manifesations

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amyloidosis

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group of diseases having in common the deposition or pathologic proteinaceous substance in various tissues and organs of the body in wide variety of clincal settings

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cancers arising from mesenchymal tissues are called

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sarcomas

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cancers arising form epithelial tissues are

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carcinomas

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all tumors benign and malignant are composed of what two basic components

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parenchyma and supporative stroma

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what are the criteria used to determine whether a tumor is begnin or malignant?

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differentiation and anaplasia, rate of growth, local invasion, metastasis

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what are the three pathways of cnacer dissemination

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direct seeding of body cavities or surfaces, lymphatic spread, hematogenous spread

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the most common pathway for th intial spread of cacrinomas

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lymphatic spread

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tumor grading

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based on the degree of differentiation of the tumor cells and the number mitosis wthin in the tumor as presumed correlates of the neoplasms aggressiveness

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staging of cancers

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based on the size of the primary lesion its extent of spread to regional lymph nodes and the presence or abscence of blood borne metastisis

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which DNA viruses are thought to be capable of inducing neoplastic transformation

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papillomaviruses, Epstein Barr virus, hepatitis B virus, Kaposi sarcoma herpesvirus

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paraneoplastic syndromes

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symptom complexes in cancer bearing patients that cannot readily be explained either by the local or distant spread of the tumor or by the elaboration of hromones indigenous to the tissue from which the tumor arose