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SGU Immuno Post-midterm
Diseases of autoimmunity, etc. SGU Immunology 2009
55
Health Care
Graduate
11/05/2009

Additional Health Care Flashcards

 


 

Cards

Term
Systematic Lupus Erythematosus
Definition

Mediated by Immune Complexes (IC)

F/M 10:1

ANTI-DSDNA, LEUKOCYTE, PHOSPHOLIPID Abs

 

systemic and multiorgan (NON-organ-specific) IC are formed in serum and trapped in basement memb. of glomeruli, kidney, joints ANTI-DS-DNA, anti leukocyt Antibodies Anti-phospholipid antibody Polyclonal B cell activation Etiology unknown

Term
Rheumatoid Arthritis
Definition

Cell mediated and Immune Complex mediated

F/M 3:1

REHEUMATOID FACTOR Abs bind to Fc of IgG

 

Excessive TYPE 1 Cytokines

 

Rheumatoid factors IgM or IgG/A to FcgammaG (not essential for disease)

Term
MS
Definition

F/M 2:1

ANTI MBP+ CNS Abs Cell Mediated

 

Organ specific Ab to myelin basic protien (MBP)

 

Oligoclonal, no polyclonal Ab in CSF Treatment with IFNbeta (inhibits IFNgamma expression of MHCII)

Term
HASHIMOTO'S THYROIDITIS
Definition

Type IV Hypersensitivity

F/M 50:1 !!

Cell mediated (T-cell)

Thyroid-specific Anti-thyroglobin Ab and anti-microsomal Ab are secondary to thyroid destruction (diagnostic tool) Manifests as goiter/hypothyroidism Peaks 3rd, 4th decade

Term
Goodpasture's syndrome
Definition

Type II HypersensitivityReaction

ANTI GBM Abs bind to cell Glomerular Basement Membrane surface antigens

 

F/M 1:4 2 peaks: young, elderly

 

LINEAR DEPOSITION Anti-glomerular-basement Abs destroy basement membranes in lungs and kidneys: ROIs destroy cells, elastase and colligenase destroy elastin and colligen Lung, Kidney Anti-glomerular basement memb. Ab LINEAR deposition of IgG and compliment

Term
Pernicious Anemia
Definition

TWO MODES

1. Ab to PARIETAL cell surface antigens so no IF produced, or

2. BIND DIRECTLY TO INTRINSIC FACTOR blocking B-12 binding Defective RBCs Abs bind to cel surfc Ags and destroy PARIETAL GASTRIC CELLS THAT SECRETE INTRINSIC FACTOR Ab's bind to IF so no B12 binding MEGALOBLASTIC ANEMIA

Term
Grave's Disease
Definition

F/M: 8:1

 

THYROID ANTI-TSH-R Abs mimic thyroxin stimulating hormone

 

HYPERthyroidism Goiter, bulging eyes

Term
Masthenia Gravis
Definition

F/M : 4:1

 

Abs attack Ach receptors

 

BLOCK ACH BINDING ON NERVE RECEPTORS

Term
Ankylosing Spondylitis
Definition

Affects JOINTS

 

prior infection with Klebisella pneumoniae

 

NO RHEUMATOID FACTOR

Term
Cold Aglutinin Disease
Definition

F/M 1:9

 

Glycophorin (Ii) /Anti-Ii Ab

 

Ab to RBC surface antigens glycophorin or Ii

 

ONLY AT TEMPS BELOW 37 DEG. C

Term
Rhinitis
Definition

Type 1 Hypersensitivity Reaction in NOSE

 

IgE x-linking causes degranulation of mast cells and basophils, resulting in the release of histamines, prostaglandins, and leukotrienes

Term
Asthma
Definition

Type I Hypersensitivity Reaction LUNGS

 

IgE cross-linking causes degranulation of mast cells and basophils, resulting in the release of histamins, prostaglandins, and leukotrienes

Term
Anaphylaxis
Definition

Type I Hypersensitivity Reaction 

MULTIPLE SYSTEMS

 

IgE x-linking causes degranulation of mast cells and basophils, resulting in the release of histamins, prostaglandins, and leukotrienes

Term
Transfusion Reactions
Definition

Type II Hypersensitivity

 

IgM Isohemagglutins lead to compliment pathway activation + opsonin-mediated phagocytosis + ADCC of RBCs

Term
Hemolytic Disease of the Newborn
Definition

Rh Factor Incompatibility

 

Mom develops Anti-Rh+ IgGs, which lead to compliment pathway activation + opsonin-mediated phagocytosis + ADCC of infant's RBCs

Term
Rhogam
Definition

Used to prevent Rh negative mom from generating anti Rh+ antibodies following delivery of an Rh+ baby.

 

Swamps-out the Rh+ antigens by binding them all (IgG) so that mom's immune system doesn't see any.

Term
Systematic Lupus Erethrycytosis (SLE)
Definition

Type III Hypersensitivity Reaction

 

Immune complexes all over body

 

HLA DR2/DR3-related Antibodies to dsDNA

Term
Farmer's Lung
Definition

Type III Hypersensitivity Rxn

 

Immune complexes in LUNG tissue cause damage

Term
Arthus Reaction
Definition

Type III Hypersensitivity Rxn

 

First dose of horse serum sensitizes (DIPTHERIA VACCINATION, etc.)

 

Second dose causes cute reaction ANAPHYLAXIS

Term
Granulatomatous Inflammation
Definition

TYPE IV HYPERSENSITIVITY

 

- Leprae Nerves (?)

- Tuberculosis Lungs -

- Sarcoidosis Skin

 

Pathogens thrive in MACROPHAGES, form LARGE, MULTI-NUCLEATED CELLS which trigger immune responses

Term
Mantoux Reaction
Definition

Type IV TB test

 

Th1-mediated reaction which generates IFNgamma and TNF, acivates macrophages.

 

Also cytokine reaction.

 

Localized to point of intradermal injection (wheal and flare)

Term
Contact Hypersensitivity (poison oak)
Definition

Type IV (Delayed) Reaction

 

On second exposure, memory Th1 cells react to presence of URISHIOL HAPTEN.

 

Reaction may be moderated by Th2's (IL-4)

Term
Multiple Sclerosis
Definition

Type IV (T cell-mediated) CNS demyelination

 

Unregulated type 1 cytokines cause a ruckus.

 

Administration of Type-2 cytokines (Il-4, TGF, IL-13) may help (dampen Th1's).

 

Oral feding of antigen to promote "tolerance" to "switch" Th1 domination to Th2

Term
Reticular Disgenesis
Definition

Progenitor cell disorder

 

Deficient in ALL LYMPHOID AND MYELOID cells

 

ANEMIC

 

Increased susceptibility to ALL agents. Bone marrow xplant

Term
Severe Combined Immunodeficienncy SCID
Definition

NO lymphoid precursor cells

No B OR T cells

 

PRIMARY

lack of LYMPHOID PROGENITOR CELLS

 

SECONDARY:

Lack of ADA or JAK-3 Can also be secondary with lack of ADENOSINE DEAMINASE (ADA), required for PURINE metabilism, so no DNA synthesis, toxic metabolites acumulate . Absence of JAK-3 can also be a SECONDARY cause

Term
X-linked SCID
Definition
Lack of CD-132
Term
DiGeorge's Syndrome
Definition

Defective/absent Thymus

 

FEW OR NO CIRCULATIING T CELLS

 

May improve with age

Term
Chronic Mucocutaneous Candidaisis
Definition

Lack T-CELL RECEPTORS for CANDIDA

 

"Hole in Repitorie"

 

Normal B-cell immunity to Candida still OK.

Term
X-linked Agammaglobulinemia
Definition

Block Pre-B to Immature B maturation

 

LACK ALL TYPES OF Ig

 

Recurrent bacterial infections

Defect in tyrosine kinase.

Apparant at 6 mo. age when mom-derived Abs degraded

Term
Transient HYPOgammaglobulinemia of infancy
Definition

Lack of IgE, IgA, IgG

 

patients recover with antibiotics

 

apparant at 6 months.

 

increased suscep. to bacterial infections

Term
COMMON VARIABLE hypogammaglobulinemia
Definition

NORMAL NUMBERS OF PERHIPERAL B CELLS

 

Lack of ALL Igs

 

Onset at any age

 

F=M

Term
Selective IgA deficieny
Definition

Increase in sinopulmonary infections.

Missing IgA

 

Treat with ANTIBIOTICS since other Ig's OK.

(If gave IgA, recipient would form Anti-IgA Abs.)

Term
Ig deficiency with increased IgM
Definition

Defective CD40 (B-cell) / CD40L (T-cell) interaction

 

 

  ISOTYPE SWITCHING DOES NOT HAPPEN.

Term
Why don't we give live vaccines before one year of age?
Definition

Mom's immunity gone,

 

but infant's immuno system hasn't yet fully matured.

Term
Chediak Higashi Syndrome
Definition

Accumulation of large cytoplasmic granules in phagocytes which become dysfunctional:

 

granules won't fuse to lysosomes.

 

NK also impaired.

 

LACK OF MELANIN in skin, eyes, hair. SHORT-TERM: anti-fungal, Anti-bact LONG-term: Bone Marrow Xplant

Term
Chronic Granulomatous Diesase (CGD)
Definition

Dysfunction of NADPH OXIDASE

 

Short-term treatment

: IFNgamma (upregulates ROIs), anti-fungal, anti-bacterial.

 

Long-term is Bone Marrow Transplant

Term
Leukocyte Adhesion Disorder (LAD)
Definition

Imparired trafficking of Leukocytes

 

CD-18 Deficiency

Term
C1 Eserase Inhibitor Protien Deficiency
Definition

UNCONTROLLED ACTIVATION OF C1

->

proteolysis of C2/C4

-->

more C2b, vasoactive kinin, C4a, anaphylatoxin. Also make more Kallikrein which cleaves kinnogen to relase BRADYKININ

-->

Life-threatening edema HERIDITARY ANGIOEDEMA

Term
C3 deficiencies
Definition

Affects classical and altternate compliment paths

 

Increases suscep. to ALL BACTERIAL infections.

 

Chronic nephritis from deposition of C3 nephritic factor

Term
C5-C9 Deficiency
Definition

Can't MAC Attack!

 

Susceptibility to ONLY to NISSERIA bacteria (memingitis and ghonnorea), which sugests that C3 opsonin phagocytosis is the normal role of compliment-mediated defense, not MAC lysis !!!!!!! Wow!!!!!!!!!!

Term
Decay Accelerating Factor (DAF) Deficiency
Definition

(DAF facilitates C3 convertase decay)

 

Less DAF

-->

activation of MAC, lyses RBCs

-->

PAROXYSMAL NOCTURNAL HEMOGLOBINURIA (you see RBC wreckage in urine after overnight build-up)

Term
Burkitt's Lymphoma
Definition

B-cell lymphoma seen in after EPSTEIN-BARR virus (MONONUCLEOSIS)

 

In immunocompromised patients

Term
Increased cancers in immunosupressed AIDS patients
Definition

 

 

Lymphomas

Skin cancers

Kaposi's sarcoma

Term
Epstein-Barr virus
Definition

Causes mononucleosis

 

Predisposes to B-cell lymphoma

(Burkitt's Lymphoma) in immunocompromised patients

Term
Tumor Specific Antigen (TSA)
Definition

Antigens Found ONLY on tumors

 

Example: Chronic lymphocytec luekemia (CLL)

Term
TAA Tumor Associated Antigen
Definition

Antigens found on tumors

 

as well asother places

 

e.g. oncofetal antigens such as CEA, AFB, Beta-HCG

Term

CEA

 

Cardino-Embryonic Antigen

Definition

Onco=fetal antigen

 

colon, breast, stomach cancers.

 

High in cigarette smokers, COPD patients, Alchoholics with chirrosis

Term

AFP

 

Alpha Fetal Protien

Definition

High in patients wiht pancreatic, gastric, lung cancers

 

Seen in patients with ataxia telegectasia and alcoholic cirrosis

Term
Beta HCG
Definition
High in ovarian cancer patients
Term
MAGE-1 through MAGE-3
Definition

colon cancer UNIQUE antigens (TSAs)

 

used for diagnosis

Term
17-1-A
Definition

Unique antigen (TSA)

 

for OVARIAN cancer

 

used for diagnosis

Term
Bence-Jones Protiens
Definition

Overproduction of LIGHT CHAINS by Myelomas

 

show up in urine

Term

Examples of

 

Cancer therapy via enhanced APCs

Definition

1. Enhance DC antigen presentation via enhancing migration to spleen

 

2. adding tumor epitopes to DCs ex-vivo

 

3. fuse DCs with tumor cells to get more MHCI and II expressed

Term
Cytokine-based cancer therapy
Definition

Add GM-CSF to tumors in-vitro then reinfuse into patient

 

Other versions of this therapy add

IL-1, IL-12, or IFNgamma

Term
Monoclonal Antibody cancer therapy
Definition

Take a sample of patient's bone marrow

-->

In-vitro, purge of bone marrow samples: make 'em cancer free.

-->

Chemotherapy for patient to kill cancer

-->

inject "clean" marrow back into patient

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