17. Innate System II

Question 1

Which of the complement pathways are innate immunity? (MG)

A. Classical
B. Alternative
C. MBL
D. A&B
E. B&C
F. A&C

Answer 1

E. B&C

Question 2

MAC deficiencies are common in _____ infections (MG)

A. Saccharomyces cerevisiae
B. Nocardia asteroids
C. Actinomyces
D. Neisseria meningitidis

Answer 2

D. Neisseria meningitidis

Question 3

Meningococal meningitis is due to a deficiency in which pathway and components?

A. Alternative Pathway, Factor H
B. Classical Pathway, C1q
C. Lectin Pathway, C4
D. Terminal Pathway, Properdin
E. Alternative Pathway, MCP

SZ

Answer 3

Ans. D Terminal Pathway, Properdin

C5 and C9 are also involved in terminal pathway

Question 4

A patient presents to the ED with an a rare disease. She complains of swelling around her eye beginning suddenly last evening. She denies trauma or use of new skin care products. There is no urticaria or tenderness. Testing shows high levels of anaphyatoxins C3a and C5a. This is do to which of the following?

A. Reduced C3
B. Elevated C4 Activator 
C. Absence of C9
D. Reduced C1 Inhibitors
E. Elevated C1 Inhibitors 

SZ

Answer 4

Ans D Reduced C1 Inhibitor

The patient is experiencing Hereditary angioedema. It is caused by dysregulation of the complement classical and MBL pathways. There is an excessive activation of the complement pathway due to a mutation in the C1 inhibitor which causes an increases of C3a and C5a and a reduction in C4.

Question 5

A patient is hospitalized for sarcoidosis. Which is a central action of the central soluble protein adding his immune response.

A. Induces nitric oxide synthase
B. Inhibits transcription and translation of viral proteins
C. Competes with pathogens for iron
D. Binds with phosphocholine in bacteria
E. Forms C3 convertase

RFA

Answer 5

Ans. A- this is question is hinting at the use of INF-gamma, which is the bodies way of dealing with substance in can’t remove like in sarcoidosis. INF-gamma is produced by Th1, CD8+ and NK cells

It has many functions including promoting NK activity, increasing macrophages, increasing MHCI and MHC II expressing and promoting adhesion and INDUCING NITRIC OXIDE SYNTHASE to cause vasodilation

B. This is done by INF alpha and INF beta which is made by almost all cells

C. This is done by Lactoferrin

D. This is done by CRP( C reactive protein)

E. This is done by the cleave of C1 and C4 in the classical pathway of the compliment system

Question 6

A 22 year old women has complaints of general poor feeling and sudden high fever with sudden and serve headaches. Testing is done and it a Neisseria infections with normal levels of C5-C9. Which deficiency of innate immunity most likely caused the infection?

A. Properdin Deficiency 
B. C4 Deficiency 
C. MAC Deficiency 
D. DAF Deficiency 
E. C1- Inhibitor  Deficiency 

RFA

Answer 6

Ans. A Properdin Deficiency- says in note Properdin deficiency risk of overwhelming Neisseria infection

B. C4 Deficiency- wrong in two ways cause Systemic Lupus, Glomerulonephritis, Vasculitis and is part of the Classical pathway which is Adaptive immunity

C. MAC Deficiency- causes Neisseria infection but C5-C9 levels are normal

D. DAF- is decay accelerating factor (CD55 and CD59), an inhibitor of C3 and C4 deficiency causes Paroxysmal Nocturnal Hemoglobinuria

E. C1-inhibitor-regulates the classical pathway and deficiency results in angioedema