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MRCPCH Part 2 > Immunity > Flashcards

Immunity Flashcards

1
Q

Causes of toxic shock syndrome

A

Staph aureus

Group A strep

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2
Q

Which lab test can you do in toxic shock syndrome?

A

CK - raised

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3
Q

Quantitative test of B cell function particularly in children over 2

A

Antibodies to polysaccharide vaccines

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4
Q

Test of T cell function assessing mitogen proliferation

A

PHA (phytohemagglutinin)

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5
Q

What is PHA?

A

Stimulus to T cell proliferation

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6
Q

Diagnostic test for SCID with neurological abnormalities

A

PNP enzyme activity

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7
Q

What does positive hep B surface antigen indicate?

A

Either acute infection or chronic infection

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8
Q

How do you prove chronic hep B infection?

A

Either two positive hep B surface antigen tests three months apart, or simultaneous demonstration of HbsAg and IgG core antibody to core antigen (anti HBc)

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9
Q

Which mothers are at particular risk of passing hepatitis B on to their babies?

A

Those who have detectable ‘e’ antigen - high rates of active viral replication

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10
Q

What should infants of hep B ‘e’ antigen positive mothers receive at birth?

A

Immunoglobulin (HBIG) and immunisation, in separate limbs

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11
Q

What should infants of hep B surface antigen positive mothers receive at birth?

A

Vaccination within 48 hours and then complete the course

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12
Q

How long should you observe a patient post anaphylaxis?

A

6-12 hours

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13
Q

6 most important opportunistic infections in paediatric HIV?

A 
CMV retinitis
PCP
Disseminated MAC
Oesophageal candidiasis
Cryptococcal meningitis
Chronic cryptosporidium enteritis
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14
Q

Blood tests in SCID?

A

Lymphopenia
Low T cell numbers
Poor functional activity of T cell

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15
Q

Suspect if delayed separation of umbilical cord and no pus?

A

Leucocyte adhesion defect

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16
Q

How do you diagnose cyclical neutropenia?

A

Twice weekly FBC for 8 weeks

17
Q

How is cyclical neutropenia treated?

A

GCSF, if treatment is needed

18
Q

What is the mutation in Bruton’s?

A

btk gene (bruton tyrosine kinase) causing defective pre-B to B-cell transformation

19
Q

Presents with gingivostomatitis at regular intervals

A

Cyclical neutropenia

20
Q

Presents at 6m-2y with recurrent bacterial infections, reduced or absent lymphoid tissue, IgG, M, and A all low and very low or absent CD19/CD20

A

Bruton’s X linked agammaglobulinaemia

21
Q

What is the treatment for Bruton’s

A

Regular IVIG or SCIG infusions

22
Q

Presentation with eczema, recurrent bacterial infections and purpura

A

Wiskott-Aldrich

23
Q

How is Wiskott-Aldrich diagnosed?

A

WASP expression

24
Q

Which investigations should children with Wiskott-Aldrich receive?

A

Liver-spleen scan and serum immunoglobulins

25
Q

What are the risks of Wiskott-Aldrich?

A

Serious herpes infection, malignancy, autoimmunity

26
Q

What is the treatment for Wiskott-Aldrich?

A

Platelet transfusion if indicated, BMT (can be curative)

27
Q

Presents with recurrent infections and low IgG +/- low IgA in infants

A

Transient hypogammaglobulinaemia of infancy

28
Q

Immune-related blood tests in HIV

A

Raised IgG

Reversed CD4-CD8 ratio

29
Q

Presents early in infancy with failure to thrive, chronic diarrhoea, recurrent infections, infection with unusual organisms and chronic candidiasis

A

SCID

30
Q

What investigations should be done in suspected SCID?

A

Serum immunoglobulins
Lymphocyte subsets
PHA stimulation tests

31
Q

Cause of chronic granulomatous disease

A

Inherited defect in the NADPH dependent oxidase enzyme system, unable to deal effectively with certain phagocytksed organisms

32
Q

Presents with suppurative infection, macrophage activation and formation of granulomata

A

Chronic granulomatous disease

33
Q

Test for CGD

A

Flow cytometry to assess neutrophil respiratory burst activity

34
Q

Lab tests in ataxia telangiectasia

A

Low IgA
Elevated serum alpha fetoprotein
Increased white cell sensitivity to irradiation
T cells may be low

35
Q

Presents with very high IgE, eczema, staphylococcal abscesses

A

Hyper IgE syndrome (Job syndrome)

36
Q

Cause of roseola infantum

A

HHV6

37
Q

Cause of molluscs contangiosum

A

Poxvirus

38
Q

What should be regularly checked in children on immunoglobulin therapy?

A

LFTs
Hep C status
Trough Ig levels

39
Q

Test for LAD?

A

Flow cytometry for CD11b

MRCPCH Part 2 (24 decks)

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