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PPQ PATH > Immuno > Flashcards

Immuno Flashcards

1
Q

Atypical granulomatous infection in previously healthy patient

A

IFN gamma, IFNgamma receptor deficiency, IL-12, IL-12 receptor
Salmonella, atypical
Mycobacteria, TB and BCG.

Patients are unable to form granulomata

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2
Q

6 days every 3 weeks; give G-CSF

A

Cyclic neutropenia

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3
Q

X linked tyrosine kinase - BTK gene

Failed production of mature B cells, no antibodies, symptoms 3-6 months

A

Brutons agammaglobulinaemia

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4
Q

congenital neutropenia=NO NEUTROPHILS

A

Kostmann

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5
Q

Rheumatoid arthritis patient with mycobacterial infections

A

Iatrogenic - TNF antagonists

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6
Q

Recurrent infections with negative NBT and dihidrorhodamine tests

A

Chronic granulomatous disease

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7
Q

Young girl with normal B cells, normal CD8+ but absence of CD4+ (jaundice and hepatosplenomegaly). kid unwell by 3 months of age:

A

Bare Lymphocyte Syndrome BLS. IgG would be low

(Answer type 1 and 2 exist, but more common to have type 2 with absent CD4 compared to type 1 with absent CD8).

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8
Q

Young boy with normal B cells and absence of CD8+ and CD4+

A

Di George

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9
Q

Immune deficiency that has improved with age but not mum is concerned about delayed speaking and language

A

Di George

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10
Q

Normal B and T cells, high IgM but absence of IgA, IgE and IgG– Pneumocystis Cariini and failure to thrive.

A

Answer – CD40L deficiency – this is hyper-IgM. Presents in first years of life with recurrent bacterial infections. X-linked; can’t class switch so no IgA and IgG

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11
Q

Patient with recurrent pneumococcal infections and meningitisforming membrane attack complex) can predispose to infection from encapsulated organisms.

A

C5-C9 Deficiency

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12
Q

A 6-month old boy with severe failure to thrive and recurrent infections, early infant death…etc… his T cells were undetectable and B cells were NORMAL even if you think they should be lower

A

(Answer – X-linked SCID) Failure to thrive, and deficiency in IL-2.

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13
Q

SLE. Membraneous lymphogromelulonephritis

A

C1q deficieny.

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14
Q

Marker of antibody mediated rejection

A

C4d

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15
Q

Most important to match for rejection

A

HLA: DR>B>A

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16
Q

Hyper-acute rejection (ABO incompatibility)

A

Preformed Ab activates complement

Thrombosis and necrosis, prevented by cross matching properly

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17
Q

Can lead to development of post transplantation lymphoproliferative disease. PTLD is a proliferation (rapid increase) of lymphoid (immune) cells. It can develop in people who are taking immunosuppressive drugs to prevent rejection of an organ or an allogeneic (donor) bone marrow or stem cell transplant

A

calceurin inhibitors

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18
Q

Causes progressive multifocal leukoencephalopathy

A

mycophenolaTe myofetil T cells

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19
Q

Mechanism behind GVHD Graft versus host disease (GvHD)

A

○ Donor cells attacking host
○ Days-weeks, rash, N+V, bloody diarrhoea, abdo pain, jaundice
○ Prophylaxis: methotrexate/cyclosporine
○ Treat with steroids

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20
Q

Mechanism behind antibody mediated rejection

A

○ Antibodies attack vessels
○ Exposure -> proliferation + maturation of B cells ->
○ Effector phase - antibodies bind to graft endothelium
(->vasculitis), two weeks after the actual transplant

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21
Q

Mechanism behind cellular rejection

A

○ T cells, type IV reaction
○ TReat with T cell suppressors
○ Donor APC presenting antibodies to recipient
○ Cellular infiltrate

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22
Q

Diffuse systemic scleroderma

A

scl-70 topoisomerase

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23
Q

Limited cutaneous scleroderma

A

anti-centromere

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24
Q

Anti phospholipid syndrome

A

anti-cardiolipin

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25
Q

epistaxis and haematuria

A

Wegener’s granulomatosis c-ANCA

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26
Q

Serum sickness - Type X reaction?

A

III reaction, following antibiotics, symptoms take 7-12h to develop

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27
Q

dry eyes and mouth antibodies

A

anti-Ro, anti-La

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28
Q

weight loss, anti TTG antibodies, anti-endomysial antibodies, steatorrhoea

A

Coeliac

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29
Q

CREST

A

Calcinosis, Raynaud’s, Esophageal dysmotility, Sclerodactyly, Telangiectasia

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30
Q

SLE

A

anti ds DNA

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31
Q

Pernicious anaemia

A

anti parietal cell > anti intrinsic factor

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32
Q

heamoptysis and haematuria

A

goodpasture, anti-collagen membrane IV

33
Q

How to monitor the activity of SLE?

A

C3 & C4 levels

34
Q

How to monitor a patient with HIV?

A

CD4 T lymphocyte cell count to assess immune function and plasma HIV RNA (viral load) to assess level of HIV viremia.

35
Q

How to monitor Autoimmune Hepatitis?

A

Anti-SM

36
Q

FAS pathway

A

REMEMBER FAS IN THE ALPS: ALPS syndrome, auto-immune lymph-proliferative syndrome, mutation in the FAS gene which steers lymphoproliferation of the immunce cells. ALPS is characterized by the production of an abnormally large number of lymphocytes (lymphoproliferation). Accumulation of excess lymphocytes results in enlargement of the lymph nodes (lymphadenopathy), the liver (hepatomegaly), and the spleen (splenomegaly). FAS drives high lymphocyte proliferation, thus BIG BIG ALPES of hepatmogelay, SPLENOMGALY, SPLENOMEGALY

37
Q

Mentioned MEFV gene, periodic abdominal pain and ascites.

A

Familial Mediterranean Fever

38
Q

abnormal production of IL-1 and the attack of the pleura surfaces

A

Familial Mediterranean Fever

39
Q

Nod2/CARD15

A

Crohns Disease

40
Q

Single gene mutation involving FOXp3 resulting in the abnormality of Treg cells (Which normally regulate T-helper cell function)

A

IPEX – (Immune dysregulation polyendocrinopathy enteropathy an X-lined) is caused by

41
Q

Autoimmune Polyendocrinopathy Syndrome Type 1 - AIRE mutation.

A 
2/3 components: 
(regulatory trush) 
chronic mucocutaneous candidiasis, hypoparathyroidism
adrenocortical insufficiency
Treg cell defect.
42
Q

Hereditary angioedema. A patient with some description [can’t remember details] of C1 inhibitor deficiency – she was still able to talk

A

C1 inhibitor deficiency C1 inhibitors, which are responsible for maintaining proper balance (homeostasis) in the complement system (specifically, keeping the C1 part of the classical complement pathway from being overactive). C1q esterase needed

43
Q

When they eat cherries, apples, pears and hazelnuts, they get itchy mouths

A

Acute Angiodema/ Oral Allergy Syndrome

44
Q

Hypertensive and diabetic, with angioedema

A

ACE inhibitors

45
Q

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

A

carcinoid

46
Q

A patient with some rash etc… after eating.

A

H1 oral antihistamines

47
Q

A patient with some rash and wheeze etc

A

IM adrenaline

48
Q

Cytokine responsible for promoting antibody synthesis

A

IgE

49
Q

Main cellular source of histamine

A

Mast cell

50
Q

How do you measure mast cell degranulation

A

Mast cell tryptase levels

51
Q

Chemokine responsible for promoting eosinophil growth

A

IL5

Secrete Igs, cytokines, present antigens

52
Q

Present antigens; migrate to lymph nodes when activated

A

Dendritic

53
Q

CD8+

A

Cytotoxic - MHC I

54
Q

In its immature form it is specialized to phagocyte pathogens, and in its mature form it is specialized to present to other cells

A

Monocyte (macrophages)

55
Q

Monocytes resident in peripheral skin cells

A

Langerhans cell

56
Q

Connective Tissue

A

Histiocyte

57
Q

Cells that express Foxp3 and CD25

A

Treg

58
Q

Differentiated B cells that produce immunoglobulins

A

The effect or cells

59
Q

Responsible for the killing of cancerous cells and are inhibited by MHC-I –

A

NK cells

60
Q

The multimetric immune modulator

A

ISCOM

61
Q

Can be used for RA depletes B-cells

A

Anti-CD20 Rituximab,

62
Q

Antibody against IL6 receptor

A

Used in caslteman’s, RA if not responding to methotrexate, sulfasalazine

63
Q

Pooled Ig used in the treatment

A

CVID

64
Q

Prophylaxis of allograft rejection, IV before + after Antibody against

A

IL-2Ralpha chain of CD25 Basiliximab

65
Q

Inhibits T-cell migration and may only be used against highly active remitting/relapsing MS

A

Anti Alpha-4 integrin Natulizumab

66
Q

Treatment options include; inhibition of IL-12/23, TNF-alpha and IL17a

A

Psoriasis

67
Q

Treatment options include; inhibition of IL-6, TNF-alpha and depletion of B-cells

A

Rheumatoid arthritis

68
Q

Antiproliferative agent - B>T cells affected) Alkylates guanine base of DNA, Damages

A

Cyclophosphamide

69
Q

IFNgamma

A

Chronic granulomatous disease

70
Q

Used to treat malignant melanoma, involved in T cell checkpoints

A

ANTI-PD1

71
Q

Used to prevent transplant rejection, by blocking T cell proliferation and activation

A

mycophenolate myofetil

72
Q

Vaccine that eradicated small pox

A

Vaccinia

73
Q

Antibody to p40 subunit of IL12 and IL23

A

Ustekinumab

74
Q

Antiproliferative agent - B>T cells affected

A

Cyclophosphamide

75
Q

Used to treat malignant melanoma, involved in T cell checkpoints

A

Pemrolizumab (ANTI-PD1)

76
Q

Hepatitis C, Hepatitis B, Kaposi’s sarcoma

A

Interferon alpha:

77
Q

Interferon beta

A

Relapsing MS

78
Q

influenza A only, targets M2 channel

A

Amantadine

79
Q

NA inhibitors

A

Oseltamivir, zanamivir, sialic acid

PPQ PATH (5 decks)

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