Type I and II Hypersensitivity Reactions
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Questions and Answers

Which of the following is the primary mediator of Type I hypersensitivity reactions?

  • IgM
  • IgA
  • IgE (correct)
  • IgG

Type II hypersensitivity reactions always involve the formation of antigen-antibody complexes deposited in tissues.

False (B)

What is the primary mechanism by which Type II hypersensitivity causes cell lysis?

Complement activation or phagocytosis

Type III hypersensitivity reactions are characterized by the deposition of antigen-antibody complexes, leading to activation of ______ and subsequent tissue damage.

<p>complement</p> Signup and view all the answers

Match the type of hypersensitivity with its corresponding reaction time:

<p>Type I = 15-30 minutes Type II = 15-30 minutes Type III = 6 hours Type IV = 24-48 hours</p> Signup and view all the answers

Which of the following hypersensitivity types does NOT involve antibodies in its mechanism?

<p>Type IV (A)</p> Signup and view all the answers

Erythroblastosis fetalis is an example of Type III hypersensitivity.

<p>False (B)</p> Signup and view all the answers

A patient presents with contact dermatitis after exposure to poison ivy. Which type of hypersensitivity is most likely responsible for this reaction?

<p>Type IV (A)</p> Signup and view all the answers

What is the primary cell type involved in initiating the inflammatory response in Type IV hypersensitivity reactions?

<p>T cells</p> Signup and view all the answers

Which of the following conditions is associated with Type III hypersensitivity due to the chronic production of antigen-antibody complexes?

<p>Systemic Lupus Erythematosus (SLE) (A)</p> Signup and view all the answers

Which types of immunoglobulin are primarily involved in Type II hypersensitivity reactions?

<p>IgM (B), IgG (D)</p> Signup and view all the answers

Which of the following are characteristics of Type I hypersensitivity reactions?

<p>IgE antibodies involvement (A), Immediate reaction upon exposure (D)</p> Signup and view all the answers

Examples of type I hypersensitivity.

<p>drug reaction, rhinitis, atopic eczema, bee sting, asthma</p> Signup and view all the answers

Histamine, kinin, prostaglandins, interleukins, and leukotrienes; are released as chemicals that show signs/symptoms of anaphylaxis

<p>True (A)</p> Signup and view all the answers

Match the immunoglobulins with their associated hypersensitivity:

<p>Type I = IgE Type II = IgM + IgG Type III = IgG Type IV = none</p> Signup and view all the answers

Examples of Type II reactions

<p>transfusion reactions, erythroblastosis fetalis, myasthenia gravis, hyperacute graft rejection</p> Signup and view all the answers

Which are examples of type III hypersensitivity?

<p>glomerulonephritis (A), vasculitis (C)</p> Signup and view all the answers

Match each hypersensitivity with what it's considered.

<p>Type I = atopic/anaphylactic Type II = cytotoxic/cytolytic Type III = immune complex/Arthus reaction Type IV = delayed hypersensitivity</p> Signup and view all the answers

What is the primary genetic abnormality associated with Chronic Myeloid Leukemia (CML)?

<p>Translocation between chromosomes 9 and 22, forming the Philadelphia chromosome (D)</p> Signup and view all the answers

A patient with suspected CML presents with several symptoms. Which combination of findings would most strongly suggest a diagnosis of CML?

<p>High granulocyte count, splenomegaly, and fatigue (C)</p> Signup and view all the answers

Why is allogeneic bone marrow transplantation preferred over autologous transplantation in the treatment of CML?

<p>Allogeneic BMT provides a source of healthy donor immune cells that can eliminate residual CML cells (A)</p> Signup and view all the answers

A patient with CML is being treated with an anti-bcr/abl therapy. What is the primary goal of this treatment?

<p>To specifically reduce the number of leukemia cells carrying the <em>bcr/abl</em> fusion gene (B)</p> Signup and view all the answers

A patient with CML progresses to blast-stage CML (AML). Based on the provided information, what is the expected prognosis for this patient?

<p>Poor, as blast-stage CML (AML) carries a less favorable outcome (D)</p> Signup and view all the answers

In an autologous bone marrow transplant, what is the source of the stem cells?

<p>The patient's own bone marrow. (A)</p> Signup and view all the answers

What is the primary difference in the source of hematopoietic stem cells between autologous and allogeneic bone marrow transplantation?

<p>Autologous uses the patient's own stem cells, while allogeneic uses stem cells from a donor. (D)</p> Signup and view all the answers

CML cells have a low degree of segmentation.

<p>False (B)</p> Signup and view all the answers

Match the average ages with their respective types of cancer:

<p>Chronic myeloid leukemia (CML) = 40-50 years old Hairy cell leukemia = 55 years old Acute lymphoblastic leukemia (ALL) = 3-7 years old + 2nd peak Plasma cell myeloma (multiple myeloma) = 40 years and up, median 65 years old</p> Signup and view all the answers

Symptoms of CML (5)

<p>fatigue/weight loss/sweats/bleeding/abdominal discomfort</p> Signup and view all the answers

A child presents with bone pain, fever, and enlarged lymph nodes. Which condition is most likely suspected based on the provided information?

<p>Acute Lymphoblastic Leukemia/Lymphoma (ALL) (D)</p> Signup and view all the answers

In Acute Lymphoblastic Leukemia/Lymphoma (ALL), a malignant transformation of T-cells has a better prognosis compared to B-cells.

<p>False (B)</p> Signup and view all the answers

What type of cells are considered abnormal in Acute Lymphoblastic Leukemia/Lymphoma (ALL)?

<p>lymphoblasts</p> Signup and view all the answers

The primary treatment to induce remission in Acute Lymphoblastic Leukemia/Lymphoma (ALL) is __________.

<p>chemotherapy</p> Signup and view all the answers

Which of the following symptoms is least likely observed in a child with Acute Lymphoblastic Leukemia/Lymphoma (ALL)?

<p>Decreased bruising (C)</p> Signup and view all the answers

In regards to ALL: (blank) % result of malignant transformation of B cells; (blank)% involve T cells

<p>80, 20</p> Signup and view all the answers

Symptoms of ALL (7)

<p>bone pain, fever, bruising, abdominal pain, fatigue, loss of appetite, infection</p> Signup and view all the answers

5% of ALL cases may have CNS signs

<p>False (B)</p> Signup and view all the answers

5 year survival rate in children with ALL?

<p>85% (C)</p> Signup and view all the answers

In Hairy Cell Leukemia (HCL), what cellular characteristic is most distinctive for identifying malignant cells in a peripheral blood smear?

<p>Cells with hair-like projections on their surface. (D)</p> Signup and view all the answers

A patient diagnosed with Hairy Cell Leukemia (HCL) has splenomegaly but is otherwise asymptomatic. According to the typical treatment guidelines for HCL, which approach is most appropriate?

<p>Active surveillance with regular monitoring of blood counts and spleen size. (D)</p> Signup and view all the answers

In Hairy Cell Leukemia (HCL), the disease primarily targets B-cells. How does this impact the immune system?

<p>Results in a weakened humoral immune response and increased susceptibility to infections. (B)</p> Signup and view all the answers

What is the expected outcome for a patient who receives appropriate treatment for Hairy Cell Leukemia (HCL)?

<p>A complete remission rate of approximately 80%. (D)</p> Signup and view all the answers

what type of leukemia is HCL?

<p>rare, chronic type</p> Signup and view all the answers

Clinical manifestations of HCL?

<p>splenomegaly (A), reduced granulocytes (B), low RBC &amp; platelets (D)</p> Signup and view all the answers

What type of cells are affected in Plasma Cell Myeloma (Multiple Myeloma)?

<p>Mature, antibody-secreting B lymphocytes (A)</p> Signup and view all the answers

What is a characteristic finding in the blood of patients with Plasma Cell Myeloma?

<p>Accumulation of excessive identical monoclonal antibodies (C)</p> Signup and view all the answers

What are Bence Jones proteins?

<p>Light chain antibody fragments produced by malignant plasma cells (C)</p> Signup and view all the answers

What is a common treatment approach for managing chronic bone pain in patients with Plasma Cell Myeloma?

<p>Narcotic pain relievers and radiation to localized bone lesions (A)</p> Signup and view all the answers

A large amount of 1 type of antibody causes characteristic spike, plasma cell myeloma has a monoclonal antibody spike.

<p>True (A)</p> Signup and view all the answers

what serum protein detects excessive identical monoclonal antibodies in plasma cell myeloma?

<p>electrophoresis</p> Signup and view all the answers

Malignant plasma cells accumulate in bone causing:

<p>Pathological fractures (A), Bone pain (C)</p> Signup and view all the answers

monoclonal gammopathy of undetermined significance (MGUS) is the premalignant stage of multiple myeloma when there is no Bence jones or bone lesions, just monoclonal antibodies

<p>True (A)</p> Signup and view all the answers

What are the characteristics of bone involvement in plasma cell myeloma? (Select all that apply)

<p>Honeycomb appearance (A), Pathological fractures (B)</p> Signup and view all the answers

Which of the following are indicators of bone marrow depression in multiple myeloma? (Select all that apply)

<p>All of the above (D)</p> Signup and view all the answers

First symptom of multiple myeloma is bone pain

<p>True (A)</p> Signup and view all the answers

what does Bence Jones do?

<p>helps confirm diagnosis of multiple myeloma (plasma cell myeloma)</p> Signup and view all the answers

RBC destruction due to recipient antibodies occurs in which of the following situations?

<p>Transfusion reaction (A)</p> Signup and view all the answers

A patient's lab results indicate low MCHC, MCH, and MCV. Which condition is most consistent with these findings?

<p>Iron deficiency anemia (B)</p> Signup and view all the answers

A patient with anemia is suspected of having excessive red blood cell lysis. Which laboratory test would be most useful in assessing the degree of RBC breakdown?

<p>Serum bilirubin (B)</p> Signup and view all the answers

A patient is diagnosed with aplastic anemia. Which of the following best describes the condition resulting from this disease?

<p>Pancytopenia, affecting all blood cell lines (A)</p> Signup and view all the answers

A patient is diagnosed with anemia due to a lack of intrinsic factor. Which type of anemia is most likely affecting this patient?

<p>Pernicious anemia (B)</p> Signup and view all the answers

A patient undergoing chemotherapy presents with prolonged bleeding after a minor injury. What is the most likely cause of this bleeding?

<p>Thrombocytopenia (B)</p> Signup and view all the answers

A patient with liver cirrhosis exhibits prolonged prothrombin time (PT) and elevated international normalized ratio (INR). Which of the following is the most likely reason for these laboratory findings?

<p>Clotting factor deficiency (C)</p> Signup and view all the answers

An infant presents with melena, bleeding from the umbilicus, and hematuria shortly after birth. The mother had a normal pregnancy with no complications. What is the most probable underlying cause of these symptoms?

<p>Vitamin K deficiency (C)</p> Signup and view all the answers

A patient with a history of chronic aspirin use is scheduled for an elective surgery. Which of the following would be the most appropriate recommendation to minimize the risk of bleeding complications during and after the procedure?

<p>Discontinue aspirin use several days prior to the surgery. (A)</p> Signup and view all the answers

A patient presents with increased prothrombin time (PT) and international normalized ratio (INR), normal bleeding time, and normal platelet count. Which of the following conditions is most consistent with these findings?

<p>Vitamin K deficiency (C)</p> Signup and view all the answers

What laboratory finding is most consistent with a diagnosis of Hemophilia?

<p>Prolonged aPTT and normal platelet count (A)</p> Signup and view all the answers

A patient with hemophilia experiences prolonged bleeding after a minor injury. Which of the following is the most appropriate initial treatment?

<p>Infusion of the deficient clotting factor (B)</p> Signup and view all the answers

In a patient with severe hemophilia, what is the most likely cause of spontaneous bleeding episodes?

<p>Deficiency in a clotting factor essential for the coagulation cascade. (A)</p> Signup and view all the answers

Which coagulation pathway is assessed by the Prothrombin Time (PT) test?

<p>Extrinsic Pathway (C)</p> Signup and view all the answers

What does INR stand for in blood coagulation assessments?

<p>International Normalized Ratio (C)</p> Signup and view all the answers

Which coagulation pathway is evaluated using the aPTT test?

<p>Intrinsic Pathway (D)</p> Signup and view all the answers

What does an elevated aPTT indicate?

<p>Slower than normal clot formation in the intrinsic pathway (A)</p> Signup and view all the answers

In Disseminated Intravascular Coagulation (DIC), what laboratory findings would you expect to see?

<p>Decreased platelet count and elevated PT/INR/APTT. (A)</p> Signup and view all the answers

What is the primary approach to managing Disseminated Intravascular Coagulation (DIC)?

<p>Removal or correction of the underlying cause. (B)</p> Signup and view all the answers

In the progression of DIC, why does the initial hypercoagulable state eventually lead to a hypocoagulable state?

<p>The overconsumption of clotting factors and platelets depletes the body's reserves, impairing its ability to form clots. (C)</p> Signup and view all the answers

What is happening during disseminated intervascular coagulation (DIC)?

<p>clotting and bleeding occurring at same time</p> Signup and view all the answers

Flashcards

Type I Hypersensitivity

Immediate allergic reaction mediated by sensitized mast cells and IgE antibodies.

Type II Hypersensitivity

Antibodies (IgM or IgG) bind to antigens on cell surfaces, leading to cell lysis.

Type III Hypersensitivity

Antigen-antibody complexes deposit in tissues, activating complement and causing inflammation.

Type IV Hypersensitivity

Sensitized T cells react with altered or foreign cells, causing delayed inflammation.

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Mast Cell Degranulation

Mast cell degranulation releases mediators causing vasodilation, hypotension, and bronchoconstriction.

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IgE Cross-linking

IgE antibodies on mast cells are cross-linked by antigen, initiating the allergic reaction.

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Antibody-mediated lysis

IgM or IgG antibodies bind to antigens on cell surfaces, activating complement.

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Immune Complex Activation

Antigen-antibody complexes activate complement, attracting phagocytes and causing tissue damage.

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T Cell-Mediated Inflammation

Activated T cells cause inflammation and tissue damage in response to antigens.

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Examples of Type IV Hypersensitivity

Contact dermatitis, tuberculin reactions, and transplant rejections.

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Chronic Myeloid Leukemia (CML)

A type of leukemia characterized by malignant granulocytes carrying the Philadelphia chromosome.

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bcr/abl fusion gene

The translocation (9 & 22) creates a fusion gene responsible for CML.

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CML and Granulocytes

High granulocyte count is a common diagnostic indicator.

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Splenomegaly in CML

Enlargement of the spleen due to increased cell production and accumulation.

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Anti-bcr/abl therapy

Targets the bcr/abl fusion gene to reduce the number of leukemia cells.

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Autologous BMT

A transplant using the patient's own cells.

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Allogeneic BMT

A transplant using cells from a donor.

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Cell Selection in BMT

Procedure where patient's cells are processed to select healthy ones.

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Source of cells: Allogeneic BMT

Bone marrow transplant using tissue from a donor

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Source of cells: Autologous BMT

Bone marrow transplant using patient's own tissue

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What is ALL?

Malignant disorder of lymphoid cell lineage; primarily affects children.

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ALL symptoms?

Bone pain, fever, bruising, enlarged spleen/liver/lymph nodes, abdominal pain; CNS signs in 3%.

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What are abnormal ALL cells?

Lymphoblasts.

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ALL survival rate?

85% in children; 30-50% in adults.

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ALL treatments?

Chemotherapy (remission & post-remission), stem cell transplant, monoclonal antibodies.

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Acute Lymphoblastic Leukemia (ALL)

Malignancy of lymphoid cells, most commonly affecting children.

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B cell involvement in ALL

Malignant transformation most commonly affects these cells in ALL.

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ALL peak incidence

Peak age range for ALL incidence in children.

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Symptoms of ALL

Common initial symptoms of ALL.

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Enlarged organs in ALL

Organs commonly enlarged in ALL.

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Hairy Cell Leukemia (HCL)

A rare, chronic leukemia affecting B-cells, characterized by cells with hairlike projections.

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HCL Clinical signs

HCL cells present in the blood, reduced counts of granulocytes, platelets and RBCs, and enlarged spleen.

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Hairy Cell Leukemia: Demographics

Median age is approximately 55 years; more prevalent in males.

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HCL Treatment start

Treatment is initiated when the patient begins showing symptoms such as splenomegaly, recurrent infections, bleeding disorders or anemia.

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HCL: Prognosis

With appropriate intervention, about 80% of patients achieve complete remission.

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Plasma Cell Myeloma

A malignant proliferation of mature, antibody-secreting B lymphocytes.

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Monoclonal Antibodies in Myeloma

Malignant plasma cells produce excessive, identical antibodies, leading to a characteristic "spike."

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Bence Jones Proteins

Light chain antibody fragments produced by malignant plasma cells that accumulate in blood/urine.

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Myeloma Treatment

Using antineoplastic agents, high dose chemo and stem cell transplants to manage malignant plasma cell proliferation.

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Bone Pain in Myeloma

Common symptom of myeloma which can be managed with narcotic pain relievers and radiation.

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Transfusion Reaction

Destruction of red blood cells due to antibodies from the recipient.

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Iron Deficiency Anemia

A condition with low mean corpuscular hemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH), and mean corpuscular volume (MCV).

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CO2 Transport

Primary form of is transported as bicarbonate ions.

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Bilirubin

Pigment that indicates excessive red blood cell lysis.

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Erythropoietin

Hormone produced by the kidneys that stimulates red blood cell production.

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Aspirin and Bleeding

Aspirin inhibits platelet function, which can lead to increased bleeding time.

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Chemotherapy & Thrombocytopenia

Chemotherapy can suppress bone marrow function, leading to a decrease in platelet count.

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Liver and Clotting

The liver produces clotting factors, so liver dysfunction can result in impaired blood coagulation.

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Vitamin K Deficiency

Vitamin K is essential for the synthesis of certain clotting factors, so a deficiency leads to increased PT/INR.

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Newborns & Vitamin K

Newborns with Vitamin K deficiency may experience bleeding in the stool, from the umbilicus, or in the urine.

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Hemophilia

Inherited coagulation disorder causing excessive/prolonged bleeding

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Inherited coagulation disorder

Most common type of inherited bleeding disorder

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aPTT in Hemophilia

Lab test that is prolonged in Hemophilia

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Platelet Count in Hemophilia

This blood component is usually normal in Hemophilia

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Excessive/Prolonged Bleeding

What is the main symptom of Hemophilia?

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PT/INR

Evaluates the extrinsic pathway of coagulation.

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aPTT

Evaluates the intrinsic pathway of coagulation.

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Extrinsic Pathway

Reflects how well the extrinsic pathway's clotting cascade functions.

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Intrinsic Pathway

Reflects how well the intrinsic pathway's clotting cascade functions.

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Coagulation Time

Time taken for blood to clot.

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DIC (Disseminated Intravascular Coagulation)

Acquired syndrome where simultaneous clotting and bleeding occur.

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Fibrinogen Level in DIC

In DIC, this clotting protein is significantly reduced.

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Platelet Count in DIC

In DIC, these blood cells are consumed due to widespread clotting.

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Bleeding Time in DIC

In DIC, this measures the time it takes for blood to stop bleeding. This is extended.

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PT/INR/APTT/D-dimer in DIC

Prolonged coagulation times and measures fibrin degradation.

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Description

Overview of Type I (immediate allergic) and Type II (cytotoxic) hypersensitivity reactions. Type I is mediated by mast cells and IgE, leading to anaphylaxis. Type II involves antibody-mediated lysis of cells.

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