All of the following are correctly matched except?
Type I HSR - IgE mediated
Type II HSR - IgA mediated
Type III HSR - Immune complex - IgG mediated
Type IV HSR - Cell mediated
All of the following are true about hygiene hypothesis except
Excessive hygeine
Overuse of antibiotics
Not vaccinating the child
All of the following are components of a typical adaptive response to an helminthic infection except
CDH4 Th1 cells
Cytokines - IL 3,4,5,9,10,13
antibodies IgE and IgG 1 and 4
Effector cells such as eosinophils, basophils and mast cells
The main components of type I HSR are neutrophils and lymphocytes
Sensitization to antigen involves class switching to IgE production on first contact with an allergen
All of the following are stages in HSR I except
Initial exposure to immunogen which results in the production of reactive B and T cells - no symptoms
B cell - T cell interaction - antigen activation of Th2 cells
Production of IL 4 + IL 13
Production of IgE
Binding of IgE to Fc Epsilon Receptor and activation/sensitization of mast cell and release of mediators
None of the above
The following is true about HSR I immediate and late response
Within minutes mast cell + Basophils will release histamine and serotonin causing wheal and flare
In hours Eosinophils +Th2 will release second wave of mediators prostaglandis and leukotrienes
Both are correct
Intrinsic asthma is Type I HSR reaction
The Primary method for diagnosing HSR I is by skin testing, with the characteristic response being "wheal and flare" reaction within minutes
RAST detects IgG anti-allergen in patient's serum
All of the following are used as treatment strategies for HSR I
Allergen avoidance
Correct Th1/Th2 imbalance (not clinically feasible)
Block mediators either with antihistamine, lipoxygenase inhibition or steroid use
Correct isotype switch to IgE
Prevent IgE binding to mast cells to prevent IgE mediated degranulation
Epinephrine is the main treatment for anaphylaxis - true or false
In desensitization treatment the allergen binds to IgG thereby preventing IgE mediated response - true or false
Omalizumab is a mab that binds to Fc region of IgE thereby blocking the arming of mast cells - true or false
All of the following are true about HSR II except
HSR II is mediated by IgG or IgM not IgE
HSR II the antibodies bind to the self antigen on cell membranes and extracellular matrix
HSR II makes autoreactive antibodies
HSR II activates the alternate complement pathway
All of the following are mechanisms for cell damage in HSR II except?
recruitment of neutrophils - causing tissue injury and inflammation
Opsonization and Phagocytosis
Interfere with cellular functions - either block or stimulate cell receptors
All of the above
All of the following are HSR II reactions except
Hemolytic disease of the newborn
Blood transfusion reactions
Penicillin reaction
Extrinsic asthma
All of the following are true regarding Hemolytic disease of the newborn (HDNB) except
Seen when mother is Rh+ and baby is Rh-
Mother is O type blood group and baby A,B or AB
Prevention is by giving Rhogam to the mother
All of the following are non cytotoxic type II HSR diseases except
Myasthenia gravis
NDIIM
Graves disease
Pernicious anemia
Penicillin allergy
All of the following are cytotoxic HSR II except?
Erythroblastosis fetalis (Hemolytic disease of the newborn)
PCN reaction
Rheumatic fever
Autoimmune thrombocytopenic purpura
Goodpasture syndrome
Grave's disease
Type III HSR - damaged tissues are innocent bystanders when a circulating (soluble antigen) immune complex becomes deposited in the tissues - true or false
When immune complexes (ICs) exceed disposal the net result is inflammation locally or systemically - true or false
All of the following are Type III HSR except
Serum sickness
Farmer's lung (Arthus reaction)
SLE
Post Streptococcal glomerulonephritis (PSGN)
Lumpy bumpy pattern of nephritis is characteristic of PSGN - true or false
All of the following are true about Arthus reaction except?
Farmer's lung is an example of Arthus reaction
Arthus reaction is used in the skin testing of HSR III
Arthus reactions are visualized in the skin
none of the above
All of the following are true about delayed type IV HSR except?
Starts 49-72 hours after antigen exposure
T cell release cytokines that activate macrophages resulting in cell damage
B cells form antibodies that are delayed in their response hence called delayed HSR
Mediated by Th1 cells and CD8+ cytotoxic T cells
HSR IV is an inappropriate manifestation of DTH response that normally protects against intracellular bacterial and fungal infections - true or false
All of the following are examples of IV HSR except
PPD
Poison ivy dermatitis
contact dermatitis due to nickel exposure
Celiac disease
PSGN
