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!!Path Past Papers (COPY) > Immuno > Flashcards

Immuno Flashcards

1
Q

EBV and amoxicillin/ampicillin/cephalosporin

A

Causes hypersensitivity reaction in presence of EBV - not true allergy

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2
Q

Ibrutinib can be used in which leukemia?

A

CLL

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3
Q

Tx Psoriasis

A

Ustekinumab (anti IL-12/23)

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4
Q

Tx RA (not DDMARD/MTX)

A

Rituximab (anti CD20), anti-TNFa (etanercept or adalimumab), tocilizumab (anti-IL6)

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5
Q

Wegener’s with severe flare

A

Cyclophosphamide

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6
Q

Worsening Crohn’s, already on Azathioprine and Prednisolone, what tx?

A

Infliximab (Anti-TNFa)

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7
Q

Malignant melanoma medical treatment

A

Pembrolizumab

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8
Q

Rituximab

A

RA or Lymphoma

anti-CD20

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9
Q

Transplant drugs

A 
Tacrolimus, Cyclosporin
Azathioprine
Mycophenolate Mofetil
Antithymocyte globulin (ATG
Prednisolone
Basiliximab (anti-CD25/IL-2) (prophylactic)
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10
Q

Type I hypersensitivity

A

Allergy/Atopic eczema

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11
Q

Type II hypersensitivity

A

Auto-immune/auto-inflammatory e.g. Graves

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12
Q

Type III hypersensitivity

A

Complex mediated e.g. SLE

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13
Q

Type IV hypersensitivity

A

Delayed e.g. contact dermatitis, diabetes

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14
Q

CD40L associated

A

Hyper IgM

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15
Q

GPA’s other name

A

Wegener’s Granulomatosis

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16
Q

eGPA’s other name

A

Churg-Strauss Syndrome

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17
Q

Monitoring SLE

A

C3, C4

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18
Q

Chest and renal

A

Good-pasture’s classically but can be GPA/eGPA

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19
Q

Hyperacute rejection (transplant)

A

Minutes-hours

Pre-formed Abs activate complement
–> Thrombosis and necrosis

Prevent by cross-match and HLA typing

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20
Q

Acute cellular rejection (transplant)

A

Weeks-months

CD4 cells –> type IV hypersensitivity reaction –> cellular infiltrate

Tx: T-cell immunosuppression e.g. Steroids

Memory aid: T cell = T 4

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21
Q

Acute Ab-mediated rejection (transplant)

A

Weeks-months

B-cells --> antibodies --> attack vessels and endothelial cells --> vasculitis
Complement deposition (C4d)

B-cell immunosuppression & remove Abs

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22
Q

Chronic rejection (transplant)

A

Months-years

Various immune+non-immune mechs –> fibrosis, GN, ischaemia –> Tx: minimise organ damage

RF: multiple acute rejections, HTN, hyperlipidaemia

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23
Q

GvHD

A

Days-weeks (T cell mediated)

Rash, bloody D&V, & jaundice

Tx: Immunosuppress with steroids

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24
Q

Acute vascular rejection

A

4-6 days post transplant after xenograft - presents similarly to hyperacute

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25
Q

H1 vs H2 antagonisst

A 
H1 = antihistamines
H2 = reducing gastric acid
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26
Q

Itchy skin when running in cold for an hour

A

Acute urticarial –> H1 antagonist

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27
Q

Hereditary angioedema treatment

A

C1q esterase inhibitor (reduces swelling)

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28
Q

Measure of mast cell degranulation

A

Mast cell tryptase levels

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29
Q

Chemokine promoting eoosinophil growth

A

IL-5

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30
Q

Tingly mouth after eating apples, melons etc.

A

OAS (Sxs limited to mouth)

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31
Q

Woman with flushed face, breathing problems (happened multiple times) and hepatomegaly

A

Hereditary angioedema

Tx: C1 esterase inhibitor

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32
Q

Kid with rash on extensor surfaces, IgE mediated

A

Atopic dermatitis

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33
Q

Hypertensive and diabetic with angioedema - potential cause?

A

ACE inhibitor

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34
Q

Absent T cells and normal B cells

A

X-linked SCID

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35
Q

1m baby, serious bacterial infections
Normal CD8, no CD4
B cells present
IgM present, IgG absent

A

Bare Lymphocyte Syndrome (Type 2)

Absent expression of MHC Class II molecules

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36
Q 
Jaundiced 4m baby, FTT, recurrent infections
raised ALP, low CD4, defect protein regulates MHC class 2
A

Bare Lymphocyte Syndrome (Type 2)

Associated with sclerosing cholangitis –> jaundice

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37
Q

Recurrent strep. pneumonia

FHx of having it and dying young

A 
Complement deficiency
(Encapsulated organism)
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38
Q

Child with recurrent infections, improved with age, now delay in language and speech

A

DiGeorge

Immune function improves with age
Can be associated with lots of speech/language issues and LDs as well as rest of CATCH-22

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39
Q

Loss of the terminal complement pathway

A

Encapsulated organisms

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40
Q

Recurrent meningitis

A

Complement deficiency (C5-9)

Encapsulated organism e.g. Hib or N. meningitidis

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41
Q

Recurrent infections, negative NBT test

A

Chronic Granulomatous disease

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42
Q

PID causing atypical granulomas

A

IFNy/IL12 or receptor deficiency

Predisposed to mycobacterial infections
Inability to form granulomas hence atypical

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43
Q

Recurrent infections
negative NBT test
negative dihydrorhodamine test

A

Chronic Granulomatous disease

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44
Q

6m boy, sevete FTT & recurrent infections

No T cells, B cells normal

A

X linked SCID

45
Q

Alternative complement pathway components

A

Factor B, I & P

“BIP”

46
Q

Alternative complement pathway components

A

Factor B, I & P

“BIP”

47
Q

Lady with spinal fracture due to TB

A

IFNy/IL12 or receptor deficiency

Mycobacteria susceptible –> Pott’s disease

48
Q

Felty’s syndrome (3 features)

A

RA, neutropenia and splenomegaly

49
Q

Rheumatoid arthritis and splenomegaly

A

Felty’s

50
Q

Monocytes in peripheral skin cells

A

Langerhands

51
Q

Cells that express Foxp3 and CD25

A

Treg

52
Q

Responsible for killing cancerous cells + inhibited by MHC-I

A

NK cells

53
Q

PEP exists against (3)

A

Rabies, HIV, tetanus

54
Q

Routine vaccine that is not given to immunocompromised patients

A

MMR

If oral steroids in past 3 months delay vaccine

55
Q

Vaccine target HA

A

Influenza

56
Q

Every 5 years post splenectomy

A

Pneumococcal

57
Q

Adaptive response to HIV:

Neutralising antibodies against what?

A

anti-gp120 and anti-gp41

58
Q

Adaptive response to HIV:

Non-neutralising antibodies against what?

A

anti-p24 & gag IgG

59
Q

Co-receptor required for HIV entry into CD4

A

CCR5 & CXCR4

60
Q

HIV binding to CD4

  1. Initial binding
  2. Conformational change
  3. Co-receptors
  4. What are they co-receptors on?
A
  1. gp120
  2. gp41
  3. CCR4 & CXCR5
  4. Macrophages
61
Q

Intrastructural support for HIV

A

gag protein

62
Q

Chemokines which block CCR5 (inhibit HIV entry into cell)

A

MIP-1a, MIP-1b, and RANTES

63
Q

HIV enzyme that copies with errors

A

RT

64
Q

AIRE gene - which condition?

A

AIPS2 (APECED)

65
Q

FAS gene mutation causes which condition?

A

ALPS (autoimmune lymphoproliferative syndrome)

66
Q

MEFV gene, periodic abdominal pain and ascites

A

Familial Mediterranean Fever

67
Q

Nod2/CARD15

A

Crohn’s

68
Q

DR4 and CCP

A

RA

69
Q

HLA-B27

A

Ank spond

70
Q

What should you check before starting azathioprine?

A

TPMT levels (enzyme)

71
Q

Serum sickness = what type of hypersensitivity?

A

Type 3 Hypersensitivity

72
Q

Adult with bronchiectasis, recurrent sinusitis, diarrhoea and development of atypical SLE

A

CVID

73
Q

What does IPEX stand for?

A

Immune dysregulation (autoimmune conditions)
Polyendocrinopathy
Enteropathy
X-linked inheritance syndrome

Absolute deficiency of Treg cells (Foxp3 mutation)
BMT is only cure

74
Q

CTLA4 receptor on t cells

A

associated with AI conditions like diabetes and thyroid disease

75
Q

PTPN22

A

Tyrosine phosphatase associated with RA

76
Q

CTD screening antibody

A

ANA

77
Q

CGD treatment type

A

IFN gamma

78
Q

SE of cyclophosphamide

A

infertility

79
Q

SE of azathioprine

A

neutropenia (especially if TPMT is low)

80
Q

SE of cyclosporin

A

Hypertension

81
Q

SE of Mycofenolate Mofetil

A

Progressive multifocal leukencephalopathy (caused by JC virus)

82
Q

60yo develops rash while under general anaesthetic, what do you do?

A

Measure mast cell tryptase

83
Q

75yo man with hypertension, tongue and periorbital swelling. Cause of swelling?

A

ACEi

84
Q

Complement deficiency and nephritis factor

A

Membranoproliferative nephritis and bacterial infections

85
Q

C1q deficiency

A

Skin conditions, childhood onset SLE (severe), infections, kidney disease

86
Q

anti-CD25

A

Basilixumab

87
Q

anti IL12/23

A

Ustekinumab

88
Q

anti IL-6

A

Tocilizumab

89
Q

AI hep/PSC antibody

A

Anti smooth muscle Ab

90
Q

Goodpasteurs connective tissue thing

A

Type IV collagen

91
Q

Mouldy hay

A

EAA

92
Q

Oligoclonal bands of IgG on CSF with myelin basic protein

A

MS

93
Q

OKT3

A

A mab for hyperacute rejection

94
Q

Calcineurin inhibitor

A

Cyclosporin (reduces IL-2)

95
Q

Medication that inhibits DNA synthesis in an attempt to prevent proliferation of T cells (post transplant)

A

Azathioprine

96
Q

IVDU who has multiple aneurysms

A

Hep B is associated with PAN

97
Q

SLE pt develops bleeding from gums and nose bleeds, with low platelet count

  1. Antibody target
  2. name of condition developed
A
  1. Glycoprotein IIb-IIIa

2. Autoimmune thrombocytopenic purpura

98
Q

Drug that prevents cell replication by damaging DNA (B cells more than T cells)

A

Cyclophosphamide

Used in SLE, wegeners, leukemias, CTD

99
Q

CTLA4-immunoglobulin fusion protein

A

Abatacept (rheumatoid arthritis)

100
Q

Mycophenylate Mofetil MoA

A

Guanine synthesis (IMPDH is the enzyme)

101
Q

Kveim test

A

Sarcoidosis

102
Q

Test for HSP

A

immunofluoresence

103
Q

Increased CH50

A

acute inflammation e.g. RA

104
Q

Pot strep rheumatoid fever (mechanism)

A

Molecular mimicry

105
Q

1st exposure to allergen IL

A

IL-12

106
Q

Cyclosporin MoA

A

Calcineurin inhibitor

107
Q

Dermatomyositis appearance on immunofluoresence

A

Speckled (Anti-Jo1)

108
Q

Lipiduria

A

Minimal change disease (increase in lipids to try to maintain oncotic pressure)

109
Q

TNF-ß is central in diagnosis of which condition?

A

CREST

!!Path Past Papers (COPY) (6 decks)

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