immunity

Question 1

what is lymphodynopathy

Answer 1

enlargement of lymph nodes

Question 2

what is lymphadenitis

Answer 2

enlargement due to infection => swollen and ppainful

Question 3

what are the causes of splenomegaly

Answer 3

malaria, chronic myloid lekaemia, lymphoproliferative disorder, hepatitis, endocarditis

Question 4

what are the causes of hyposlenism what are t5he problems

Answer 4

non-functional, sickle cell, coelic, splencetomy

risk of sepsis especially by encapsulated mechanisms i.e. H. inflenzae

Question 5

what is the connection between lymph and blood

Answer 5

right lymphatic duct=> right subclavian vein

thoracic duct=> left subclavian vein

Question 6

what is the starting point of thoracic duct and at what levle
What is it’s pathway

Answer 6

L2=> cisterna chyli (expanded sac from left lumber and intestinal trunk) crosses midline at T5, posterior to thorax)

Question 7

what are the trunks of right lymphatic duct

Answer 7

right jugular, bronch-medistinal and subclavian

Question 8

What is lymphooedeme

Answer 8

blockage of lymphatic drainage due to tumour or lymphoma

Question 9

what are the lymph vesselsbin the lining of small intestine, what is their role

Answer 9

lacteals=> fatabsorption

Question 10

what microbal structure can be recognised by the inate immune system

Answer 10

Pathogen-associated molecular patterns (PAMPs)

Question 11

What receptor is used to recognise PAMPS

Answer 11

pathohen recognition receptor

Question 12

what are the causes of neutrophilia

Answer 12

o Malignancy
o Smoking
o Myloproliferative disease
o Drugs (steroids)

Question 13

what are the causes of neutrpenia

Answer 13

o	Viral infection
o	Drugs => chemotherapy, cytotoxic agents, carbimazole 
o	Severe sepsis, 
o	SLE
o	Bone marrow failure

Question 14

how does CRP activate the complement system

Answer 14

binds to the phosphocholine on dead/dying cells and some bacteria

Question 15

what are the three complement pathwyas what is the outcome

Answer 15

classic, alternative, Mannan-binding lectin (MBL)

C3 that is an enzyme that amplifies the complement pathways

Question 16

what are the functions of opsins

Answer 16

cell lysis, opsinisation, solubilsation and clearance of immune complexes, inflammation => degranulation of basophiles/mast cells

Question 17

what are the two conditions that affcet neutrophilic pahgocytosis and how

Answer 17

o Chronic granulomatous disease (No respiratory burst)

o Chédiak-Higashi syndrome (no phagolysosomes formation)

Question 18

what ore the functions of mast cells other than direct effect of histamin

Answer 18

proteolitic enzymes = C3
archodonic acid=> prostaglandins/ lukotienes
cytokines (IL3 and 8) => adaptive immunity

Question 19

which MHc is respons9ible for recognition of viral and bacterial PAMPS

Answer 19

1-viral=CD8

2-bacterial =CD4

Question 20

Give and example of a virus that can sensitise the immune system to pancreatic islet cells

Answer 20

Coxsackieviruses

Question 21

what are the two ways invollved in killing cells by T CD8 cells

Answer 21

interaction of T cell receptor with MHC 1 => release of cytotoxic granules=>perforin (pore formation) and granzyme (apoptosis )
FAS-FAS ligand pathway =>binding of Fas receptor to fas ligand leads to apoptiosis

Question 22

what are the molecules relased by TH1 cells what change sdo they cause and what are they prompted by

Answer 22

release: IL-2, TNF, IFN-gamma
cause: T cell proliferation, increase on CD8 and NK and macrophages activation, enhance IgG production

stimulated by IL-12

Question 23

what are the molecules relased by TH2 cells what change sdo they cause and what are they prompted by

Answer 23

release: IL-4, 5 (eosinophile atractant), 13
Ab class swithch A to E, synthesis of A, E, G eosinophile recruitment
require: IL-4 and 13

Question 24

How do Th cells cross inhibit each other

Answer 24

TH1 ihibited by IL 4 and 10

TH2 inhibited by IFN-gamma

Question 25

what are the functions of antibodies

Answer 25

o Neutralising of toxins
o Prevent pathogen from entering the cell
o Activate complement through the classical pathway
o Opsonisation of pathogen

Question 26

what are the prefcursosr for blood cells

Answer 26

Myeloid abd Lymphoid

Question 27

what is the name given to;

Low red cell count -

Answer 27

Low red cell count - anaemia.

Question 28

.what is the name given to;

Low white blood –

Answer 28

Low white blood – leucopenia.

Question 29

what is the name given to;

Low neutrophil count

Answer 29

.

Low neutrophil count - neutropenia

Question 30

what is the name given to;

Low platelet count -

Answer 30

Low platelet count - thrombocytopenia.

Question 31

what is the name given to;

Low red blood cells, white blood cells, andplatelets

Answer 31

Low red blood cells, white blood cells, andplatelets - pancytopenia.

Question 32

What are the causes of pancytoponea

Answer 32

•	B12/folate deficiency 
•	Malignancy 
•	Idiopathic immune aplastic anaemia 
•	Drugs
o	Chemotherapy 
o	Antibodies
o	DMARDs
•	Viruses
o	EBV 
o	Viral hepatitis (not A-C)
o	HIV
•	Congenitalbone marrow failure 
o	Fanconi’s anaemia
o	Dyskeratosiscongenita

Question 33

define atopy

Answer 33

state of high risk of allergy

Question 34

what’s angioodedema

Answer 34

swelling of tongue, lips and upper rspiratory tract => dermis allergy

Question 35

define urticaria

Answer 35

itch rash of the skin

Question 36

what could you look for in the blood in dignosis of hypersensitivity 1

Answer 36

IgE to the alergen, mast cel tryptase, skin prick, challange test

Question 37

what antibodies are produced in type 2 hypersensitivity and what do they activate

Answer 37

IgG and IgM => complement => chomatxis i.e. neutrophiles
function in autoimmunity

Question 38

what is tensilon test

Answer 38

tensilon given that acts as Ach in MG testing

Question 39

what test is used fro pernicious anaemia

Answer 39

schilling test