FMS Week 10 Flashcards
Immunology
What is graft-vs-leukemia effect?
T-cells from donated bone marrow have mild GVHD and kill residual cancer cells
How are PABs and MABs used in organ transplantation?
At the beginning, to suppress the immune system for a “clean start” or in crisis
Why does glucocorticoids cause increased WBC counts?
impaired neutrophil migration
What genes are important for MHCI matching?
HLA-A, HLA-B, HLA-C of chromosome 6
Features, symptoms, findings, and treatment of Leukocyte Adhesion Deficiency:
Defective neutrophil/lymphocyte migration
Type 1: defect in CD18 (LFA1) which is part of several integrins
Key findings: delayed umbilical separation, omphalitis (stump infection), recurrent bacterial infections, elevated WBC (especially neutrophilia)
What are TRECs?
Loops of DNA that are formed during recombination of TCR; presence indicates that SCID is unlikely in neonatal testing
What are the advantages of virus-like particle vaccines?
Very safe, do not need to grow pathogen, highly immunogenic, inside of particle can be modified with adjuvants
What is the primary target of HIV?
CD4 Th cells
What is the most common presentation of chronic rejection in the heart?
narrowing of coronary arteries
Where are H1 receptors most common?
Endothelial cells and sensory nerve endings
also GI/bronchial smooth muscle and brain
what is a xenograft?
transplant taken from another species
Why are steroids usually tapered down?
Can lead to adrenal insufficiency, steroid use suppresses HPA axis
Adrenal crisis: hypotension/shock, weakness, fever, confusion/coma, abdominal symptoms
What are the disadvantages of DNA vaccines?
effectiveness unclear (may be more effective in therapeutic vaccines), safety unclear, likely multiple doses/delivery platforms
What autoimmune diseases are associated with HLA-B27?
ankylosing spondylitis, psoriasis, IBD, Reiter syndrome
Who are most at risk of hyperacute rejection?
parrous women, people having received blood transfusions or previous transplants
Mechanisms, presentation, key findings and treatment of X-linked Agammaglobulinemia:
(Bruton Agammaglobulinemia) Defect in bruton tyrosine kinase gene (BTK); light chains of b-cells not produced
Symptoms begin around 6 months of age after loss of maternal antibodies
Recurrent respiratory bacterial infections (loss of opsonization): recurrent otitis media/sinusitis/pneumonia
GI pathogen infections (loss of IgA): enteroviruses &
giardia
Key findings: absence of mature peripheral B cells and antibodies, underdeveloped germinal centers of lymph nodes
Treatment: IVIG (intravenous immunoglobulin)
What is the most common organ transplant?
Kidney (you only need one)
What are the most important eicosanoids for protecting GI mucosa?
PGE2 and PGI2
what are the disadvantages of live attenuated vaccines?
can revert back to pathogenic form, requires system to grow virus, potential contamination, less safe
What is a syngenetic graft?
transplant taken from identical twin
What is the presentation of hyperacute rejection?
blood vessels spasm leading to intravascular coagulation and ischemia (white rejection)
What are the 3 main genes of HIV?
Gag (nucleocapsid)
Pol (polymerase)
Env (envelope proteins)
COX-1
constitutively expressed cyclooxygenase in all cells
important for GI mucosal function
Features, symptoms, findings, and treatment of ataxia telangiectasia:
Defective ATM gene on Chromosome 11 (dsDNA repair, nonhomologous end-joining)
Autosomal recessive; hypersensitivity of DNA to ionizing radiation
Symptoms: ataxia, spider veins, recurrent respiratory infections, high risk of cancer
Presents in childhood with progressive symptoms
Key findings: elevated AFP, low IgA