21. Allergy and Immmunology

Question 1

Given Total lymphocytes, Cd4 T cells and CD8 T cells. How can you calculate B cells?

Answer 1

Total lymphocytes minus CD4 T cells

Question 2

Differentiated X-linked agammaglobulinemia from common variable immunodeficiency

Answer 2

XLA - Severe, recurrent sinopulm or GI infx in late infancy. Low immunoglobulins and b cell
CVID - similar but less severe sx after adolescence and B cell conc are normal.

Question 3

patient with pulmonary abscess and recurrent cutaneous abscess with organism-filled neutrophils are consistent with what condition? how can you dx?

Answer 3

Chronic granulomatous disease
Susceptible to Catalase positive pathogens (s aureus, serratia, burkholderia, aspergillus)
Dx - Dihydrorhodamine 123 test; nitroblue tetrazolium test

Question 4

What is the major toxicity of azathioprine?

Answer 4

Dose-related diarrhea, leukopenia, and hepatotoxicity

Question 5

What is the major toxicity of mycophenolate?

Answer 5

Mycophonlate = bone Marrow suppression

Question 6

What major side effects are assoc with cyclosporine?

Answer 6

Calcineurin inhibitor - inhibit IL-2 transcription
Nephrotoxic, hyperkalemia, HTN, gum hypertrophy, hirsutism, tremor
Note: Tacrolimus has the same toxicity (also a calcineurin inhibitor), but no hirsutism or gum hypertrophy