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Year 5 > Immuno > Flashcards

Immuno Flashcards

1
Q

Burkitt’s translocation

A

t (8:14)

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2
Q

CML translocation

A

t (9;22)

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3
Q

APML translocation

A

t (15;17)

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4
Q

Mantel Cell Lymphoma translocation

A

t (11;14)

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5
Q

Follicular lymphoma translocation

A

t (14;18)

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6
Q

Infliximab

A

TNF alpha inhibitor

e.g. Crohn’s

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7
Q

Antiphospholipid Syndrome (Hugh’s Syndrome) Antibodies

A

Antibodies against:
- cardiolipin
- β2 glycoprotein

lupus anticoagulant

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8
Q

Autoimmune hepatitis ANTIBODIES [3]

A

Anti-smooth muscle antibody
Anti Liver Kidney microsomal-1 (anti-LKM-1)
Anti-Soluble Liver Antigen (anti-SLA)

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9
Q

Autoimmune haemolytic Anaemia ANTIBODIES

A

Anti-Rh Blood Group Antigen

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10
Q

Autoimmune Thrombocytopenic Purpura ANTIBODIES

A

Anti-Glycoprotein IIb-IIIa or Ib-IX Antibody

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11
Q

Churg-Strauss Syndrome (eGPA) ANTIBODIES

A

Perinuclear/protoplasmic-staining antineutrophil cytoplasmic antibodies (p-ANCA)

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12
Q

Coeliac disease ANTIBODIES

A

Anti-tissue transglutaminase antibody (IgA)
Anti- endomysial antibody (IgA)
Anti-gliadin

Key note: check IgA levels before

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13
Q

Congenital heart block in infants of mothers with SLE ANTIBODIES

A

Anti-Ro antibody

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14
Q

Dermatitis herpetiformis ANTIBODIES

A

Anti-endomysial antibody (IgA)

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15
Q

Dermatomyositis ANTIBODIES

A

Anti-Jo-1 (t-RNA Synthetase)

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16
Q

Diffuse Cutaneous Scleroderma ANTIBODIES

A

Antibodies to:
- Topoisomerase/Scl70
- RNA Polymerase I,II,III
- Fibrillarin (nucleolar pattern)

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17
Q

Goodpasture’s Syndrome ANTIBODIES

A

Anti-GBM Antibody

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18
Q

Graves’ Disease ANTIBODIES

A

Anti-TSH Receptor Antibody (stimulatory antibody)

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19
Q

Hashimoto’s Thyroiditis ANTIBODIES

A

Antibodies to:
- Thyroglobulin
- Thyroperoxidase

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20
Q

Limited cutaneous scleroderma (CREST) ANTIBODIES

A

Anti-centromere antibody

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21
Q

Microscopic Polyangiitis (MPA) ANTIBODIES

A

Perinuclear/protoplasmic-staining antineutrophil cytoplasmic antibodies (p-ANCA)

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22
Q

Mixed connective tissue disease ANTIBODIES

A

Anti-U1RNP antibody (speckled pattern)

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23
Q

Myasthenia Gravis ANTIBODIES

A

Anti-Ach Receptor Antibody

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24
Q

Pernicious anaemia ANTIBODIES [2]

A

Antibody to:
- gastric parietal cells (90%)
- intrinsic factor (50%)

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25
Q

Polymyositis ANTIBODIES

A

Anti-Jo-1 (t-RNA Synthetase)

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26
Q

Primary biliary cirrhosis ANTIBODIES

A

Anti-mitochondrial antibody

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27
Q

Rheumatoid Arthritis ANTIBODIES

A

Anti-CCP Antibodies, Rheumatoid Factor (less specific)

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28
Q

Sjogren’s syndrome ANTIBODIES

A

Anti-Ro, Anti-La antibody (speckled pattern), 60-70% have positive RF

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29
Q

Systemic Lupus Erythematosus ANTIBODIES

A

Antibodies to dsDNA+ Histones (Homogenous) and Ro La, Sm, U1RNP (speckled)

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30
Q

Type 1 Diabetes Mellitus ANTIBODIES

A

Antibodies to Glutamate Decarboxylase and pancreatic β Cells

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31
Q

Wegener’s Granulomatosis (GPA) ANTIBODIES

A

Cytoplasmic antineutrophil cytoplasmic antibodies (c- ANCA)

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32
Q

Type IV hypersensitivity diseases

A

T1DM
Crohns
Rheumatoid Arthritis
Multiple Sclerosis
Contact dermatitis
Mantoux test

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33
Q

Type III hypersensitivity diseases

A

SLE
Polyarteritis Nodosa
Mixed Essential cryoglobulinaemia
Serum sickness

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34
Q

Type II hypersensitivity diseases

A

Haemolytic Disease of the Newborn (HDN)
Autoimmune Haemolytic Anaemia (+ ITP = Evan’s Syndrome)
Goodpasture’s Syndrome
Pemphigus Vulgaris
Graves’ disease
Myasthenia Gravis
Acute Rheumatic Fever
Pernicious Anaemia
Churg-Strauss Syndrome (eGPA)
Wegener’s Granulomatosis (GPA)
Microscopic Polyangiitis (MPA)
Chronic Urticaria

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35
Q

Type I hypersensitivity diseases [6]

A

Atopic dermatitis
acute urticaria
latex food syndrome
allergic rhinitis
food allergy
oral allergy syndrome

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36
Q

measure of mast cell degranulation

A

tryptase

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37
Q

cell findings in X-linked SCID

A

low/absent T cells and NK cells
normal or elevated B cells

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38
Q

cell findings in ADA deficiency

A

low/absent T cells and NK cells
low/absent B cells

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39
Q

defect causing X-linked SCID

A

common gamma chain (IL-2RG) of the IL-2 receptor

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40
Q

Cytokine for T cells

A

IL-2

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41
Q

Cytokine for B cell differentiation in plasma cells

A

IL-4

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42
Q

Cytokines that induce fever

A

IL-1 and IL-6

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43
Q

what hypersensitivity does skin prick testing assess

A

type 1 IgE mediated e.g. allergic rhinitis

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44
Q

what hypersensitivity does patch testing assess

A

type IV e.g. contact dermatitis

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45
Q

Gold standard for food allergy

A

double-blind, oral food challenge

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46
Q

anti RANKL drug

A

denosumab

prevents development of osteoclasts which have the RANK receptor

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47
Q

Which cytokine is important in the pathogenesis of rheumatoid arthritis, anyklosing spondylitis and inflammatory bowel disease?

A

TNF alpha

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48
Q

live attenuated vaccines

A

MMR
Varicella
BCG
Oral polio (sabine)
Yellow Fever

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49
Q

Inactivated vaccines

A

Influenza quadrivalent
Polio Salk
Cholera
Pertussis
Rabies
Hep A

typically for boosters
As the pathogen cannot replicate, it usually requires multiple booster shots to provide immunity.

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50
Q

Conjugated vaccines

A

Neissiera meningitidis
Haemophilus influenzae
Streptococcus pneumoniae

For encapsulated bacteria.
Consist of bacterial polysaccharides conjugated to an immunogenic toxin

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51
Q

Subunit vaccines

A

Hep B
HPV

typically for viruses
contains proteins found on the surface of the viruses in addition to an adjuvant

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52
Q

Toxoid vaccines

A

Diphtheria
Tetanus

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53
Q

DNA/RNA vaccines

A

SARS CoV 2

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54
Q

What is the specific antigen recognised by the immune system in Goodpasture’s syndrome?

A

Type IV collagen

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55
Q

p-ANCA target

A

Myeloperoxidase

UC, Eosinophilic Granulomatosis with Polyangiitis, Primary Sclerosing Cholangitis or Microscopic Polyangiitis

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56
Q

c-ANCA target

A

Proteinase-3
[C is the third letter of the alphabet]

Granulomatosis with polyangiitis (Wegner’s)

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57
Q

Reticular dysgenesis

A

It is an autosomal recessive condition characterised by:

Severe, life threatening infections shortly after birth
Profound sensorineural deafness
Deficiency of the myeloid and lymphoid cell lineages

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58
Q

Anti-alpha-4-beta-1 integrin (binds to VCAM1 and MadCAM1 to mediate rolling/arrest of leukocytes), inhibits T cell migration

A

Natalizumab

Relapsing-remitting MS, Crohn’s disease

Risk: JC virus infection causing progressive multifocal leukoencephalopathy

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59
Q

What is the most common inherited immunodeficiency?

A

Selective IgA def

A lack of IgA leads to infections of mucosal surfaces

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60
Q

calcineurin inhibition drugs

A

cyclosporine and tacrolimus

intracellular pro proliferative molecule; prevents T cell
proliferation/function via reduced IL-2 expression

Rejection prophylaxis
(transplantation), SLE, psoriatic arthritis.

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61
Q

What lymphocyte lineage does azathioprine predominantly inhibit?

A

T cells

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62
Q

immunosuppressant that particularly inhibits T cell activation and proliferation

A

azathioprine

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63
Q

what must be checked before starting azathioprine?

A

TPMT polymorphism

They cannot metabolise the drug putting them at risk of bone marrow suppression

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64
Q

HLA associations in coeliac disease

A

HLA-DQ2 (90%)
HLA-DQ8

Th1 response

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65
Q

treatment for Kostmann syndrome

A

regular injections of granulocyte colony stimulating factor, which increases myelopoiesis and increases neutrophil levels

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66
Q

HLA association in Graves

A

HLA-DR3

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67
Q

most common transfusion reaction to packed red cells

A

Febrile non-haemolytic transfusion reaction I

Caused by white blood cells releasing cytokines such as IL-1 during storage.

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68
Q

What protein is defective in X linked Severe Combined Immunodeficiency?

A

common gamma chain of IL-2R

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69
Q

A mutation in what protein is the most common cause of Hyper IgM syndrome?

A

CD40 (on B cells)

inability to class switch

risk of pneumocystitis

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70
Q

What is the basic pathophysiology of SLE

A

Due to the ineffective clearance of dead or dying cells from the body, leading to antibody complex formation.

When cells die, they are removed from the body by phagocytosis. If cells are not removed quickly, an immune response against antigens inside the cell may be mounted

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71
Q

drugs that blocks CD3 on T cells, mouse monoclonal antibody (OKT3)

Use?

A

Muromonab

Used to prevent active allograft transplant rejection

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72
Q

Anti-CD20 drug that depletes mature B cells (not plasma cells)

Use?

A

Rituximab

Lymphoma, rheumatoid arthritis, SLE

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73
Q

Anti-IL-6 receptor drug that reduces macrophage, T cell, B cell, neutrophil activation

Use?

A

Tocilizumab

Castleman’s disease, Rheumatoid arthritis

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74
Q

TNFalpha/TNFbeta receptor drug

also p75-IgG fusion protein, inhibits both cytokines.

A

Etanercept

Rheumatoid arthritis, Ankylosing spondylitis, Psoriasis and psoriatic arthritis

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75
Q

anti-IL-17A drug

A

Secukinamab

psoriasis, psoriatic arthritis, ankylosing spondylitis

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76
Q

drugs involved in IL-4 / 5/ 13 blockade treat which conditions?

A

Eczema, asthma, eosinophilic asthma

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77
Q

Inhibits phospholipase A2

A

prednisolone

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78
Q

tests for Sjogrens syndrome

A

Anti Ro and Anti-La
Schirmer test

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79
Q

what type of bacteria are you at risk of with chronic granulomatous disease?

A

Catalase positive

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80
Q

what pro inflammatory cytokine is released by T killer cells?

A

IFN gamma

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81
Q

what is the defect leading to cyclic neutropenia

A

gene coding for neutrophil elastase –> failure of neutrophil maturation

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82
Q

What is the role of Gp120 on HIV?

A

This receptor is responsible for initial binding to CD4 and a co-receptor, such as the CCR5 receptor.

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83
Q

What is the role of Gp41 on HIV?

A

Binding of gp120 exposes gp41.
gp41 then leads to fusion with the host cell membrane and viral entry into the cell.

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84
Q

Mutation in what cell surface receptor may confer immunity from HIV?

A

CCR5

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85
Q

HLA association of rheumatoid arthritis

A

HLA-DR4

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86
Q

NRTI

A

Zidovudine, Abacavir

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87
Q

Non-nucleoside reverse transcriptase inhibitor

A

Efavirenz

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88
Q

Protease inhibitor

A

Ritonavir

89
Q

Integrase inhibitor

A

Dolutegravir

90
Q

What is the confirmatory test for HIV infection?

A

Western blot after ELISA

91
Q

what is the defect in Bruton’s agammaglobulinaemia

A

BTK (tyrosine kinase gene) for B cell development

92
Q

what is released by neutrophils to attract other cells like macrophages?

A

IL-1

93
Q

What monoclonal antibody targets alpha4 integrin and is used in the treatment of relapsing remitting multiple sclerosis?

A

Natalizumab

94
Q

Diagnostic criteria for Common Variable Immunodeficiency

A

Decrease in serum IgG and a decrease in one of IgM or IgA.
There is a lack of antibody response to antigens or immunisation
More than 4 years old.

Treat with normal human immunoglobulin

95
Q

what IL is secreted by activated CD4+T cells or activated T killer cells

A

IL-2

96
Q

Treatment for Bruton’s

A

Normal human Ig

97
Q

Key features of brutons

A

There is a notable lack of lymphoid tissue (lack of tonsils and adenoids) or lack of lymphadenopathy during infections.

98
Q

what T cell response do parasites and helminths activate?

A

Th2 mediated by IL-4, Il-5, IL-13

99
Q

what T cell are implicated in the development of allergic diseases, such as asthma or eczema

A

T helper 2 cells

mediated by IL-4, Il-5, IL-13

100
Q

A correctable/reversible deformity suggests Jaccoud’s arthropathy which is part of which disease?

A

SLE rather than a diagnosis of rheumatoid arthritis.

101
Q

drug that binds to IL-12 and IL-23

A

Ustekinumab

psoriasis, psoriatic arthritis

102
Q

drugs that binds just IL-23

A

Guselkumab

psoriasis, psoriatic arthritis

103
Q

what cell line does mycophenolate mofetil inhibit

A

T cells

104
Q

which type of infections does a lack in IgA lead to?

A

mucosal surface infection e.g. Resp tract, ear, sinus

105
Q

what are people with IgA def at risk of?

A

autoimmune disease e.g. coeliac disease

106
Q

examples of adjuvants

A

Alum or Aluminium Hydroxide (prime naive B cells)
Bacterial products such as toxoids
Cytokines such as IL-1 or IL-2 In research
Freund’s complete adjuvant (dried Mycobacterium tuberculosis)

107
Q

Immunoglobulins may bind to cell surface receptors on viruses, to prevent viral binding and entry of human cells.

What is this function of immunoglobins known as?

A

neutralisation

108
Q

What is the full chromosomal abnormality found in DiGeorge syndrome?

A

22q11.2 deletion

109
Q

mechanism of hyper acute rejection

A

preformed antibodies against ABO therefore sensitisation must have occurred beforehand

110
Q

treatment for allergic rhinitis

A

nasal corticosteroids
oral antihistamines e.g. cetrazine (half life 6 hours)

111
Q

deficiencies in C2, C3 or C4 (classical pathway) predispose to

A

SLE

112
Q

how can the function of the complement system be quantified

A

CH50 or CH100 tests

test the ability of a serum to lyse sheep erythrocytes

113
Q

which Immunoglobulin is the most abundant in the serum

A

IgG

114
Q

when is IgG created in response to an infection

A

after 5 days

highly specific

115
Q

what are functions of IgG

A

Its functions include:
- activation of the classical pathway of complement via C1q
- neutralisation or antibody dependent cell-mediated cytotoxicity.

116
Q

how is the response to treatment of anaphylaxis monitored

A

mast cell tryptase (mast cell activation marker)

117
Q

What happens in graft versus host disease?

A

lymphocytes from a transplant donor attack cells and tissues of a transplant recipient.
Typically, this occurs when the recipient is heavily immunosuppressed (and cannot destroy the donor lymphocytes) or very young.

118
Q

where is most of the damage in GvHD

A

mucosal surfaces in the area of the transplant

119
Q

what drug may be used in GvHD

A

methotrexate

120
Q

HLA classes A, B and C, which MHC class

A

1

121
Q

HLA DR, DQ, which MHC class

A

2

122
Q

what are the most important HLA classes in terms of transplant

A

HLA DR > B > A

123
Q

in what fashion are HLA subtypes inherited

A

co-dominant (therefore all are expressed)

Up to 6 HLA subtypes may be inherited, 3 from each parent.

124
Q

Skin sign seen in polyarteritis nodosa

A

livedo reticularis

125
Q

what infection is polyarteritis nodosa associated with

A

Hep B

126
Q

what is the classical appearance seen in biopsy in polyarteritis nodosa

A

Rosary bead (small aneurysms in the arterial wall)

127
Q

where is the biopsy for polyarteritis nodosa usually taken?

A

sural nerve (calf)

128
Q

what type of hypersensitivity reaction occurs in polyarteritis nodosa

A

type 3

129
Q

what is the treatment for polyarteritis nodosa

A

prednisolone
cyclophosphamide

130
Q

CD14 is typically a marker of what type of immune cell?

A

monocytes/macrophages

131
Q

what does CD14 recognise

A

bacterial endotoxin lipopolysaccharide (LPS)

132
Q

What key molecule in involved in the pathophysiology of septic shock

A

bacterial endotoxin lipopolysaccharide

133
Q

Which type of immunoglobulin is primarily secreted into breast milk and is responsible for passive immunity in newborns?

A

IgA

134
Q

IgA structure

A

dimeric, 4 antigen binding sites

135
Q

main function of IgA

A

neutralisation

136
Q

treatment of mild urticaria during blood transfusion

A

non-sedating antihistamine

137
Q

What is the short-term treatment for severe, life threatening antibody mediated damage or dysfunction, for example myasthenic crisis, cyroglobulinaemia or antibody mediated rejection?

A

plasmapheresis

Plasmapheresis allows for blood to be cleared of harmful antibodies. This means it may be a short term treatment for Type II hypersensitivity reactions or diseases caused by antibodies.

138
Q

why must serum IgA levels be checked when investigating coeliac disease

A

Anti-TTG and anti-endomysial antibodies are IgA subtype, therefore a concurrent IgA deficiency (1 in 600) would give a false negative result.

139
Q

What is the only lymphocyte subset considered to be part of the innate immune system?

A

NK cells

140
Q

how do NK cells go about with their ting

A

NK cells can recognise either lack of MHC (a common tactic of viruses to avoid the immune system, by preventing MHC expression)

or an imbalance in numerous cell surface receptors. Imbalances in cell surface receptors suggests that the cell may be infected, cancerous or dying.

141
Q

features of Granulomatosis with polyangitis

A

rapidly progressive crescentic glomerulonephritis
bleeding (nose bleed, coughing blood due to lung cavitations) - 👃 🩸 IS KEY
elevated CRP
peripheral neuropathy

142
Q

most common cause of b12 def

A

pernicious anaemia

143
Q

CD19 is typically a marker of what immune cell?

A

B cells

144
Q

how is ANA detected

A

indirect immunofluroscence

145
Q

homogenous pattern of ANA staining

A

anti-dsDNA

146
Q

“speckled” pattern of ANA staining

A

anti-centromere antibodies and hence CREST syndrome.

147
Q

what other auto anitbody may be found in SLE

A

RF

148
Q

what other auto antibody may be found in SLE

A

RF

149
Q

what are the acute phase proteins

A

IL-1
IL-6
CRP

150
Q

which interleukins are pyrogenic

A

IL-1
IL-6

151
Q

where does CRP bind and what does it activate

A

binds to the surface of dead/dying cells
activates the classical complement cascade via C1q

152
Q

what is found on CSF electrophoresis of a patient with MS

A

oligoclonal bands of IgG

153
Q

What lymphocyte lineage does tacrolimus predominantly inhibit?

A

T cells

154
Q

What lymphocyte lineage does cyclophosphamide predominantly inhibit?

A

B cells

155
Q

when should you stop the transfusion in an allergic reaction

A

headache, severe widespread rash, airway involvement

156
Q

Which cell type secretes immunoglobulins?

A

plasma cells

157
Q

how is Transfusion Associated Circulatory (TACO) treated

A

diuretics

158
Q

how is Transfusion Associated Circulatory (TACO) treated

A

diuretics

159
Q

what malignancy is Sjogrens syndrome at greater risk of

A

Mucosa Associated Lymphoid Tissue lymphoma (of the parotid)

160
Q

What is the most abundant leukocyte found in peripheral blood?

A

neutrophils

161
Q

A tumour cell has mutated and no longer expresses endogenous peptides and MHC Class I on the surface. What immune cell would recognise and kill this mutated cell?

A

natural killer cells

162
Q

do natural killer cells express B or T cell receptors

A

neither

163
Q

Symptoms of TACO

A

shortness of breath (pulmonary oedema), peripheral oedema and hypertension.

164
Q

6 acute transfusion reactions

A

Anaphylaxis
ABO incompatibility
bacterial contamination
febrile non-haemolytic transfusion reaction
TACO
Transfusion related acute lung injury

165
Q

What virus is polyarteritis nodosa associated with?

A

Hepatitis B

166
Q

which complement deficiencies are most likely to cause symptoms

A

C5b, C6, C7, C8 and C9 deficiencies are most likely to cause symptoms.

all involved in the MAC complex

167
Q

Infections by what type of bacteria are more common in patients deficient in the complement protein C9?

A

Encapsulated bacteria include meningococcus (Neisseria spp.), Haemophilus spp. or pneumococcus (Streptococcus spp.)

168
Q

What blood product is most commonly contaminated by bacteria?

A

platelets

169
Q

max time period an infusion can occur for

A

4 hours

170
Q

what type of collagen is a major component of kidney and lung basement membrane

A

type IV collagen

171
Q

what two organs can Goodpastures affect

A

kidneys (glomerulonephritis)
lungs (pulmonary haemorrhage)

172
Q

which fruits are commonly cause symptoms in latex food syndrome

A

banana
pineapple
avocado

173
Q

what is the effect of histamine binding to H1 receptor on endothelial cell surfaces

A

vasodilation

174
Q

features of myasthenia gravis

A

weakness, fatiguability, double vision

175
Q

treatment of myasthenia gravis

A

neostigmine

176
Q

What primary immunodeficiency is suggested in a patient with recurrent infections with E Coli, Staphylococcus Aureus, Listeria spp, Klebiella spp, Serratia marcescens and Candida species?

A

Chronic Granulomatous Disease

these are catalase positive organisms

177
Q

oral vs oesophageal candidiasis

A

A white pseudomembrane which can be removed is highly suspicious for candidiasis. Often, it may be itchy, sore or bleed.
Oral candidiasis may be seen in patients with poor inhaler technique using inhaled corticosteroids for asthma or COPD.

Oesophageal candidiasis presents differently, usually with a difficulty in swallowing. In any patient with oral or oesophageal candidiasis, it is highly suspicious for an immunodeficiency - indeed oesophageal candidiasis is an AIDs defining illness.

178
Q

What autoantibody, sometimes detectable in Graves’ disease, is a useful clinical marker in monitoring thyroid cancer?

A

Anti-thyroglobulin antibodies

179
Q

What monoclonal antibody targets CD25 and is used in the prophylaxis and treatment of allograft rejection?

A

basiliximab

CD25, or the interleukin 2 receptor chain alpha, is one of the three components of the IL-2 receptor.

It used to be used in the treatment of allograft rejection, but now may be used for treatment of multiple sclerosis.

180
Q

what do drugs that target CD25 stop the proliferation of

A

T cells

CD25, or the interleukin 2 receptor chain alpha, is one of the three components of the IL-2 receptor –> T cells

181
Q

What disease is Tofacitinib used in? [3]

A

rheumatoid arthritis
psoriatic arthritis
ulcerative colitis

JAK1/3 inhibitor reduces the expression of pro-inflammatory cytokines that are responsible for cellular damage.

182
Q

what drug can cause a benign leukocytosis

A

corticosteroids
lithium

183
Q

inheritance of Kostmann syndrome

A

autosomal recessive

184
Q

What predilection do Kostmann syndrome babies have to form

A

abscess formation

185
Q

tightening of the skin on wrist, arm, trunk and around mouth

limited SS or diffuse SS?

A

diffuse

186
Q

Chimeric Antigen Receptor T cells example

A

tisagenlecleucel against CD19

used for B cell Acute Lymphoblastic Leukaemias or large B cell lymphomas

187
Q

which transciption factor do Treg express

A

FoxP3

188
Q

what does Treg secrete to suppress the immune response

A

secreting IL-10

189
Q

how can Treg inhibit the T cell response

A

inhibitory signal via CTLA4, competitively binding to CD28

190
Q

drug that inhibits Tregs

A

Anti-CTLA4 antibodies (Ipilimumab)

causing an increase in immune system function. Useful in cancers

191
Q

What monoclonal antibody targets CD52 and causes depletion of all lymphocyte subsets?

A

alemtuzumab

CD52 is found on both B and T cell lymphocytes at various stages of development.
Used for T cell lymphomas

192
Q

which cell is response for the white material in pus

A

neutrophils

193
Q

what cell has CD20

A

mature B cells

194
Q

What condition may be precipitated by mutations in NOD2/CARD15?

A

Crohn’s Disease

195
Q

antibody likely to be found in patient wtih SLE with recurrent clots

A

anti-cardiolipin

196
Q

Used to treat severe ankylosing spondylitis not controlled by NSAIDs

A

etanercept

197
Q

Used to treat malignant melanoma, involved in T cell checkpoints

A

ipilimumab or nivolumab

198
Q

differential diagnosis for anaphylaxis

A
  • C1 inhibitor deficiency (herediatory angioedema)
  • ACEi induced angioedema
  • anxiety
  • urticaria
199
Q

Woman with flushed face, problems breathing that has happened multiple times with enlarged liver

A

hereditary angioedema

200
Q

Can lead to development of post transplantation lymphoproliferative disease

A

Epstein Barr Virus

201
Q

Ankylosing spondylitis – they’ve tried NSAID and TNF inhibitor, what else can you target

A

IL-17

e.g. Secukinamab

202
Q

what conditions can be treated with CAR-T therapy?

A

B cell cancers

ALL
Non-Hodgkin lymphoma

203
Q

what CD does CAR-T therapy often target

A

CD19

204
Q

What is the effect of the gene mutation in familial Mediterranean fever?

A

increased IL-1 production

205
Q

Woman with periorbital purple rash (heliotrope) and rash on knees, which enzyme is elevated?

A

creatine kinase

dx: dermatomyositis

206
Q

two key features of dermatomyositis

A

Heliotrope rash with eyelid oedema
gottrons papules

207
Q

complication with cyclophosphamide

A

haemorrhagic cystitis

208
Q

which cells are inhibted by MHC-1

A

NK cells

209
Q

formula to express herd immunity threshold

A

1-1/R0

210
Q

What is the effect of the gene mutation in familial mediterranean fever?

A

increased IL-1production

211
Q

Drug that can be used in advanced melanoma and metastatic renal cancer

A

Ipilimumab
Pembrolizumab
Nivolumab

212
Q

What protein on HIV initiates binding on which protein of its target cell?

A

Gp120 on HIV binds CD4 on T helper cells.

After binding, it undergoes conformation changes to enable binding to co receptors on host cells namely CCR5 (macrophages or T cells) or CXCR4 (T cells)

213
Q

Which protein on HIV is prone to mutation

A

Gp120

214
Q

Cell numbers in BLS 1

A

Low CD8
Normal CD4 therefore normal antibody levels
Normal B cells

215
Q

Cell numbers in BLS 2

A

Low CD4
Normal CD8
Normal B cells

No antibodies produced as no CD4 to prime the B cells

216
Q

ALL flow cytometry markers

A

CD34= precursor/stem cells
CD3, 4, 8 = T cells
CD19, 20, 22= B cells
TdT

217
Q

AML flow cytometry markers

A

CD34= precursor/ stem cells
CD33, CD13, CD117, MPO= myeloid cells

218
Q

Which cancers have the translocation t(9;22)

A

CML and ALL

219
Q

what are the antibody levels in X-linked SCID, BLS 1 and BLS 2

A

X-linked SCID: low
BLS 1: normal
BLS 2: low

x-linked: no CD4 T cells to isotype switch
BLS 1: CD4 cells present to isotype switch
BLS2: no CD4 cells present to isotype switch

Year 5 (13 decks)

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