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Immuno > IMMUNO > Flashcards

IMMUNO Flashcards

1
Q

What are the major criteria for the API

A

parental asthma, sensitization of aeroallergen, Dr dx of AD

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2
Q

What are the minor criteria for the API

A

food sensitization, >4% Eos, wheezing apart from colds

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3
Q

What is considered a positive API

A

one major OR two minor criteria

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4
Q

Chemokines important in AD

A
  • CTACK aka CCL27 (cutaneous T-lymphocyte attracting chemokine)
  • TARC (thymus and activation-regulated chemokine)
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5
Q

What does TSLP stand for?

A

TSLP: Thymic Stromal Lymphopoeitin

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6
Q

Which cells contain Birbeck Granules

A

Langerhans cells

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7
Q

Prolamin superfamily types of foods and proteins

A

seed storage proteins, lipid transfer protein, alpha-amylase/protein inhibitors

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8
Q

Cupin superfamily (may only give numbers)

A

7s vicillin and 11s globulins (7/11!)

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9
Q

PR10 protein family

A

Bet v 1, birch

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10
Q

Atopy leads to increased risk for which agents anayphlayxis?

A

My EX RADdy was a LATE IDIOt

  • Exercise induced anaphylaxis
  • Radiocontrast
  • Latex
  • Idiopathic anaphylaxis
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11
Q

Which agent does pre-treatment not help in anaphylaxis risk?

A

Latex

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12
Q

Which agents does pre-treatment HELP in anaphylaxis risk?

A

radiocontrast, cold and flueorescien-related anaphylaxis

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13
Q

Farmer’s lung

A

thermophilic actinomyteces (sacchropolyspora rectivirgula, thermoactinomyces vulgaris); Mycopolyspora - moldy hay, grain, compost

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14
Q

Bagassosis bacteria and what is the agent it’s found in?

A

Thermoactinomyceses sacchari; moldy sugar cane

- Think of a bag and a SACK (sach) of moldy sugar cane

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15
Q

Humidifier fever/AC lung

A

Thermoactinomyces (T. Vulgarin, T. sacchiri, T candidus); Klebsiella, Acanthamoeba
- KAT loves the humid AC

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16
Q

Hot tub lung

A

Mycobacterium avian complex (MAC) or Cladosporium - from contaminated water
“Mac clad into the Hot tub”

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17
Q

Basement shower lung

A

Epicoccum nigrum; mold growing in unventilated showers

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18
Q

Malt worker’s lung

A

aspergillus species

- exposure can be malt, tobacco, soy

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19
Q

Cheese worker’s lung

A

Penicillium casei - exposure to moldy cheese

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20
Q

Machine operators lung

A

Pseudomonas, Acinetobacter, Mycobacter

-PAM operates MY PSEUDO ACting

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21
Q

Bird fancier’s lung, pigeon breeder’s lung

A

Avian proteins - exposure to droppings, feathers, serum

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22
Q

Detergent worker’s lung

A

Bacillus subtilis

- also seen in egg worker

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23
Q

Woodworker’s lung

A

Alternaria - moldy wood dust

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24
Q

Winegrower’s lung

A

Botrytis cinerea - mold on grapes

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25
Q

Summer type HP

A

Trichosporium cutaneum - contaminated houses, common in Japan

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26
Q

El niño lung

A

Pezizia - exposure to mushroom fungus after heavy rainfall

- let’s eat pizza during el Nino

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27
Q

Saxophonist lung

A

Candida albicans

- Think Bill Clinton has a yeast infection

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28
Q

Wheat weevil lung/miller’s lung

A

Sitophilus - contaminated flour

- think sito –> silo, wheat in silo

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29
Q

Chemical worker’s lung

A

TDI (toluene diisocyanate), MDI (diphenylmethane diisocyanate)

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30
Q

Epoxy Resin worker’s lung

A

Phthalic Acid

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31
Q

Plastic Worker’s lung

A

Trimelittic anhydride

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32
Q

Cocamidopropyl betaine

A

in shampoos, facial cleaners and bath products; one of the MCC contact sensitivity

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33
Q

Paraphenylenediame is related to which occupation?

A

MCC cause of contact HSN in hair dressers

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34
Q

Glycerol thioglycolate

A

Permanent wave solution; one of the MCC contact sensitivity

- does not become less allergenic with washing hair out

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35
Q

Ethylenediamine dihydrochloride

What to avoid if sensitive

A

in topical creams; need to avoid nystatin, aminophylline, and piperazine antihistamines (meclizine and cyclizine)
- does NOT cross react with EDTA: ethylenediamine dihydrochloride

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36
Q

Allergen in Henna

A

paraphenylenediamine (same as hair dresser contact derm)

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37
Q

Only long term/prophylaxis medication for HAE?

A

Cinryze: plasma derived C1-INH

(I can see the CINRYZE (sunrise) in the long run”

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38
Q

Which HAE medication has a risk for anaphylaxis:

A

Kalbitor (kallikrien inhibitor ecallantide) - “Kalli has anaphylaxis”

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39
Q

Live Vaccines Mnemonic

A 
ROME Is MY Very Best Place to go AlwayS
Rubella/Rotavirus
Oral Polio
Measles
Endemic Typhus 
Mumps
Yellow Fever 
Varicella Zoster (chickenpox) and Herpes Zoster(shingles) 
BCG
Plague (Yersinia Pestis)
Adenovirus
Shingles
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40
Q

Which two sinuses have the most complications in sinusitis?

A

sphenoid, frontal

“My Sweet Friend is complicated”

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41
Q

Which sinuses are most likely to have polyps?

A

Ethmoid sinuses

- “PolEEps”

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42
Q

Which allergen is CRS w polyps more likely to be sensitive to?

A

DM

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43
Q

Kabuki syndrome: mutation and seen in which disease?

A

A type of CVID - KMT2D mutation

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44
Q

WHIM syndrome mutation

A

CXCR4 mutation AD - GOF

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45
Q

Where do neutrophil precursors arrest in severe congenital neutropenia

A

promyelocyte-myelocyte phase

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46
Q

Molecular defect for SCN1

A

ELANE defect - AD

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47
Q

Molecular defect for SCN2

A

GFII

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48
Q

Molecular defect for SCN3

A

HAX1

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49
Q

Molecular defect for SCN4

A

G6PC3

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50
Q

Molecular defect for SCN5

A

VPS45

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51
Q

Which 2 micro bugs is CGD NOT associated with?

A

Streptococcus PNA, Pneumocystis (PJP) infections

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52
Q

Which infectious bugs is CGD associated with? MUST KNOW ALL; also which type of infections? Mnemonic

A

CATALASE POSITIVE; S3CNAB Philly Franc G

  • staph aureus
  • serratia marcescens
  • salmonella
  • chromobacter violaceum
  • nocardia spp
  • aspergillus fumigatus; aspergillus nidulans
  • burkholderia cepacia
  • Philomegaria Fransicella
  • Granulibacter Bethesdensis
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53
Q

CCL5 : aka / receptor

A

CCL5 aka RANTES – receptor CCR 1, 3, 5

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54
Q

CCL11: aka / receptor

A

CCL11 aka Eotaxin – receptor CCR3

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55
Q

CCL17: aka / receptor

A

CCL17 aka TARC– receptor CCR4

1+7 = 8 / 2 = 4

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56
Q

CXCL8: aka / receptor

A

CXCL8 aka IL8 – receptor CXCR1, 2

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57
Q

Spina bifida antigens for latex

A

Hev b1, Hev b 3

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58
Q

Where does latex allergen come from?

A

Cytoplasmic exudate of the hevea brasiliensis tree, Hev b 1-13

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59
Q

Hev b 2 assoc food?

A

Bell pepper, olive

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60
Q

Hev b 5 assoc food?

A

kiwi, potato, sugar beet

5kpb

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61
Q

Hev b 6 assoc food?

A

banana, avocado, chestnut, sweet pepper

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62
Q

Hev b 7 assoc food?

A

Hev b 7 = “patatin like proteins”; potato and tomato

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63
Q

Hev b 13 assoc food?

A

Potato

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64
Q

MCC of biting insect systemic run?

A

Triatoma - painless bite

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65
Q

What do Asain Lady Beetle cross react with?

A

Asian lady beetle (Harmonia Axydris) - cross reactive with cockroach

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66
Q

Order of sinus development? Mnemonic

A

My Extremely Sweet Friend: Maxillary, Ethmoid, Sphenoid, Frontal

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67
Q

Sinus drainage - Mnemonic?

A

FM AM, PS SS
Frontal, Maxillary, Ant Ethmoid - Middle meatus
Post Ethmoids, Sphenoid - Sphenoethmoid recess=above Superior turbinate

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68
Q

What does the middle meatus open into?

A

Hiatus Semilunaris

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69
Q

Which mutation is seen in Myeloproliferative HES?

A

PDGFRB, FGFR1 rearrangements; Deletion of 4q12 –> FIP1L1-PDGFRA fusion

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70
Q

What is the mutation and inheritance in familial HES?

A

5q 31-33 , AD

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71
Q

Well’s syndrome is…

A

eosinophilic cellulitis

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72
Q

How do you treat myeloproliferative HES?

A

Imatinib: tyrosine kinase inhibitor

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73
Q

What is the ligand for CD117? (what is CD117 aka?)

A

CD117 aka C-kit - ligand is stem cell factor, which is also required for mast cell survival

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74
Q

What CD markers are mast cells in mastocytosis identified with?

A

+ CD2 AND/OR +CD25, +CD117

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75
Q

What is the spirochetal infection causing Lyme disease?

A

Borrelia burgdorferi

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76
Q

What tick does Borrelia burgdorferi infect?

A

Ixodes ricinus

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77
Q

Rx for Lyme?

A

Doxy, cefuroxime, amoxicillin (>8 years old)

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78
Q

Human Monocyte Ehrlichiosis infectious cause?

A

Ehrlichiosis chaffeensis

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79
Q

Principle vector tick for Ehrlichiosis is?

A

Amblyomma americanum

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80
Q

Treatment for Ehrlichiosis?

A

Tetracycline and chlroamphenicol

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81
Q

Human Granulocyte Anaplasmosis infectious agent?

A

Anaplasma phagocytophilum is infectious agent

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82
Q

Human Granulocyte Anaplasmosis vector?

A

Ixodes scapularis is Human Granulocyte Anaplasmosis vector

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83
Q

Infectious agent causing babesiosis?

A

Babesia microti

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84
Q

Babesiosis vector?

A

Ixodes scapularis

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85
Q

Babesiosis symptoms/lab findings

A

Babesiosis: fatigue, fever; hematologic and liver Abn

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86
Q

Is p-anca or c-anca more specific in Wegener’s (granulomatosis w polyangiitis)?

A

C-ANCA/PR3 (proteinase 3)

DONT CONFUSE WITH EGPA

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87
Q

Which vaccines are considered protein vaccines?

A

Tetanus and Diphtheria (T cell dependent)

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88
Q

Which vaccines are considered polysaccharide vaccines?

A

Meningococcal and Pneumococcal (Pneumovax); T cell independent

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89
Q

Which type of Ag do NKT and gamma/delta T cells respond to?

A

Lipid antigens

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90
Q

The meningococcal and pneumococcal vaccines are considered what type of vaccines?

A

Polysaccharide; conjugated

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91
Q

What are the cytokines of MHC1

A

IFN alpha, beta, gamma

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92
Q

What are the cytokines of MHC2

A

IFNgamma

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93
Q

Which components are part of the MHC1 processing pathway?

A

proteasome, TAP

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94
Q

Calnexin, Calreticulin, Erp57, and tapasin are “chaperone proteins” in which MHC pathway?

A

MHC1

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95
Q

Where on chromosome 6 are TAP proteins encoded?

A

Class 2 locus

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96
Q

Where on chromosome 6 are LMPs from the proteasome encoded?

A

Class 2 locus

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97
Q

What are components of the MHC2 processing pathway?

A

cathepsins, Ii (invariant chain), CLIP (class 2 invariant chain peptide), HLA-DM

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98
Q

What molecule removes CLIP for peptides to bind MHC2?

A

HLA-DM removed CLIP

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99
Q

MHC2 def: what factors is usually deficient?

A

transcription factors for MHC2: MHC2TA, RFX5, FRXAP, FRXANK

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100
Q

Types of infections in MHC class 1 def?

A

sinopulmonary, granulomatous skin lesions, necrobiosis lipoidica

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101
Q

Types of infections in MHC class 2 def?

A

diarrhea, hepatosplenomegaly, transaminitis, sclerosis cholangitis (Crypto); pulm infxn: PJP, encapsulated bacteria, herpes, RSV; meningitis

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102
Q

Treatment of MHC1 vs MHC 2?

A

MHC2: HSCT; MHC1: aggressive infection Rx

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103
Q

What is the inheritance of MHC 1+2?

A

AR

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104
Q

What 2 factors determine lymphocyte tolerance?

A

Antigen concentration and Antigen affinity determine tolerance; high [ ] and affinity promote negative selection

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105
Q

What markers do Tregs express?

A

Tregs: CD4, CD25, FOXP3

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106
Q

What is the other name for CD25?

A

IL2Ra chain

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107
Q

What 3 cytokines do Tregs depend on?

A

IL2, TGFB;

IL10 helps maintain tolerance

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108
Q

Which cytokines are released in super antigen stimulation?

A

IFNg and TNFa

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109
Q

What kind of cells express AIRE?

A

AIRE is expressed by thymus medullary epithelial cells

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110
Q

BAFF

A

TNF family member, signal for B cell homeostasis

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111
Q

What enzyme is class switching mediated by?

A

Class switching is mediated by AID instead of RAG

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112
Q

How much Ig does the adult human produce in 1 day?

A

2-3 grams of Ig per day

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113
Q

Which Ig fixes complement the best?

A

IgM fixes complement the best

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114
Q

Which Ig has the highest total body concentration?

A

IgA

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115
Q

Which Ig has the most daily production?

A

IgA

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116
Q

Best Ig for ADCC?

A

IgG1

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117
Q

IgG subtype with shortest half life?

A

IgG3

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118
Q

IgA1 vs IgA2 in location?

A

IgA1: serum and respiratory tract
IgAs: lower GI tract

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119
Q

Ig with shortest half life?

A

IgE: 2 days

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120
Q

Class switch recombination changes which region: V vc C?

A

Class switch changes C region

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121
Q

Somatic hypermutation changes which region: V or C?

A

Somatic hypermutation changes the V region

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122
Q

What kind of T cells does IL2 stimulate?

A

Antigen activated T cells; and Treg

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123
Q

Which chromosome is C1-INH on?

A

Chromosome 11 - SERPING1 gene

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124
Q

Molecular mimicry: Coxsackie B virus

A

Glutamic decarboxylase

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125
Q

Molecular mimicry: Hep B virus

A

Major Basic Protein

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126
Q

Molecular mimicry: HSV

A

Ach receptor

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127
Q

What are the 5 types of PRR?

A

LRR, RLR, Ddx, Pyphin, CLR

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128
Q

What does TIR stand for?

A

Toll IL-1R domain (on LRR)

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129
Q

Which TLR is triggered by influenza?

A

TLR10

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130
Q

Which TLR is triggered by flagellin?

A

TLR5 = flaggelin

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131
Q

Which TLRs are associated with Heat Shock proteins?

A

TLR 2, 4, 6 (all extracellular)

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132
Q

Which is the TLR that does not use IRAK4?

A

TLR3 does not use IRAK4/IRAK1/IRAK2

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133
Q

What is the next step after MyD88 stimulation in the pathway?

A

MyD88 –> IRAK4/2/1 –> TRAF6 –> NEMO –> NFkB

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134
Q

Which TLR is associated with CD14?

A

TLR 4 is associated with CD14 (there is a #4 in both)

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135
Q

Which NLR is associated with Crohn’s disease?

A

NOD2 is mutated in Crohn’s disease

- also the mutation in Blau’s syndrome

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136
Q

What does STING stand for?

A

STING: Stimulator of INF Genes protein; abn in SAVI

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137
Q

What does NALP stand for?

A

Nacht domain leucine-rich repeat and PYD containing proteins

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138
Q

What does RLR stand for?

A

RNA-sensing RIG-I-like receptors

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139
Q

What does SAVI stand for?

A

SAVI: STING-associated vasculopathy with onset in infancy

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140
Q

What kind of mutation leads to SAVI?

A

GOF mutations of STING leads to SAVI

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141
Q

What is the function of Dectin 1/2?

A

Dectin 1/2 is a CLR receptor: recognize the fungal cell wall B glucan to facilitate mold allergen uptake

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142
Q

What is the function of DC sign?

A

DC sign is a CLR receptor: receptor to facilitate entry for Ara h 1 / Der p 1/2

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143
Q

What is the function of mannose receptor?

A

Mannose receptor is a CLR receptor: recognizes candida; allows for entry of Ara h 1 / Der p 1/2

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144
Q

What happens when there is a breakdown CLR anti-candida pattern?

A

Chronic non-invasive candidate infections

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145
Q

What is the difference bw Dectin 1 and CARD9 mutation?

A

Dectin 1: strictly mucocutaneous

CARD9: some invasive infection, dermatophytes

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146
Q

What cells are CD3- and CD56 +

A

NK cells

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147
Q

Which cytokine do NK cells require for DEVELOPMENT?

A

NK cells require IL-15, EOMES

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148
Q

Which HLA is prominent in gestational trophoblasts?

A

HLA-G (babies say gaga)

- HLA-G and F are present on extravillous trophoblast to protect fetus from maternal immune rejection

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149
Q

Which lymphocyte is most prevalent in pregnant decidua

A

The NK cell

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150
Q

Which chromosome is KIR inherited on?

A

Chromosome 19

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151
Q

Which chromosome is MHC inherited on?

A

Chromosome 6 (order: Class II, III, I ; 2, 3, 1)

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152
Q

What are the transcription factors needed for ALL ILCs?

A

NIFL3, TOX, Id2 (NIFty TOXic IDeas)

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153
Q

What infections are TLR3 deficiency more prone to?

A

TLR3 def: HSV encephalitis; influenza cerebritis (CNS inflammation, decrease in IFN-lambda production)

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154
Q

What is the inheritance of TLR3 def?

A

AD

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155
Q

What is deficient in production in TLR3 def?

A

INF alpha, beta, lambda

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156
Q

UNC93B def inheritance?

A

AR

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157
Q

UNC93B infections?

A

HSV encephalitis

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158
Q

TRIF/TRAF3/TBK1/IRF3 def infections?

A

HSV encephalitis

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159
Q

What does Dectin1/2 induce in CMCC?

A

Induces Syk/CARD9

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160
Q

Which diseases present with Oculocutaneous albinism?

A

Oculocutaenous albinism: Chediak Higashi, Griscelli syndrome, Hermansky Pudlak

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161
Q

How to differentiate Chediak Higashi, Griscelli syndrome, Hermansky Pudlak ?

A

BLEEDING in Hermansky Pudlok because of platelet granule defect

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162
Q

CNKD1 mutation and inheritance?

A

GATA2 - AD

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163
Q

CNKD2 mutation and inheritance?

A

MCM4 (mini chromosome maintenance complex 4)- AR

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164
Q

FNKD1 mutation and inheritance; which cytokine?

A

FCGR3A (CD16) - AR

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165
Q

What is missing in GATA2 def? CD 56 dim or CD56 bright?

A

CD56 bright are missing from GATA2 def (CNKCD1)

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166
Q

What kind of killing is affected in FNKC def?

A

ADCC intact; spontaneous cytotoxicity decreased; EBV cells not killed

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167
Q

What are the Src family kinases?

A

lyn, lck, fyn

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168
Q

What are the Syk family kinases?

A

Syk, ZAP-70

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169
Q

What are the Btk family kinases?

A

Btk, Itk

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170
Q

What are the inhibitory phosphatases of ITIM?

A

SHP-1, SHP-2, SHIP

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171
Q

Generation of which molecule leads to the intracellular increase in Ca in the TCR pathway?

A

Generation of IP3 (Which is generated after PIP2 is hydrolyzed by PLCg and produces IP3 and DAG)

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172
Q

IL-12RB1 mutation leads to which type of infections?

A

IL-12RB1 def leads to salmonella and atypical mycobacteria

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173
Q

What kind of infections does IRAK4 def lead to ?

A

IRAK4 def: pyogenic infections: Strep pneumo

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174
Q

Castleman’s disease: hyper production of what and what symptoms?

A

Castleman’s disease: Hyper IL6 productions: fever, microcytic anemia, normal BM, hypo albumin, elevated CRP

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175
Q

What type of cell does IL2 promote and in which function?

A

IL2 promotes survival and function of Treg cells

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176
Q

IL5, what does it promote (cell and Ig)?

A

IL5 promotes eosinophils and production of IgA Ab

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177
Q

Which two cytokines promote IgE class switching?

A

IL4 and IL13

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178
Q

Which cytokines promotes mucus formation?

A

IL13

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179
Q

How does BAFF work?

A

Upregulates Bcl2 which is an anti-apoptotic protein

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180
Q

How does APRIL work?

A

Upregulates Bcl2 which is an anti-apoptotic protein

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181
Q

What is the basophil differentiating cytokine?

A

IL3 –> basophils

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182
Q

What is the other name for CD23 and what does it bind to?

A

CD23 (FceRII) binds to IgE AND B cells

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183
Q

What does the basophil activation test evaluate?

A

Basophil activation: evaluates for CD63 or CD203c

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184
Q

What is the tryptase measurement calculation?

A

> /=1.2x baseline tryptase + 2 microgram/mL

- proposed to assess for mast cell activation event

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185
Q

How to test for NK cell cytotoxicity?

A

Chromium release assay (Cr51); check for CD107a

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186
Q

Deficiency of what part of the complement system leads to recurrent encapsulated infections and autoimmunity?

A

Defects in early complement C1q, C2, C4, C3 –> encapsulated bacteria and autoimmunity

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187
Q

Deficiency of what part of the complement system leads to recurrent meningococcal infections?

A

Defects in terminal complement C5-C9 –> meningococcal infections

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188
Q

Which part of the IL2R makes it high affinity?

A

IL2Ra

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189
Q

What IL receptors is gamma chain (gc) a part of?

A

gc = IL2, IL4, IL7, IL9, IL15, IL21

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190
Q

What two components are part of the IL13R?

A

IL4Ra and IL13R

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191
Q

What two components are part of the TSLPR?

A

IL7Ra and TSLPR

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192
Q

IL-18 aka? Which IL is is similar to?

A

IL18 aka IFN-g inducing factor ; most similar to IL1b

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193
Q

Which adhesion marker does IL18 induce?

A

ICAM1

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194
Q

What diseases have elevated IL6?

A

Castleman’s dz; Atrial myxoma; MM; RA, JIA

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195
Q

IFNg deficiency inheritance and results in susceptibility to which types of infections?

A
  • AD STAT 1 deficiency

M. tb and other intracellular bacteria

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196
Q

What receptor does dupilumab act?

A

IL4Ra which is on IL4 and IL13

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197
Q

What are the chemokines for lymphocyte homing to LN?

A

CCL19/CCL21 –> CCR7

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198
Q

What are the chemokines for pro Th2 response?

A

CCL17/CCL22 –> CCR4 (seen more on Th2 cells)

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199
Q

What is the function of E selectin?

A

E selectin: on the endothelium; homing of T lymphocytes to peripheral sites of inflammation; E = extremity (far away/peripheral)

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200
Q

What is the function of L selectin?

A

L selectin; on Lymphocytes and Leukocytes; GLYCAM - to LN HEV; and MadCAM to PMN rolling

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201
Q

What is the importance of B integrin family a4b7?

A

Binds to MADCAM - important for gut homing

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202
Q

ICAM1 CD name

A

ICAM1 = CD54 (think 5=4 = 9, which is almost 10)

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203
Q

ICAM2 CD name

A

ICAM2 = CD102 (has a 2 in the name)

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204
Q

ICAM3 CD name

A

ICAM3 = CD 50 (3 and 5 both prime numbers)

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205
Q

ICAM4 CD name

A

ICAM4 = CD242 (242 has 4 and 4 is a multiple of 2)

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206
Q

What does ICAM1 bind?

A

LFA1, MAC1, rhinovirus

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207
Q

What does ICAM2 bind?

A

LFA1

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208
Q

What does ICAM3 bind?

A

LFA1 and CD18

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209
Q

What does ICAM4 bind?

A

LFA1 and CD18

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210
Q

What is the CD name for VCAM1?

A

VCAM1 = CD106

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211
Q

What does VCAM1 bind?

A

VCAM1 binds VLA4 - vascular

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212
Q

What does PECAM bind?

A

CD31 and CD38 - platelets

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213
Q

What is the CD name for PECAM?

A

PECAM = CD31 (which it also binds, and E looked like backwards 3)

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214
Q

What does MadCam bind?

A

MadCAM binds a4b7 - mucosa

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215
Q

What does NCAM bind?

A

Binds VLA4 (a4b1)

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216
Q

What is the CD name for NCAM?

A

CD56

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217
Q

What are the important chemokines in allergy?

A

CCL2, 5, 7, 11; CXCL8

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218
Q

What proteins inhibit the formation of MAC?

A

S protein and CD59

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219
Q

Which molecules are considered anaphylotoxins? Which is the most potent for basophil and mast cell degranulation?

A

C5a> C3a > C4a

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220
Q

What is C3a chemotactic for?

A

eosinophils ONLY

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221
Q

What is the CD name for CR1?

A

CR1 aka CD35

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222
Q

What is the CD name for CR2?

A

CR2 aka CD21 (#2 in both)

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223
Q

What is the other name for CR3?

A

CR3 aka Mac-1, CD11b/CD18

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224
Q

What is the other name for CR4?

A

CR4 aka gp 150/95, CD11c/CD18

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225
Q

What is the other name for CD46?

A

CD46 aka MCP = membrane cofactor protein

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226
Q

What is the other name for CD55?

A

CD55 = DAF (decay accelerating factor)

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227
Q

What is the other name for CD59?

A

CD59 = protectin

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228
Q

What is the ligand for CR1?

A

C3b, C4b, iC3b (B1)

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229
Q

What is the ligand for CR2?

A

C3d, iC3b, C3dg (D2)

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230
Q

What is the ligand for CR3?

A

iC3b and ICAM1

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231
Q

What is the ligand for CR4?

A

iC3b

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232
Q

What is the ligand for CD46?

A

C4b and capsid

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233
Q

What is the ligand for CD55?

A

C5b-8 and monomeric C9

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234
Q

How is properdin deficiency inherited?

A

X linked (all other complement def are typically AR)

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235
Q

What is the most common complement d/o seen in SLE?

A

C1q deficiency.

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236
Q

What is the most common AR agammaglobulinemia?

A

mu heavy chain

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237
Q

What is a common codominantly inherited blood disorder?

A

Blood typing (ABO)

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238
Q

ADA SCID T/B/NK?

A

ADA SCID = (T-/B-/NK-)

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239
Q

Reticular dysgenesis T/B/NK?

A

Reticular dysgenesis AKA AK2 (T-/B-/NK-)

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240
Q

RAG1/2 T/B/NK?

A

RAG1/2 T-/B-/NK+

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241
Q

Artemis T/B/NK?

A

Artemis T-/B-/NK+

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242
Q

Cernunnos and ligase IV: T/B/NK?

A

Cernunnos and ligase IV: T-/B-/NK+

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243
Q

Common gamma chain T/B/NK?

A

Common gamma chain: T-/B+/NK-

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244
Q

IL7Ra: T/B/NK?

A

IL7Ra: T-/B+/NK+

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245
Q

CD3 subunit def: T/B/NK?

A

CD3 subunit def: IL7Ra: T-/B+/NK+

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246
Q

Coronin 1-A def: T/B/NK?

A

Coronin 1-A def: T-/B+/NK+

- no thymus regress

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247
Q

CD45 tyrosine phosphatase def: T/B/NK?

A

CD45 tyrosine phosphatase def: T-/B+/NK+

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248
Q

What is the abn in reticular dysgenesis?

A

defect in mitochondrial adenylate kinase2

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249
Q

What are the Es of OmEnn syndrome?

A

Es: Erythroderma, Eosinophilia, Elevated IgE

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250
Q

Wiscott-Aldrich gene mutation?

A

WASP gene mutation - X-linked

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251
Q

At what age does alpha fetoprotein increase in Ataxia Telangiectasia?

A

Increased alpha fetoprotein after 6-12 months

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252
Q

CD40L deficiency inheritance?

A

X-linked - CD40L

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253
Q

CD40 deficiency inheritance?

A

Autosomal Recessive

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254
Q

NEMO deficiency inheritance?

A

X-linked

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255
Q

Which def one presents with neutropenia: CD40L, CD40, NEMO

A

CD40L

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256
Q

What are the two enzymes in B cells needed for class switching?

A

AID and UNG

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257
Q

XLP1 mutation?

A

X linked SH2D1A/SAP gene

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258
Q

XLP2 mutation?

A

X linked defect in XIAP gene

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259
Q

MAGT def?

A

XMEN: X linked immunodeficiency with mag defect

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260
Q

What is RALD and what mutation is seen?

A

RALD: RAS Associated Leukoproliferative Disorder: NRAS/KRAS mutation; nil DNTs

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261
Q

What is the mutation in APECED including which gene?

A

AIRE mutation, AR ; 21q22

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262
Q

IPEX mutation

A

X linked FOXP3 mutation

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263
Q

How is BTK mutation inherited?

A

BTK = X linked

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264
Q

How is mu heavy chain inherited?

A

AR - the most common of AR agammaglobulinemia

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265
Q

What are AD forms of agammaglobulinemia?

A

E47, AKA, E2A, TCF3

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266
Q

What is the function of BTK?

A

BTK phosphorylates PLCg2 - also present in monocytes and platelets and that is how you can screen for Btk bc these patients have no B cells.

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267
Q

CD27+ is on which type of cells

A

CD27+ are memory B cells

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268
Q

CD 27 are part of which cytokines family?

A

CD27 part of the TNF family of cytokines

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269
Q

CD21 aka and what is it’s function?

A

CD21 aka CR2 which is the C3d receptor ; C3b opsonizes Ag –> C3b degraded to C3d –> C3d ligand for CD21, which is part of the BCR complex (CD21-CD19-CD81)

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270
Q

What are the ligands for TACI?

A

Ligands for TACI receptor on B cells are BAFF and APRIL

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271
Q

What is the function of AID?

A

AID - deaminated cytosine to uracil (C->U); receptor editing function

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272
Q

What is the function of UNG?

A

Removes Us; function in receptor editing

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273
Q

How are CD21, CD19, CD81 defects inherited?

A

AR

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274
Q

What class of meds can cause IgA deficiency?

A

IgA def: anticonvulsants: phenytoin, carbamazepine, valproic acid

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275
Q

Which IgG subclass def is assoc with IgA def?

A

IgG2 subclass def

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276
Q

When is the IgG nadir in children?

A

IgG nadir is about 3-6 months (400mg/dL)

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277
Q

What results from a Lyst mutation?

A

Lyst mutation: primary and secondary granules fuse - giant granules (which is Chediak Higashi)

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278
Q

Which mutations cause lack of phagocyte secondary granules and lack of defensins?

A

C/EBPe mutation

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279
Q

What is the Rx for CGD?

A
  • antifungals: AZOLEs - decreased mortality
  • abx: BACTRIM ppx
  • INFg
  • steroids
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280
Q

What is the difference in neutrophil function (rolling, tethering, etc) in LAD1 vs LAD2?

A

LAD1: defect in adhesion, sticking vs LAD2: defect in rolling

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281
Q

What is the cytokine that induces mast cells?

A

SCF

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282
Q

What are the transcription factors for basophils?

A

C-EBPa and GATA-2

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283
Q

What are the contents of a basophil?

A

histamine, IL4, IL13, TSLP

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284
Q

How are mast cells and basophils different in how they mature?

A

Mast cells can mature in the periphery; Basophils leave the Bone marrow mature (BB = mature)

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285
Q

Can mast cells regranulate?

A

Yes - mast cells can regranulate

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286
Q

Which mast cell type is deeper in the tissue versus more superficial?

A

Deeper: MCtc; more superficial: MCt

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287
Q

Which mast cell responds to C5a?

A

MCtc (Basophils also respond to C5a)

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288
Q

Which mast cell responds to PAF?

A

MCt

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289
Q

Which mast cell responds to opiates?

A

MCtc

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290
Q

Which mast cell responds to substance P?

A

MCtc and MCt

- early phase mediator

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291
Q

Which mast cell responds to antigen?

A

MCtc

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292
Q

MCtc vs MCt: respond to which triggers?

A
  • MCtc: responds to more triggers (substance P, Ag, opiates, C5a)
  • MCt: responds to PAF
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293
Q

What cell responds to f-met-leu-phe?

A

basophils

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294
Q

What are the two cytokines tested in basophil activating test?

A

CD63 and CD203c

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295
Q

What is CD63?

A

CD63 on basophils - protein coated on the inside of secretory granules ; histamine degranulation

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296
Q

What is CD203c?

A

CD203c on basophils - ectoenzyme, cleaves nucleotides outside the cell; piecemeal degranulation

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297
Q

What is CD name for IL3R? (to help ID basophils on basophil activating test)

A

IL3R = CD123

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298
Q

What chemical do basophils not make?

A

Prostaglandins

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299
Q

Does omalizumab bind free or bound IgE?

A

omalizumab binds free IgE

300
Q

On which cell does omalizumab reduce IgE receptors on: mast cells of basophils?

A

Basophils, mast cells, DC, monocytes

301
Q

What type of tryptase is released with anaphylaxis? *****

A

B tryptase is released with anaphylaxis

302
Q

What are the dx criteria for cutaneous mastocytosis?

A

1 major + 1 minor; MAJOR: typical skin lesions assoc w Darier’s sign. MINOR: bx shows increased mast cells OR activating KIT mutation in bx

303
Q

True or false: Scabies can cause eosinophilia

A

True, scabies can cause hypereos

304
Q

What is the CD marker for selectin?

A

CD62 P, E, L

305
Q

Common gamma chain inheritance?

A

X linked

306
Q

What is the side effect of mepolizumab?

A

Herpes zoster - consider immunizing beforehand

307
Q

Which biologic has adverse side effect of candidiasis?

A

Secukinumab (used for psoriasis, IL17A is the target) - blocks the IL17 pathway leading to candidiasis

308
Q

Which biologic has a side effect of niesserial infections?

A

Eculizumab (C5 inhibitor, used for PNH, aHUS), blocks C5 and terminal complement pathway

309
Q

Which biologic has alpha gal picture?

A

Cetuximab (EGFR blocker), makes IgE Ab to galactose-a-1, 3-galactose, sensitization to the lone star tick

310
Q

Zinc deficiency clinical phenotype?

A

periorificial and aural (limbs) dermatitis, alopecia (loss of hair) and diarrhea

311
Q

What is acrodermatitis enteropathica, inheritance, and what mineral is deficient?

A

AR metabolic condition affecting Zinc def: patients have zinc def phenotype: periorificial and aural (limbs) dermatitis, alopecia (loss of hair) and diarrhea

312
Q

What is the MAO of Rapamycin?

A

mTOR/AKT blockage

313
Q

Which medications are calcineurin inhibitors?

A

Tacrolimus, Sirolimus, and Pimecrolimus

314
Q

Felty syndrome

A

RA, Neutropenia, and Splenomegaly (FELTY RANS)

315
Q

How does location of eczema differ from infants/small children to adults?

A

Infants/small children: face, scalp, extensor (side opposite the joint) surfaces ; Adults: flexural surface

316
Q

What is the genetic defect in Comel-Netherton Syndrome?

A

SPINK5 - which encodes LEKT1

317
Q

LL-37

A

cathelicidin, antimicrobial peptide that is decreased in eczema; important in antiviral (think eczema herpeticum and vaccinatum)

318
Q

Which coxsackie strain is related to eczema coxsackium

A

coxsackievirus A6

319
Q

What is eczema vaccinatum?

A

disseminated live vaccinia virus from smallpox vaccination (no one gets smallpox anymore in US because it’s been eradicated)

320
Q

Which antimicrobial peptides are abnormally regulated in AD?

A

LL-37 (cathelicidin) and HBD2-3 (human B-defensins)

321
Q

Which two cold urticarias have a low CH50?

A

low CH50: cyroglobulinemia and leukocytoclastic vasculitis

322
Q

Systemic atypical acquired cold urticaria

A

Localized or generalized urticaria with cold exposure; negative ice cube test

323
Q

Cold dependent dermatographism

A

Dermographic whealing after stroking pre-cooled skin

324
Q

Cold-induced cholinergic urticaria

A

Exercise in cold environments leads to generalized urticaria

325
Q

Delayed cold urticaria

A

Urticaria develops 12-48 hours after application of cold provocation

326
Q

Localized cold reflex urticaria

A

Positive immediate urticarial response at a site distant to cold provocation

327
Q

FCAS: Fam cold auto-inflamm syndrome: Symptoms, inheritance, and mutation

A

Pseudourticaria, fever, arthralgia, conjunctivitis occurring 1-2 hours after cold exposure; AD mutation in NLRP3/CIAS

328
Q

PLAID: Phospholipase Cg2 associated def and immune dysregulation: symptoms and test?

A

Cold urticaria in childhood, Ab def, autoimmunity. Positive Evaporative cooling test

329
Q

How to physically test for PLAID?

A

Positive evaporative cooling test; neg. ice cube test

330
Q

What is the mutation in PLAID?

A

mutation in PLCG2 - AD

331
Q

Which type of solar urticaria is assoc with erythropoietic protoporphyria ?

A

Type 6 VI

332
Q

Which type of urticarias can be passively transferred by serum?

A

Acquired Cold (IgE, IgM, IgG, cryoglobulins), Solar (Type 1 and 4) and Dermatographism (IgE) (ADS)

333
Q

Factor I def.

A

AR, urticaria, decrease Factor I (C3b inactivator), dec C3 levels

334
Q

What is SERPING1?

A

SERPING1 = C1-INH gene in hereditary angioedema

335
Q

Treatment in Giant cell arteritis?

A

STEROIDS!! Need to decrease risk for visual loss

336
Q

What is the treatment for Kawasaki disease?

A

IVIG x 1 and aspirin: decrease the risk of aneurysms

337
Q

What diseases can polyarteritis nodosa be associated with?

A

Hep B or Hep C

338
Q

Which HLA is associating with Abacavir Sn?

A

Abacavir Sn in white = HLA-B*5701

339
Q

Which HLA is associating with Carbemazepine Sn in Han Chinese?

A

Carbepazepine in Han Chinese = HLA-B*1502

340
Q

Which HLA is associating with Carbemazepine Sn in Europeans?

A

Carbemazepine Sn in Europeans = HLA-B*3101

341
Q

Which HLA is associating with allopurinol reactions in Asians?

A

allopurinol reactions in Asians = HLA-B*5801

342
Q

Which HLA is associating with insulin, gold, and penicillamine reactions?

A

HLADR3

343
Q

Which cytokine is produced by the T-cells in AGEP?

A

IL8 / CXCL8

344
Q

Major determinant for PCN allergy

A

Major: BenzylpeniciLOYL (PrePen)

345
Q

Minor determinant for PCN allergy

A

Minor: Penicilloate, penilloate, benzylpenicillin (Pen G)

346
Q

Which cytokine is related to mucus gland hypertrophy?

A

IL9 –> mucous gland hypertrophy

347
Q

Which sinuses drain into the middle meatus?

A

Anterior ethmoid, frontal, maxillary

348
Q

Where is the OME complex located?

A

OME complex is located under the middle meatus, and that is why the Anterior ethmoid, frontal, maxillary all drain into the OME/middle meatus area

349
Q

Where do the posterior ethmoids drain?

A

Sphnoethmoid recess

350
Q

Do anti-leukotriene agents block the early or late phase?

A

anti-leukotriene block the early and the late phase

351
Q

Do antihistamines block the early or late phase reaction?

A

Early phase reaction

352
Q

What CT finding is seen in empty nose syndrome?

A

turbinates are very small

353
Q

Where is a haller cell located?

A

Haller cell = medial floor of the orbit (basically next to the nose and under the eye.

354
Q

What is the cell type in Western nasal polyps?

A

Eosinophilic

355
Q

What is the cell type in Asain nasal polyps?

A

Neutrophilic (elevated IL8)

356
Q

What is the first line treatment for acute rhinosinusitus?

A

Augmentin; then doxy or a resp flouroquinolone (moxi)

357
Q

How long does it take after pet removal for allergen to go back to normal levels?

A

about 4 months (16-20 weeks)

358
Q

Which nasal spray is ok to use in pregnancy?

A

Budesonide; B=baby (cromolyn is also safe in pregnancy)

359
Q

Which immunosuppressed group can receive the varicella vaccine?

A

Isolated B cell deficiency

360
Q

What is the rule for antibody containing antibody product and vaccines?

A

If a patient has recently received Antibody containing blood product, they must wait 3 months before receiving MMR and varicella (except zoster) containing vaccines. If patient got vaccine first, wait 2 weeks to give Ab product.

361
Q

What is the CI for getting Rotavirus vaccine?

A

CI are: immunodeficiency and h/o intussusception

362
Q

What is the vaccine rule for nonfunctional spleen?

A

Functional or anatomic asplenia: patient should have PCV13 and Menactra 4 weeks apart (cannot get them on the same day like other patients)

363
Q

What is the timing rule for live vaccines?

A

Either get the live vaccines on the same day, OR get them 4 weeks apart.

364
Q

Which vaccine is the exception to the live vaccine rule (which vaccine may be given)?

A

Rule is: get same day or 4 weeks apart; but can get Yellow Fever <30 days from MMRV containing vaccines

365
Q

What if a live vaccine is given < 4 weeks/28 days from last live vaccine?

A

Will need to repeat dose of 2nd vaccine given bc the response probably was not robust enough

366
Q

Which vaccines contain yeast?

A

Hep B (any Hep B containing vaccine)

367
Q

Which vaccine is contraindicated in egg allergy?

A

Yellow fever (MMR and influenza are not)

368
Q

Which vaccines contain Gelatin?

A 
Too Much Running for this Very Yellow Zebra: 
Typhoid
MMR
Rabies
Varicella Zoster 
Yellow Fever 
Zoster - herpes
369
Q

What mutation confers HIV resistance?

A

CCR5 deletion of bp32 confers resistance to HIV: dbl mutation = resistance, single mutation = slower progression
- CXCR4 and CCL3L1 mutations can also have affect on HIV burden

370
Q

What is lipocalin also known as?

A

lipocalin aka calycin

371
Q

What is a direct bronchoprovocation test?

A

Methacholine challenge

372
Q

What is an indirect bronchoprovocation test?

A

Exercise, cold air, mannitol, adenosine monophosphate

373
Q

What is considered a positive methacholine challenge test?

A

< 8 +; 4-16 is borderline

374
Q

Which cells make IL-12?

A

IL12 is made by myeloid cells, but not T cells or innate cells

375
Q

Conventional dendritic cells CD markers

A

CD1, CD11b/c, CD13, CD14

376
Q

Plasmacytoid dendritic cells CD markers

A

CD123

377
Q

Langerhans cells CD markers

A

CD11c, CD207

378
Q

Interstitial dendritic cells CD markers

A

CD11c, CD2, CD9, CD68

379
Q

Which lipid mediator is lower in AERD after COX inhibition, leading to bronchospasm?

A

PGE2 production goes down after COX1 inhibition, and there is no block of 5LO, leading to uncontrolled production of cysLT

380
Q

What is higher in the urine of AERD patients?

A

LTE4 (because of uncontrolled production of cysLT)

381
Q

Which CD markers does basophils have?

A

CD123, CD203c, CD63, CD69

382
Q

Which cells produce PGD2?

A

Only mast cells produce PDG2

383
Q

Platelet Activating Factor: preformed, lipid, or cytokine?

A

lipid

384
Q

heparin: preformed, lipid, or cytokine?

A

preformed

385
Q

chondroitin sulfate E: preformed, lipid, or cytokine?

A

preformed

386
Q

chymotryptase: preformed, lipid, or cytokine?

A

preformed

387
Q

carboxypeptidase: preformed, lipid, or cytokine?

A

preformed

388
Q

What is the gene mutation in Familial Cold AutoInflammatory Syndrome?

A

CIAS1, AD: Cold Induced Auto-Inflammatory Syndrome 1 gene

389
Q

What is the gene mutation in Muckle Wells Syndrome?

A

CIAS1, AD: Cold Induced Auto-Inflammatory Syndrome 1 gene

390
Q

Which cat allergen is related to Pork-Cat syndrome

A

Fel d 2: albumin

391
Q

Where does superantigen bind on the TCR (and CD name)?

A

Vb chain of the TCR (CDR4)

392
Q

Do superantigen bind to MHCI or MHCII?

A

Superantigen bind to MHCII (extracellular bacteria)

393
Q

What are the Staph superantigens?

A

SEA, SEB, (staph enterotoxins); TSST (toxic shock syndrome toxin)

394
Q

What are the strep super antigens?

A

SPE-A (Strep Pyogenes exotoxins)

395
Q

Where do Tregs develop?

A

Tregs develop in the thymic medulla

396
Q

Which TLR binds to mycoplasma and what is its ligand?

A

TLR6 - ligand is diacyl lipopeptides

397
Q

Which TLR binds to synthetic sources?

A

TLR 7/8 - imidazoquinoloones, synthetic, virus

398
Q

Which TLR binds to unmethylated CpG motifs of bacteria and viruses?

A

TLR 9

399
Q

Serum Sickness is which type of HSN d/o?

A

Serum sickness if type 3

400
Q

Which medications do you have to be careful of fluticasone causing Cushing’s?

A

Protease Inhibitors - namely Ritonavir

401
Q

Which PID is associated with fractures?

A

Hyper-IgE/Jobs/STAT3 deficiency - AD

402
Q

What is the major mouse allergen and which part of the mouse does it come from?

A

Mus m 1: Lipocalin: Urine of the male mouse

403
Q

In which eye disease can you see keratoconus?

A

AKC

404
Q

In which eye disease can you see anterior cataracts?

A

AKC

405
Q

Biopsy in dematographism

A

dermal edema with a few perivascular mononuclear cells., dilated blood vessels w perivascular cells, normal epidermis, no spongiosis of hyperplasia

406
Q

How to test HIV infected infant

A

PCR: at birth, 14-21 days, 1-2 months, and 4-6 months
ELISA: 12 and 18 months (baby still has maternal Ab until 18 mo)

407
Q

What is the prophylaxis HIV + infants are on from when until when?

A

PJP prophylaxis from 4-6 weeks to at least 1 year of age

408
Q

Which of the complement factors ONLY regulates the alternative pathway?

A

Factor H - is this right?

409
Q

What is the ligand for MADCAM?

A

a4b7 for gut homing

410
Q

What binds VCAM1?

A

VCAM1 = VLA4 (a4b1)

411
Q

What is the other name for VLA4?

A

a4b1

412
Q

What does NCAM bind?

A

NCAM = VLA4

413
Q

What is the CD marker for dendritic cells?

A

CD11b/c they all share EXCEPT pDC which have CD123

414
Q

Which TLR does RSV bind to?

A

TLR4

415
Q

What is the ligand for TLR6?

A

diacyl lipopeptides

416
Q

Which TLR had ssRNA as it’s ligand?

A

TLR8

417
Q

Pollutant involved in worse asthma?

A

Ozone / O3

418
Q

Pollutant skewing to Th2 ?

A

Diesel exhaust

419
Q

Pollutant that is by product of photochemical smog?

A

Nitrogen dioxide

420
Q

What complement tests are low in early complement deficiency (C1q, C1s, C2, C4)?

A

decreased CH50

421
Q

Which complement tests are low in C3 deficiency?

A

Decrease CH50, decreased AH50, decreased C3; + C3 Nephritic factor, IgG anti-C3 AutoAb

422
Q

Which complement tests are low in C5-C9 deficiency?

A

decreased CH50, decreased specific complement, decreased AH50

423
Q

Which complement tests are low in Factor B, D, properdin deficiency?

A

decreased AH50

424
Q

What is the genetic mutation in MBL deficiency?

A

MASP2 mutation

425
Q

Which OA agent is associated with welder, chemical/metal workers?

A

Platinum salts/potassium chromate (think welder holding fancy metal glass with banana juice)

426
Q

Which OA agent is associated with hairdressers?

A

Persulfate salts (ammonia persulfate) - think of a hairdresser holding a purse

427
Q

Which OA agent is associated with adhesives, epoxy resin, paint and plastics?

A

Phlthalic anhydride

428
Q

Which OA agent is associated with plastics/paint?

A

Trimellitic anhydride

429
Q

Which OA agent is associated with shellac, lacquer, plastics, cleaners?

A

Amines

430
Q

Which OA agent is associated with hospitals and labs?

A

Formaldehyde, Psyllium

431
Q

What phenotype are all the radiosensitive SCID, and name them all?

A

T-B-NK+ : ARTEMIS, CERNUNNOS, ligase IV, Nijmegen Breakage Syndrome
- Ataxia Telangiectasia is also radiosensitive

432
Q

HyperIgM1: mutation, inheritance, and germinal centers?

A

HyperIgM1: CD40L deficiency; X linked; absent germinal centers

433
Q

HyperIg3: mutation, inheritance, and germinal centers?

A

HyperIgM3: CD40 deficiency; AR; absent germinal centers

434
Q

HyperIgM2: mutation, inheritance, and germinal centers?

A

HyperIgM2: AID; AR; giant germinal centers and lymphoid hyperplasia

435
Q

HyperIgM4: mutation, inheritance, and germinal centers?

A

HyperIgM4: UNG; AR; giant germinal centers and lymphoid hyperplasia

436
Q

Which is the only HyperIgM syndrome that does not have AR inheritance?

A

HyperIgM1: CD40L, X linked

437
Q

Ataxia telangiectasia: inheritance and gene mutation?

A

ATM mutation; AR

438
Q

Chronic mucocutaneous candidiasis: inheritance and gene mutation?

A

AIRE mutation; AR

439
Q

APS-1: inheritance and gene mutation?

A

AIRE; AR

440
Q

APECED: inheritance and gene mutation?

A

AIRE; AR

441
Q

What is TNFS5?

A

TNFS5 = CD40L

442
Q

What is the gene defect in DiGeorge Syndrome?

A

22q11.2 (think CATCH 22, 90%) OR 10p13-14 (renal/GU defect)

443
Q

What is the autoimmune Ab that may be seen in DiGeorge Syndrome?

A

TUPLE1 (FISH)

444
Q

How is CTLA4 inherited?

A

CTLA4 is a haploinsufficiency

445
Q

Which disease would have low/absent CD15?

A

LAD2 would have abs/low CD15/Sialyl-Lewis X

446
Q

Which disease would have low/absent CD18, CD11b?

A

LAD1

447
Q

What gene is abnormal in LAD1?

A

ITGB2 gene: B2 integrin CD18 - beta chain - , CD11b abnormal

- ITGB2 - “IT Got Bad”

448
Q

What gene is abnormal in LAD2?

A

FUCT1, GDP-fucose transporter; CD15/Sialyl Lewis X

449
Q

What gene is abnormal in LAD3?

A

FERMT3; Kindlin3 (intracellular beta intern activator)

450
Q

What is CD79a?

A

Ig alpha chain on B cells, part of B cell receptor

451
Q

What is CD79b?

A

Ig beta chain on B cells, part of B cell receptor

452
Q

What is CD179?

A

B cell light chain

453
Q

Colophony - which industry?

A

Electronics industry (think of PHONE - electronic)

454
Q

Which mutation in AAT gives you increased risk of emphysema?

A

ZZ mutation

455
Q

Major Ag in honeybee venom?

A

Phospholipase A2 (Api m 1)

456
Q

What is vespula venom standardized by?

A

Vespula venom is standardized by the amount of hyaluronidase

457
Q

What does yellow jacket cross reaction with?

A

White faced hornet, yellow Hornet “Horney yellow jacket”

458
Q

What drugs decrease the clearance of theophylline?

A

(CIMZiA)

  • cimetidine
  • zileuton
  • allopurinol
  • also: macrolide Abx and cipro
  • decrease clearance = increased level
459
Q

What does Der p 23 bind to?

A

Chitin - chitin recognized by TLR2

460
Q

Which are the ice cube test NEGATIVE urticarias?

A
  • cold induced cholinergic urticaria
  • systemic cold urticaria
  • cold dependent dermatographism
  • FCAS: Familial Cold AutoInfl. Syndrome
  • PLAID
    (the syndromes, systemic and cholinergic)
461
Q

What disease can HUVs be associated with?

A

COPD

462
Q

Which DM and cockroach allergens are tropomyosin?

A
  • Der p 10
  • Per a 7
    Tropical Derm Purse 107
463
Q

Major allergen for vespids?

A

Antigen 5

464
Q

Which antigen can stimulate BOTH T and B cell proliferation?

A

Pokeweed Antigen

465
Q

What is the allergen for celery?

A

Api g 1 (A pig ate 1)

466
Q

Which milk allergen is a lipocalin?

A

Bos d 5: lactoglobulin

467
Q

What is the allergen Met e 1?

A

Met e 1 is a shrimp tropomyosin

468
Q

Which type of allergen involves the peel of the fruit?

A

lipid transfer protein

469
Q

Which class of allergen involves the pulp of the fruit

A

PR-10, Bet v 1

470
Q

What kind of urticaria is seen in PLAID?

A

Cold Urticaria

471
Q

What pairs with cashew?

A

Pistachio

472
Q

What pairs with walnut

A

Pecan

473
Q

In AD, does IFNg increase or decrease in the skin?

A

Decrease

474
Q

Which type of mutation is present in AD of filaggrin?

A

Loss of function mutation: filaggrin

475
Q

What is the treatment for disseminated eczema herpeticum?

A

Systemic acyclovir

476
Q

Patients on dapsone should be monitored for which side effects?

A
  • anemia
  • neuropathy
  • methemoglobinemia
477
Q

What Ab are present in Goodpasture’s disease?

A

Anti-Glomerular Basement Membrane (anti-GBM) Ab

478
Q

What is the most common side effect of nasal steroids?

A

local nasal irritation

479
Q

What is the time duration for chronic rhino-sinusitis?

A

Greater or equal to 12 weeks (EPOS 2012)

480
Q

Where do double positive T cells develop?

A

Thymus cortex

481
Q

Where do double negative T cell develop?

A

Thymus cortex

482
Q

Where do single positive T cells develop?

A

Thymus medulla

483
Q

Where do B cells develop before and after birth?

A
  • Before: Fetal Liver

- After: Bone marrow

484
Q

What is the CD marker for the common gamma chain?

A

CD132

485
Q

How is the function of IL4, IL5, and IL13 different?

A 
IL4 and IL13 --> class switch to IgE
IL5 --> Eos
486
Q

Are CD8 T cells involved in acute or chronic graft rejection?

A

CD8+ CD45RO + cells involved in acute graft rejection

487
Q

Which cytokine is produced by CD4 cells to help augment CD8 cells?

A

IL21

488
Q

Encapsulated Bacteria Mnemonic

A

Some Nasty Killers Have Serious CaBsule ProtEction

  • Strep Pneumo / Group B
  • Neisseria
  • Klebsiella
  • H flu
  • Salmonella Typhi
  • Cryptococcus Neoformans
  • Bordatella Pertusis/ Bacilus Anthracis
  • Pseudomonas/E coli (some)
489
Q

Dry/sunny/windy mold Mnemonic

A

AC2E and BO PITyed SMUT because of his DRESs

  • Alternaria
  • Curvalria
  • Cladosporium
  • Epicoccum
  • Botrytis
  • Pitospora
  • Smut spores
  • Dreschlera
490
Q

Rainy day mold mnemonic

A

AscosBosF:

  • ascosporidium
  • basidiospores
  • fusarium (F looks like R)
491
Q

Humid Night mold

A
  • ascosporidium

- basidiospores

492
Q

What does CTLA4 bind to?

A

CTLA binds to B7-1(CD80)/B7-2 (CD86)

493
Q

How is TGFb involved in Igs?

A

TGFb promotes IgA production by inducing B cells to switch to this phenotype

494
Q

Are B1 cells T cell independent or dependent? What other cells are they analogous to?

A

B1 cells = T cell 1ndependent , help with polysaccharide vaccines; analogous to delta T cells

495
Q

Are B2 cells T cell independent or dependent?

A

B2 cells = T cell dependent , help with protein vaccines

496
Q

Which chromosome is B2 microglobulin encoded on ?

A

Chromosome 15

497
Q

HLA-E function

A

NK cell recognition; NEK (neck)

498
Q

HLA-F function

A

Localized to ER and Golgi apparatus (EFG)

499
Q

HLA-H function

A

Iron metabolism (H–>I)

500
Q

MHC1 vs MHC2 deficiency: which disease has absent germinal centers

A

MHC2 deficiency has absent germinal centers

- both have AR inheritance

501
Q

What is the end result of receptor editing, and is it central or peripheral tolerance?

A

In B cells, CENTRAL tolerance ONLY in the bone marrow; if too reactive in the bone marrow –> rearrangement and production of new light chain

502
Q

FasL aka?

A

FasL aka CD98 –> Fas=FasL –> caspase activation

503
Q

What receptor is downregulated in peripheral B cell tolerance?

A

CXCR5 is down regulated in B cell peripheral tolerance, inhibiting homing and interaction w B cells

504
Q

Which are the purine nuceolotides?

A

A, G

505
Q

Which are the pyrimidine nuceolotides?

A

T, C

506
Q

What is the earliest B cell to produce Ig?

A

pre-B lymphocyte earliest to produce Ig

507
Q

Which of the IgG subclasses is the latest to reach adult levels?

A

IgG2 is the latest to reach adult levels

508
Q

Somatic Hypermutation involves which region of Ig?

A

V region

509
Q

Class switch recombination involves which region of Ig?

A

C region; C for class switch

510
Q

Lck is in which family and binds to what?

A

Lck in the Src family and binds to CD4 and CD8

511
Q

Fyn is in which family and binds to what?

A

Fyn is in the Src family and binds to CD3

512
Q

What SCID phenotype is Zap70 deficiency?

A

T-/B+/NK+

513
Q

Which cytokine especially responds to gram negative rods?

A

TNF especially responds to gram negative rods

514
Q

Which cytokine does IL-10 inhibit production of?

A

IL-10 inhibits production of IL-12 (IL-12 promotes TH1 cells)

515
Q

Which cytokine promotes B lymphocytes into Ab producers?

A

IL-6

516
Q

Which cytokine is required for NK cell differentiation and activation?

A

IL-15

517
Q

Which cytokine induces adhesion molecule ICAM1?

A

IL-18 induced ICAM1 and other adhesion molecules, leading to enhanced recruitment of leukocytes

518
Q

Which cytokine is important for resistance of Klebsiella pneumoniae?

A

IL-23 ; Kleb 23 (Klerb23)

519
Q

Which cytokine promotes differentiation and maintenance of T cells that produce IL-17?

A

IL-23

520
Q

Which cytokine receptors share common B chain?

A

IL3, IL5, GM-CSF

521
Q

Mutation in which gene confers malaria resistance?

A

GATA in DARC gene confers malaria resistance in African Americans

522
Q

Which selectins are affected in LAD2 deficiency?

A

P and E selectin

523
Q

What is the chemokine abn in Heparin Induced Thrombocytopenia?

A

CXCL4

524
Q

What are SIGLECS?

A

Sialic Acid binding Ig lectin: have ITIM, work to dampen the immune system response (Siglec-8 on Eos)

525
Q

What are the two types of gravitational samplers?

A

Durham and Settle (Gravity Settled in Durham NC after the storm)

526
Q

Which pollen sampler allows you to sample over an entire weekend?

A

Allergenco Air Sampler: Grab type sampler allows for sampling over an entire weekend

527
Q

Which pollen sampler orients to the wind?

A

Burkard sampler, which is a type of gravitational sampler

528
Q

In Factor H or Factor I deficiency, which complement tests would be low?

A

low CH50 and low AH50

529
Q

Which lymph organs is the production of IgE the highest?

A

tonsils and adenoids

530
Q

What body secretions is IgA secreted in?

A

BiMiSaSw:

  • bile
  • milk
  • saliva
  • sweat
531
Q

Where are the marginal zone B cells found?

A

marginal zone of the spleen

532
Q

Der p 1 size and homology?

A

Der p 1 : 24 kD and cysteine protease

533
Q

CXCR5: which cells bind and what is it’s ligand?

A

CXCR5 - expressed on mature naive B cells

CXCR5 binds CXCL13

534
Q

Function of DNA PK?

A

DNA-PK = DNA-dependent protein kinase complex: opens up hairpins at coding ends (like Artemis)

535
Q

Function of ku?

A

ku: binds broken DNA ends of coding segment and recruits DNA-PK

536
Q

Endonuclease function?

A

Endonuclease: removes nucleotides for junctional diversity

537
Q

DNA ligase function and other name?

A

DNA ligase aka XRCC4: ligate both coding and RSS ends

538
Q

Sphingosine - 1 - phosphate receptor (S1PR1)?

A

CD69: decreases surface expression of S1PR1

539
Q

Where is CD1 encoded?

A

CD1 encoded on chromosome 15 (like B2 micro globulin of MHC1)

540
Q

What is the CRTH2 receptor?

A

CRTH2 receptor is PGD2 receptor

541
Q

What are the transcription factors for mast cells vs basophils vs eosinophils?

A

mast cells: GATA2
basophils: GATA2
eosinophils GATA1

542
Q

Where do eosinophils mature (BM vs Tissue)?

A

Eosinophils mature in the bone marrow, just like basophils. Mast cells mature in the tissues

543
Q

Which cells is the trimeric form of FceRI on?

A

DC, monocytes, and eosinophils

544
Q

Which allergen cleaves FceRII (CD23)?

A

Der p 1 cleaves FceRII

545
Q

Does omalizumab block the early or late phase reaction?

A

Omalizumab blocks early and late reactions

546
Q

Where does IgE bind to FceRI?

A

IgE binds to FceRI by the alpha chain

547
Q

CD marker for C5a?

A

C5a = CD88

548
Q

Basophils are present in early or late allergic disease response?

A

Basophils = late response

549
Q

CD 69 and basophil release?

A

CD69 is NOT associated with degranulation; rather with TLR stimulation (NON-allergen stimulation)

550
Q

Primary granules of Eosinophil and what is their other name?

A

Charcot Leyden crystal aka Galectin-10

551
Q

What are the two main chemokines for neutrophils?

A
  • CXCL8 (IL8)

- LTB4 (B looks like 8; 4x2=8)

552
Q

Mnemonic for Epithelial cell layers

A

Before Signing, Get Legal Counsel

  • Basale (bottom)
  • Spinosum
  • Granulosum
  • Lucidum
  • Corneum
553
Q

Which cytokines do keratinocytes/epithelial cells secrete?

A

TSLP, GM-CSF, IL25, IL33 (IL33 part of the IL1 family)

554
Q

Where are hassall’s corpuscles located (be as specific as possible)

A

Hassall’s corpuscles are located in the thymus medullary

555
Q

What are the immune privileged sites of the body?

A

BAT: Brain, Anterior Chamber of eye, Testis

556
Q

Where are the largest number of lymphocytes found?

A 
#1: spleen
#2: bone marrow: 
#3: GI tract
#4: skin
557
Q

Which vessels carries lymphocytes into the spleen?

A

Splenic artery

558
Q

How much mucus is produced in an adult nose per day?

A

1 quart

559
Q

Where does the nasolacrimal duct drain?

A

Inferior meatus

560
Q

CCL27: aka and receptor?

A

CCL27 aka CTACK; receptor = CCR10

561
Q

Bullous Pemphigus or pemphigoid has prominent pruritus?

A

Bullous pemphigoid has prominent pruritus

562
Q

When does herpes gestationis/pemphigoid gestationis occur and symptoms?

A
  • occurs in 2nd trimester; pruritus and tense bullae
563
Q

What molecule are defensins abundant in?

A

Cysteine rich peptides, abundant in neutrophils

564
Q

Which phase of a clinical trial is submitted for FDA approval?

A
  • after phase 3
565
Q

In which phase of clinical trial is long term safety tested in?

A

Phase 4: “post marketing”, may find adverse reactions outside the clinical trials

566
Q

What are the phases of clinical trials and what are the checking for?

A

1: Safety
2: Efficacy
3: Confirm finding in large patient population –> FDA approval
4: Long term safety in a diverse population; “post marketing”

567
Q

Type I and Type II error difference?

A
  • Type I: no true difference: null hypothesis falsely rejected
  • Type II error: true difference: null hypothesis falsely accepted
568
Q

What % of eosinophils on a nasal smear in NARES?

A

> 20% eosinophils

569
Q

What are the bacteria that are involved in Atrophic Rhinits?

A
  • Klebsiella Ozaenae
  • S Aureus
  • Proteus Mirabalis
  • Coccobacillus faoetidus ozaenae
  • Pseudomonas Aeriginosa
  • E Coli
    “KOSA the CFO of PM wanted PeACE”
570
Q

When should AIT be started in AFRS?

A

AIT for fungal and non fungal allergens should be started 5-6 weeks post surgery

571
Q

Which eye pathologies are Horner-Tranta’s dots seen in?

A

VKC and AKC

572
Q

Order of eye diseases that Eos seen in conjunctiva (greatest to least)?

A 
#1 GPC
#2 VKC
#3 AKC
#4 SAC/PAC
"Giant Vernal AtopieS
573
Q

Cytokines in Acute and Chronic AD

A
  • Acute: IL4, IL13: “4 suits with 13 cards in each deck, including ACes”
  • Chronic IL5, IL12, IFNg: “ Education is chronic starting at 5 through Grade 12”
574
Q

What Vitamin deficiencies can be related to rash similar to Eczema?

A

Vitamin B6, niacin, Biotin (vitamin B7)

575
Q

Anti-CCP Ab indicate which disease and high/low severity?

A

Anti-CCP indicate more aggressive disease in RA (so does RF)

576
Q

What gene in asthma/atopy has cluster of IL4 that may affect severity?

A

Chromosome 5q

577
Q

What % of asthmatics can have their asthma triggered by NSAIDs?

A

10%

578
Q

What % of asthmatics also have GERD?

A

45-65%

579
Q

Obstruction parameters for asthma

A

Moderate 50-69%
Severe 35-49%
Very severe <35

Vs GOLD criteria for COPD :

  • Gold 0: symptoms only
  • Gold 1: FEV1 >/= to 80; mild
  • Gold 2: 50-79; moderate
  • Gold 3: 30-49; severe
  • Gold 4: <30 or < 50 with chronic respiratory failure present; very severe
580
Q

What factors increase FeNO levels ?

A

Increase FeNO levels:

  • Viral URI
  • Atopy/AR
  • Nitrite Rich foods: hot dog, salami, bacon, baloney
  • Spinach, green bean, carrot, beet: (2 green, 1 orange, 1 beet: Think of Barney (purple w green middle) eating carrots, spinach
581
Q

Foods with sulfites

A
  • think beer/wine/processed foods:
  • processed potato
  • dried fruit
  • sauerkraut
  • shrimp
  • lemon/lime
  • pickled peppers
  • maraschino cherries
  • pickled veggies
    “Beer, Wine, Lemon/lime”
582
Q

Linear epitope for allergens characteristics

A

Allergen is stable and persistent; more prolonged allergy

583
Q

Confirmational epitope for allergens characteristics

A

Allergen is unstable; mild transient allergy

584
Q

What are the two foods that there are 95% NPV cut off for?

A

Egg and milk

585
Q

What are the cut off for EGG for 95% NPV?

A

2y/o: 2/7

  • <2 y/o: IgE > 2
  • > 2 y/o: IgE> 7
586
Q

What are the cut off for MILK for 95% NPV?

A

1y/o: 5/15

  • <1 y/o: IgE > 5
  • > 1 y/o: IgE> 15
587
Q

Which peanut component goes along with oral allergy syndrome?

A

Ara h 8

588
Q

% of children who outgrow Peanut allergy and ages likely to outgrow

A

20% by age 6; unlikely to outgrow after age 10

589
Q

% of children who outgrow tree nut allergy and rule about outgrowing

A

9%; unlikely to outgrow if allergic to more than 1 TN

590
Q

LEAP study inclusions and cut offs

A
  • Egg allergy or severe eczema or both
  • Serum IgE: <0.35 –> home challenge; >0.35 –> SPT
  • SPT:
    • 0-2mm wheal : home intro
    • 3-7 mm wheal: supervised challenge
    • > /= 8mm wheal: allergic
591
Q

What % of anaphylaxis does biphasic response occur?

A
  • 20% of anaphylactic episodes have biphasic reaction
592
Q

How to differentiate exercise anaphylaxis and cholinergic urticaria?

A

Cholinergic urticaria can occur with Passive Warming

593
Q

How long will serum vs urinary histamine be elevated for?

A
  • serum: 5-60 minutes

- urinary: 24 hours

594
Q

How long it tryptase elevated for?

A
  • up to 5 hours
595
Q

What is the mechanism and reaction of oversulfated chondroitin sulfate?

A
  • contaminant in heparin
  • activation of contact system by C5a
  • rxn: hypotension, AE, no urticaria or pruritus
596
Q

Latex allergens specific for health care workers?

A

Hev b 5, 6, 7: “5-6-7 Health!”

597
Q

What is the key allergen for Dolichovespula arenaria / maculata (hornet)?

A

Dol m 5 - Antigen 5 (hornet)

598
Q

What is the key allergen for Vespula?

A

Antigen 5 - Ves v 5

599
Q

% of + venom ST with negative serum IgE

% of + venom serum IgE with negative ST

A
  • % of + venom ST with negative serum IgE: 20%

- % of + venom serum IgE with negative ST: 10%

600
Q

What is the official name for Bed Bugs?

A

Cimicids, Cimex lectularius

- bite In a row: “breakfast, lunch and dinner, all in a row”

601
Q

PUPPP: Pruritus Urticarial Papules and Plaques or Pregnancy - what areas does it spare? What is the Rx?

A
  • PUPPP: is erythematous papule within abdominal striae
  • SPARES: spares umbilicus, face, palms, soles
  • Rx: loratadine, cetirizine
602
Q

What percentage of new asthma diagnoses in the US are occupational ?

A

9-15% of new asthma diagnoses in the US are occupational

603
Q

Which test, if done at work and negative, excludes OA?

A

Methacholine challenge: should be done when a patient is symptomatic and at work

604
Q

Organic Dust Toxic Syndrome (ODTS)?

Is ODTS or farmer’s lung more common?

A
  • from dust exposure that contains toxin-producing fungi (grain, hay, textiles)
  • lack of ST to common fungi
  • ODTS is 50X more common than farmers lung
605
Q

Toxic fume bronchiolitis: what exposure?

A

Nitrogen dioxide and sulfur dioxide

606
Q

Silo unloader’s disease: what exposure?

A
  • acute exposure of NO2 leading to asphyxia
607
Q

Byssinosis: what exposure?

A
  • dust inhalation of cotton, flax, hemp
608
Q

What is Myroxylon pereirae?

A

Balsam of Peru

609
Q

What is the spot test for nickel called?

A

Dimethylglyoxime test

- pink = positive

610
Q

What flavorings does Balsam of Peru cross react with?

What plant does Balsam of Peru cross react with?

A
  • Cinnamon and vanillin
  • pine tree
  • may cross react with Colophony (also made from pine trees)
611
Q

Most common preservative in the US, and is it formaldehyde releaser or not?

A

Quaternium 15: formadehyde releaser

612
Q

What is colophony made from?

A

`Colophony made from pine trees

613
Q

What are the four classes of steroids?

A 
HyTriBetah17
A: hydrocortisone
B: triamcinolone 
C: betamethasone
D: hydrocortisone-17-butyrate
614
Q

Antifibrinolytic Side Effects

A
  • thrombosis
  • postural hypoTN
  • myalgia, myositis
  • n/v/d
  • muscle cramps
  • fatigue
615
Q

What SCID phenotype is PNP deficiency?

A

T-/B+/ NK+or-

616
Q

Which PID has skeletal abn and rachitic rosary?

A

ADA SCID : T-/B-/NK-

617
Q

What is PNP deficiency from?

A

defective purine nucleotide metabolism:

T-/B+/NK-+

618
Q

Which radiosensitive SCID has an absence of Hassall’s corpuscles on biopsy?

A

Nijmejen breakage syndrome

619
Q

What kind of blood products can SCID babies get?

A

CMV negative, irradiated

620
Q

RIDDLE Syndrome

A
  • RNF168 mutation
  • increased IgM and low IgG: “How funny it is like HyperIgM”
  • E Coli and HSV infection
621
Q

Job’s Syndrome/Stat3 deficiency inheritance

A

AD-STAT3

622
Q

DOCK8 inheritance

A

AR-DOCK8

623
Q

What is Tyk2 syndrome and how is it inherited?

A

AR-Tyk2

- similar to DOCK8 with disseminated BCG lymphadenitis and salmonellosis

624
Q

How is Wiskott-Aldrich inherited?

A

X-linked Wiskott-Aldrich

Think WIXcott

625
Q

What do the germinal centers in XLA look like

A

XLA germinal centers: small/absent lymphoid tissue, no germinal center

626
Q

PASLI disease

A

P-delta Activating mutation with Senescent T cells, LAD and Immunodeficiency

  • Recurrent infections starting in childhood, chronic EBV, increase in EBV lymphoma
  • MTOR is excessively activated
627
Q

Most familial CVID are inherited in which way?

A

Familial CVID = AD

628
Q

What class of drugs can cause IgG subclass deficiency?

A

Anti-epileptics

629
Q

Mutations in CGD

A
  • gp91 - CYBB, X-linked, 65%
  • gp47 - NCF1, AR, 25%
  • gp22 - CYBA, AR, 5%
  • gp67 - NCF2, AR, 5%
  • gp40, NCF4, AR, <1%
630
Q

What are the subunits of IL-12?

A

IL-12: p35, p40

631
Q

What are th subunits of IL-23?

A

IL-23: p19, p40

632
Q

Which cells are CCR5 on ?

A

Monocytes/macrophages

633
Q

Which cells are CXCR4 on?

A

T cells

634
Q

What can gp120 bind?

A

gp-120 can bind DC-SIGN

635
Q

Which chemokine is implicated in EOE?

A

Eotaxin-3; induced by IL-13

636
Q

How long should a patient be on PPI before checking biopsy for EoE?

A

8 weeks/2 months

637
Q

IgE value for 95% PPV for Peanut?

A

> /= to 14

638
Q

IgE value for 95% PPV for Fish?

A

> /= to 20

639
Q

Which layer of the GI tract can eosinophils be found normally?

A

Found in the lamina propria normally, not the surface epi

- Eos NOT normal in the esophagus

640
Q

Meeting how many of the criteria is needed for diagnosis of mastocytosis?

A

1 major and 1 minor
OR
3 minor

641
Q

Which TLRs are involved in killing mycobacterium?

A

TLR2 and TLR4

642
Q

What is the presentation of children with croup?

A
  • barking cough
643
Q

Which cytokines induce Th17?

A

IL1B, IL6, IL21, IL23, TGFB –> Th17

644
Q

Which immunomodulator requires a yearly eye exam?

A

Hydroxychloroquine

645
Q

What is the Ig involved in immunohematologic disease?

A

IgG

IgM usually involved in auto-immune disease

646
Q

How to prevent nonhemolytic febrile reactions?

A

Removed leukocytes before storage; helps decrease cytokines release of TNFa and IL1b which play a role

647
Q

How to prevent urticarial transfusion reactions?

A

Washing future blood products; IgE mediated

648
Q

How to prevent anaphylactic transfusion reactions?

A

Twice washing RBCs or use product from IgA deficient donor

649
Q

How to prevent GVHD transfusion reactions?

A

Gamma irradiation of cellular blood product

650
Q

Which receptor for NK cell and ADCC?

A

FcGRIIIA; binds ONLY to clustered IgG, not monomeric

651
Q

Which autoantibody is seen in Primary Adrenal failure?

A

Anti-CYP21A1 (enzyme necessary to make cortisol)

652
Q

Most common cause of nephrotic syndrome in adults?

A

Membranous nephropathy

653
Q

Most common cause of nephrotic syndrome in children?

A

Minimal change disease

654
Q

Most common glomerulonephritis in the world?

A

IgA nephropathy

655
Q

What is the treatment for scleritis?

A

NSAIDs, steroids, immunosuppression

656
Q

What does the pupil look like in Anterior Uveitis?

A

Miotic Pupil

657
Q

What is the main side effect of colchicine?

A

GI distress: pain, bleeding; rare: BM suppression

658
Q

What is the fever syndrome with the longest lasting fevers?

A

TRAPS (TNF receptor disorder) has fevers for up to several weeks

659
Q

Lofgren’s syndrome

A

sarcoid + rash (erythema nodosum) + joints

660
Q

Does C-ANCA correlate with disease severity in Granulomatosis with Polyangiitis?

A

No

661
Q

Is EGPA related to C-ANCA or P-ANCA?

A

EGpA = P-ANCA = myeloPeroxidase

662
Q

Which organ transplants do not require immunosuppression?

A

cornea, bone, joint tissue

663
Q

How long after a HSCT can one receive live vaccines?

A

2 years after HSCT can a patient receive live vaccines

664
Q

Which SCID does the best after HSCT?

A

T-/B+/NK- SCID - no conditioning (not including X-linked who have B cells present and non-functional)

665
Q

Which SCID does the worst after HSCT?

A

T-/B-/NK-

666
Q

Acute vs Chronic GVHD timeline?

A
  • Acute = first 100 days - CD8

- Chronic > 100 days - CD4

667
Q

Types of rejection and timing?

A
  • Hyperacute: on the table, minutes to hours; thrombosis
  • Accelerated: 2-5 days; thrombosis
  • Acute: 7 days - 3 months; CD8
  • Chronic: months to years; CD4
668
Q

Which of the stem cells take the longest to engraft?

A

Umbilical cord cells take the longest of the stem cells to engraft

669
Q

Which foods should CF patients avoid?

A

CF patients should avoid soy because of glutathione dysfunctions

670
Q

Which HLA , cytokines, and complement regulatory proteins are placental specific?

A
  • HLA-E, F, G
  • PGE2, IL-10, Il-4 - regulatory cytokines
  • CD46, DAF - prevent complement activation
671
Q

What time of day is pollen count the highest?

A

Early morning from 5-10AM

672
Q

Northern Grass Mnemonic

A

I grew up in the NORTH, where I got TO Relish Fresh Sweet Blueberries

  • Timothy
  • Orchard
  • Rye
  • Fescue
  • Sweet vernal
  • Bluegrass (Kentucky)
673
Q

Southern Grass Mnemonic

A

Then I moved to the SOUTH for LOVE, where by Boo Bought me Johnsons and a Prarie

  • lovegrass
  • bermuda
  • bahia
  • Johnson
  • prairie
674
Q

Which two allergen types cannot be mixed with pollens?

A

Mold and cockroach

675
Q

Which allergen extracts may be able to be placed with high protease activity extracts?

A

ragweed and cat in 50% glycerin

676
Q

Effective doses for standardized pollens?

A

RaCe to the GDP(B)

  • RW: 1000-4000 AU
  • Cat: 1000-4000 BAU
  • Grass: 1000-4000 BAU
  • DM: 500-2000 AU
  • Bermuda: 300-1500 BAU
  • Venom: 100mcg single; 300 mcg mixed
677
Q

What is the effective dose for dog allergen in AIT?

A

15 micrograms of Can f 1

“My dog weighs 15 lbs”

678
Q

What is the effective dose for short ragweed allergen in AIT?

A

6-12 microgram of Amb a 1

679
Q

What is the dose of glucagon you would use in a patient who is on B-Blocker and on AIT?

A

1-5mg glucagon IV push

680
Q

Dual H1 and mast cell mediators?

A

AlcAz OKe

  • alcaftidine
  • azelastine
  • olapatidine
  • ketotifen
  • epinastine
681
Q

Which second gen H1 blockers to use in pregnancy?

A
  • cetirizine, levocetirizine, and loratadine
682
Q

Which second gen H1 blockers to use in liver disease?

A

fexofenadine (My liver is Fine)

683
Q

Which second gen H1 blockers to use in kidney disease?

A

loratadine

684
Q

Which antihistamines give you the side effect of prolonged QT?

A

FIRST generation antihistamines (chlorpheniramine, diphenhydramine, doxepin, hydroxyzine) have this side effect in high doses
- blockage of potassium current –> prolonged QT –> torsade de points

685
Q

What are the cardioselective BB?

A

Cardioselective:

  • metoprolol
  • atenolol
686
Q

Which pregnancy category is montelukast?

A

Category B

Zileuton is category C

687
Q

Which anti-leukotriene agent may have liver toxicity?

A

Zafirlukast

688
Q

Which medications do you need to adjust while on Zileuton? ***

A 
Theos War Prop : 
Theophylline 
Warfarin 
Propranalol 
- Zileuton inhibitis CYP1A2 - need to decrease the dose of above medications bc Zileuton increases their serum concentration
689
Q

Muscarinic Receptor functions

A

M1: eosinophils in COPD; found in ganglia and mast cells
M2: Inhibitory rec on parasympathetic nerves: decreased in viral infections, increased Ach
M2: primary mediator of smooth muscle contraction in human airways - increases intracellular Ca, casting bronchoconstriction
– H1 blockers can have AntiAch effects via M3 receptor

690
Q

First line bronchodilator in COPD?

A

SAMA - ipratropium

691
Q

Steroid drug metabolism

A 
INCREASE LEVELS:
Cathy TROLls UP the RITunda looking to Kates Birth Control
- Clarithromycin
- troleandromyecin
- increase steroid levels 
- Ritonavir (Protease Inhibitor)
- Ketoconazole 
- OCP
692
Q

Does omalizumab increase or decrease total IgE?

A

Omalizumab increases total IgE but decreases free IgE

693
Q

Where does IgE bind on FceRI?

A

IgE binds at the alpha chain of FcERI

694
Q

What is the CD marker for CTLA4?

A

CD152

695
Q

Which disease has Hurthle cells?

A

Hashimoto’s aka Chronic Lymphocytic Thyroiditis

696
Q

What disease is associated with antibodies against P antigen?

A

Paroxysmal cold hemoglobinuria

697
Q

What cells enter the LN through high endothelial venules ?

A

Naive B and T cells enter through high endothelial venules

698
Q

Asplenic patient: Prevnar or Menactra first?

A

Get Prevnar first

699
Q

Thermoactinomyces sacchari vs vulgaris

A
  • Thermoactinomyces Sacchari: Bagassosis, mold sugar cane

- Thermoactinomyces vulgaris: Farmer’s lung

700
Q

Are CD4 or CD8 cells seen in the parotid biopsy of Sjogren’s disease?

A

CD4 cells

701
Q

How are prions removed from Ig replacement?

A

Cold ethanol fractionation (modified Cohn-Oncley cold ethanol fractionation)

702
Q

What are the 3 criteria for aspirin desensitization?

A

1: FEV1> 70% predicted
2: Montelukast started 1 week prior
3: Patient should continue treatment of ICS +/- LABA Rx

703
Q

What is the concentration of Epi for SQ/IM and IV administration?

A
  • SQ/IM: 0.01mg/kg of 1:1000

- IV: 0.01mg/kg of 1:10,000

704
Q

Which vaccines have neomycin?

A 
Neomycin: 
MVP
- MMR
- Varicella and Herpes Zoster 
- Polio
705
Q

Japanese Encephalitis Vaccine Reaction

A

Delayed Urticaria and angiodema

706
Q

MMR Vaccine Reaction

A

rash, thrombocytopenia, late fever (5-12 days)

707
Q

Tetanus Vaccine Reaction

A

Brachial neuritis, arthus reaction

708
Q

Pertussis Vaccine Reaction

A

Febrile seizures, inconsolable crying hypotonic hyporesponsive event
- vaccine contraindicated in patient who had encephalopathy <7 days after pertussis containing vaccine

709
Q

Yellow Fever Vaccine Reaction

A

Encephalitis

710
Q

Smallpox Vaccine Reaction

A

Myopericarditis, eczema vaccinatum

711
Q

TB skin test vaccine CI

A

MMR given same day as TB or 4 weeks apart

712
Q

Steroids and vaccines

A

<2 weeks on steroids, OK to get

>2 weeks >20 mg/day, wait 1 month

713
Q

Sulfa antibiotic versus antibiotic: what is the difference?

A

Non-antibiotic does not have the aromatic amine at the N4 position (and why there is little cross reactivity)
- Sulfa antibiotic: SO2NH2 moiety

714
Q

Periostin is produced in response to which cytokine?

A

IL13

715
Q

Reproducibility of FEV1 and FVC?

A

3 effort that should be within 150ml of each other

716
Q

What are the SLE Ab?

Which is the most Specific, which is the most Sensitive?

A

ANA - SNOUT - most sensitive
anti-dsDNA
anti-smith - SPIN - most specific

717
Q

When can you get Tdap vaccine if pregnant?

A

Tdap during third trimester

718
Q

How much bleach per water ratio for eczema?

A

1/3 cup 8.25% bleach per one tub

719
Q

Which cell types are CD62L on?

A

CD62L are on B, T, and NK cells

- on T memory cells, NOT effector cells ***

720
Q

Which specific CD marker B cells are missing in BTK?

A

CD19+ B cells

721
Q

NBT test : positive vs negative:

A

Positive: changes from yellow –> BLUE (can reduce NBT to formazan)
- negative: yellow - no change

722
Q

AH50 vs CH50: sheep vs rabbit

A
  • AH50: rAbbit - Alternative

- CH50: sheep jumping over clouds - Classical

723
Q

Which allergen confers honeybee and vespid cross reactivity?

A

Hyaluronidase

724
Q

Which DNA measuring method is used to quantify TRECS?

A

quantitative PCR

725
Q

Which viral infection can decrease the number of TRECs?

A

HIV1 - TREC numbers improve with HAART

726
Q

Radiation of XRAY vs CT?

A

CT has 60-120 times more radiation

727
Q

Food challenge: what amounts of wet and dry food?

A

Dry food: 10g
Wet food: 100ml
Double the amount for meat and fish

728
Q

IgE value for 95% PPV for Soybean?

A

30 kAu/L

729
Q

IgE value for 95% PPV for Wheat?

A

26 kAu/L

730
Q

IgE value for 95% PPV for TreeNuts?

A

15 kAu/L

731
Q

What are the NPV for ST for egg and PN?

A

= to 3mm

732
Q

What are the NPV for Serum IgE for egg, milk and PN?

A

= to 2 (no reaction history to peanut)

- reaction history to peanut =5)

733
Q

What’s the risk of peanut allergy in a child whose sibling is allergic to peanut?

A

7%

734
Q

Atopic patient with eczema and food allergy, risk of being allergic to PN?

A

30%

735
Q

Risk of being becoming allergic it cut out peanut?

A

1%

736
Q

Major grass families

A
  • Northern: Pooiedae

- Southern: Chloridiodae, Panicoideae (Chlorine in the Pain)

737
Q

How is aspirin made?

A

Aspirin is made from the bark of a willow tree

738
Q

Mnemonic for Indoor molds

A

Indoor CAMPR

  • Cladosporium (outdoor that moves indoor)
  • Aspergillus
  • Mucor
  • Penicillium
  • Rhizopsus
739
Q

Which allergen cleaves CD25?

A

Der p 1 and Der p 2

740
Q

Can DM mix with cockroach or mold?

A

Yes, DM which has high protease activity, can mix with cockroach or mold (but cockroach and mold cannot be mixed with pollens)

741
Q

IPEX-like disorder mutation

A

STAT5b deficiency; low CD25 and low Treg;

742
Q

What is the receptor for adenovirus?

A

CD46/MCP

743
Q

Lifetime prevalence of eczema for school children?

A

17%

744
Q

What immunodeficiency is seen in Ataxia Telangiectasia?

A

low IgA, low IgE

745
Q

How do lymphocytes get to GALT?

A

GALT has no HEV, so lymphocytes get there via afferent lymphatics

746
Q

What organization is responsible for AIT standardization?

A

CBER: Center for Biologics Eval and Research

747
Q

Is RF an IgM or IgG?

A

RF is an IgM against IgG

- think about how IgG is for antibody protection and IgM is for active Rheum or infection

Immuno (2 decks)

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