Immunology and Serology

When do autoimmune diseases occur?

What theory states that Burnet postulated that when an error in self-recognition occurs during fetal life and lymphs against an autoantigen are not destoryed, then autoantibodies are produced?

What theory states that clones developed during fetal life are not stimulated by low doses of antigens and the ability to produce antibodies against higher doses of antigens is still present?

What theory states that some antigens are hidden from the immune system during fetal development, and when tissue is damaged, the hidden cells are exposed?

What theory states that supporessor T cells control antibody production by B cells and if suppressor T cells exhibit decreased activity, then antibodies against autoantigens are produced?

What theory states that an individual can make antibodies or reactive T cells to an infectious agent that cross reacts with self antigens?

What theory states that a number of bacteria and viruses are known to nonspecifically stimulate B cells, and if these B cells have activity against self antigens, an autoimmune disease can result?

What clinical conditions are antinuclear antibodies (ANAs) associated with?

What is an anti-antibody, typically IgM, that bind to the Fc portion of abnormal IgG?

What clinical conditions are associated with cryoglobulins?

What clinical condition is a chronic, noninfectious inflammatory disease involving many organs and tissue injury is caused by autoantibodies and immune complexes deposited into the tissues?

What clinical condition is a chronic, noninfectious, systemic inflammatory disease that primarily afects the joints and is due to production of IgG or IgM antibodies against IgG in the synovium?

What clinical condition is consisten with the findings:
ESR increased
CRP increased
RF positive
Cryoglobulins positive
ANA positive or negative
Synovial fluid is cloudy with WBC between 5000-20000, increased protein
Poor mucin clot development
Complement decreased
RF positive

What clinical condition is an inflammation of the salivary and lacrimal glands causing dryness of the mouth and eyes?

What clinical condition is consistent with the findings:
Polycolonal hypergammaglobulinemia
Autoantibodies agains the salivary glands
RF positive
ANA speckled or diffuse pattern
Anti-SSA
Anti-SSB

What clinical condition has:
an increased rate of RBC destruction
DAT positive
Cold agglutinins (sometimes)
Autoantibody against RBC antigens

What disease occurs when
Humoral and cellular immunity are activated
Destruction of normal thyroid tissue leads to hypothyroidism
Loss of thyroid function
Low levels of thyroid hormones in the blood
Detection of antithyroid antibodies

What disease is characterized by:
Hypoplasia and diffuse goiter caused by an autoantibody reacting with thyroid receptor on cells that overstimulates the thyroid gland
Autoantibody mimics the activity of thyroid stimulating hormone (TSH)
TT3 increased
FT3 increased
TT4 increased
FT4 increased
TSH decreased
Exophthalmos
Infiltrative dermopathy
Thyrotoxicosis

What disease is a:
Neuromuscular disease in which the nerve muscles do not function normally
Most patients exhibit antibodies to acetylcholine receptors

What disease is:
Considered a chronic progressive inflammatory disease with demyelination of the nerves
Active lesions (plaques) contain CTLs, T helper cells, and macrophages
IgG increased in CSF
Oligoclonal bands in CSF

What differentiates true increase of IgG due to a production rather than increases in permeability of the blood-brain barrier?

What is the IgG index calculation?

What is the reference range for IgG index?

What disease has:
Islet cell destruction in the pancreas
Autoantibodies and CTLs reactive against pancreatic beta cells produce marked atrophy and fibrosis of the islet cells - causing insulin deficiency

What types of responses are humoral mediated and immediate?

What type of responses are cell mediated at delayed?

What type of hypersensitivity reaction is:
Classified as an immediate hypersensitivity reaction b/c it occurs within minutes after reexposure
After 1st exposure, basophils and mast cells are sensitized with IgE
After 2nd exposure, IgE binds to a specific allergen and chemical mediators are released

What do allergens contacting the bronchus cause?

What is the systemic form of type I hypersensitivity?

What mediator of Type I hypersensitivity:
Causes contraction of bronchioles and smooth muscle of blood vessels
Increases capillary permeability
Increases mucus secretion in the airway

What mediator of Type I hypersensitivity:
Causes vasodialation 
Increased vascular permeability

What mediator of Type I hypersensitivity:
Causes erythema and wheat formation
Has 30-100 times the ability of histamine to cause bronchospasms
Stimulate mucus secretion in the airways

What type of hypersensitivity reaction is
Due to IgG or IgM antibodies directed against cell surface antigens
PMNs bind to antibody sensitized cells and destroy the cells by phagocytosis or antibody dependent cellular cytotoxicity reaction

What occurs when antibody-antigen complex on cell surface activates the complement pathway to cause cell lysis?

Name an example of Type II hypersensitivity reactions

What type of hypersensitivity reaction is:
When immune complexes are deposited on tissues, causing inflammation
Can activate complement, which can lyse nearby (innocent bystander) cells
Can stimulate degranulation of granulocytes, which triggers inflammation and tissue damage

What 2 sites are where immune complexes are often deposited?

What happens when immune complexes are deposted into the renal glomeruli?

What hypersensitivity reaction is:
Caused by soluble factors or lymphokines released by T cells
Antibody and complement are NOT involved in this reaction
Recruitment and activation of the cells takes 24-72 hours, and therefore referred to as delayed hypersensitivity

How does Type IV hypersensitivity (cell mediated) reaction work?

Name examples of Type IV hypersensitivity (cell mediated)

What clinical condition is:
Marked deficiency of all classes of immunoglobulins is detected after about 6 months of age
Recurrent, life-threatening infections occur with encapsulated bacteria (Strep pneumo and H. influenzae)
B cells are markedly decreased or absent

What clinical condition is:
X linked genetic disease
Serum IgM increased
IgG and IgA are markedly decreased or absent
Defect in CD40 ligand on T helper cells prevents class switching from IgM to IgG, IgA, or IgE
Patients prone to respiratory tract infections
Autoantibodies to platelets, RBCs, and neutrophils

What clinical condition has:
Patients present with small amounts or absence of serum and secretory IgA
Usually caused by a genetic defect or by drugs (phenytoin and penicillin)
Anaphylaxis may result if IgA is administered to someone with this deficiency (blood transfusion)

What clinical condition is:
Autosomal recessive disorder that presents with ataxia, telanectasia, recurrent sinopulmonary infections, high incidence of malignancy, and variable immune defects
IgA deficiency
Sometimes IgE deficiency
NOT primarily an immunodeficiency but a defect in a kinase gene that regulates the cell cycle
B and T helper cells are affected

What clinical condition has:
Symptoms that include hypocalcemic tetany, due to underdevelopment of the thymus, and heart disease
Immune defect is variable, from slight decrease in T cells to no T cells in bloodstream
Patients very susceptible to opportunistic infections and have poor prognosis

What clinical condition has:
Accumulation of nucleotide metabolites in all cells, which is particularly toxic to T and B cells
T cells decreased
Children often have an underdeveloped thymus, lack of tonsils or lymph nodes, hypogammaglobulinemia, and lymphopenia

What clinical condition is:
With an MHC class II deficiency, T helper cells fails to develop - patient present with hypogammaglobuminemia and no CMI response
MHC class I defiency is less severe - loss of CTLs and response to intracellular pathogens

What clinical condition has:
A mutation in the gene that codes for the Wiskott-Adrich syndrome protein (WASP) - a protein involved with cytoskeletal reorganization necessary for delivering cytokines
Defect prevents T helper cells from delivering lymphokines to B cells, macrophages, and other target cells
Patients demonstrate eczema, throbocytopenic purpura, and increase risk of infection
Platelets are small and defective