Immunity

Question 1

Which antibodies would be raised in rheumatoid arthritis?

Answer 1

Rheumatoid Factor
Anti-Cylic Citrullinated Peptide

Question 2

A female feels unwell with symptoms of glomerulonephritis. She has had a BACTERIAL infection for 2 weeks, what type of hypersensitivity reaction is this?

Answer 2

Type IV
(DELAYED & INVOLVES IN MACROPHAGES)

Question 3

What is the most appropriate screening test for Food Protein Induced Enterocolitis Syndrome (FPIES)?

Answer 3

Elimination diet

Question 4

What antibody is responsible for a 2 year old presenting with abdo pain/constipation from FPIES?

Answer 4

Non IgE (older + abdo pain/constipation)

Question 5

What antibody is responsible for a <1 year old presenting with vomiting/red face/diarrhoea from FPIES?

Answer 5

IgE (younger + vomiting)

Question 6

What is the pathophysiology behind an anaphylaxis?

Answer 6

1. Cross linking of IgE receptors on surface of mast cell.
2. Which activates mast cells

Question 7

List some mediators produced by mast cells.

Answer 7

Tryptase
Histamine
Platelet activating factor
Leukotrines C4

Question 8

How do you use an epi pen safely?

Answer 8

1. Remove safety cap
2. Place device against mid anterolateral thigh
3. Hold in place for 10 seconds once click is heard
4. Massage injection site for 10 seconds
   (blue to the sky, orange to the thigh)

Question 9

What are some systemic features of anaphylaxis?

Answer 9

Urticaria
Stridor/Wheeze
Tachycardia/Bradycardia
Confusion/Loss of consciousness
N+V

Question 10

What advice can you give to somebody being discharged after a food allergy?

Answer 10

Avoid food trigger
Training on how to use Epipen
Carry Epipen everywhere
Medic alert bracelet

Question 11

What are the x-ray findings in RA?

Answer 11

Narrowing of joint space
Juxta-articular bony erosions
Subluxation

Question 12

Other features of RA that don’t effect joints?

Answer 12

Pericarditis
Splenomegaly
Lymphadenopathy
Carpel tunnel

Question 13

What monoclonal antibodies can be used in RA?

Answer 13

Infliximab + Adalimunab
(Inhibition of TNF-alpha)

Question 14

What’s the pathophysiology behind SLE?

Answer 14

1. Formation of self antigens and the failure of the immune system to inactive B/T cells that recognise these
2. Development of autoantibodies that form circulating complexes
3. Activation of the complement system

Question 15

How do you diagnose SLE?

Answer 15

ANA +ve
Photosensitivity
Malar rash
Arthralgia