First Aid 197-220 Flashcards
Which immunoglobulins fix complement?
IgG
IgM
IgE binds to
mast cells and basophils;
activates eosinophils
What must be present to facilitate the presentation of an antigen by MHC?
Peptide component
For example, LPS is completely made of polysaccharide, and therefore cannot be presented to T cells
What are the two main opsonins?
C3b (b binds bacteria)
IgG
PNH is caused by GPI-anchored enzyme deficiency, aka:
DAF (delay-accelerating factor)
What is the reaction catalyzed by G6PD?
Glucose-6-P –> 6-phosphogluconate;
requires NADP+ –> NADPH (from HMP shunt)
What interferon is critical for immunity against viral infections and intracellular bacterial?
IFN-gamma
Where is CD14 found?
Macrophages;
CD14 is a receptor for PAMPS ie LPS
What is anergy?
T and B cells cannot become activated if no co-stimulatory signal is provided
Toxoid is an example of what kind of immunity?
Active
What hypersensitivity reactions are antibody mediated?
I, II, III
Direct Coomb’s test detects
antibodies that have adhered to a patient’s RBCs;
example, test an Rh + infant of an Rh - mother
Eczema is what kind of hypersensitivity reaction?
Contact dermatitis?
Eczema - type I
Contact dermatitis - type IV
Febrile nonhemolytic transfusion reaction
What kind of hypersensitivity reaction?
Type II
Host antibodies against donor HLA antigens/WBCs
Acute hemolytic transfusion reaction
What kind of hypersensitivity reaction?
Type II
ie ABO blood group incompatibility
hemoglobinuria = intravascular hemolysis
jaundice = extravascular hemolysis
Give the associated disorder with the following autoantibody:
anti-CCP
Rheumatoid arthritis
Give the associated disorder with the following autoantibody:
Anti-U1 RNP (ribonuceloprotein)
Mixed connective tissue disease
Give the associated disorder with the following autoantibody:
Anti-smooth muscle
Autoimmune hepatitis type I
Give the associated disorder with the following autoantibody:
Antiphospholipase A2 rceptor
Primary membranous nephropathy
Give the associated disorder with the following autoantibody:
Antimitochondrial antibody
Primary biliary cirrhosis
Give the associated disorder with the following autoantibody:
Anti-glutamic acid decarboxylase (GAD-65)
Type 1 DM
STAT3 mutation results in deficiency of Th17 cells;
Leads to impaired recruitment of neutrophils to sites of infection;
Dx?
Job syndrome aka AD Hyper-IgE syndrome; "FATED" coarse Facies; staph Abscesses (non-inflamed); retained primary Teeth; increase IgE and low IFN-gamma; Dermatologic problems ie eczema
Chronic mucocutaneous candidiasis involves dysfunction of what cell type?
T cells
Selective IgA deficiency is a disorder of what cell type?
B cells
CVID is a disorder or what cell type?
B cells
IL-2R gamma chain dysfunction;
X-linked
A kind of SCID
Ataxia telangectasia involves deficiency of what immunglobulin?
IgA, IgG, IgE;
combined B and T cell disorder
Inheritance of:
Wiskott-Aldrich syndrome
Hyper IgM syndrome
Chronic granulomatous disease
X-linked recessive
Leukocyte adhesion deficiency is the result of a defect in what protein on phagocytes?
LFA-1 integrin (CD18) protein;
AR
Phagocyte dysfunction disorder with giant granules in granulocytes and platelets;
Dx?
Chediak-Higashi syndrome;
AR
Chronic transplant rejection involves what kind of hypersensitivity reactions?
Types II and IV;
reaction is dominated by forms of arteriosclerosis
GVHD is a type IV hypersensitivity reaction
Main AE of cyclosporine
nephrotoxicity
MOA cyclosporine
calcineurin inhibitor
binds cyclophilin
prevents IL-2 transcription
Tacrolimus (aka FK506) also prevents IL-2 transcription
What medication blocks mTOR by binding to FKBP and is used to prevent kidney transplant rejection?
Sirolimus
Kidney “sir”vives
prevents response to IL-2
What monoclonal antibodies are used as immunosuppressants because they bind to the IL-2 receptor?
Basiliximab
Deaclizumab
6MP (is Azathioprine) is degraded by
xanthine oxidase
Alemtuzumab targets:
CD52
for CLL, MS
“aLYMtuzumab”
Bevacizumab targets:
VEGF
colorectal cancer, RCC, neovascular age-related macular degeneration
Cetuximab targets:
EGFR
stage IV colorectal cancer, head and neck cancer
Rituximab targets:
CD20
CLL, B-cell non-Hodgkin lymphoma, RA, ITP
Trastuzumab targets:
Her2/neu
What mab to use for high risk infants for RSV prophylaxis?
Pavilizumab
Abciximab targets:
platelet glycoproteins IIb/IIIa;
use in PCI to prevent ischemic complication
Bcl2 prevents cytochrome c release by binding to and inhibiting
APAF-1
APAF-1 normally binds cytochrome c and induces activation of caspase 9 –> caspase cascade
Nocardia causes what kind of cellular necrosis?
Caseous
How does fibrinoid necrosis look on stain?
Vessel walls are thick and pink;
ie fibrinoid necrosis of the placenta in pre-ecclampsia;
immune complexes combine with fibrin –> vessel wall damage
A common cause of Budd-Chiari syndrome
Polycythemia vera
Neurons most vulnerable to hypoxic-ischemic insults include:
Purkinje cells of the cerebellum;
pyramidal cells of the hippocampus and neocortex
Parts of colon most vulnerable to ischemia
rectum
splenic flexure
Cyanosis
Chocolate-colored blood
Dx?
Methemoglobinemia
PaO2 normal, SaO2 down because Iron in heme has been oxidized to Fe3+ –> cannot bind oxygen
Area of the cell that oxidizes very long chain FA and FA with branch points at odd numbered carbons through beta oxidation
peroxisome
Peroxisome defects result in build up of toxins and early death ie Zellwegger syndrome (leads to improper CNS myelination), Refsum disease
Mitochondria can beta oxidize only some/short FA
Why can dihydropyridine calcium channel blockers (Amlodipine, Nifedipine) cause peripheral edema?
Preferential dilation of the arterioles increases hydrostatic pressure
Most common genetic source of Turner syndrome and missing gene
Meiotic nondisjunction (paternal) Missing SHOX gene which contributes to long bone growth
Meiotic nondisjunction also implicated in trisomy 13, 18, 21 and Klinefelter syndrome
Benzos ok to use in patients with impaired liver function
Lorazepam
Oxazepam
Temazepam
