CIS 1, 2, 3 / Practice Questions Flashcards
Say there’s a virus that is down regulating the amount of MHCI, what is going to act and what is not going to act?
CD8 aren’t going to be able to destroy, but NK cells are going to ramp up from decrease of inhibition signals
What is present on NK cells? what kind of hypersensitivity is this considered?
CD16
2 for some reason
B cells have what on their surface?
CD19
What cells can capture antibody coated HIV visions through their FC receptors?
Follicular Dendritic Cells
Cyclosporine?
methotrexate is used for?
minimize lymphocyte-mediated transplant rejection
graft vs host disease
Transfusion reactions are what kind of hypersensitivity?
2!
Complement is found in what hypersensitivity reaction?
2 + 3
When there’s antibody being directed at a parasitic infection, what should you be thinking?
ADCC (antibody-mediated cellular cytotoxicity)
IgG and IgE antibodies bearing Fc receptors coat the parasite and have them lysed.
Serum sickness is what?
injected foreign protein, produces widespread antigen-antibody complex deposition, PARTICULARLY IN THE KIDNEYS
What is an Arthur reaction and what are you going to see?
localized immune complex reaction at the site of the injection and the depletion of complement C3
smooth and linear is what?
type 2 hypersensitivity reaction.
what antibody is going to scream good pasture?
anti-basement membrane antibody
IL-17 does what?
recruits neutrophils
IL-2 does what?
T cell proliferation
IL-5 does what?
activates eosinophils
IL-10 does what?
immunosuppressive
injury of a injection and 48 hours you have erythema. something stains positive for CD4. what is it?
what test is in this grouping too?
type 4 hypersensitivity (delayed type hypersensitivity)
PPD skin test
fundamental mechanism behind SLE?
defective clearance and hence increased burden of nuclear apoptotic bodies in thymus lymphocyte development
why would someone have recurrent thrombosis in SLE?
antiphospholipid antibodies like anticardiolipin –> against phospholipid protein complexes, lead to inc rebased thrombosis
what’s likely to develop in people with SLE? 2 things
chronic renal failure
hemolytic anemia through the development of anti-RBC antibodies
what are you going to see that screams CREST syndrome?
anti-centromere
what are you going to see that screams Scleroderma?
SCL-70 (or Anti-DNA topoisomerase)
What are you going to see that screams mixed connective tissue disease?
Anti-U1-RNP
Sjogrens hs an increased risk of what?
Lymphoma
What’s causing the problems of scleroderma?
what does this lead to in individuals?
CD4
severe hypertension
say something says severe, recurrent bacterial, fungal and viral infections.. what should you be thinking?
what causes this?
what happens but is less likely?
SCID
X linked mutation in COMMON GAMMA CHAIN
in autosomal recessive cases –> problems with adenosine deaminase
C1 inhibitor problems, what do they present with?
swelling of the face, but ALSO throat, trouble swallowing, abdominal pain, cramping.
seems like a type 1 hypersensitivity, but it’s just complement causing massive edema
(hereditary angioedema)
Wiskott Aldrich Syndrome is characterized by what?
what do they have an increased risk for?
thrombocytopenia, eczema, and decreased IgM (increased recurrent infections)
whenever there’s an immunodeficiency disorder, immune dysregulation or this, think NON Hodgkin Lymphoma
What cancers are common in aids patients?
B cell lymphoma, burkitts lymphoma
Apple green and Congo red are seeing in what type of what?
what does not show up on Congo red but still is bubblegum looking?
light chain amyloid (AL) –> plasma cells secreting it so MYELOMA
AA which is seen in chronic inflammatory diseases like RA or lupus
Polymyositis?
chronic inflammation of the muscles and associated tissues
you see focal necrosis of the muscle fibers
Poison ivy is what hypersensitivity?
type 4! contact dermatitis
Hydrops fetalis is what hypersensitivity?
2
Mixed connective tissue disease is a mix of what?
SLE, Polymyositis, scleroderma
CVID has what 2 things associated with ti?
hypogammaglobulinemia for bacterial infections and GIARDIA
difference between discoid and classic SLE?
discoid does not have a positive DS-DNA
if there’s “nuclear pattern” in the name, what should you be thinking?
crest / scleroderma
Tetany in the question, what should you jump too?
hypocalcemia –> digeorge
what leads to lung fibrosis that is found in the environment?
inorganic dusts –> inhaled and ingested by macrophages, they release cytokines leading to fibrosis
drowning is associated with what hemorrhage style?
strangulation?
falling?
mastoid sinuses
petechial hemorrhages
contusions
retinal hemorrhages?
shaken baby
subdural vs epidural hemorrhage?
epidural hemorrhage is lucid period but then 3 days later you keel over
subdural gives you confusion and lasts weeks
Organophosphate poisoning mnemonic?
SLUDGE
salivation, lacrimation, urinary incontinence, defacation, GI changes, emesis and miosis
methanol does what to the body?
screws up the CNS and retina
early loss of fetus correlates with what usually?
what about late?
chromosomal abnormality
congenital infection
Hydrops and icterus are in the name and it’s immune related. what should you be thinking?
erythroblastosis fetalis and Rh problems
Hyaline membrane disease is associated with what?
NRDS
what’s usually to blame for PPROM?
acute chorioamnionitis or strong bacterial infections
turner syndrome is what genotype?
45X0
leukomalacia is associated with what infection?
Toxoplasmosis
baby is born with a flattened nose, prominent infraorbital creases, contracture of arms, vagus deformities of the feet.. pulmonary hypoplasia. what’s the finding?
petter sequence –> oligohydramnious caused by renal agenesis of both kidneys leading to pulmonary hypoplasia
missing both irises is associated with what?
WAGR –> Wilms tumor
bloody stool in newborn, what should you see on radiograph and what is it?
dilated bowel
necrotizing enterocolitis
Niacin
what’s the other name
what do people present with
clinical name
B3
dementia, dermatitis, diarrhea
pellagra
Child with a vitamin C deficiency leads to what?
OSTEOID MATRIX PRODUCTION for type 1 collagen problem!
so they’ll also have problems!!! don’t be fooled with this and rickets
neural tube defects, what’s the problem
neural tube defects
Iron deficiency, what will you see
anemia
liver problems, abnormal bleeding, what is missing?
vitamin K
what leads to renal tubular damage and chronic pulmonary disease?
cadmium
lead poisoning causes an increase in what?
zinc protoporphyrin
alcohol + acetaminophen, what is the COD
brainstem depression first
Low estrogen-containing oral contraceptives for a long period cause what?
increase risk of MI
hypertension in renal blood vessels on autopsy, and a sudden death
cocaine
what factor necessitates skin grafting?
dermal appendages such as sweat glands and hair follicles
heat exhaustion vs heat stroke?
exhaustion is failure of CV system to compensate for hypovolemia
stroke is organ damage and a greater core temp of 36+
inhaling gases and hot fumes from a fire gives you what?
pulmonary edema
hypothermia causes what?
peripheral vasoconstriction along with edema caused by increased vascular permeability
Atrophic gastritis affects what absorption?
B12
osteomalacia, what’s the problem?
what can cause this to happen?
vitamin D malabsorption
biliary tract disease, pancreatic disease, chronic cholestatic liver disease
Leptin does what?
decreases synthesis of NPY which is an appetite stimulant
it’s a satiety hormone
Ghrelin does what?
the “hungry” gene
obesity gene
MC4R
Positive for vimentin?
positive for cytokeratin?
soft tissue malignancies (sarcomas)
carcinomas are cytokeratin
ionizing radiation activates which checkpoint?
G2/M –> monitors completion of DNA Replication
Japanese cancer?
Gastric
type 1 tumor is called what?
low grade and low stage (well differentiated and localized)
Retroperitoneum is a typical location for what in an adult?
sarcoma
BCR-ABL is known to cause what and what’s the translocation?
translocation is t(9:22)
CML
what’s the best thing to use for identifying GENE alterations involved in carcinogenesis?
what about proteins?
single nucleotide polymorphisms
immunohistochemistry –> evaluates the protein products of gene expression
alpha-fetoprotein
testicular and liver cancer
adenocarcinoma leads to what?
blood loss from mucosal erosion and necrosis –> so you would see microcytic hypo chromic anemia
what stage is it considered if you have something at a primary spot in the body but it’s everywhere?
advanced
purpose of therapeutic radiotherapy is what?
direct image to the cells through the generation of oxidant free radicals
uterus –> benign and circumscribed.
malignant and endometrium?
Leiomyoma
Adenocarcinoma
how can we tell the difference between an enlarged lymph node from an infection to an enlarged lymph node from cancer?
gene rearrangement studies demonstrating clonality
what’s the most common soft tissue neoplasm?
lipoma
human papilloma virus gives us what cancer?
squamous cell carcinoma
Small cell anaplastic lung carcinoma can have what immunohistochemical staining?
ACTH –> Cushing syndrome like from paraneoplastic syndrome
NOTCH is associated with what?
VEGF
hyperchromatism typical for malignant cells indicates what?
what phase?
DNA synthesis
S phase
Ewing sarcoma are childhood neoplasms arising in what?
bone
most common benign neoplasm of the breast
fibroadenoma
Something’s been on someone’s chest for many years… what is it
why isn’t it a nevus
benign –> hemangioma is a. common benign lesion of the skin.
nevi are light brown
any mention of lymphadenopathy, what do you think?
malignancy.
multiple varying sized tan metastatic lesions in the liver from hematogenous spread of carcinoma.. what is it?
metastatic adenocarcinoma
t(9;22) translocation?
what treatment?
chronic myelogenous leukemia
inhibiting tyrosine kinase since BCR-ABL works on that
development of colonic adenocarcinoma.. how doe s it work?
takes years, multiple mutations in a step wise fashion!
p16 is an inhibitor of what?
what other mediator is also associated with this?
cyclin dependent kinases –> seen in melanoma
CDKN2A
what does TGF-B do in cancer?
inhibits cell proliferation by activation of growth-inhibiting genes
familial adenomatous polyposis –> when is the earliest event leading to misfunctino?
loss of APC gene function –> prevents destruction of B-catenin which translocates to the nucleus.. activating the WNT SIGNALING PATHWAY
if there’s a family history of different types of tumors, what should you be thinking?
TP53 stuff.. this is the two hit hypothesis.
NF1 is associated with what?
what is this activating?
neurofibromatosis type 1 –> which encodes for GTPase activating protein that helps change RAS to inactive RAS
