Term
| Effector molecules and cells of type I hypersensitivity |
|
Definition
|
|
Term
| Three general mechanisms by which antibodies can induce tissue damage in hypersensitivity reactions |
|
Definition
* Opsonization and phagocytosis
* Complement- and Fc receptor-mediated inflammation
* Antibody-mediated cellular dysfunction (eg, Grave's disease and myasthenia gravis) |
|
|
Term
| Macromolecules responsible for Rh blood group |
|
Definition
| Proteins (eg, Rh D antigen) |
|
|
Term
| Macromolecule responsible for A, B, and O blood groups |
|
Definition
|
|
Term
| Precursor to A and B blood type antigens |
|
Definition
|
|
Term
| Blood type of patient who lacks enzyme to convert H antigen into A or B antigens |
|
Definition
|
|
Term
| Is the Rh+ allele expressed with autosomal dominance or recessiveness? |
|
Definition
|
|
Term
| Immunoglobulin isotype associated with antibodies against A and B blood type antigens |
|
Definition
|
|
Term
| Type of anti-Rh D antibody (IgG, IgM, etc.) produced in an Rh- individual |
|
Definition
| Trick question; there are no naturally occurring anti-Rh D antibodies |
|
|
Term
| Mechanism of transfusion reaction |
|
Definition
* Patient is given blood of opposite blood group
* IgM binds blood cells
* Activation of classical complement pathway
* Immediate lysis |
|
|
Term
| Why maternal anti-Rh D antibodies are always of the IgG variety in hemolytic disease of the newborn |
|
Definition
| Because only IgG can cross placenta |
|
|
Term
| Rh- mother has anti-Rh D antibodies. How many children has she had? |
|
Definition
|
|
Term
| Prophylactic treatment of hemolytic disease of the newborn |
|
Definition
| Injection of anti-Rh D IgD antibodies into the mother |
|
|
Term
| Characteristics of Goodpasture syndrome |
|
Definition
* Autoreactive IgG against kidney and lung basement membranes
* Activates classical complement pathway
* Kidney failure
* Pulmonary bleeding |
|
|
Term
| What direct Coombs test measures |
|
Definition
| Measures antibodies bound to cells |
|
|
Term
| What indirect Coombs test measures |
|
Definition
| Measures antibodies that could potentially bind to cells |
|
|
Term
| Immunoglobulin isotype associated with Goodpasture syndrom |
|
Definition
|
|
Term
| Graves disease is associated with antibodies that stimulate what receptor? |
|
Definition
|
|
Term
| Graves disease and myasthenia gravis are associated with immunoglobulins of what isotype? |
|
Definition
|
|
Term
| Plasmapheresis works only with reactions mediated by what isotype of immunoglobulin? |
|
Definition
|
|
Term
| Mechanism of type III hypersensitivity |
|
Definition
* Antigen:IgG complexes deposit in tissue (systemic or local)
* Complement recruitment
* Vasodilation
* Neutrophil recruitment
* Mast cell activation
* Tissue damage |
|
|
Term
| Effector molecules/cells of type III hypersensitivity reaction |
|
Definition
* Complement
* Neutrophils |
|
|
Term
| Organ most commonly affected by type III hypersensitivity |
|
Definition
|
|
Term
| Systemic type III hypersensitivity is associated with what two disorders? |
|
Definition
* Systemic lupus erythematosus
* Serum sickness |
|
|
Term
| Characteristics of post-streptococcal glomerulonephritis |
|
Definition
* Local immune complex disease
* Follows streptococcal pharyngitis ("strep throat")
* Immune complexes deposit in kidney
* Results in renal insufficincy |
|
|
Term
| Name of highly localized type III hypersensitivity reactions |
|
Definition
|
|
Term
| Type of hypersensitivity associated with farmer's lung and necrosis |
|
Definition
| Type III hypersensitivity (immune complex disease) |
|
|
Term
| Diagnosis of immune complex disease |
|
Definition
* Clinical syndrome
* Serum complement levels
* Kidney biopsy |
|
|
Term
| Characteristics of delayed-type hypersensitivity |
|
Definition
* Only type mediated by cells of adaptive immune response (usually CD4+ T cells, but sometimes CD8+)
* Takes 1-3 days to develop |
|
|
Term
| Mechanism of delayed-type hypersensitivity reaction |
|
Definition
* Memory TH1 cells activated by specific antigen
* TH1 cell releases roinflammatory cytokines (eg, IFNγ)
* Nonspecific phagocytes (eg, macrophages) recruited |
|
|
Term
| Mechanism of CD4+ T cell-independent type IV hypersensitivity |
|
Definition
* CD8+ T cells activated
* Direct killing of cells in the absence of inflammatory mediators |
|
|
Term
| Protective role of type IV hypersensitivity is especially important against what bacteria? |
|
Definition
|
|
Term
| TH1 cells stimulate macrophages by secreting what cytokine? |
|
Definition
|
|
Term
| Macrophages stimulate T cells by secreting what cytokine? |
|
Definition
|
|
Term
| Rheumatoid arthritis is associated with what type of hypersensitivity? |
|
Definition
|
|
Term
| Contact dermatitis is mediated by what cell type largely? |
|
Definition
| T cells and macrophages (as part of delayed-type hypersensitivity) |
|
|
Term
| Nickel is an important antigen in what type of hypersensitivity reaction? |
|
Definition
| Delayed-type hypersensitivity |
|
|
Term
| The tuberculin skin test is associated with what type of hypersensitivity? |
|
Definition
| Delayed-type hypersensitivity |
|
|
Term
| Where is tuberculin antigen injected in a PPD test? |
|
Definition
|
|
Term
| Induration following PPD test is associated with what type of cellular immune response |
|
Definition
| Mononuclear response (macrophages) |
|
|
Term
| T/F: Hypersensitivity response can occur in response to an antigen that has never been seen by the patient |
|
Definition
| False; all hypersensitivity reactions require prior exposure |
|
|
Term
|
Definition
| Allergy; ie, associated with type I (immediate) hypersensitivity |
|
|
Term
| Three phases of type I hypersensitivity reaction |
|
Definition
* Sensitization
* Activation
* Effector phase |
|
|
Term
| IgE production during sensitization phase of type I hypersensitivity is dependent upon what type of T cell? |
|
Definition
|
|
Term
| Cytokine responsible for triggering TH1 cell production |
|
Definition
|
|
Term
| Type of T cell associated with allergy |
|
Definition
|
|
Term
| Cytokine that pushes TH cell development to the TH2 side |
|
Definition
|
|
Term
| Cell that produces histamine and IL-4 |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
* NK cell activation
* TH1 development |
|
|
Term
|
Definition
* B cell development
* TH2 cell development
* IgE class switch
* Inhibition of TH1 cell development |
|
|
Term
|
Definition
* NK cell activation
* Macrophage activation
* Inhibition of TH2 cell production
* Stimulates MHC II expression |
|
|
Term
| Role of TH2 cells in immediate hypersensitivity |
|
Definition
* Secrete IL-4
* Stimulate B cell development
* Induce IgE class switch |
|
|
Term
| Allergen associated with spinal cord defects |
|
Definition
|
|
Term
| Cross-allergenicity of penicillin drugs |
|
Definition
|
|
Term
| Effector cells of immediate hypesensitivity reaction |
|
Definition
|
|
Term
| Mechanism by which strawberries can alternatively activate mast cells |
|
Definition
|
|
Term
| Four alternative mechanisms of mast cell activation |
|
Definition
* Anti-IgE crosslinking
* Lectin crosslinking
* Chemical crosslinking
* Anti FcεR1 crosslinking |
|
|
Term
| Two general types of inflammatory mediators released from mast cells |
|
Definition
* Preformed
* Newly formed |
|
|
Term
| Acute and late effector phase of immediate hypersensitivity is associated with what mediators? |
|
Definition
* Acute: soluble mediators
* Late: eosinophils and mediators |
|
|
Term
| Distribution of H1 receptors |
|
Definition
* Bronchial smooth muscle: constriction
* Vascular smooth muscle (relaxation) and endothelial cells (contraction): vasodilation, increased permeability |
|
|
Term
| Distribution and functions of H2 receptors |
|
Definition
| Increases mucus production or acid secretion in stomach |
|
|
Term
| Two preformed mediators released by mast cells |
|
Definition
* Histamine
* Eosinophil chemotactic factor |
|
|
Term
| Two newly synthesized mediators released by mast cells |
|
Definition
* Leukotrienes
* Prostaglandins |
|
|
Term
| Function of leukotrienes in allergic response |
|
Definition
| Prolonged constriction of smooth muscle |
|
|
Term
| Function of prostaglandins released by mast cells during allergic response |
|
Definition
* Smooth muscle constriction (especially in bronchioles)
* Vascular dilation
* Increased vascular permeability
* Chemokine |
|
|
Term
| Roughly: acute and late effector phases or allergic response are mediated by soluble factors or cells? |
|
Definition
* Acute phase: soluble factors
* Late phase: cells and newly formed soluble factors |
|
|
Term
| Acute effector phase of allergic response is associated with what effects on vasculature and bronchioles? |
|
Definition
* Vasodilation
* Bronchiole constriction |
|
|
Term
| Late (chronic) effector phase of allergic response is associated with what changes in bronchiole dilation? |
|
Definition
* TH2 cell recruitment
* Bronchiole dilation
* Smooth muscle hypertrophy
* Increased mucus production by goblet cells
* Eosinophil recruitment and secretion of proteases that damage bronchiole |
|
|
Term
| Major functions of leukotrienes and prostaglandins in allergic response |
|
Definition
* Leukotrienes: smooth muscle constriction
* Prostaglandins: vasodilation |
|
|
Term
| Common events in allergic response |
|
Definition
* Vasodilation
* Increased vascular permeability
* Broncho- and bronchioloconstriction
* Itchiness, sneezing |
|
|
Term
| Cutaneous manifestation of allergy |
|
Definition
| Urticaria (itchy rash due to histamine release and vasodilation with increased vascular permeability) |
|
|
Term
| Characteristics of urticaria |
|
Definition
* Itch rash
* Caused by histamine release from mast cells
* Vasodilation
* Increased permeability
* Migratory, not fixed
* Also called hives |
|
|
Term
| Type of hypersensitivity associated within asthma |
|
Definition
|
|
Term
| Immediate cause of anaphylaxis |
|
Definition
| Sudden release of huge quantities of histamine |
|
|
Term
|
Definition
* Tremendous vasodilation due to loss of vascular tone
* Massive increase in permeability
* Bronchoconstriction
* Mucus production |
|
|
Term
| Specific and non-specific methods of diagnosing allergies |
|
Definition
* Specific: pin-prick, allergen-specific [IgE]
* Non-specific: eosinophilia, total serum [IgE] |
|
|
Term
| Methods of preventing sensitization to allergen |
|
Definition
| Monoclonal antibodies to IgE |
|
|
Term
| Methods of desensitization to allergen |
|
Definition
| Administer Ig to bind allergen before IgE can |
|
|
Term
| Rationale for administering anti-venom IgG to patient allergic to venom |
|
Definition
| Anti-venom IgG will bind venom before it has a chance to crosslink patient's endogenous anti-venom IgE on mast cells |
|
|
Term
| Rationale for using corticosteroids in asthma treatment |
|
Definition
| Block mast cell mediator production |
|
|
Term
| Mechanism of action of cromolyn sodium in allergy treatment |
|
Definition
| Cromolyn sodium stabilizes mast cells, making them less likely to degranulate |
|
|
Term
| General mechanism of action of corticosteroids and cromolyn sodium in treatment of allergies |
|
Definition
|
|
Term
| Primary receptor bound by antihistamines |
|
Definition
|
|
Term
| Example of a first generation antihistamine |
|
Definition
|
|
Term
| Side effects of first generation antihistamines |
|
Definition
| Sedative with autonomic effects |
|
|
Term
| Benefits of improved first generation antihistamines |
|
Definition
| Fewer sedative and autonomic effects |
|
|
Term
| Example of improved first generation antihistamine |
|
Definition
|
|
Term
| Second generation antihistamine example and benefits |
|
Definition
| Loratadine (non-sedative and effectively no autonomic effects) |
|
|
Term
| Route of administration of drugs that prevent activation of allergic response |
|
Definition
|
|
Term
| Pharmacokinetics and pharmacodynamics of antihistamines |
|
Definition
* Oral route of administration
* Extensive hepatic metabolism
* Sedative effects secondary to lipid solubility |
|
|
Term
| Which generation of antihistamines crosses the blood brain barrier? |
|
Definition
| First generation (eg, diphenhydramine), and improved first generation, but not second generation |
|
|
Term
| Mechanism of action of montelukast |
|
Definition
| Leukotriene inhibitor that binds leukotriene receptor to prevent bronchoconstriction |
|
|
Term
| Mechanism of action of epinephrine for treating allergic reaction |
|
Definition
| β2-agonist counteracts effect of histamine in bronchioles |
|
|
Term
| One mechanism by which monoclonal antibodies could protect against allergic reaction |
|
Definition
| Prevent IgE binding to mast cells |
|
|
Term
| Treatment for anaphylaxis |
|
Definition
| Epinephrine (bronchodilation, vasoconstriction) |
|
|
Term
| How hygiene hypothesis explains recent rise in allergy incidence |
|
Definition
| Infections upregulate TH1, but with hygienic environment, fewer TH1 cells are produced, pushing TH2 development; TH2 is associated with allergies and parasites |
|
|
