Physio/simple/autoimmune

Front 1

How may microorganisms adapt to their host?

Back 1

a bacterial capsule may prevent attachment to host macrophages.
The cell wall may resist digestion and may contain endotoxins, toxic lipopolysaccharides of Gram neg organisms particularly.
bacteria may secrete exotoxins some of which can damage phagocytic cells; others(aggressins) alter the environment in a way that promotes spread of bacteria.

Front 2

deficiency in phagocytic cells and complement will cause susceptibility to bacterial infections since phagocytic cells and complement are the first line defense against bacteria. TRUE/FALSE

Back 2

TRUE. Since complement is important in the removal of immune complexes, patients with complement deficits may develop diseases of immune complex deposition, with vasculitis, nephritis and arthritis.

Front 3

What is leukocyte adhesion deficiency?

Back 3

defective leukocyte function results in increased susceptibility to infection.

Front 4

What is Chediak-Higashi syndrome?

Back 4

It is a hereditary disorder of lysosomes that affects neutrophils, monocytes, lymphocytes and other kinds and other cells, resulting in infections, and hemorrhage(platelet) neurologic involvement and albinism.

Front 5

Individuals with T cell deficiencies are open to many infections but still may be able to handle microbes with polysaccharide antigens. TRUE/FALSE

Back 5

TRUE. Defense against polysaccharide antigens involves antibody that is T cell independent.

Front 6

Increased complement activity may also occur when feedback inhibitory components of the complement cascade are deficient. TRUE/FALSE

Back 6

TRUE.
In hereditary angioneurotic edema there are attacks of skin and mucosal(laryngeal) membrane edema from excessive complement activity.

Front 7

What happens paroxysmal nocturnal hematuria?

Back 7

RBCs are usually susceptible to complement lysis because the normal proteins that help prevent this are missing.

Front 8

What is the Schwartzman reaction?

Back 8

There is an overreactive response to microbes; bacterial endotoxin(LPS) induces the production of tumor necrosis factor(TNF) in phagocytes. TNF causes in excess myocardial contractility, vascular blood coagulation, poor tissue perfusion and shock(endotoxin).

Front 9

What is type 1- type 1V reactions?

Back 9

Type 1- IgE hypersensitivity
Type 11- IgG/IgM
Type 111- antibody-antigen complex reactions
Type1V-T helper or T cytotoxic cells in cell mediated immunity.

Front 10

What causes Type 1 reactions/

Back 10

(pollen allergy) are acute reactions mediated by IgE. IgE attaches to Fc receptors on blood basophils and tissue mast cells. When this occurs with cross linking of the antigen with IgE, the mast cell(or basophil) degranulates releasing vasoactive substances. This can demonstrate as a rash or anaphylactic shock with hypotension and bronchiolar spasm.

Front 11

Type 1 is the most common form of hypersensitivity. TRUE/FALSE

Back 11

TRUE. It can flair up in minutes.

Front 12

What are type 11 reactions?

Back 12

Blood transfusion reactions, autoimmune disease, transplant rejection by antibodies are mediated by IgG and IgM.

Front 13

List 10 type 11 related diseases.

Back 13

1. Autoimmune hemolytic anemia
2. Autoimmune thrombocytopenic purpura
3. Diabetes mellitus
4. resistant ovary syndrome
5. Goodpastures syndrome
6. Grave's disease
7. Myasthenia gravis
8. Pemphigus
9. Pernicious anemia
10. Rheumatic fever

Front 14

What is resistant ovary syndrome?

Back 14

The ovary fails to respond to hormonal stimulation because of autoantibodies against hormone receptors in the ovary.

Front 15

What is Goodpatures syndrome/

Back 15

Autoantibodies to collagen in renal glomeruli and lung alveoli result in nephritis and pulmonary hemorrhages.

Front 16

What is Grave's disease/

Back 16

Autoantibodies to TSH receptors on thyroid cells have a stimulatory effect on thyroid production, causing hyperthyroidism.

Front 17

What is pemphigus?

Back 17

Autoantibodies to epidermal proteins cause skin and mucus membrane blistering.

Front 18

Rheumatic fever may be associated with streptococcal pharyngitis. TRUE/FALSE

Back 18

TRUE. Unlike post-streptococcal glomerulonephritis, rheumatic fever does not involve the kidney but does cause, fever, migratory polyarthritis and occasionally carditis.

Front 19

What is Waldenstrom's macroglobulinemia?

Back 19

There is excess production of monoclonal IgM, coinciding with the anemia and bone marrow infiltration from abnormal, proliferating lymphocytes and plasma cells.
Excess IgM may cause hyperviscosity of the blood.

Front 20

What is Multiple myeloma?

Back 20

It is a plasma cell tumor that invades bone. In addition to hypercalcemia from marrow destruction, there is increased production of monoclonal antibody(usually IgG) and excess production of antibody light chains. These light chains may filter through the kidney and are detectable on urine testing(Bence- Jones protein).

Front 21

List some type 111 reactions.

Back 21

chronic glomerulonephritis
serum sickness
rheumatoid arthritis
Arthus' reaction.
These are mediated by antigen/antibody complexes.

Front 22

What initiates tissue damage in type 111 reactions?

Back 22

Unphagocytosed antigen/antibody complexes may settle in tissues and excessively activate.
The activated complement in turn activates neutrophils and macrophages to produce tissue destructive lytic enzymes and phagocytose host cells.

Front 23

Neutrophils and macrophages can also be activated directly by immune complexes without the assistance of complement. TRUE/FALSE

Back 23

TRUE.

Front 24

What is serum sickness?

Back 24

When the immune complex forms in the blood stream, as in the infusion of foriegn serum.

Front 25

What is the Arthus reaction?

Back 25

It is a localized form of immune complex hypersensitivity.

Front 26

List 4 type 111 reactions?

Back 26

1. Polyarteritis nodosa
2. post-streptococcal glomerulonephritis
3. Rheumatoid arthritis
4. Systemic lupus erythematosis

Front 27

What is post-streptococcal glomerulonephritis?

Back 27

An immune complex of antigens from the streptococcal wall with antibody to them results in glomerulonephritis.

Front 28

What is Rheumatoid arthritis?

Back 28

This condition may involve IgM autoantibodies(rheumatoid factors) to IgG.

Front 29

What is systemic lupus erythematosis?

Back 29

Autoantibodies to DNA and nucleoproteins result in vasculitis, nephritis, and arthritis, among other things.

Front 30

What are type 1V reactions?

Back 30

Graft rejection, contact sensitivity, tbc response are cell mediated reactions.
damage may be caused by cytokines released from T helper cells, by activated T cytotoxic cells, or by antibody production that is indirectly stimulated by T cell interaction with B cells.

Front 31

cell mediated hypersensitivity reactions take longer than antibody-mediated reactions, often hours or days, the delay being due to the time required to mobilize cells through the T cell chain of interactions. TRUE/FALSE

Back 31

TRUE.

Front 32

What exactly is contact sensitivity?

Back 32

Skin Langherhans cells respond to antigen on the skin and initiate a T helper response. An eczematous rash may appear 1-2 days later.

Front 33

What is tuberculin skin testing?

Back 33

This is another example of delayed hypersensitivity due to cell mediated reactions. Tbc antigen is injected intradermally, and aclassic reaction in a person who has been exposed to tbc, develops 48-72 hrs later in the form of an indurated reactive area in the skin.

Front 34

What is the pathogenesis of tuberculosis?

Back 34

Cell mediated immunity attempts to eliminate the tbc bacillus by activating macrophages, which ingest the bacilli.
If the bacilli remain alive, the body may attempt a chronic inflammatory response, walling off the affected cells in damaging granulomas, in the lungs and elsewhere.

Front 35

sarcoidosis(nodules in lungs, eyes skin, Chgron's disease and ulcerative colitis and temporal arteritis are other examples of granulomatous diseases that are believed to involve cell mediate immunity. TRUE/FALSE

Back 35

TRUE.

Front 36

List several non-granulomatous diseases that may have an origen in cell mediated immune responses?

Back 36

Multiple sclerosis
Myasthenia gravis(occasionally
Grave's disease
Viral myocarditis

Front 37

is autoimmunity always against host cells?

Back 37

A foriegn antigen, virus or drug attaches to the host cell. The immune response is against the foreign antigen, and in the process kills the host cell too.

Front 38

What is polyclonal activation?

Back 38

certain antigens(bacterial lipopolysaccharide) can induce a generalized clonal proliferation of B cells(polyclonal activation) including the small population of self reacting B cells that otherwise would be insufficient in number to mount an autoimmune response.

Front 39

Why do certain ocular injuries require removal of the eye?

Back 39

If there is laceration of the choroid layer of the eye with permanent loss of vision, doctors may opt to remove the damaged eye, because leaving it may lead to an autoimmune reaction against the opposite eye(post-traumatic uveitis) from antigens originally sequestered in the choroid but now released.

Front 40

What is Digeorge syndrome?

Back 40

there is failure of thymic development, and hence a deficiency in T cells.