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Hypersensitivity Reactions (Type I–IV)
Type Mechanism Timing Key Feature Classic Examples I IgE, mast cells Immediate Allergic reaction Anaphylaxis, Asthma II IgG/IgM vs cells Rapid Cell destruction Hemolytic anemia III Immune complexes Hours Inflammation SLE, GN IV T-cell mediated Delayed No antibodies Contact dermatitis
Memory Tricks:
- Type I = Immediate = IgE
- Type II = Attacks cells
- Type III = Immune complexes
- Type IV = T-cells (Delayed)
Exam Triggers:
- Anaphylaxis → Type I
- Transfusion reaction → Type II
- Lupus → Type III
- Poison ivy / TB test → Type IV
Advanced Pathophysiology – MUST KNOW Cheat
Sheet
HEMATOLOGY
- Microcytic = iron deficiency (↓ iron, ↓ ferritin, ↑ transferrin)
- Reticulocytes: LOW = production problem, HIGH = destruction/blood loss
- Anemia causes: ↓ production, ↑ destruction, blood loss
IMMUNE SYSTEM
- Type I = IgE (anaphylaxis)
- Type II = IgG/IgM (cell destruction)
- Type III = immune complexes (SLE)
- Type IV = T-cells (delayed)
- Autoimmune = misdirected immune response
CARDIOVASCULAR
- Hypertension → pressure overload → LV hypertrophy
- Orthopnea = dyspnea lying flat
- PND = nighttime dyspnea
PULMONARY
- Obstructive = asthma, COPD (air trapping, ↑ resistance)
- Restrictive = fibrosis (↓ compliance)
- PE = V/Q mismatch
- Dyspnea = most specific symptom
RENAL
- Kidney functions: EPO, renin, vitamin D
- CKD: ↓ EPO → anemia, ↑ K+ → hyperkalemia
- GFR ↓ when Bowman pressure ↑
- Obstruction → hydronephrosis (stones most common)
KEY EXAM TRIGGERS
- ACE inhibitor → dry cough (bradykinin)
- Anaphylaxis → Type I
- Lupus → Type III
- Kidney disease → hyperkalemia + anemia
Kidney Function & Electrolytes – 1-Page Cheat Sheet
Kidney Functions:
- Filtration (GFR)
- Electrolyte balance
- Acid-base balance
- Hormones: EPO, Renin, Vitamin D
GFR Regulation:
- ↓ GFR: ↑ Bowman’s capsule pressure (obstruction), ↓ perfusion
- ↑ GFR: ↑ blood pressure
Electrolyte High (Hyper-) Low (Hypo-) Potassium (Kn) Arrhythmias, muscle weakness (CKD) Weakness, arrhythmias Sodium (Nan) Dehydration, confusion Edema, seizures Calcium (Ca²n) Kidney stones, confusion Tetany, cramps
Chronic Kidney Disease (CKD):
- ↓ EPO → anemia
- ↑ Kn → hyperkalemia
- ↑ phosphate, ↓ calcium
- Metabolic acidosis
Obstruction:
- Stones = most common cause
- Leads to hydronephrosis → ↓ GFR
Exam Triggers:
- CKD + anemia → ↓ EPO
- CKD + arrhythmia → hyperkalemia
- Obstruction → hydronephrosis
Pulmonary Concepts – 1-Page Cheat Sheet
Key Functions of the Lungs:
- Gas exchange (O2 in, CO2 out)
- Acid-base regulation
- Defense (mucus, cilia, immune cells)
Feature Obstructive Restrictive Examples Asthma, COPD Fibrosis, ARDS Problem Air can't get OUT Lungs can't expand Compliance Normal/↑ ↓ Airway Resistance ↑ Normal
Ventilation-Perfusion (V/Q):
- PE → V/Q mismatch (ventilation OK, perfusion ↓)
- Shunt → perfusion OK, ventilation ↓
- Diffusion problem → fibrosis (thick membrane)
Key Symptoms:
- Dyspnea = most specific
- Cough, wheezing, hypoxia
Exam Triggers:
- Sudden dyspnea + chest pain → PE
- Chronic smoker + cough → COPD
- Wheezing → asthma
- ACE inhibitor → dry cough (bradykinin)
Immune System – 1-Page Cheat Sheet
Feature Innate Immunity Adaptive Immunity Speed Immediate Delayed Specificity Non-specific Specific Cells Neutrophils, macrophages T cells, B cells Memory No Yes
Hypersensitivity Reactions:
- Type I = IgE (anaphylaxis, asthma)
- Type II = IgG/IgM (cell destruction)
- Type III = immune complexes (SLE)
- Type IV = T-cells (delayed)
Key Immune Concepts:
- Inflammation = redness, heat, swelling, pain
- Cytokines = signaling molecules
- Complement = enhances immune response
Immune Disorders:
- Autoimmune = attacks self
- Immunodeficiency = weak response (infection risk)
- Hypersensitivity = exaggerated response
Exam Triggers:
- Anaphylaxis → Type I
- Transfusion reaction → Type II
- Lupus → Type III
- Poison ivy / TB test → Type IV
