Pathology · USMLE Step 1

USMLE Pathology: Immunopathology and Systemic Disease

Hypersensitivity reaction types, autoimmune disease morphology, and amyloidosis patterns as tested on USMLE Step 1.

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Which antibody class mediates Type I hypersensitivity reactions?
IgE
Which cell type degranulates to release histamine in Type I hypersensitivity?
Mast cells (and basophils)
What is a classic clinical example of a Type I hypersensitivity reaction?
Anaphylaxis
How quickly does a Type I hypersensitivity reaction typically develop after antigen exposure?
Within minutes
In Type II hypersensitivity, what does the antibody bind to?
Antigens directly on a cell surface or in the extracellular matrix
What is a classic example of a Type II hypersensitivity disease?
Goodpasture syndrome
What is the mechanism of Type III hypersensitivity?
Antigen-antibody immune complexes deposit in tissue and activate complement
What is a classic example of Type III hypersensitivity?
Serum sickness
What is the mechanism of Type IV hypersensitivity?
T cell mediated, without antibody involvement
Type IV hypersensitivity is also known by what name, based on its timing?
Delayed-type hypersensitivity
In Goodpasture syndrome, autoantibodies target which structural protein?
Type IV collagen in the basement membrane
What is the most sensitive autoantibody screening test for systemic lupus erythematosus?
Antinuclear antibody (ANA)
What autoantibody is most specific for systemic lupus erythematosus?
Anti-double stranded DNA (anti-dsDNA)
What is the most severe pattern of lupus nephritis seen on renal biopsy?
Diffuse proliferative glomerulonephritis
What characteristic facial rash occurs in systemic lupus erythematosus?
Malar (butterfly) rash

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