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WorksheetsPatho- Immune Disorders- Type I Hypersensitivity (Exam 4)
Total questions: 57
Worksheet time: 31mins
What type of sensitivity is an allergic or atopy reaction?
I
II
III
IV
What is the mechanism of a type I hypersensitivity?
Ag induces cross-linking of IgE bound to mast cells and basophils with release of vasoactive dilators
Ab directed against cell surface antigens mediates cell destruction via complement activation or Ab-dependent cell-mediated cytotoxicity (ADCC). RBCs are common targets
Ag-Ab complexes deposited in various tissues induce complement activation an dan ensuing inflammatory response mediated by massive infiltration of neutrophils
sensitized T cells (TH1, TH2, and others) release cytokines that activate macrophages or TC cells, which mediate direct cellular damage
What are the typical manifestations of a type I hypersensitivity?
Induce systemic anaphylaxis and localized anaphylaxis such as hay fever, asthma, hives, food allergies, and eczema
includes blood transfusion reactions, erythroblastosis, fettles, and autoimmune hemolytic anemia
includes localized Arthus reaction and generalized reactions such as serum sickness, necrotizing vasculitis, glomerulonephritis, RA, and systemic lupus erythematosus
includes contact dermatitis, tubular lesions, and graft rejection
What are the signs and symptoms of allergic rhinitis?
sneezing (and sneezing so hard/frequently that you get infraorbital cyanosis)
nasal, ocular, palatal itching (which can cause the occurrence of transverse nasal crease)
runny nose and/or congestion
pale, bluish nasal mucosa
cough
What are the laboratory findings of allergic rhinitis?
nasal eosinophils
evidence of allergen-specific IgE by skin or radioallergosorbent testing (RAST)
topical skin rash
extranasal fluid
Which immunoglobulin is responsible for type I hypersensitivity?
IgE
IgG
IgA
IgM
In a person who is not experiencing a type I hypersensitivity or infection with worms, is the concentration of IgE high or low in concentration in the blood serum?
high
low
What two things initiate an allergy?
IgE antibody
multivalent antigen
T cells
memory B cells
_________ individuals produce IgE against common environmental antigens.
atopic
allergic
weak
When atopic individuals produce IgE against common environmental antigens, what are the antigens usually?
proteins
glycoproteins
pet dander
environmental factors (pollen etc)
What type of response is induced after an antigen enters mucosal tissue at very low concentrations?
IgE-stimulating TH2 responses
IgE-stimulating TH1 responses
IgE-stimulating TC cell release
IgE antibodies act by cross-linking what kind of receptor on the surfaces of innate immune cells?
Fcε receptors
PAMPs
G-protein-linked receptors
Although antibodies are not harmful by themselves, the granule contents released include histamine, heparin, proteases, leukotrienes, prostaglandins, and chemokines, which can cause allergic reactions.
true
false
Which receptor is responsible for most allergy symptoms and is expressed on mast cells and basophils?
FcεRI
Fcε
FcεRII
Which low affinity IgE receptor regulates production of IgE by B cells?
FcεRI
Fcε
FcεRII
The high-affinity IgE receptor FcεRI linking receptors trigger _____________ phosphorylation of ITAMs.
oxidative
Lyn-mediated
glucose
protein
Lyn-mediated phosphorylation of ITAMs triggers which 2 pathways, leading to allergic effects?
JAK-STAT
PKC
MAPK
Mast cells express two types of receptors: FcεRI (activating) and FcγRIIB (inhibiting) Ig receptors. If a cell binds both IgE and IgG, which signal wins? (Hint: this is what makes allergy shots effective)
IgE
IgG
________ can phosphorylate ITIMs on FcγRIIB, which will inhibit signaling.
Lyn
JAK-STAT
MAPK
Which type of immunity is responsible for type I hypersensitivity reactions?
innate
adaptive
Which 2 molecules are produced by innate immune cells that are responsible for type I hypersensitivity symptoms?
leukotrienes
prostaglandins
chemokines
histidine
Leukotrienes and prostaglandins are considered __________: formed when membrane phospholipids are enzymatically cleaved.
primary mediators
secondary mediators
tertiary mediators
Secondary mediators (leukotrienes and prostaglandins produced by innate immune cells) are 1000x more potent than histamine at inducing bronchoconstriction and more potent stimulators of:
vascular permeability
mucous secretion
asthma
vascular constriction
neuropathy
Mast cells and basophils release several signaling molecules, but the important ones are
cytokines
chemokines
eosinophils
immunoglobulins
Interleukins are examples of ________.
cytokines
chemokines
What do IL-4 and IL-13 stimulate?
TH2 responses to increase IgE production by B cells
TH1 responses to increase IgE production by B cells
TH2 responses to increase IgE production by T cells
TH1 responses to increase IgE production by T cells
What stimulates the production and activation of myeloid cells such as granulocytes?
GM-CSF
TH2
What type of response occurs within minutes of allergen exposure?
early
late
How are early responses mediated?
mast cell granule release of histamine, leukotrienes, and prostaglandins
cytokines released from the mast cells increase expression of chemokines and CAMs on endothelium facilitating influx of neutrophils, eosinophils, and TH2 cells. Eosinophils play a large role in recruiting neutrophils and degranulation
What type of response occurs hours later as a result of recruited cells?
early
late
How are late responses mediated?
mast cell granule release of histamine, leukotrienes, and prostaglandins
cytokines released from mast cells increase expression of chemokines and CAMs on endothelium facilitating influx of neutrophils, eosinophils, and TH2 cells. Eosinophils play a large role in recruiting neutrophils and degranulation
What is the third phase of a type I hypersensitivity described as involving?
basophils
eosinophils
neutrophils
fibroblasts
Which type I hypersensitivity reaction is often initiated by an injected or gut-absorbed allergen such as bee sting venom, PCN, seafood, or nuts?
systemic anaphylaxis
localized reaction
food allergy
Which type I hypersensitivity is limited to a specific tissue or organ ie allergic rhinitis (hay fever), atopic dermatitis (eczema), or atopic urticaria (hives)?
systemic anaphylaxis
localized reaction
food allergy
Which type I hypersensitivity is a common type of atopy on the rise, often water-soluble glycoproteins stable to heat, acid, and proteases?
systemic anaphylaxis
localized reaction
food allergies
Which immunoglobulin mediates food allergies?
IgG
IgE
IgA
IgM
What is used to explain why countries with improved hygiene are experiencing increases in asthma and allergy rates?
the hygiene hypothesis, which says that exposure to some pathogens early in life allows for a better T-cell balance
cleaner countries tend to have more air pollution
because hygiene is better, pathogens have become stronger
Can environmental factors and diet and genetics affect susceptibility to allergies?
yes
no
Infants with eczema and children deficient in _________ support the hygiene hypothesis.
filaggrin
keratin
melanin
carotene
Which type of epithelial cells produce innate cytokines that affect DCs and induce allergen-specific TH2 cells, which trigger B cell isotope switch to IgE?
skin epithelial cells
intestinal epithelial cells
In which type of epithelial cells are ILC2, TH2, and TH9 cells activated by binding IgE to produce cytokines that recruit, support, and activate mast cells and basophils?
skin epithelial cells
intestinal epithelial cells
When diagnosing type I hypersensitivities, skin testing may be used. What symptoms indicate allergic response?
swelling
redness
anaphylaxis
itching
What binds and blocks H1 receptors on target cells for treatment of type I hypersensitivity?
antihistamines
leukotriene antagonists
inhalation corticosteroids
Which type I hypersensitivity inhibits innate immune cell activity in airways, treating asthma?
inhalation corticosteroids
antihistamines
leukotriene antagonists
How do leukotriene antagonists work?
like antihistamines
like inhalation corticosteroids
Benadryl, or diphenhydramine is what kind of antihistamine?
first generation
second generation
Acrivastine is what kind of antihistamine?
first generation
second generation
Zyrtec, or cetirizine is which type of antihistamine? **still causes some drowsiness
first generation
second generation
Allegra, or fexofenadine is what kind of antihistamine?
first generation
second generation
Claritin, or loratadine is what kind of antihistamine?
frist generation
second generation
Which antihistamine given can be used for the indication of dermatitis?
Benadryl (diphenhydramine)
Zyrtec (cetirizine)
Allegra (fexofenadine)
Claritin (loratadine)
Which of the following cell-surface receptors is MOST closely linked to activating type I hypersensitivity reactions?
FcεRII
FcγRIIB
FcεRI
LFA-1
none of the answers are correct
Which of the following cell types are targets of the products of mast-cell degranulation, as well as the mediators produced by mast cells following degranulation?
smooth muscle
nervous tissue
hematopoietic cells
epithelial cells
all of the answers are correct
Which of the following effects is NOT a result of histamine binding to histamine receptor H1?
intestinal smooth muscle contraction
suppression of mast cell degranulation
increased vascular permeability
increased mucous secretion
all of the answers result from histamine binding H1
Which of the following cytokines is NOT generally associated with allergic reactions?
TNF-α
GM-CSF
IL-4
TGF-β
all of the answers are associated with allergic reactions
The immune response to a peanut allergy is MOST similar to a
poison ivy rash
positive PPD test
bee sting
transfusion reaction
none of the answers are similar
Which of the following is a potential cause of chronic inflammation?
obesity
infectious agents
tissue damage
intestinal commensal microbiota components
all of the answers are correct
