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آرشیو پست ها
502
👑 A patient receives an ABO-incompatible blood transfusion and within minutes develops fever, lower back pain, hemoglobinuria, and intravascular clotting. Laboratory studies demonstrate extensive intravascular hemolysis.
🔹Which of the following sequences BEST explains the pathogenesis of this reaction?
🔹A) Preformed IgG binds donor RBCs → Fc-mediated ADCC → perforin/granzyme release → hemolysis
🔹B) Preformed IgM binds donor RBC antigens → classical complement activation → MAC formation and C3b deposition → intravascular hemolysis
🔹C) Anti-RBC antibodies form circulating immune complexes → vascular deposition → neutrophil-mediated vasculitis
🔹D) Sensitized T lymphocytes recognize donor RBC antigens → cytokine release → macrophage activation → RBC destruction
502
👑 A 24-year-old Rh-negative woman delivers her first Rh-positive child. Two years later, during her second pregnancy with another Rh-positive fetus, laboratory testing reveals high titers of anti-Rh antibodies. The fetus subsequently develops severe hemolytic anemia.
🔹Which ONE of the following statements is CORRECT?
🔹A) Disease occurs because maternal IgM crosses the placenta and activates complement.
🔹B) Rhogam is used to neutralize bilirubin released from fetal RBCs.
🔹C) The first pregnancy primarily acts as the sensitization phase.
🔹D) The disease represents antibody-dependent cellular dysfunction.
502
👑 Which of the following findings would most strongly support complement-mediated Type II hypersensitivity rather than ADCC?
🔹A) Fc receptor engagement
🔹B) Release of perforin
🔹C) Generation of C3b
🔹D) Release of TNF
502
👑 A patient develops muscle weakness due to antibodies directed against acetylcholine receptors. Which of the following best describes the mechanism?
🔹A) MAC-mediated lysis of muscle fibers
🔹B) Antibody-mediated cellular dysfunction
🔹C) Immune complex deposition
🔹D) Delayed T-cell mediated injury
502
👑 Type II Hypersensitivity Pearl #1
🔹Not every Type II hypersensitivity destroys cells.
🔹Myasthenia gravis = antibody BLOCKS receptor.
🔹Graves disease = antibody STIMULATES receptor.
👑 Type II Hypersensitivity Pearl #2
🔹In transfusion reactions, hemoglobin doesn’t just disappear after RBC destruction.
🔹Free hemoglobin has 2 fates:
🔹→ Hemoglobinuria (passes into urine)
🔹→ Bilirubin formation (can become toxic)
👑 Type II Hypersensitivity Pearl #3
🔹The dangerous Rh+ pregnancy is usually NOT the first one.
🔹1st pregnancy = sensitization.
🔹2nd Rh+ pregnancy = memory response.
🔹The fetus is attacked by maternal IgG crossing the placenta.
502
Repost from HemGlobin 🎗️
🔰Opsonization … C3b
🔰edema …C2a
🔰anaphylatoxins … C5a , C3a
🔰chemotactic for neutrophils … C5a
🔰chemotactic for macrophages … IL8
🔰eosinophilia …IL5
🔰basophilia , mucus secretion in RT … IL3
🔰cachexia… TNF-alpha
🔰induction of acute phase protein from the liver… IL1 ,IL6 , TNF-alpha.
502
👑 A researcher creates a genetically modified IgE molecule that retains normal FcεRI binding but completely loses its Fab region. After mast-cell sensitization, the subject is exposed to allergen.
🔹What happens?
🔹A) Immediate severe anaphylaxis
🔹B) Normal degranulation
🔹C) No degranulation
🔹D) Increased complement activation
سؤال فلسفي اذا رادوا يصعبوها :)
502
👑 A patient receives an IV radiographic contrast agent and immediately develops hypotension, bronchospasm, and urticaria. Laboratory testing later shows no evidence of allergen-specific IgE. Which mechanism best explains the reaction?
🔹A) Type II hypersensitivity
🔹B) Immune-complex deposition
🔹C) Direct mast-cell mediator release
🔹D) Complement fixation by IgE
