Cases Immunology

Question 1

Serum specific IgE testing (RAST)

Answer 1

measures presence of antibodies

(you can be sensitiesded = but may not get a reaction so not allergic)

Question 2

What is the MOA of Adrenaline in Anaphylaxisß

Answer 2

1. Vasoconstriction
2. Boncholdilation
3. decreased exocytosis ?? of mast cells)

Question 3

Why are antihistamines no longer recommended in the treatment of anaphylaxis?

Answer 3

Can be distractions in maksing symtpms (improve skin reactions) butt not CVS or repiratory symptoms

Question 4

What is the late-phase reaction in anaphylaxis mediated by?

Answer 4

Mostly within first 6h, can happen for up fto 72h

Release of leukotriens, prostaglandins and postacyclins
–< trigger synthesisation of other things

Late phase symptoms
- nasal congestion
- hyperreactivation

Question 5

Mast cell triptase

Answer 5

Should be measured within 4h of reaction

baseline also needed
anaphylaxis assumed if 1.2 x baseline +2

Question 6

What innate immunosuffieiciencies are particularly associated with recurrent meningitis?

Answer 6

Complement deficiency predisposes to recurrent infection with **encapsulated organisms ** –>

suscepitble to and Vaccinate against:
* neisseria meningitditis
* haemophilus influenzae etc.
* pneumococcus

Question 7

How do you test for complement levels?

Answer 7

C3 + 4 (levels)
CH 50 (classical) and AP 50 (alternative) = functional test of complements

Question 8

How should lupus renal disease be minitored?

Answer 8

1. Urinarlysis at every vitis: ptoetinuria+ microscopic haematuria

+ urine microscopy

+ can do renlal biopsy

Question 9

What are the main inflammatory mediators involved in the pathogenesis of Rheumatoid ARthritis?

Answer 9

TNF alpha and
IL-6

(+ T and B-cells play a role)

Question 10

What is the first line treatment of RA?

Answer 10

DMARDS:
Methotrexate
Others Sulphasalazine, hyrroxychloroquine, leflunnomide

+ other biologics