Cells and Problems Flashcards

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1
Q

Expresses Foxp3 and CD25 and secretes IL-10. Deficient in the monogenic autoimmune disease known as IPEX (immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome)

  1. Th17 cell
  2. Macrophage
  3. Epithelial cell
  4. T reg cell
  5. Dendritic cell
  6. CD4+ T cell
  7. Neutrophil
  8. Th1 cell
  9. Plasma cell
  10. Megakaryocyte
  11. Lymphocyte
A

T-reg cells

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2
Q

In the immature form these cells are adapted for recognition and uptake of pathogens. Maturation is associated with expression of CCR7, migration to lymph nodes and enhanced capacity for antigen presentation.

  1. Th17 cell
  2. Macrophage
  3. Epithelial cell
  4. T reg cell
  5. Dendritic cell
  6. CD4+ T cell
  7. Neutrophil
  8. Th1 cell
  9. Plasma cell
  10. Megakaryocyte
  11. Lymphocyte
A

Dendritic cells

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3
Q

These cells can be rapidly mobilised from bone marrow. They express pathogen recognition receptors and Fc receptors and are able to engage in oxidative and non-oxidative killing. They do not express HLA class II molecules and so do not activate CD4 T cells. They are the predominant cell type in synovial fluid taken from patients with gout,

  1. Th17 cell
  2. Macrophage
  3. Epithelial cell
  4. T reg cell
  5. Dendritic cell
  6. CD4+ T cell
  7. Neutrophil
  8. Th1 cell
  9. Plasma cell
  10. Megakaryocyte
  11. Lymphocyte
A

Neutrophils

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4
Q

These cells may be formed following a germinal centre reaction involving isotype switching and affinity maturation of receptors. They are long-lived and reside in bone marrow.

  1. Th17 cell
  2. Macrophage
  3. Epithelial cell
  4. T reg cell
  5. Dendritic cell
  6. CD4+ T cell
  7. Neutrophil
  8. Th1 cell
  9. Plasma cell
  10. Megakaryocyte
  11. Lymphocyte
A

Plasma cells

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5
Q

These cells express CD3 and secrete IL-17 and IL-22. They are thought to be important in some auto-immune conditions including rheumatoid arthritis.

  1. Th17 cell
  2. Macrophage
  3. Epithelial cell
  4. T reg cell
  5. Dendritic cell
  6. CD4+ T cell
  7. Neutrophil
  8. Th1 cell
  9. Plasma cell
  10. Megakaryocyte
  11. Lymphocyte
A

Th17 cells

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6
Q

These cells may be resident in peripheral tissues (eg Kupffer cells in liver, microglia in neural tissue) express pathogen recognition receptors and Fc receptors and are able to engage in oxidative and non-oxidative killing. They are an important source of cytokines such as IL-1 and TNF-alpha and are thought to play an important role in some auto-inflammatory and auto-immune diseases.

  1. Th17 cell
  2. Macrophage
  3. Epithelial cell
  4. T reg cell
  5. Dendritic cell
  6. CD4+ T cell
  7. Neutrophil
  8. Th1 cell
  9. Plasma cell
  10. Megakaryocyte
  11. Lymphocyte
A

Macrophages

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7
Q

The normal function of these cells is to express cytokines in response to recognition of specific peptides presented by HLA class II molecules. Depletion of these cells during HIV infection is an important factor in development of AIDS.

  1. Th17 cell
  2. Macrophage
  3. Epithelial cell
  4. T reg cell
  5. Dendritic cell
  6. CD4+ T cell
  7. Neutrophil
  8. Th1 cell
  9. Plasma cell
  10. Megakaryocyte
  11. Lymphocyte
A

CD4+ T-cells

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8
Q

Play a role in protective immunity against HIV infection by killing virus infected cells via perforin and FAS.

  1. Gp120
  2. Anti-metabolites
  3. CCR5
  4. Reverse transcriptase
  5. Basophils
  6. Gastric parietal cells
  7. Protease inhibitors
  8. CCR7
  9. Macrophages
  10. CD8 T cells
  11. IL-8
A

CD8 T-cells

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9
Q

Acts as a co-receptor for HIV entry to cells

  1. Gp120
  2. Anti-metabolites
  3. CCR5
  4. Reverse transcriptase
  5. Basophils
  6. Gastric parietal cells
  7. Protease inhibitors
  8. CCR7
  9. Macrophages
  10. CD8 T cells
  11. IL-8
A

CCR5

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10
Q

Serves to generate complementary DNA from RNA, which can then be integrated into host cell genes

  1. Gp120
  2. Anti-metabolites
  3. CCR5
  4. Reverse transcriptase
  5. Basophils
  6. Gastric parietal cells
  7. Protease inhibitors
  8. CCR7
  9. Macrophages
  10. CD8 T cells
  11. IL-8
A

Reverse transcriptase

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11
Q

Directs homing of dendritic cells to lymph nodes

  1. Gp120
  2. Anti-metabolites
  3. CCR5
  4. Reverse transcriptase
  5. Basophils
  6. Gastric parietal cells
  7. Protease inhibitors
  8. CCR7
  9. Macrophages
  10. CD8 T cells
  11. IL-8
A

CCR7

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12
Q

Are often infected by HIV if they express CD4

  1. Gp120
  2. Anti-metabolites
  3. CCR5
  4. Reverse transcriptase
  5. Basophils
  6. Gastric parietal cells
  7. Protease inhibitors
  8. CCR7
  9. Macrophages
  10. CD8 T cells
  11. IL-8
A

Macrophages

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13
Q

Antibodies against this target are partially protective against HIV infection

  1. Gp120
  2. Anti-metabolites
  3. CCR5
  4. Reverse transcriptase
  5. Basophils
  6. Gastric parietal cells
  7. Protease inhibitors
  8. CCR7
  9. Macrophages
  10. CD8 T cells
  11. IL-8
A

GP120

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14
Q

Are effective in management of HIV infection if used in combination with other drugs

  1. Gp120
  2. Anti-metabolites
  3. CCR5
  4. Reverse transcriptase
  5. Basophils
  6. Gastric parietal cells
  7. Protease inhibitors
  8. CCR7
  9. Macrophages
  10. CD8 T cells
  11. IL-8
A

Protease Inhibitors

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15
Q

Mutated MEFV - failure to regulate neutrophil function

Rheumatoid Arthritis
Familial Mediterranean Fever
IPEX
Crohn's
Ankylosing Spondylitis
A

Familial Mediterranean Fever

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16
Q

Polygenic autoinflammatory disease in which NOD2 (CARD15) mutations are common

Rheumatoid Arthritis
Familial Mediterranean Fever
IPEX
Crohn's
Ankylosing Spondylitis
A

Crohn’s Disease

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17
Q

Mixed pattern disease with 90% heritability and strongly associated with HLA-B27

Rheumatoid Arthritis
Familial Mediterranean Fever
IPEX
Crohn's
Ankylosing Spondylitis
A

Ankylosing Spondylitis

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18
Q

Polygenic auto-immune disease associated with polymorphisms in PAD enzymes (which citrullinate proteins). Environmental factors including smoking and gum infection are associated with disease.

Rheumatoid Arthritis
Familial Mediterranean Fever
IPEX
Crohn's
Ankylosing Spondylitis
A

Rheumatoid Arthritis

19
Q

Monogenic auto-immune disease due to a mutation in Foxp3

Rheumatoid Arthritis
Familial Mediterranean Fever
IPEX
Crohn's
Ankylosing Spondylitis
A

IPEX

20
Q

Congenital heart block in infants of mothers with SLE

Anti-DNA
Anti-RNP
Anti-GAD
Anti-centromere
Anti-Ro
A

Anti-Ro

21
Q

Lupus nephritis

Anti-DNA
Anti-RNP
Anti-GAD
Anti-centromere
Anti-Ro
A

Anti-DNA

22
Q

Mixed connective tissue disease

Anti-DNA
Anti-RNP
Anti-GAD
Anti-centromere
Anti-Ro
A

Anti-RNP

23
Q

Limited cutaneous systemic sclerosis

Anti-DNA
Anti-RNP
Anti-GAD
Anti-centromere
Anti-Ro
A

Anti-centromere

24
Q

Sjogren’s syndrome

Anti-DNA
Anti-RNP
Anti-GAD
Anti-centromere
Anti-Ro
A

Anti-Ro

25
Q

Antibody to gastric parietal cells

Autoimmune hepatitis
Coeliac disease
Pernicious anaemia
Dermatitis herpetiformis
Primary biliary cirrhosis
A

Pernicious anaemia

26
Q

Anti-smooth muscle antibody

Autoimmune hepatitis
Coeliac disease
Pernicious anaemia
Dermatitis herpetiformis
Primary biliary cirrhosis
A

Autoimmune hepatitis

27
Q

Anti-endomysial antibody

Autoimmune hepatitis
Coeliac disease
Pernicious anaemia
Dermatitis herpetiformis
Primary biliary cirrhosis
A

Coeliac disease

Dermatitis herpetiformis

28
Q

Anti-tissue transglutaminase antibody

Autoimmune hepatitis
Coeliac disease
Pernicious anaemia
Dermatitis herpetiformis
Primary biliary cirrhosis
A

Coeliac disease

Dermatitis herpetiformis

29
Q

Anti-mitochondrial antibody

Autoimmune hepatitis
Coeliac disease
Pernicious anaemia
Dermatitis herpetiformis
Primary biliary cirrhosis
A

Primary biliary cirrhosis

30
Q

Mediated predominantly by antibodies which usually form after the transplantation

Hyperacute rejection
Acute cellular rejection
Acute vascular rejection
Chronic allograft rejection

A

Acute vascular rejection

31
Q

Both immunological and non-immunological mechanisms contribute

Hyperacute rejection
Acute cellular rejection
Acute vascular rejection
Chronic allograft rejection

A

Chronic allograft rejection

32
Q

Due to presence of pre-formed antibodies

Hyperacute rejection
Acute cellular rejection
Acute vascular rejection
Chronic allograft rejection

A

Hyperacute rejection

33
Q

Mediated by activation of CD4 T cells which provide help for a CD8 T cell and B cell response and occurs within 1-4 weeks

Hyperacute rejection
Acute cellular rejection
Acute vascular rejection
Chronic allograft rejection

A

Acute cellular rejection

34
Q

42 year old lady develops pruritis, rash, hypotension and difficulty breathing. She has received an intra-articular injection of hydrocortisone and lignocaine 10 minutes previously

Physical urticaria
Type IV hypersensitivity to latex
Allergic rhinitis 
Anaphylaxis
C1 inhibitor deficiency
A

Anaphylaxis

35
Q

16 year old develops itchy red wheals on her skin whenever she goes running. Symptoms tend to be worse in the summer

Physical urticaria
Type IV hypersensitivity to latex
Allergic rhinitis 
Anaphylaxis
C1 inhibitor deficiency
A

Physical urticaria

36
Q

36 year old lady presents with swelling of face and tongue following dental surgery. There is a family history of similar reactions – both her mother and sister are affected.

Physical urticaria
Type IV hypersensitivity to latex
Allergic rhinitis 
Anaphylaxis
C1 inhibitor deficiency
A

C1 inhibitor deficiency

37
Q

14 year old presents with nasal irritation and discharge during the summer months. The symptoms are relieved by over the counter anti-histamines

Physical urticaria
Type IV hypersensitivity to latex
Allergic rhinitis 
Anaphylaxis
C1 inhibitor deficiency
A

Allergic rhinitis

38
Q

25 year old junior doctor develops pruritic/blistering rash on hands within two weeks of starting placement on surgical firm

Physical urticaria
Type IV hypersensitivity to latex
Allergic rhinitis 
Anaphylaxis
C1 inhibitor deficiency
A

Type IV hypersensitivity to latex

39
Q

A 58 year old pharmacist presents with a 3 month history of skin itching associated with lethargy and loss of energy.
Physical examination is normal, but liver function tests reveal:
Total bilirubin = 36umol/l (0-17umol/l)
ALT = 28U/l (0-31U/l)
Alkaline phosphatase 420U/l (30-130).

  1. anti-acetyl choline receptor antibody
  2. anti-adrenal cortex antibody
  3. antibody to double stranded DNA
  4. anti-centromere antibody
  5. anti-TTG antibody
  6. anti-intrinsic factor antibody
  7. anti-mitochondrial antibody
  8. anti-neutrophil cytoplasmic antibody
  9. anti-RNP antibody
  10. anti-smooth muscle antibody
A
  1. anti-mitochondrial antibody
40
Q

A 56 year old prison officer presents with a history of recurrent nose bleeds, haemoptysis and joint pain associated with profound lethargy.
On examination, he has crackles in his upper left lung field, and a cavitating left lung lesion is demonstrated on chest radiography.
Urine dipstick is positive for protein and blood.

  1. anti-acetyl choline receptor antibody
  2. anti-adrenal cortex antibody
  3. antibody to double stranded DNA
  4. anti-centromere antibody
  5. anti-TTG antibody
  6. anti-intrinsic factor antibody
  7. anti-mitochondrial antibody
  8. anti-neutrophil cytoplasmic antibody
  9. anti-RNP antibody
  10. anti-smooth muscle antibody
A
  1. anti-neutrophil cytoplasmic antibody
41
Q

A 22 year old woman presents with joint pain and fatigue. She has an intermittent, skin-sensitive rash, and also complains of mouth ulcers. Physical examination is otherwise normal.
Urine dipstick is positive ++ protein and ++ blood.
Full blood count shows a normocytic normochromic anaemia.

  1. anti-acetyl choline receptor antibody
  2. anti-adrenal cortex antibody
  3. antibody to double stranded DNA
  4. anti-centromere antibody
  5. anti-TTG antibody
  6. anti-intrinsic factor antibody
  7. anti-mitochondrial antibody
  8. anti-neutrophil cytoplasmic antibody
  9. anti-RNP antibody
  10. anti-smooth muscle antibody
A
  1. antibody to double stranded DNA
42
Q

A 30 year old plumber attends his GP complaining of feeling tired all the time. He has type I diabetes, which is currently well controlled, and a history of irritable bowel syndrome. A full blood count shows a microcytic hypochromic anaemia, and iron studies confirm iron deficiency. Vitamin D levels are within the insufficient range.

  1. anti-acetyl choline receptor antibody
  2. anti-adrenal cortex antibody
  3. antibody to double stranded DNA
  4. anti-centromere antibody
  5. anti-TTG antibody
  6. anti-intrinsic factor antibody
  7. anti-mitochondrial antibody
  8. anti-neutrophil cytoplasmic antibody
  9. anti-RNP antibody
  10. anti-smooth muscle antibody
A
  1. anti-TTG antibody
43
Q

A 44 year old builder presents with a history of fingers intermittently becoming very cold and white with recent development of a gangrenous tip of his finger. The skin over his fingers feels ‘tight’ and you note telangectasia on his hands.

  1. anti-acetyl choline receptor antibody
  2. anti-adrenal cortex antibody
  3. antibody to double stranded DNA
  4. anti-centromere antibody
  5. anti-TTG antibody
  6. anti-intrinsic factor antibody
  7. anti-mitochondrial antibody
  8. anti-neutrophil cytoplasmic antibody
  9. anti-RNP antibody
  10. anti-smooth muscle antibody
A
  1. anti-centromere antibody
44
Q

A 19 year old student presents with a chronic, extremely itchy rash consisting of papules and vesicles which is distributed symmetrically over the extensor surfaces of her elbows, legs and buttocks. You suspect dermatitis herpetiformis.

  1. anti-acetyl choline receptor antibody
  2. anti-adrenal cortex antibody
  3. antibody to double stranded DNA
  4. anti-centromere antibody
  5. anti-TTG antibody
  6. anti-intrinsic factor antibody
  7. anti-mitochondrial antibody
  8. anti-neutrophil cytoplasmic antibody
  9. anti-RNP antibody
  10. anti-smooth muscle antibody
A
  1. anti-acetyl choline receptor antibody
  2. anti-adrenal cortex antibody
  3. antibody to double stranded DNA
  4. anti-centromere antibody
  5. anti-TTG antibody
  6. anti-intrinsic factor antibody
  7. anti-mitochondrial antibody
  8. anti-neutrophil cytoplasmic antibody
  9. anti-RNP antibody
  10. anti-smooth muscle antibody