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ID Ex 2 > Immune Dis and Defic. > Flashcards

Immune Dis and Defic. Flashcards

1
Q

In the first 2-3 years of life, what is a “healthy” # of otitis media and gastroenteritis?

A

More than 6 episodes of otitis media

or
More than 2 episodes of gastroenteritis/yr

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2
Q

4 components of immune fxn

A
  1. Anatomic
  2. Phagocytes
  3. Cellular immunity
  4. Humoral immunity

*there are diff tests you can run on all of these - refer to slide near end of lecture

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3
Q

Humoral immunity

A 
specific ab (B cells)
- Ig_

Complement

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4
Q

Public vs Private Immunodeficiency phenotypes

- Which one can wane with age?

A
  1. You have a broad syndrome/disease that leads you suceptible to multiple infxns w/ multiple organisms
  2. Private phenotype: you have a very specific mutation/selective defect that leads you suceptible to one infxn
    * Private phenotype can wane with age: can develop antibodies
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5
Q

Most common source of immunodeficiency?

A

Usually secondary:

Malnutrition

  • Vit A def
  • Iron def
  • Micronutrient def
  • less caloric intake

–> increased risk for infxn and decreased outcome of infxn

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6
Q

2nd and 3rd largest source of immunodef.

A

2nd: HIV-1/AIDS
- 35 mill infected

3rd: Age

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7
Q

Phagocytes (WBCs) mainly consist of which two types of cells?

A

PMNs (60%)
- neutrophils

Lymphocytes (30%)
- 1500-4000

Monocytes (10%)
- macrophages

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8
Q

Sources of infxn with chemotherapy-associated Neutropenia

A
  1. Intestines
    - transcytosis from epithelium
    - perirectal abcess
  2. Periodontal
  3. Skin/Catheters

*pts may have less inflammation (tumor, rubor, calor, dolor)

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9
Q

Chronic Granulomatous Disease (CGD) pts have _____ phagocyte number, but _______ fxn.
- Presentation

A

Sufficient phagocyte number, but decreased fxn
- Defect in NADPH oxidase (oxygen radicals decreased)

Can die young from infxn (fam hx)

*more likely to get uncommon organisms

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10
Q

Conductor/director of immunity

A

CD4+ T cells

Tells everybody what to do and when to do it. They dont actually kill themselves.

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11
Q

causes of decreased cellular immunity

A
  1. Malnutrition
  2. Oral steroids
  3. Immunotherapy
  4. Chemotherapy
  5. Transplantation
  6. HIV/AIDS
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12
Q

Causes of pneumonia in:

Elderly

A
  1. S. pneumoniae
  2. H. flu
  3. Influenza (Virus winter)
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13
Q

Causes of pneumonia in:

Young adult

A
  1. M. pneumoniae
  2. C. pneumoniae
  3. S. pneumoniae
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14
Q

Causes of pneumonia in:

AIDS

A

S. pneumoniae

P. jirovecii (PCP)

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15
Q

Causes of pneumonia in:
BMT

Nosocomial

SE Asia/Africa

A

BMT: Aspergillus sp

Nosocomial: GNR

SE Asia/Africa: TB

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16
Q

Protozoans you are more likely to get with impaired cellular immunity

A
  1. Toxoplasma

2. Cryptosporidium

17
Q

Helminths you are more likely to get with impaired cellular immunity

A

Strongyloides

18
Q

Viruses you are more likely to get with impaired cellular immunity

A

HSV
CMV
Varicella

19
Q

Secondary immunodeficiecy in developing countries vs developed countries

A

Developing country:

  1. Malnutrition
  2. HIV-1/AIDS
  3. Measles
  4. Age

Developed country:

  1. Immunotherapy (steroids)
  2. HIV-1/AIDS
  3. Cancer Therapy
  4. Transplantation
20
Q

3 pathogens with invasive polysacc capsules

  • which antibody is going to recognize it?
A
  1. strep pneumo
  2. G. mening
  3. H. flu

IgG2 - recognize polysaccharides

21
Q

Antigen binding region

A

Fab (Fragment Antigen Binding)

  • variable region
  • each is unique
22
Q

Which region of antibody defines isotype?

A

Fc Constant region

  • activates compliment
  • binds phagocytes via Fc receptors
23
Q

Antibody deficiency leaves you susceptible to

A
  1. Respiratory infxn
  2. Encapsulated bacteria
  3. Viruses (enterovirus)
  4. Giardia
24
Q

IgA1,2 are found where?

A

Mucosal>blood

25
Q

Hyper IgE syndrome

A

Job’s syndrome

26
Q

Most common primary immunodefienciency

A

Selective IgA deficiency
- Fam hx

*normally you produce more IgA than IgG and IgM - no mas

Lots of people have this, m: there is very little associated increased infxn rate (look for concurrent infxn: like low IgG2)

27
Q

Which complement stimulates opsonization/phagocytosis

A

C3

Complements act with antibodies to “opsonize” bacteria and facilitate lysis of GNR or killing by phagocytes

28
Q

List the primary immunodefiency in adults

A
  1. IgA deficiency
  2. IgG2 subclass def
  3. CVID - common variable immunodeficiency
  4. Hyper-IgE syndrome (job’s syndrome)
  5. Cystic fibrosis

*most primary immunodeficiencies are present in childhood and a result of single gene defects

29
Q

Immunodeficiency is an increased incidence and severity of what 3 things?

A
  1. INfection
  2. Malignancy
  3. Autoimmunity
30
Q

How id neutropenia defined?

A

PMNs are usually

31
Q

In the first 10 yrs, what is the healthy number of URI/yr?

A

less than 6-8 URI/ yr

32
Q

Which complement deficiency is most common?
Which complement deficiencies presents with pyogenic infxns?
Which with serial Neisserial infections?

A

C2

pyogenic: C1-4 (mainly C3)

Neisserial:
C5-9

33
Q

Which complement def presents with hereditary angioedema?

A

C1 esterase inhibitor deficiency

- swelling is similar to hives but it is under the skin.

34
Q

Which complement def. presents with complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria?

A

DAF (GPI- anchored enzyme) deficiency

Decay accelerating factor helps prevent complement
activation on self cells

35
Q

Most common serious primary immuno defect in adults

A

Common variable immunodeficiency (CVID)

36
Q

Low fxn in these tests are indicative of what type of immunodeficiency - Phagocytic, cellular, or humoral immunity?

  1. NBT
  2. Skin tests
  3. Anti RBC
  4. Vaccination
A
  1. NBT: phagocytic
    - sufficient phagocyte # but decreased fxn
  2. Skin tests: Cellular
  3. Anti RBC: humoral
  4. Vaccination: Humoral
37
Q

Low # in these tests are indicative of what type of immunodeficiency - Phagocytic, cellular, or humoral immunity?
1. Lymphs

A
  1. Lymphs less than 1500

- cellular immunodef.

ID Ex 2 (18 decks)

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