Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Romesh Path NEWONE > Immuno 10: Immuno Modulating Therapies 2 > Flashcards

Immuno 10: Immuno Modulating Therapies 2 Flashcards

1
Q

How do Corticosteroids inhibit Prostaglandins and hence have an anti-inflammatory effect ?

A

Corticosteroids INHIBIT Phospholipase A2

(Normaly)
Phospholipase A2 converts phospholipids into Arachidonic acid
Arachidonic acid is converted to Prostaglandins or leukotrienes by COX enzymes.
Prostaglandins cause Inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Give 2 examples of Eicosanoids ?

A

Prostaglandins

Leukotrienes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give 3 examples of immune modulating functions of corticosteroids ?

A 
Inhibit Prostaglandin synthesis 
Inhibit Phagocyte entry into inflamed tissues 
Causes lymphopenia (Lymphocytes sequester in lymphoid tissues)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give 3 examples of Anti-proliferative agents ?

A

Cyclophosphamide
Azathioprine
Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the mechanism by which cyclophosphamide inhibits lymphocyte proliferation?

A

Cyclophosphamide alkylate guanine bases on DNA

Prevents cell replication particularly in rapidly dividing cells (cancer, lymphocytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give 3 examples of diseases in which Cyclophosphamide is indicated ?

A

SLE
GPA (granulomatosis with polyangitis) (wegner’s granulomatosis)
Cancers- Hodgkin’s lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Suggest 3 side effects of cyclophosphamide ?

A

Hair loss
Sterility
Haemorrhagic cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the mechanism by which azathioprine inhibits DNA replication ?

A

Metabolised to 6-mercaptopurine which blocks synthesis of adenine and guanine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give 3 indications for azathioprine ?

A

Transplantation
auto-immune diseases
Crohn’s and UC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which genetic polymorphism contraindicates the use of azathioprine because of risk of bone marrow suppression ?

A

Thiopurine methyl transferase (TPMT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is an alternative to azathioprine used in transplantation ?

A

Mycophenolate Mofetil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which virus can cause Multifocal leukoencephalopathy infection in the immunocompromised patient ?

A

JC virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does plasmapheresis work ?

A

Patients blood is separated and the plasma is treated to remove immunoglobulins and is then re-infused

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is Plasmaphoresis indicated ?

A

Severe transplant rejection
Severe acute myasthenia gravis
Goodpasture’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the role of IL2 in the T cell response ?

A

IL2 causes T cell proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does cyclosporin inhibit T cell proliferation ?

A

Cyclosporin is a calcineurin inhibitor.
It blocks IL2 production
Thereby inhibiting T cell proliferation

17
Q

How do Anti-thymocyte globulins cause T cell depletion ?

A

Thymocytes (lymphocytes from human thymus) were injected into rabbits
Rabbits produced antibodies to the thymocytes
The antibodies are retrieved and injected into humans to cause a non-specific immune response against T cells

18
Q

Which cells are affected by Rituximab ?

A

B cells

Rituximab targets CD20 a B cell marker

19
Q

Name a drug that inhibits leukocyte binding to VCAM1 and is used to treat relapsing-remitting Multiple sclerosis ?

A

Natalizumab

20
Q

Which disease is characterised by a IL6 producing tumour

A

Castleman’s disease

21
Q

List 4 diseases in which anti-TNF alpha antibodies (infliximab) is indicated ?

A

Rheumatoid arthritis
Ankylosing spondylitis
Psoriasis/psoriatic arthritis
IBD

22
Q

Explain what effect RANK L binding to RANK receptors has on bone ?

A

RANKL produced by Osteoblasts binds to RANK receptor on osteoclast precursors causing them to differentiate into Osteoclasts.
This causes increased bone resorption

23
Q

What is Osteoprotegrin (OPG) and what role does it have in controlling bone resorption ?

A

OPG is secreted by Osteoblasts and is a decoy receptor for RANKL to reduce activation and differentiation of Osteoclasts.
Hence inhibiting bone resorption

24
Q

What is the mechanism by which Denosumab works in Osteoporosis treatment ?

A

Monoclonal antibody to RANKL so that it cant bind to RANK receptor on osteoclast precursors.
This reduces Osteoclast resorption of bone

25
Q

What is a complication of osteoporosis treatment with denosumab ?

A

Avascular necrosis of the jaw

26
Q

Name a drug that prevents DNA replication especially of T cells

A

Mycofenylate mofetil

27
Q

Which immuno modulating drug causes a transient increase in neutrophil count ?

A

Prednisolone

28
Q

Which immuno modulating drug can cause gingival hypertrophy as a side effect?

A

Ciclopsporin

29
Q

List 3 side effects of methotrexate ?

A

Pneumonitis
pulmonary fibrosis
cirrhosis

30
Q

A patient with signs of severe myasthenia gravis requires ventilation. Which one of the following would be the most suitable treatment ?

A) Corticosteroids
B) Ciclosporin
C) Tacrolimus
D) Plasmapheresis

A

D) Plasmapherisis

can remove the Ach receptor antibodies in the blood so is useful initially. Later needs acetylcholinesterase inhibitors.

31
Q

Name a monoclonal antibody drug that targets IL-2 to prevent T cell proliferation. This drug is used prophylactically in allograft transplant.

A

Basiliximab

Targets CD25 on the alpha chain of IL-2 which stops T-cell proliferation if they are presented with donor HLA.

32
Q

Name a drug that is a CTLA4- IgG fusion protein and is used in the treatment of rheumatoid arthritis resistant to DMARDs ?

A

Abatacept

A fusion protein between CTLA4 and Immunoglobulin IgG.
Binds to APCs to prevent them from stimulating T cells.

33
Q

Name 2 drugs used to treat malignant melanoma ?

A

Ipilimumab

Pembrolizumab

34
Q

Which drug works by inhibiting phospholipase A2 ?

A

Prednisolone

35
Q

Which mutation if present can cause severe neutropenia with azathioprine treatment ?

A

TPMT

can’t metabolise azathioprine

36
Q

Which 2 drugs can be used in transplant rejection ?

A
  • OKT3 Muromonab (CD3 inhibitor mouse monoclonal antibody)
  • ATG (anti thymocyte globulin)

(can also do plasmapheresis if antibody mediated rejection or IVIG)

37
Q

List 2 drugs that can be given before transplant

A
  • Basiliximab

- Alemtuzumab (anti CD52)

38
Q

What is Ustekinumab used for ?

A

Psoriasis

-Targets IL12 and IL23

39
Q

List 4 drugs given as maintenance therapy post transplantation ?

A
  • Cyclosporin
  • Mycofenolate mofetil
  • Azathioprene
  • Prednisolone

Romesh Path NEWONE (96 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions