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USMLE - Immunopath

USMLE - Goljan, Chapter 3 Immunopathology

QuestionAnswer
Name the two types of immunity Innate and Acquired
Name cells of the innate immunity phagocytes (neutrophils, macrophages), NK cells
Name cells of acquired immunity B and T cells (antigen-dependent)
If a newborn already has IgM at birth, what should you suspect? Congenital infection because normally, IgM synthesis only begins at birth
When does IgG synthesis begin? 2 months old; IgG presence at birth is usually mom's IgG
MHC complex proteins that display self and non-self antigens to T cells
MHC class 1 bind to CD8 T cells
MHC class 2 bind to CD4 helper T cells
HLA genes subset of genes in the MHC region (on chromosome 6)
HLA A, B, C Belong to MHC class I group; present on all cells except RBCs; recognized by CD8 T cells and NK cells
HLA DP, DQ, DR belongs to MHC class II group; present on all antigen-presenting cells (B cells, macrophages, dendritic cells); recognized by CD4 helper T cells
HLA-B27 ankylosing spondylitis
HLA-DR2 MS
HLA-DR3 and DR4 Type 1 DM
Name 3 functions of CD4 T cells secrete IL-2 --> proliferation of CD4/CD8 T cells; secrete gamma-interferon --> activate macrophages; help B cells become antibody-producing plasma cells
What do CD8 T cells do? kill virus-infected, tumor (neoplastic), or foreign cells (donor)
Do APC's interact with CD4 or CD8 cells? CD4 T cells
What type of cells do NK cells attack? Virus-infected or tumor (neoplastic)
What are dendritic cells? APC's found in skin
What Ig is involved in Type I hypersensitivity? IgE --> activation of mast cells
Atopic disorders -- what type of hypersensitivity rxn? Type 1
Hay fever -- what type of hypersensitivity rxn? Type 1
Eczema -- what type of hypersensitivity rxn? Type 1
Hives -- what type of hypersensitivity rxn? Type 1
Asthma -- what type of hypersensitivity rxn? Type 1
anaphylaxis -- what type of hypersensitivity rxn? Type 1
Drug allergy to penicillin -- what type of hypersensitivity rxn? Type 1
Mnemonic for Type 1 Hypersensitivity Rxns ANAPHYLAXIS Annie's ASTHMA FLAREs when her FOOD contains HAY. FLARE = wheal/flare (insect stings, allergy testing); FOOD = food allergies; HAY = hayfever
Mnemonic for Type 2 Hypersensitivity Rxns The BULLdog E.F. ARF the II HAd GOOD TaPas, while DuM MaG-Gie PAssed on them.
Name the complement-dependent diseases associated with Type 2 Hypersensitivity reactions Complement Dependent: BULL=Bullous pemphigoid; E.F.=Erythroblastosis Fetalis; ARF=Acute Rheumatic Fever; II=type 2; HA=hemolytic anemia; GOOD=Goodpasteur's Syndrome; TP=thrombocytopenic purpura (autoimmune).
Name the complement-independent diseases associated with Type 2 Hypersensitivity reactions Complement-independent: DM=Diabetes Mellitus; MG=Myasthenia Gravis; G=Graves; PA=Pernicious Anemia.
Type II Hypersensitivity Rxns Antibody-dependent
ABO mismatch -- what type of hypersensitivity rxn? Type II - antibody dependent, complement-dependent, by lysis (MAC)
Hyperacute transplantation rejection -- what type of hypersensitivity rxn? Type II - antibody dependent, complement dependent, by lysis (MAC)
Goodpasteur's Syndrome -- what type of hypersensitivity rxn? Type II - antibody dependent, complement dependent, by lysis (MAC)
Warm IgG autoimmune hemolytic anemia -- what type of hypersensitivity rxn? Type II - antibody dependent, complement dependent, by phagocytosis (macrophages)
ABO and Rh disease of the newborn -- what type of hypersensitivity rxns? Type II - antibody dependent, complement dependent, by phagocytosis (macrophages)
helminth destruction by eosinophils -- what type of hypersensitivity rxn? Type II - antibody dependent, complement INdependent, cell-mediated cytotoxicity
Type III Hypersensitivity Rxns Immune complex-mediated diseases
Mnemonic for Type 3 Hypersensitivity Rxns ARTHur was the 3rd PaGaN, RA in SLE with PNEUMONITIS in his PeNis!! ARTH=ArthusRxn; 3rd=Type III; PGN=Post-StrepGlomeruloNephritis; RA=RheumArthritis; SLE; Pneu=HypersensitivityPneumonitis; PN=PolyarteritisNodosum
Serum sickness -- what type of hypersensitivity rxn? Type III - immune complex dependent
Type IV Hypersensitivity Rxns T-cell mediated diseases
Mnemonic for Type 4 Hypersensitivity Rxns Don't CONTACT Ms. GUILLIAN HASHIMOTO FOR NEURo TrouBles because she's GraVid. D=IDDM; CONTACT=ContactDermatitis; Guillian Barre; HashimotoThyroiditis; Neuritis; TB=tuberculosis; GV=Graft vs. Host Dz
What is delayed Type 4 Hypersensitivity? CD4 T cell mediated; macrophage activation, cytokines released --> inflammation.
What is cell-mediated cytolysis Type 4 Hypersensitivity? CD8 T cell cytolysis
IL-1 Secreted by macrophages --> inflammatory mediators --> pyrogenic response
IL-2 Secreted by helper (CD4) T cells --> both helper and cytotoxic T cells --> make more T cells!!
IL-3 Secreted by helper (CD4) T cells --> stimulate bone marrow stem cells --> growth and differentiation of progenitors of all blood cells
IL-4 Secreted by Th2 (subset of CD4's) cells 1. B cells --> IgE/IgG production, 2. differentiation of naïve CD4's into Th2's, 3. suppress gamma-interferon actions of macrophages
IL-5 Secreted by Th2 (subset of CD4's) cells 1. B cells --> make IgA, 2. eosinophils --> activate to kill worms
IL-6 Secreted by Th2 (subset of CD4's) cells AND macrophages --> acute phase reactants and Ig's by hepatocytes; --> stimulates growth of plasma cells (antibody-producing B cells)
IL-8 Secreted at site of inflammation --> chemotasis of neutrophiles
IL-10 Secreted by Th2 (subset of CD4's) cells AND activated macrophages --> 1. block Th1 and activated macrophages; 2. stimulate Th2
IL-12 Secreted by B cells to activate NK cells; secreted by macrophages to activate Th1 (IFN-gamma release and phagocytic ingestion of microbes)
IFN-gamma Secreted by Th1 (subset of CD4's) AND NK cells --> stimulate Th1's and macrophages, block Th2
Created by: christinapham