IMMUNO Flashcards
(747 cards)
1
Q
What are the major criteria for the API
A
parental asthma, sensitization of aeroallergen, Dr dx of AD
2
Q
What are the minor criteria for the API
A
food sensitization, >4% Eos, wheezing apart from colds
3
Q
What is considered a positive API
A
one major OR two minor criteria
4
Q
Chemokines important in AD
A
- CTACK aka CCL27 (cutaneous T-lymphocyte attracting chemokine)
- TARC (thymus and activation-regulated chemokine)
5
Q
What does TSLP stand for?
A
TSLP: Thymic Stromal Lymphopoeitin
6
Q
Which cells contain Birbeck Granules
A
Langerhans cells
7
Q
Prolamin superfamily types of foods and proteins
A
seed storage proteins, lipid transfer protein, alpha-amylase/protein inhibitors
8
Q
Cupin superfamily (may only give numbers)
A
7s vicillin and 11s globulins (7/11!)
9
Q
PR10 protein family
A
Bet v 1, birch
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
11
Q
Which agent does pre-treatment not help in anaphylaxis risk?
A
Latex
12
Q
Which agents does pre-treatment HELP in anaphylaxis risk?
A
radiocontrast, cold and flueorescien-related anaphylaxis
13
Q
Farmer’s lung
A
thermophilic actinomyteces (sacchropolyspora rectivirgula, thermoactinomyces vulgaris); Mycopolyspora - moldy hay, grain, compost
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
15
Q
Humidifier fever/AC lung
A
Thermoactinomyces (T. Vulgarin, T. sacchiri, T candidus); Klebsiella, Acanthamoeba
- KAT loves the humid AC
16
Q
Hot tub lung
A
Mycobacterium avian complex (MAC) or Cladosporium - from contaminated water
“Mac clad into the Hot tub”
17
Q
Basement shower lung
A
Epicoccum nigrum; mold growing in unventilated showers
18
Q
Malt worker’s lung
A
aspergillus species
- exposure can be malt, tobacco, soy
19
Q
Cheese worker’s lung
A
Penicillium casei - exposure to moldy cheese
20
Q
Machine operators lung
A
Pseudomonas, Acinetobacter, Mycobacter
-PAM operates MY PSEUDO ACting
21
Q
Bird fancier’s lung, pigeon breeder’s lung
A
Avian proteins - exposure to droppings, feathers, serum
22
Q
Detergent worker’s lung
A
Bacillus subtilis
- also seen in egg worker
23
Q
Woodworker’s lung
A
Alternaria - moldy wood dust
24
Q
Winegrower’s lung
A
Botrytis cinerea - mold on grapes
25
Summer type HP
Trichosporium cutaneum - contaminated houses, common in Japan
26
El niño lung
Pezizia - exposure to mushroom fungus after heavy rainfall
| - let's eat pizza during el Nino
27
Saxophonist lung
Candida albicans
| - Think Bill Clinton has a yeast infection
28
Wheat weevil lung/miller's lung
Sitophilus - contaminated flour
| - think sito --> silo, wheat in silo
29
Chemical worker's lung
TDI (toluene diisocyanate), MDI (diphenylmethane diisocyanate)
30
Epoxy Resin worker's lung
Phthalic Acid
31
Plastic Worker's lung
Trimelittic anhydride
32
Cocamidopropyl betaine
in shampoos, facial cleaners and bath products; one of the MCC contact sensitivity
33
Paraphenylenediame is related to which occupation?
MCC cause of contact HSN in hair dressers
34
Glycerol thioglycolate
Permanent wave solution; one of the MCC contact sensitivity
| - does not become less allergenic with washing hair out
35
Ethylenediamine dihydrochloride
| What to avoid if sensitive
in topical creams; need to avoid nystatin, aminophylline, and piperazine antihistamines (meclizine and cyclizine)
- does NOT cross react with EDTA: ethylenediamine dihydrochloride
36
Allergen in Henna
paraphenylenediamine (same as hair dresser contact derm)
37
Only long term/prophylaxis medication for HAE?
Cinryze: plasma derived C1-INH
| (I can see the CINRYZE (sunrise) in the long run"
38
Which HAE medication has a risk for anaphylaxis:
Kalbitor (kallikrien inhibitor ecallantide) - "Kalli has anaphylaxis"
39
Live Vaccines Mnemonic
```
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
```
40
Which two sinuses have the most complications in sinusitis?
sphenoid, frontal
| "My Sweet Friend is complicated"
41
Which sinuses are most likely to have polyps?
Ethmoid sinuses
| - "PolEEps"
42
Which allergen is CRS w polyps more likely to be sensitive to?
DM
43
Kabuki syndrome: mutation and seen in which disease?
A type of CVID - KMT2D mutation
44
WHIM syndrome mutation
CXCR4 mutation AD - GOF
45
Where do neutrophil precursors arrest in severe congenital neutropenia
promyelocyte-myelocyte phase
46
Molecular defect for SCN1
ELANE defect - AD
47
Molecular defect for SCN2
GFII
48
Molecular defect for SCN3
HAX1
49
Molecular defect for SCN4
G6PC3
50
Molecular defect for SCN5
VPS45
51
Which 2 micro bugs is CGD NOT associated with?
Streptococcus PNA, Pneumocystis (PJP) infections
52
Which infectious bugs is CGD associated with? MUST KNOW ALL; also which type of infections? Mnemonic
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
53
CCL5 : aka / receptor
CCL5 aka RANTES -- receptor CCR 1, 3, 5
54
CCL11: aka / receptor
CCL11 aka Eotaxin -- receptor CCR3
55
CCL17: aka / receptor
CCL17 aka TARC-- receptor CCR4
| 1+7 = 8 / 2 = 4
56
CXCL8: aka / receptor
CXCL8 aka IL8 -- receptor CXCR1, 2
57
Spina bifida antigens for latex
Hev b1, Hev b 3
58
Where does latex allergen come from?
Cytoplasmic exudate of the hevea brasiliensis tree, Hev b 1-13
59
Hev b 2 assoc food?
Bell pepper, olive
60
Hev b 5 assoc food?
kiwi, potato, sugar beet
| 5kpb
61
Hev b 6 assoc food?
banana, avocado, chestnut, sweet pepper
62
Hev b 7 assoc food?
Hev b 7 = "patatin like proteins"; potato and tomato
63
Hev b 13 assoc food?
Potato
64
MCC of biting insect systemic run?
Triatoma - painless bite
65
What do Asain Lady Beetle cross react with?
Asian lady beetle (Harmonia Axydris) - cross reactive with cockroach
66
Order of sinus development? Mnemonic
My Extremely Sweet Friend: Maxillary, Ethmoid, Sphenoid, Frontal
67
Sinus drainage - Mnemonic?
FM AM, PS SS
Frontal, Maxillary, Ant Ethmoid - Middle meatus
Post Ethmoids, Sphenoid - Sphenoethmoid recess=above Superior turbinate
68
What does the middle meatus open into?
Hiatus Semilunaris
69
Which mutation is seen in Myeloproliferative HES?
PDGFRB, FGFR1 rearrangements; Deletion of 4q12 --> FIP1L1-PDGFRA fusion
70
What is the mutation and inheritance in familial HES?
5q 31-33 , AD
71
Well's syndrome is...
eosinophilic cellulitis
72
How do you treat myeloproliferative HES?
Imatinib: tyrosine kinase inhibitor
73
What is the ligand for CD117? (what is CD117 aka?)
CD117 aka C-kit - ligand is stem cell factor, which is also required for mast cell survival
74
What CD markers are mast cells in mastocytosis identified with?
+ CD2 AND/OR +CD25, +CD117
75
What is the spirochetal infection causing Lyme disease?
Borrelia burgdorferi
76
What tick does Borrelia burgdorferi infect?
Ixodes ricinus
77
Rx for Lyme?
Doxy, cefuroxime, amoxicillin (>8 years old)
78
Human Monocyte Ehrlichiosis infectious cause?
Ehrlichiosis chaffeensis
79
Principle vector tick for Ehrlichiosis is?
Amblyomma americanum
80
Treatment for Ehrlichiosis?
Tetracycline and chlroamphenicol
81
Human Granulocyte Anaplasmosis infectious agent?
Anaplasma phagocytophilum is infectious agent
82
Human Granulocyte Anaplasmosis vector?
Ixodes scapularis is Human Granulocyte Anaplasmosis vector
83
Infectious agent causing babesiosis?
Babesia microti
84
Babesiosis vector?
Ixodes scapularis
85
Babesiosis symptoms/lab findings
Babesiosis: fatigue, fever; hematologic and liver Abn
86
Is p-anca or c-anca more specific in Wegener's (granulomatosis w polyangiitis)?
C-ANCA/PR3 (proteinase 3)
DONT CONFUSE WITH EGPA
87
Which vaccines are considered protein vaccines?
Tetanus and Diphtheria (T cell dependent)
88
Which vaccines are considered polysaccharide vaccines?
Meningococcal and Pneumococcal (Pneumovax); T cell independent
89
Which type of Ag do NKT and gamma/delta T cells respond to?
Lipid antigens
90
The meningococcal and pneumococcal vaccines are considered what type of vaccines?
Polysaccharide; conjugated
91
What are the cytokines of MHC1
IFN alpha, beta, gamma
92
What are the cytokines of MHC2
IFNgamma
93
Which components are part of the MHC1 processing pathway?
proteasome, TAP
94
Calnexin, Calreticulin, Erp57, and tapasin are "chaperone proteins" in which MHC pathway?
MHC1
95
Where on chromosome 6 are TAP proteins encoded?
Class 2 locus
96
Where on chromosome 6 are LMPs from the proteasome encoded?
Class 2 locus
97
What are components of the MHC2 processing pathway?
cathepsins, Ii (invariant chain), CLIP (class 2 invariant chain peptide), HLA-DM
98
What molecule removes CLIP for peptides to bind MHC2?
HLA-DM removed CLIP
99
MHC2 def: what factors is usually deficient?
transcription factors for MHC2: MHC2TA, RFX5, FRXAP, FRXANK
100
Types of infections in MHC class 1 def?
sinopulmonary, granulomatous skin lesions, necrobiosis lipoidica
101
Types of infections in MHC class 2 def?
diarrhea, hepatosplenomegaly, transaminitis, sclerosis cholangitis (Crypto); pulm infxn: PJP, encapsulated bacteria, herpes, RSV; meningitis
102
Treatment of MHC1 vs MHC 2?
MHC2: HSCT; MHC1: aggressive infection Rx
103
What is the inheritance of MHC 1+2?
AR
104
What 2 factors determine lymphocyte tolerance?
Antigen concentration and Antigen affinity determine tolerance; high [ ] and affinity promote negative selection
105
What markers do Tregs express?
Tregs: CD4, CD25, FOXP3
106
What is the other name for CD25?
IL2Ra chain
107
What 3 cytokines do Tregs depend on?
IL2, TGFB;
| IL10 helps maintain tolerance
108
Which cytokines are released in super antigen stimulation?
IFNg and TNFa
109
What kind of cells express AIRE?
AIRE is expressed by thymus medullary epithelial cells
110
BAFF
TNF family member, signal for B cell homeostasis
111
What enzyme is class switching mediated by?
Class switching is mediated by AID instead of RAG
112
How much Ig does the adult human produce in 1 day?
2-3 grams of Ig per day
113
Which Ig fixes complement the best?
IgM fixes complement the best
114
Which Ig has the highest total body concentration?
IgA
115
Which Ig has the most daily production?
IgA
116
Best Ig for ADCC?
IgG1
117
IgG subtype with shortest half life?
IgG3
118
IgA1 vs IgA2 in location?
IgA1: serum and respiratory tract
IgAs: lower GI tract
119
Ig with shortest half life?
IgE: 2 days
120
Class switch recombination changes which region: V vc C?
Class switch changes C region
121
Somatic hypermutation changes which region: V or C?
Somatic hypermutation changes the V region
122
What kind of T cells does IL2 stimulate?
Antigen activated T cells; and Treg
123
Which chromosome is C1-INH on?
Chromosome 11 - SERPING1 gene
124
Molecular mimicry: Coxsackie B virus
Glutamic decarboxylase
125
Molecular mimicry: Hep B virus
Major Basic Protein
126
Molecular mimicry: HSV
Ach receptor
127
What are the 5 types of PRR?
LRR, RLR, Ddx, Pyphin, CLR
128
What does TIR stand for?
Toll IL-1R domain (on LRR)
129
Which TLR is triggered by influenza?
TLR10
130
Which TLR is triggered by flagellin?
TLR5 = flaggelin
131
Which TLRs are associated with Heat Shock proteins?
TLR 2, 4, 6 (all extracellular)
132
Which is the TLR that does not use IRAK4?
TLR3 does not use IRAK4/IRAK1/IRAK2
133
What is the next step after MyD88 stimulation in the pathway?
MyD88 --> IRAK4/2/1 --> TRAF6 --> NEMO --> NFkB
134
Which TLR is associated with CD14?
TLR 4 is associated with CD14 (there is a #4 in both)
135
Which NLR is associated with Crohn's disease?
NOD2 is mutated in Crohn's disease
| - also the mutation in Blau's syndrome
136
What does STING stand for?
STING: Stimulator of INF Genes protein; abn in SAVI
137
What does NALP stand for?
Nacht domain leucine-rich repeat and PYD containing proteins
138
What does RLR stand for?
RNA-sensing RIG-I-like receptors
139
What does SAVI stand for?
SAVI: STING-associated vasculopathy with onset in infancy
140
What kind of mutation leads to SAVI?
GOF mutations of STING leads to SAVI
141
What is the function of Dectin 1/2?
Dectin 1/2 is a CLR receptor: recognize the fungal cell wall B glucan to facilitate mold allergen uptake
142
What is the function of DC sign?
DC sign is a CLR receptor: receptor to facilitate entry for Ara h 1 / Der p 1/2
143
What is the function of mannose receptor?
Mannose receptor is a CLR receptor: recognizes candida; allows for entry of Ara h 1 / Der p 1/2
144
What happens when there is a breakdown CLR anti-candida pattern?
Chronic non-invasive candidate infections
145
What is the difference bw Dectin 1 and CARD9 mutation?
Dectin 1: strictly mucocutaneous
| CARD9: some invasive infection, dermatophytes
146
What cells are CD3- and CD56 +
NK cells
147
Which cytokine do NK cells require for DEVELOPMENT?
NK cells require IL-15, EOMES
148
Which HLA is prominent in gestational trophoblasts?
HLA-G (babies say gaga)
| - HLA-G and F are present on extravillous trophoblast to protect fetus from maternal immune rejection
149
Which lymphocyte is most prevalent in pregnant decidua
The NK cell
150
Which chromosome is KIR inherited on?
Chromosome 19
151
Which chromosome is MHC inherited on?
Chromosome 6 (order: Class II, III, I ; 2, 3, 1)
152
What are the transcription factors needed for ALL ILCs?
NIFL3, TOX, Id2 (NIFty TOXic IDeas)
153
What infections are TLR3 deficiency more prone to?
TLR3 def: HSV encephalitis; influenza cerebritis (CNS inflammation, decrease in IFN-lambda production)
154
What is the inheritance of TLR3 def?
AD
155
What is deficient in production in TLR3 def?
INF alpha, beta, lambda
156
UNC93B def inheritance?
AR
157
UNC93B infections?
HSV encephalitis
158
TRIF/TRAF3/TBK1/IRF3 def infections?
HSV encephalitis
159
What does Dectin1/2 induce in CMCC?
Induces Syk/CARD9
160
Which diseases present with Oculocutaneous albinism?
Oculocutaenous albinism: Chediak Higashi, Griscelli syndrome, Hermansky Pudlak
161
How to differentiate Chediak Higashi, Griscelli syndrome, Hermansky Pudlak ?
BLEEDING in Hermansky Pudlok because of platelet granule defect
162
CNKD1 mutation and inheritance?
GATA2 - AD
163
CNKD2 mutation and inheritance?
MCM4 (mini chromosome maintenance complex 4)- AR
164
FNKD1 mutation and inheritance; which cytokine?
FCGR3A (CD16) - AR
165
What is missing in GATA2 def? CD 56 dim or CD56 bright?
CD56 bright are missing from GATA2 def (CNKCD1)
166
What kind of killing is affected in FNKC def?
ADCC intact; spontaneous cytotoxicity decreased; EBV cells not killed
167
What are the Src family kinases?
lyn, lck, fyn
168
What are the Syk family kinases?
Syk, ZAP-70
169
What are the Btk family kinases?
Btk, Itk
170
What are the inhibitory phosphatases of ITIM?
SHP-1, SHP-2, SHIP
171
Generation of which molecule leads to the intracellular increase in Ca in the TCR pathway?
Generation of IP3 (Which is generated after PIP2 is hydrolyzed by PLCg and produces IP3 and DAG)
172
IL-12RB1 mutation leads to which type of infections?
IL-12RB1 def leads to salmonella and atypical mycobacteria
173
What kind of infections does IRAK4 def lead to ?
IRAK4 def: pyogenic infections: Strep pneumo
174
Castleman's disease: hyper production of what and what symptoms?
Castleman's disease: Hyper IL6 productions: fever, microcytic anemia, normal BM, hypo albumin, elevated CRP
175
What type of cell does IL2 promote and in which function?
IL2 promotes survival and function of Treg cells
176
IL5, what does it promote (cell and Ig)?
IL5 promotes eosinophils and production of IgA Ab
177
Which two cytokines promote IgE class switching?
IL4 and IL13
178
Which cytokines promotes mucus formation?
IL13
179
How does BAFF work?
Upregulates Bcl2 which is an anti-apoptotic protein
180
How does APRIL work?
Upregulates Bcl2 which is an anti-apoptotic protein
181
What is the basophil differentiating cytokine?
IL3 --> basophils
182
What is the other name for CD23 and what does it bind to?
CD23 (FceRII) binds to IgE AND B cells
183
What does the basophil activation test evaluate?
Basophil activation: evaluates for CD63 or CD203c
184
What is the tryptase measurement calculation?
>/=1.2x baseline tryptase + 2 microgram/mL
| - proposed to assess for mast cell activation event
185
How to test for NK cell cytotoxicity?
Chromium release assay (Cr51); check for CD107a
186
Deficiency of what part of the complement system leads to recurrent encapsulated infections and autoimmunity?
Defects in early complement C1q, C2, C4, C3 --> encapsulated bacteria and autoimmunity
187
Deficiency of what part of the complement system leads to recurrent meningococcal infections?
Defects in terminal complement C5-C9 --> meningococcal infections
188
Which part of the IL2R makes it high affinity?
IL2Ra
189
What IL receptors is gamma chain (gc) a part of?
gc = IL2, IL4, IL7, IL9, IL15, IL21
190
What two components are part of the IL13R?
IL4Ra and IL13R
191
What two components are part of the TSLPR?
IL7Ra and TSLPR
192
IL-18 aka? Which IL is is similar to?
IL18 aka IFN-g inducing factor ; most similar to IL1b
193
Which adhesion marker does IL18 induce?
ICAM1
194
What diseases have elevated IL6?
Castleman's dz; Atrial myxoma; MM; RA, JIA
195
IFNg deficiency inheritance and results in susceptibility to which types of infections?
- AD STAT 1 deficiency
| M. tb and other intracellular bacteria
196
What receptor does dupilumab act?
IL4Ra which is on IL4 and IL13
197
What are the chemokines for lymphocyte homing to LN?
CCL19/CCL21 --> CCR7
198
What are the chemokines for pro Th2 response?
CCL17/CCL22 --> CCR4 (seen more on Th2 cells)
199
What is the function of E selectin?
E selectin: on the endothelium; homing of T lymphocytes to peripheral sites of inflammation; E = extremity (far away/peripheral)
200
What is the function of L selectin?
L selectin; on Lymphocytes and Leukocytes; GLYCAM - to LN HEV; and MadCAM to PMN rolling
201
What is the importance of B integrin family a4b7?
Binds to MADCAM - important for gut homing
202
ICAM1 CD name
ICAM1 = CD54 (think 5=4 = 9, which is almost 10)
203
ICAM2 CD name
ICAM2 = CD102 (has a 2 in the name)
204
ICAM3 CD name
ICAM3 = CD 50 (3 and 5 both prime numbers)
205
ICAM4 CD name
ICAM4 = CD242 (242 has 4 and 4 is a multiple of 2)
206
What does ICAM1 bind?
LFA1, MAC1, rhinovirus
207
What does ICAM2 bind?
LFA1
208
What does ICAM3 bind?
LFA1 and CD18
209
What does ICAM4 bind?
LFA1 and CD18
210
What is the CD name for VCAM1?
VCAM1 = CD106
211
What does VCAM1 bind?
VCAM1 binds VLA4 - vascular
212
What does PECAM bind?
CD31 and CD38 - platelets
213
What is the CD name for PECAM?
PECAM = CD31 (which it also binds, and E looked like backwards 3)
214
What does MadCam bind?
MadCAM binds a4b7 - mucosa
215
What does NCAM bind?
Binds VLA4 (a4b1)
216
What is the CD name for NCAM?
CD56
217
What are the important chemokines in allergy?
CCL2, 5, 7, 11; CXCL8
218
What proteins inhibit the formation of MAC?
S protein and CD59
219
Which molecules are considered anaphylotoxins? Which is the most potent for basophil and mast cell degranulation?
C5a> C3a > C4a
220
What is C3a chemotactic for?
eosinophils ONLY
221
What is the CD name for CR1?
CR1 aka CD35
222
What is the CD name for CR2?
CR2 aka CD21 (#2 in both)
223
What is the other name for CR3?
CR3 aka Mac-1, CD11b/CD18
224
What is the other name for CR4?
CR4 aka gp 150/95, CD11c/CD18
225
What is the other name for CD46?
CD46 aka MCP = membrane cofactor protein
226
What is the other name for CD55?
CD55 = DAF (decay accelerating factor)
227
What is the other name for CD59?
CD59 = protectin
228
What is the ligand for CR1?
C3b, C4b, iC3b (B1)
229
What is the ligand for CR2?
C3d, iC3b, C3dg (D2)
230
What is the ligand for CR3?
iC3b and ICAM1
231
What is the ligand for CR4?
iC3b
232
What is the ligand for CD46?
C4b and capsid
233
What is the ligand for CD55?
C5b-8 and monomeric C9
234
How is properdin deficiency inherited?
X linked (all other complement def are typically AR)
235
What is the most common complement d/o seen in SLE?
C1q deficiency.
236
What is the most common AR agammaglobulinemia?
mu heavy chain
237
What is a common codominantly inherited blood disorder?
Blood typing (ABO)
238
ADA SCID T/B/NK?
ADA SCID = (T-/B-/NK-)
239
Reticular dysgenesis T/B/NK?
Reticular dysgenesis AKA AK2 (T-/B-/NK-)
240
RAG1/2 T/B/NK?
RAG1/2 T-/B-/NK+
241
Artemis T/B/NK?
Artemis T-/B-/NK+
242
Cernunnos and ligase IV: T/B/NK?
Cernunnos and ligase IV: T-/B-/NK+
243
Common gamma chain T/B/NK?
Common gamma chain: T-/B+/NK-
244
IL7Ra: T/B/NK?
IL7Ra: T-/B+/NK+
245
CD3 subunit def: T/B/NK?
CD3 subunit def: IL7Ra: T-/B+/NK+
246
Coronin 1-A def: T/B/NK?
Coronin 1-A def: T-/B+/NK+
| - no thymus regress
247
CD45 tyrosine phosphatase def: T/B/NK?
CD45 tyrosine phosphatase def: T-/B+/NK+
248
What is the abn in reticular dysgenesis?
defect in mitochondrial adenylate kinase2
249
What are the Es of OmEnn syndrome?
Es: Erythroderma, Eosinophilia, Elevated IgE
250
Wiscott-Aldrich gene mutation?
WASP gene mutation - X-linked
251
At what age does alpha fetoprotein increase in Ataxia Telangiectasia?
Increased alpha fetoprotein after 6-12 months
252
CD40L deficiency inheritance?
X-linked - CD40L
253
CD40 deficiency inheritance?
Autosomal Recessive
254
NEMO deficiency inheritance?
X-linked
255
Which def one presents with neutropenia: CD40L, CD40, NEMO
CD40L
256
What are the two enzymes in B cells needed for class switching?
AID and UNG
257
XLP1 mutation?
X linked SH2D1A/SAP gene
258
XLP2 mutation?
X linked defect in XIAP gene
259
MAGT def?
XMEN: X linked immunodeficiency with mag defect
260
What is RALD and what mutation is seen?
RALD: RAS Associated Leukoproliferative Disorder: NRAS/KRAS mutation; nil DNTs
261
What is the mutation in APECED including which gene?
AIRE mutation, AR ; 21q22
262
IPEX mutation
X linked FOXP3 mutation
263
How is BTK mutation inherited?
BTK = X linked
264
How is mu heavy chain inherited?
AR - the most common of AR agammaglobulinemia
265
What are AD forms of agammaglobulinemia?
E47, AKA, E2A, TCF3
266
What is the function of BTK?
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.
267
CD27+ is on which type of cells
CD27+ are memory B cells
268
CD 27 are part of which cytokines family?
CD27 part of the TNF family of cytokines
269
CD21 aka and what is it's function?
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)
270
What are the ligands for TACI?
Ligands for TACI receptor on B cells are BAFF and APRIL
271
What is the function of AID?
AID - deaminated cytosine to uracil (C->U); receptor editing function
272
What is the function of UNG?
Removes Us; function in receptor editing
273
How are CD21, CD19, CD81 defects inherited?
AR
274
What class of meds can cause IgA deficiency?
IgA def: anticonvulsants: phenytoin, carbamazepine, valproic acid
275
Which IgG subclass def is assoc with IgA def?
IgG2 subclass def
276
When is the IgG nadir in children?
IgG nadir is about 3-6 months (400mg/dL)
277
What results from a Lyst mutation?
Lyst mutation: primary and secondary granules fuse - giant granules (which is Chediak Higashi)
278
Which mutations cause lack of phagocyte secondary granules and lack of defensins?
C/EBPe mutation
279
What is the Rx for CGD?
- antifungals: AZOLEs - decreased mortality
- abx: BACTRIM ppx
- INFg
- steroids
280
What is the difference in neutrophil function (rolling, tethering, etc) in LAD1 vs LAD2?
LAD1: defect in adhesion, sticking vs LAD2: defect in rolling
281
What is the cytokine that induces mast cells?
SCF
282
What are the transcription factors for basophils?
C-EBPa and GATA-2
283
What are the contents of a basophil?
histamine, IL4, IL13, TSLP
284
How are mast cells and basophils different in how they mature?
Mast cells can mature in the periphery; Basophils leave the Bone marrow mature (BB = mature)
285
Can mast cells regranulate?
Yes - mast cells can regranulate
286
Which mast cell type is deeper in the tissue versus more superficial?
Deeper: MCtc; more superficial: MCt
287
Which mast cell responds to C5a?
MCtc (Basophils also respond to C5a)
288
Which mast cell responds to PAF?
MCt
289
Which mast cell responds to opiates?
MCtc
290
Which mast cell responds to substance P?
MCtc and MCt
| - early phase mediator
291
Which mast cell responds to antigen?
MCtc
292
MCtc vs MCt: respond to which triggers?
- MCtc: responds to more triggers (substance P, Ag, opiates, C5a)
- MCt: responds to PAF
293
What cell responds to f-met-leu-phe?
basophils
294
What are the two cytokines tested in basophil activating test?
CD63 and CD203c
295
What is CD63?
CD63 on basophils - protein coated on the inside of secretory granules ; histamine degranulation
296
What is CD203c?
CD203c on basophils - ectoenzyme, cleaves nucleotides outside the cell; piecemeal degranulation
297
What is CD name for IL3R? (to help ID basophils on basophil activating test)
IL3R = CD123
298
What chemical do basophils not make?
Prostaglandins
299
Does omalizumab bind free or bound IgE?
omalizumab binds free IgE
300
On which cell does omalizumab reduce IgE receptors on: mast cells of basophils?
Basophils, mast cells, DC, monocytes
301
What type of tryptase is released with anaphylaxis? *****
B tryptase is released with anaphylaxis
302
What are the dx criteria for cutaneous mastocytosis?
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
True or false: Scabies can cause eosinophilia
True, scabies can cause hypereos
304
What is the CD marker for selectin?
CD62 P, E, L
305
Common gamma chain inheritance?
X linked
306
What is the side effect of mepolizumab?
Herpes zoster - consider immunizing beforehand
307
Which biologic has adverse side effect of candidiasis?
Secukinumab (used for psoriasis, IL17A is the target) - blocks the IL17 pathway leading to candidiasis
308
Which biologic has a side effect of niesserial infections?
Eculizumab (C5 inhibitor, used for PNH, aHUS), blocks C5 and terminal complement pathway
309
Which biologic has alpha gal picture?
Cetuximab (EGFR blocker), makes IgE Ab to galactose-a-1, 3-galactose, sensitization to the lone star tick
310
Zinc deficiency clinical phenotype?
periorificial and aural (limbs) dermatitis, alopecia (loss of hair) and diarrhea
311
What is acrodermatitis enteropathica, inheritance, and what mineral is deficient?
AR metabolic condition affecting Zinc def: patients have zinc def phenotype: periorificial and aural (limbs) dermatitis, alopecia (loss of hair) and diarrhea
312
What is the MAO of Rapamycin?
mTOR/AKT blockage
313
Which medications are calcineurin inhibitors?
Tacrolimus, Sirolimus, and Pimecrolimus
314
Felty syndrome
RA, Neutropenia, and Splenomegaly (FELTY RANS)
315
How does location of eczema differ from infants/small children to adults?
Infants/small children: face, scalp, extensor (side opposite the joint) surfaces ; Adults: flexural surface
316
What is the genetic defect in Comel-Netherton Syndrome?
SPINK5 - which encodes LEKT1
317
LL-37
cathelicidin, antimicrobial peptide that is decreased in eczema; important in antiviral (think eczema herpeticum and vaccinatum)
318
Which coxsackie strain is related to eczema coxsackium
coxsackievirus A6
319
What is eczema vaccinatum?
disseminated live vaccinia virus from smallpox vaccination (no one gets smallpox anymore in US because it's been eradicated)
320
Which antimicrobial peptides are abnormally regulated in AD?
LL-37 (cathelicidin) and HBD2-3 (human B-defensins)
321
Which two cold urticarias have a low CH50?
low CH50: cyroglobulinemia and leukocytoclastic vasculitis
322
Systemic atypical acquired cold urticaria
Localized or generalized urticaria with cold exposure; negative ice cube test
323
Cold dependent dermatographism
Dermographic whealing after stroking pre-cooled skin
324
Cold-induced cholinergic urticaria
Exercise in cold environments leads to generalized urticaria
325
Delayed cold urticaria
Urticaria develops 12-48 hours after application of cold provocation
326
Localized cold reflex urticaria
Positive immediate urticarial response at a site distant to cold provocation
327
FCAS: Fam cold auto-inflamm syndrome: Symptoms, inheritance, and mutation
Pseudourticaria, fever, arthralgia, conjunctivitis occurring 1-2 hours after cold exposure; AD mutation in NLRP3/CIAS
328
PLAID: Phospholipase Cg2 associated def and immune dysregulation: symptoms and test?
Cold urticaria in childhood, Ab def, autoimmunity. Positive Evaporative cooling test
329
How to physically test for PLAID?
Positive evaporative cooling test; neg. ice cube test
330
What is the mutation in PLAID?
mutation in PLCG2 - AD
331
Which type of solar urticaria is assoc with erythropoietic protoporphyria ?
Type 6 VI
332
Which type of urticarias can be passively transferred by serum?
Acquired Cold (IgE, IgM, IgG, cryoglobulins), Solar (Type 1 and 4) and Dermatographism (IgE) (ADS)
333
Factor I def.
AR, urticaria, decrease Factor I (C3b inactivator), dec C3 levels
334
What is SERPING1?
SERPING1 = C1-INH gene in hereditary angioedema
335
Treatment in Giant cell arteritis?
STEROIDS!! Need to decrease risk for visual loss
336
What is the treatment for Kawasaki disease?
IVIG x 1 and aspirin: decrease the risk of aneurysms
337
What diseases can polyarteritis nodosa be associated with?
Hep B or Hep C
338
Which HLA is associating with Abacavir Sn?
Abacavir Sn in white = HLA-B*5701
339
Which HLA is associating with Carbemazepine Sn in Han Chinese?
Carbepazepine in Han Chinese = HLA-B*1502
340
Which HLA is associating with Carbemazepine Sn in Europeans?
Carbemazepine Sn in Europeans = HLA-B*3101
341
Which HLA is associating with allopurinol reactions in Asians?
allopurinol reactions in Asians = HLA-B*5801
342
Which HLA is associating with insulin, gold, and penicillamine reactions?
HLADR3
343
Which cytokine is produced by the T-cells in AGEP?
IL8 / CXCL8
344
Major determinant for PCN allergy
Major: BenzylpeniciLOYL (PrePen)
345
Minor determinant for PCN allergy
Minor: Penicilloate, penilloate, benzylpenicillin (Pen G)
346
Which cytokine is related to mucus gland hypertrophy?
IL9 --> mucous gland hypertrophy
347
Which sinuses drain into the middle meatus?
Anterior ethmoid, frontal, maxillary
348
Where is the OME complex located?
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
Where do the posterior ethmoids drain?
Sphnoethmoid recess
350
Do anti-leukotriene agents block the early or late phase?
anti-leukotriene block the early and the late phase
351
Do antihistamines block the early or late phase reaction?
Early phase reaction
352
What CT finding is seen in empty nose syndrome?
turbinates are very small
353
Where is a haller cell located?
Haller cell = medial floor of the orbit (basically next to the nose and under the eye.
354
What is the cell type in Western nasal polyps?
Eosinophilic
355
What is the cell type in Asain nasal polyps?
Neutrophilic (elevated IL8)
356
What is the first line treatment for acute rhinosinusitus?
Augmentin; then doxy or a resp flouroquinolone (moxi)
357
How long does it take after pet removal for allergen to go back to normal levels?
about 4 months (16-20 weeks)
358
Which nasal spray is ok to use in pregnancy?
Budesonide; B=baby (cromolyn is also safe in pregnancy)
359
Which immunosuppressed group can receive the varicella vaccine?
Isolated B cell deficiency
360
What is the rule for antibody containing antibody product and vaccines?
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
What is the CI for getting Rotavirus vaccine?
CI are: immunodeficiency and h/o intussusception
362
What is the vaccine rule for nonfunctional spleen?
Functional or anatomic asplenia: patient should have PCV13 and Menactra 4 weeks apart (cannot get them on the same day like other patients)
363
What is the timing rule for live vaccines?
Either get the live vaccines on the same day, OR get them 4 weeks apart.
364
Which vaccine is the exception to the live vaccine rule (which vaccine may be given)?
Rule is: get same day or 4 weeks apart; but can get Yellow Fever <30 days from MMRV containing vaccines
365
What if a live vaccine is given < 4 weeks/28 days from last live vaccine?
Will need to repeat dose of 2nd vaccine given bc the response probably was not robust enough
366
Which vaccines contain yeast?
Hep B (any Hep B containing vaccine)
367
Which vaccine is contraindicated in egg allergy?
Yellow fever (MMR and influenza are not)
368
Which vaccines contain Gelatin?
```
Too Much Running for this Very Yellow Zebra:
Typhoid
MMR
Rabies
Varicella Zoster
Yellow Fever
Zoster - herpes
```
369
What mutation confers HIV resistance?
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
What is lipocalin also known as?
lipocalin aka calycin
371
What is a direct bronchoprovocation test?
Methacholine challenge
372
What is an indirect bronchoprovocation test?
Exercise, cold air, mannitol, adenosine monophosphate
373
What is considered a positive methacholine challenge test?
< 8 +; 4-16 is borderline
374
Which cells make IL-12?
IL12 is made by myeloid cells, but not T cells or innate cells
375
Conventional dendritic cells CD markers
CD1, CD11b/c, CD13, CD14
376
Plasmacytoid dendritic cells CD markers
CD123
377
Langerhans cells CD markers
CD11c, CD207
378
Interstitial dendritic cells CD markers
CD11c, CD2, CD9, CD68
379
Which lipid mediator is lower in AERD after COX inhibition, leading to bronchospasm?
PGE2 production goes down after COX1 inhibition, and there is no block of 5LO, leading to uncontrolled production of cysLT
380
What is higher in the urine of AERD patients?
LTE4 (because of uncontrolled production of cysLT)
381
Which CD markers does basophils have?
CD123, CD203c, CD63, CD69
382
Which cells produce PGD2?
Only mast cells produce PDG2
383
Platelet Activating Factor: preformed, lipid, or cytokine?
lipid
384
heparin: preformed, lipid, or cytokine?
preformed
385
chondroitin sulfate E: preformed, lipid, or cytokine?
preformed
386
chymotryptase: preformed, lipid, or cytokine?
preformed
387
carboxypeptidase: preformed, lipid, or cytokine?
preformed
388
What is the gene mutation in Familial Cold AutoInflammatory Syndrome?
CIAS1, AD: Cold Induced Auto-Inflammatory Syndrome 1 gene
389
What is the gene mutation in Muckle Wells Syndrome?
CIAS1, AD: Cold Induced Auto-Inflammatory Syndrome 1 gene
390
Which cat allergen is related to Pork-Cat syndrome
Fel d 2: albumin
391
Where does superantigen bind on the TCR (and CD name)?
Vb chain of the TCR (CDR4)
392
Do superantigen bind to MHCI or MHCII?
Superantigen bind to MHCII (extracellular bacteria)
393
What are the Staph superantigens?
SEA, SEB, (staph enterotoxins); TSST (toxic shock syndrome toxin)
394
What are the strep super antigens?
SPE-A (Strep Pyogenes exotoxins)
395
Where do Tregs develop?
Tregs develop in the thymic medulla
396
Which TLR binds to mycoplasma and what is its ligand?
TLR6 - ligand is diacyl lipopeptides
397
Which TLR binds to synthetic sources?
TLR 7/8 - imidazoquinoloones, synthetic, virus
398
Which TLR binds to unmethylated CpG motifs of bacteria and viruses?
TLR 9
399
Serum Sickness is which type of HSN d/o?
Serum sickness if type 3
400
Which medications do you have to be careful of fluticasone causing Cushing's?
Protease Inhibitors - namely Ritonavir
401
Which PID is associated with fractures?
Hyper-IgE/Jobs/STAT3 deficiency - AD
402
What is the major mouse allergen and which part of the mouse does it come from?
Mus m 1: Lipocalin: Urine of the male mouse
403
In which eye disease can you see keratoconus?
AKC
404
In which eye disease can you see anterior cataracts?
AKC
405
Biopsy in dematographism
dermal edema with a few perivascular mononuclear cells., dilated blood vessels w perivascular cells, normal epidermis, no spongiosis of hyperplasia
406
How to test HIV infected infant
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
What is the prophylaxis HIV + infants are on from when until when?
PJP prophylaxis from 4-6 weeks to at least 1 year of age
408
Which of the complement factors ONLY regulates the alternative pathway?
Factor H - is this right?
409
What is the ligand for MADCAM?
a4b7 for gut homing
410
What binds VCAM1?
VCAM1 = VLA4 (a4b1)
411
What is the other name for VLA4?
a4b1
412
What does NCAM bind?
NCAM = VLA4
413
What is the CD marker for dendritic cells?
CD11b/c they all share EXCEPT pDC which have CD123
414
Which TLR does RSV bind to?
TLR4
415
What is the ligand for TLR6?
diacyl lipopeptides
416
Which TLR had ssRNA as it's ligand?
TLR8
417
Pollutant involved in worse asthma?
Ozone / O3
418
Pollutant skewing to Th2 ?
Diesel exhaust
419
Pollutant that is by product of photochemical smog?
Nitrogen dioxide
420
What complement tests are low in early complement deficiency (C1q, C1s, C2, C4)?
decreased CH50
421
Which complement tests are low in C3 deficiency?
Decrease CH50, decreased AH50, decreased C3; + C3 Nephritic factor, IgG anti-C3 AutoAb
422
Which complement tests are low in C5-C9 deficiency?
decreased CH50, decreased specific complement, decreased AH50
423
Which complement tests are low in Factor B, D, properdin deficiency?
decreased AH50
424
What is the genetic mutation in MBL deficiency?
MASP2 mutation
425
Which OA agent is associated with welder, chemical/metal workers?
Platinum salts/potassium chromate (think welder holding fancy metal glass with banana juice)
426
Which OA agent is associated with hairdressers?
Persulfate salts (ammonia persulfate) - think of a hairdresser holding a purse
427
Which OA agent is associated with adhesives, epoxy resin, paint and plastics?
Phlthalic anhydride
428
Which OA agent is associated with plastics/paint?
Trimellitic anhydride
429
Which OA agent is associated with shellac, lacquer, plastics, cleaners?
Amines
430
Which OA agent is associated with hospitals and labs?
Formaldehyde, Psyllium
431
What phenotype are all the radiosensitive SCID, and name them all?
T-B-NK+ : ARTEMIS, CERNUNNOS, ligase IV, Nijmegen Breakage Syndrome
- Ataxia Telangiectasia is also radiosensitive
432
HyperIgM1: mutation, inheritance, and germinal centers?
HyperIgM1: CD40L deficiency; X linked; absent germinal centers
433
HyperIg3: mutation, inheritance, and germinal centers?
HyperIgM3: CD40 deficiency; AR; absent germinal centers
434
HyperIgM2: mutation, inheritance, and germinal centers?
HyperIgM2: AID; AR; giant germinal centers and lymphoid hyperplasia
435
HyperIgM4: mutation, inheritance, and germinal centers?
HyperIgM4: UNG; AR; giant germinal centers and lymphoid hyperplasia
436
Which is the only HyperIgM syndrome that does not have AR inheritance?
HyperIgM1: CD40L, X linked
437
Ataxia telangiectasia: inheritance and gene mutation?
ATM mutation; AR
438
Chronic mucocutaneous candidiasis: inheritance and gene mutation?
AIRE mutation; AR
439
APS-1: inheritance and gene mutation?
AIRE; AR
440
APECED: inheritance and gene mutation?
AIRE; AR
441
What is TNFS5?
TNFS5 = CD40L
442
What is the gene defect in DiGeorge Syndrome?
22q11.2 (think CATCH 22, 90%) OR 10p13-14 (renal/GU defect)
443
What is the autoimmune Ab that may be seen in DiGeorge Syndrome?
TUPLE1 (FISH)
444
How is CTLA4 inherited?
CTLA4 is a haploinsufficiency
445
Which disease would have low/absent CD15?
LAD2 would have abs/low CD15/Sialyl-Lewis X
446
Which disease would have low/absent CD18, CD11b?
LAD1
447
What gene is abnormal in LAD1?
ITGB2 gene: B2 integrin CD18 - beta chain - , CD11b abnormal
| - ITGB2 - "IT Got Bad"
448
What gene is abnormal in LAD2?
FUCT1, GDP-fucose transporter; CD15/Sialyl Lewis X
449
What gene is abnormal in LAD3?
FERMT3; Kindlin3 (intracellular beta intern activator)
450
What is CD79a?
Ig alpha chain on B cells, part of B cell receptor
451
What is CD79b?
Ig beta chain on B cells, part of B cell receptor
452
What is CD179?
B cell light chain
453
Colophony - which industry?
Electronics industry (think of PHONE - electronic)
454
Which mutation in AAT gives you increased risk of emphysema?
ZZ mutation
455
Major Ag in honeybee venom?
Phospholipase A2 (Api m 1)
456
What is vespula venom standardized by?
Vespula venom is standardized by the amount of hyaluronidase
457
What does yellow jacket cross reaction with?
White faced hornet, yellow Hornet "Horney yellow jacket"
458
What drugs decrease the clearance of theophylline?
(CIMZiA)
- cimetidine
- zileuton
- allopurinol
- also: macrolide Abx and cipro
- decrease clearance = increased level
459
What does Der p 23 bind to?
Chitin - chitin recognized by TLR2
460
Which are the ice cube test NEGATIVE urticarias?
- cold induced cholinergic urticaria
- systemic cold urticaria
- cold dependent dermatographism
- FCAS: Familial Cold AutoInfl. Syndrome
- PLAID
(the syndromes, systemic and cholinergic)
461
What disease can HUVs be associated with?
COPD
462
Which DM and cockroach allergens are tropomyosin?
- Der p 10
- Per a 7
Tropical Derm Purse 107
463
Major allergen for vespids?
Antigen 5
464
Which antigen can stimulate BOTH T and B cell proliferation?
Pokeweed Antigen
465
What is the allergen for celery?
Api g 1 (A pig ate 1)
466
Which milk allergen is a lipocalin?
Bos d 5: lactoglobulin
467
What is the allergen Met e 1?
Met e 1 is a shrimp tropomyosin
468
Which type of allergen involves the peel of the fruit?
lipid transfer protein
469
Which class of allergen involves the pulp of the fruit
PR-10, Bet v 1
470
What kind of urticaria is seen in PLAID?
Cold Urticaria
471
What pairs with cashew?
Pistachio
472
What pairs with walnut
Pecan
473
In AD, does IFNg increase or decrease in the skin?
Decrease
474
Which type of mutation is present in AD of filaggrin?
Loss of function mutation: filaggrin
475
What is the treatment for disseminated eczema herpeticum?
Systemic acyclovir
476
Patients on dapsone should be monitored for which side effects?
- anemia
- neuropathy
- methemoglobinemia
477
What Ab are present in Goodpasture's disease?
Anti-Glomerular Basement Membrane (anti-GBM) Ab
478
What is the most common side effect of nasal steroids?
local nasal irritation
479
What is the time duration for chronic rhino-sinusitis?
Greater or equal to 12 weeks (EPOS 2012)
480
Where do double positive T cells develop?
Thymus cortex
481
Where do double negative T cell develop?
Thymus cortex
482
Where do single positive T cells develop?
Thymus medulla
483
Where do B cells develop before and after birth?
- Before: Fetal Liver
| - After: Bone marrow
484
What is the CD marker for the common gamma chain?
CD132
485
How is the function of IL4, IL5, and IL13 different?
```
IL4 and IL13 --> class switch to IgE
IL5 --> Eos
```
486
Are CD8 T cells involved in acute or chronic graft rejection?
CD8+ CD45RO + cells involved in acute graft rejection
487
Which cytokine is produced by CD4 cells to help augment CD8 cells?
IL21
488
Encapsulated Bacteria Mnemonic
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
Dry/sunny/windy mold Mnemonic
AC2E and BO PITyed SMUT because of his DRESs
- Alternaria
- Curvalria
- Cladosporium
- Epicoccum
- Botrytis
- Pitospora
- Smut spores
- Dreschlera
490
Rainy day mold mnemonic
AscosBosF:
- ascosporidium
- basidiospores
- fusarium (F looks like R)
491
Humid Night mold
- ascosporidium
| - basidiospores
492
What does CTLA4 bind to?
CTLA binds to B7-1(CD80)/B7-2 (CD86)
493
How is TGFb involved in Igs?
TGFb promotes IgA production by inducing B cells to switch to this phenotype
494
Are B1 cells T cell independent or dependent? What other cells are they analogous to?
B1 cells = T cell 1ndependent , help with polysaccharide vaccines; analogous to delta T cells
495
Are B2 cells T cell independent or dependent?
B2 cells = T cell dependent , help with protein vaccines
496
Which chromosome is B2 microglobulin encoded on ?
Chromosome 15
497
HLA-E function
NK cell recognition; NEK (neck)
498
HLA-F function
Localized to ER and Golgi apparatus (EFG)
499
HLA-H function
Iron metabolism (H-->I)
500
MHC1 vs MHC2 deficiency: which disease has absent germinal centers
MHC2 deficiency has absent germinal centers
| - both have AR inheritance
501
What is the end result of receptor editing, and is it central or peripheral tolerance?
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
FasL aka?
FasL aka CD98 --> Fas=FasL --> caspase activation
503
What receptor is downregulated in peripheral B cell tolerance?
CXCR5 is down regulated in B cell peripheral tolerance, inhibiting homing and interaction w B cells
504
Which are the purine nuceolotides?
A, G
505
Which are the pyrimidine nuceolotides?
T, C
506
What is the earliest B cell to produce Ig?
pre-B lymphocyte earliest to produce Ig
507
Which of the IgG subclasses is the latest to reach adult levels?
IgG2 is the latest to reach adult levels
508
Somatic Hypermutation involves which region of Ig?
V region
509
Class switch recombination involves which region of Ig?
C region; C for class switch
510
Lck is in which family and binds to what?
Lck in the Src family and binds to CD4 and CD8
511
Fyn is in which family and binds to what?
Fyn is in the Src family and binds to CD3
512
What SCID phenotype is Zap70 deficiency?
T-/B+/NK+
513
Which cytokine especially responds to gram negative rods?
TNF especially responds to gram negative rods
514
Which cytokine does IL-10 inhibit production of?
IL-10 inhibits production of IL-12 (IL-12 promotes TH1 cells)
515
Which cytokine promotes B lymphocytes into Ab producers?
IL-6
516
Which cytokine is required for NK cell differentiation and activation?
IL-15
517
Which cytokine induces adhesion molecule ICAM1?
IL-18 induced ICAM1 and other adhesion molecules, leading to enhanced recruitment of leukocytes
518
Which cytokine is important for resistance of Klebsiella pneumoniae?
IL-23 ; Kleb 23 (Klerb23)
519
Which cytokine promotes differentiation and maintenance of T cells that produce IL-17?
IL-23
520
Which cytokine receptors share common B chain?
IL3, IL5, GM-CSF
521
Mutation in which gene confers malaria resistance?
GATA in DARC gene confers malaria resistance in African Americans
522
Which selectins are affected in LAD2 deficiency?
P and E selectin
523
What is the chemokine abn in Heparin Induced Thrombocytopenia?
CXCL4
524
What are SIGLECS?
Sialic Acid binding Ig lectin: have ITIM, work to dampen the immune system response (Siglec-8 on Eos)
525
What are the two types of gravitational samplers?
Durham and Settle (Gravity Settled in Durham NC after the storm)
526
Which pollen sampler allows you to sample over an entire weekend?
Allergenco Air Sampler: Grab type sampler allows for sampling over an entire weekend
527
Which pollen sampler orients to the wind?
Burkard sampler, which is a type of gravitational sampler
528
In Factor H or Factor I deficiency, which complement tests would be low?
low CH50 and low AH50
529
Which lymph organs is the production of IgE the highest?
tonsils and adenoids
530
What body secretions is IgA secreted in?
BiMiSaSw:
- bile
- milk
- saliva
- sweat
531
Where are the marginal zone B cells found?
marginal zone of the spleen
532
Der p 1 size and homology?
Der p 1 : 24 kD and cysteine protease
533
CXCR5: which cells bind and what is it's ligand?
CXCR5 - expressed on mature naive B cells
| CXCR5 binds CXCL13
534
Function of DNA PK?
DNA-PK = DNA-dependent protein kinase complex: opens up hairpins at coding ends (like Artemis)
535
Function of ku?
ku: binds broken DNA ends of coding segment and recruits DNA-PK
536
Endonuclease function?
Endonuclease: removes nucleotides for junctional diversity
537
DNA ligase function and other name?
DNA ligase aka XRCC4: ligate both coding and RSS ends
538
Sphingosine - 1 - phosphate receptor (S1PR1)?
CD69: decreases surface expression of S1PR1
539
Where is CD1 encoded?
CD1 encoded on chromosome 15 (like B2 micro globulin of MHC1)
540
What is the CRTH2 receptor?
CRTH2 receptor is PGD2 receptor
541
What are the transcription factors for mast cells vs basophils vs eosinophils?
mast cells: GATA2
basophils: GATA2
eosinophils GATA1
542
Where do eosinophils mature (BM vs Tissue)?
Eosinophils mature in the bone marrow, just like basophils. Mast cells mature in the tissues
543
Which cells is the trimeric form of FceRI on?
DC, monocytes, and eosinophils
544
Which allergen cleaves FceRII (CD23)?
Der p 1 cleaves FceRII
545
Does omalizumab block the early or late phase reaction?
Omalizumab blocks early and late reactions
546
Where does IgE bind to FceRI?
IgE binds to FceRI by the alpha chain
547
CD marker for C5a?
C5a = CD88
548
Basophils are present in early or late allergic disease response?
Basophils = late response
549
CD 69 and basophil release?
CD69 is NOT associated with degranulation; rather with TLR stimulation (NON-allergen stimulation)
550
Primary granules of Eosinophil and what is their other name?
Charcot Leyden crystal aka Galectin-10
551
What are the two main chemokines for neutrophils?
- CXCL8 (IL8)
| - LTB4 (B looks like 8; 4x2=8)
552
Mnemonic for Epithelial cell layers
Before Signing, Get Legal Counsel
- Basale (bottom)
- Spinosum
- Granulosum
- Lucidum
- Corneum
553
Which cytokines do keratinocytes/epithelial cells secrete?
TSLP, GM-CSF, IL25, IL33 (IL33 part of the IL1 family)
554
Where are hassall's corpuscles located (be as specific as possible)
Hassall's corpuscles are located in the thymus medullary
555
What are the immune privileged sites of the body?
BAT: Brain, Anterior Chamber of eye, Testis
556
Where are the largest number of lymphocytes found?
```
#1: spleen
#2: bone marrow:
#3: GI tract
#4: skin
```
557
Which vessels carries lymphocytes into the spleen?
Splenic artery
558
How much mucus is produced in an adult nose per day?
1 quart
559
Where does the nasolacrimal duct drain?
Inferior meatus
560
CCL27: aka and receptor?
CCL27 aka CTACK; receptor = CCR10
561
Bullous Pemphigus or pemphigoid has prominent pruritus?
Bullous pemphigoid has prominent pruritus
562
When does herpes gestationis/pemphigoid gestationis occur and symptoms?
- occurs in 2nd trimester; pruritus and tense bullae
563
What molecule are defensins abundant in?
Cysteine rich peptides, abundant in neutrophils
564
Which phase of a clinical trial is submitted for FDA approval?
- after phase 3
565
In which phase of clinical trial is long term safety tested in?
Phase 4: "post marketing", may find adverse reactions outside the clinical trials
566
What are the phases of clinical trials and what are the checking for?
1: Safety
2: Efficacy
3: Confirm finding in large patient population --> FDA approval
4: Long term safety in a diverse population; "post marketing"
567
Type I and Type II error difference?
- Type I: no true difference: null hypothesis falsely rejected
- Type II error: true difference: null hypothesis falsely accepted
568
What % of eosinophils on a nasal smear in NARES?
>20% eosinophils
569
What are the bacteria that are involved in Atrophic Rhinits?
- Klebsiella Ozaenae
- S Aureus
- Proteus Mirabalis
- Coccobacillus faoetidus ozaenae
- Pseudomonas Aeriginosa
- E Coli
"KOSA the CFO of PM wanted PeACE"
570
When should AIT be started in AFRS?
AIT for fungal and non fungal allergens should be started 5-6 weeks post surgery
571
Which eye pathologies are Horner-Tranta's dots seen in?
VKC and AKC
572
Order of eye diseases that Eos seen in conjunctiva (greatest to least)?
```
#1 GPC
#2 VKC
#3 AKC
#4 SAC/PAC
"Giant Vernal AtopieS
```
573
Cytokines in Acute and Chronic AD
- 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
What Vitamin deficiencies can be related to rash similar to Eczema?
Vitamin B6, niacin, Biotin (vitamin B7)
575
Anti-CCP Ab indicate which disease and high/low severity?
Anti-CCP indicate more aggressive disease in RA (so does RF)
576
What gene in asthma/atopy has cluster of IL4 that may affect severity?
Chromosome 5q
577
What % of asthmatics can have their asthma triggered by NSAIDs?
10%
578
What % of asthmatics also have GERD?
45-65%
579
Obstruction parameters for asthma
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
What factors increase FeNO levels ?
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
Foods with sulfites
- think beer/wine/processed foods:
- processed potato
- dried fruit
- sauerkraut
- shrimp
- lemon/lime
- pickled peppers
- maraschino cherries
- pickled veggies
"Beer, Wine, Lemon/lime"
582
Linear epitope for allergens characteristics
Allergen is stable and persistent; more prolonged allergy
583
Confirmational epitope for allergens characteristics
Allergen is unstable; mild transient allergy
584
What are the two foods that there are 95% NPV cut off for?
Egg and milk
585
What are the cut off for EGG for 95% NPV?
2y/o: 2/7
- <2 y/o: IgE > 2
- >2 y/o: IgE> 7
586
What are the cut off for MILK for 95% NPV?
1y/o: 5/15
- <1 y/o: IgE > 5
- >1 y/o: IgE> 15
587
Which peanut component goes along with oral allergy syndrome?
Ara h 8
588
% of children who outgrow Peanut allergy and ages likely to outgrow
20% by age 6; unlikely to outgrow after age 10
589
% of children who outgrow tree nut allergy and rule about outgrowing
9%; unlikely to outgrow if allergic to more than 1 TN
590
LEAP study inclusions and cut offs
- 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
What % of anaphylaxis does biphasic response occur?
- 20% of anaphylactic episodes have biphasic reaction
592
How to differentiate exercise anaphylaxis and cholinergic urticaria?
Cholinergic urticaria can occur with Passive Warming
593
How long will serum vs urinary histamine be elevated for?
- serum: 5-60 minutes
| - urinary: 24 hours
594
How long it tryptase elevated for?
- up to 5 hours
595
What is the mechanism and reaction of oversulfated chondroitin sulfate?
- contaminant in heparin
- activation of contact system by C5a
- rxn: hypotension, AE, no urticaria or pruritus
596
Latex allergens specific for health care workers?
Hev b 5, 6, 7: "5-6-7 Health!"
597
What is the key allergen for Dolichovespula arenaria / maculata (hornet)?
Dol m 5 - Antigen 5 (hornet)
598
What is the key allergen for Vespula?
Antigen 5 - Ves v 5
599
% of + venom ST with negative serum IgE
| % of + venom serum IgE with negative ST
- % of + venom ST with negative serum IgE: 20%
| - % of + venom serum IgE with negative ST: 10%
600
What is the official name for Bed Bugs?
Cimicids, Cimex lectularius
| - bite In a row: "breakfast, lunch and dinner, all in a row"
601
PUPPP: Pruritus Urticarial Papules and Plaques or Pregnancy - what areas does it spare? What is the Rx?
- PUPPP: is erythematous papule within abdominal striae
- SPARES: spares umbilicus, face, palms, soles
- Rx: loratadine, cetirizine
602
What percentage of new asthma diagnoses in the US are occupational ?
9-15% of new asthma diagnoses in the US are occupational
603
Which test, if done at work and negative, excludes OA?
Methacholine challenge: should be done when a patient is symptomatic and at work
604
Organic Dust Toxic Syndrome (ODTS)?
| Is ODTS or farmer's lung more common?
- 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
Toxic fume bronchiolitis: what exposure?
Nitrogen dioxide and sulfur dioxide
606
Silo unloader's disease: what exposure?
- acute exposure of NO2 leading to asphyxia
607
Byssinosis: what exposure?
- dust inhalation of cotton, flax, hemp
608
What is Myroxylon pereirae?
Balsam of Peru
609
What is the spot test for nickel called?
Dimethylglyoxime test
| - pink = positive
610
What flavorings does Balsam of Peru cross react with?
| What plant does Balsam of Peru cross react with?
- Cinnamon and vanillin
- pine tree
- may cross react with Colophony (also made from pine trees)
611
Most common preservative in the US, and is it formaldehyde releaser or not?
Quaternium 15: formadehyde releaser
612
What is colophony made from?
`Colophony made from pine trees
613
What are the four classes of steroids?
```
HyTriBetah17
A: hydrocortisone
B: triamcinolone
C: betamethasone
D: hydrocortisone-17-butyrate
```
614
Antifibrinolytic Side Effects
- thrombosis
- postural hypoTN
- myalgia, myositis
- n/v/d
- muscle cramps
- fatigue
615
What SCID phenotype is PNP deficiency?
T-/B+/ NK+or-
616
Which PID has skeletal abn and rachitic rosary?
ADA SCID : T-/B-/NK-
617
What is PNP deficiency from?
defective purine nucleotide metabolism:
| T-/B+/NK-+
618
Which radiosensitive SCID has an absence of Hassall's corpuscles on biopsy?
Nijmejen breakage syndrome
619
What kind of blood products can SCID babies get?
CMV negative, irradiated
620
RIDDLE Syndrome
- RNF168 mutation
- increased IgM and low IgG: "How funny it is like HyperIgM"
- E Coli and HSV infection
621
Job's Syndrome/Stat3 deficiency inheritance
AD-STAT3
622
DOCK8 inheritance
AR-DOCK8
623
What is Tyk2 syndrome and how is it inherited?
AR-Tyk2
| - similar to DOCK8 with disseminated BCG lymphadenitis and salmonellosis
624
How is Wiskott-Aldrich inherited?
X-linked Wiskott-Aldrich
| Think WIXcott
625
What do the germinal centers in XLA look like
XLA germinal centers: small/absent lymphoid tissue, no germinal center
626
PASLI disease
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
Most familial CVID are inherited in which way?
Familial CVID = AD
628
What class of drugs can cause IgG subclass deficiency?
Anti-epileptics
629
Mutations in CGD
- gp91 - CYBB, X-linked, 65%
- gp47 - NCF1, AR, 25%
- gp22 - CYBA, AR, 5%
- gp67 - NCF2, AR, 5%
- gp40, NCF4, AR, <1%
630
What are the subunits of IL-12?
IL-12: p35, p40
631
What are th subunits of IL-23?
IL-23: p19, p40
632
Which cells are CCR5 on ?
Monocytes/macrophages
633
Which cells are CXCR4 on?
T cells
634
What can gp120 bind?
gp-120 can bind DC-SIGN
635
Which chemokine is implicated in EOE?
Eotaxin-3; induced by IL-13
636
How long should a patient be on PPI before checking biopsy for EoE?
8 weeks/2 months
637
IgE value for 95% PPV for Peanut?
>/= to 14
638
IgE value for 95% PPV for Fish?
>/= to 20
639
Which layer of the GI tract can eosinophils be found normally?
Found in the lamina propria normally, not the surface epi
| - Eos NOT normal in the esophagus
640
Meeting how many of the criteria is needed for diagnosis of mastocytosis?
1 major and 1 minor
OR
3 minor
641
Which TLRs are involved in killing mycobacterium?
TLR2 and TLR4
642
What is the presentation of children with croup?
- barking cough
643
Which cytokines induce Th17?
IL1B, IL6, IL21, IL23, TGFB --> Th17
644
Which immunomodulator requires a yearly eye exam?
Hydroxychloroquine
645
What is the Ig involved in immunohematologic disease?
IgG
| IgM usually involved in auto-immune disease
646
How to prevent nonhemolytic febrile reactions?
Removed leukocytes before storage; helps decrease cytokines release of TNFa and IL1b which play a role
647
How to prevent urticarial transfusion reactions?
Washing future blood products; IgE mediated
648
How to prevent anaphylactic transfusion reactions?
Twice washing RBCs or use product from IgA deficient donor
649
How to prevent GVHD transfusion reactions?
Gamma irradiation of cellular blood product
650
Which receptor for NK cell and ADCC?
FcGRIIIA; binds ONLY to clustered IgG, not monomeric
651
Which autoantibody is seen in Primary Adrenal failure?
Anti-CYP21A1 (enzyme necessary to make cortisol)
652
Most common cause of nephrotic syndrome in adults?
Membranous nephropathy
653
Most common cause of nephrotic syndrome in children?
Minimal change disease
654
Most common glomerulonephritis in the world?
IgA nephropathy
655
What is the treatment for scleritis?
NSAIDs, steroids, immunosuppression
656
What does the pupil look like in Anterior Uveitis?
Miotic Pupil
657
What is the main side effect of colchicine?
GI distress: pain, bleeding; rare: BM suppression
658
What is the fever syndrome with the longest lasting fevers?
TRAPS (TNF receptor disorder) has fevers for up to several weeks
659
Lofgren's syndrome
sarcoid + rash (erythema nodosum) + joints
660
Does C-ANCA correlate with disease severity in Granulomatosis with Polyangiitis?
No
661
Is EGPA related to C-ANCA or P-ANCA?
EGpA = P-ANCA = myeloPeroxidase
662
Which organ transplants do not require immunosuppression?
cornea, bone, joint tissue
663
How long after a HSCT can one receive live vaccines?
2 years after HSCT can a patient receive live vaccines
664
Which SCID does the best after HSCT?
T-/B+/NK- SCID - no conditioning (not including X-linked who have B cells present and non-functional)
665
Which SCID does the worst after HSCT?
T-/B-/NK-
666
Acute vs Chronic GVHD timeline?
- Acute = first 100 days - CD8
| - Chronic > 100 days - CD4
667
Types of rejection and timing?
- 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
Which of the stem cells take the longest to engraft?
Umbilical cord cells take the longest of the stem cells to engraft
669
Which foods should CF patients avoid?
CF patients should avoid soy because of glutathione dysfunctions
670
Which HLA , cytokines, and complement regulatory proteins are placental specific?
- HLA-E, F, G
- PGE2, IL-10, Il-4 - regulatory cytokines
- CD46, DAF - prevent complement activation
671
What time of day is pollen count the highest?
Early morning from 5-10AM
672
Northern Grass Mnemonic
I grew up in the NORTH, where I got TO Relish Fresh Sweet Blueberries
- Timothy
- Orchard
- Rye
- Fescue
- Sweet vernal
- Bluegrass (Kentucky)
673
Southern Grass Mnemonic
Then I moved to the SOUTH for LOVE, where by Boo Bought me Johnsons and a Prarie
- lovegrass
- bermuda
- bahia
- Johnson
- prairie
674
Which two allergen types cannot be mixed with pollens?
Mold and cockroach
675
Which allergen extracts may be able to be placed with high protease activity extracts?
ragweed and cat in 50% glycerin
676
Effective doses for standardized pollens?
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
What is the effective dose for dog allergen in AIT?
15 micrograms of Can f 1
| "My dog weighs 15 lbs"
678
What is the effective dose for short ragweed allergen in AIT?
6-12 microgram of Amb a 1
679
What is the dose of glucagon you would use in a patient who is on B-Blocker and on AIT?
1-5mg glucagon IV push
680
Dual H1 and mast cell mediators?
AlcAz OKe
- alcaftidine
- azelastine
- olapatidine
- ketotifen
- epinastine
681
Which second gen H1 blockers to use in pregnancy?
- cetirizine, levocetirizine, and loratadine
682
Which second gen H1 blockers to use in liver disease?
fexofenadine (My liver is Fine)
683
Which second gen H1 blockers to use in kidney disease?
loratadine
684
Which antihistamines give you the side effect of prolonged QT?
FIRST generation antihistamines (chlorpheniramine, diphenhydramine, doxepin, hydroxyzine) have this side effect in high doses
- blockage of potassium current --> prolonged QT --> torsade de points
685
What are the cardioselective BB?
Cardioselective:
- metoprolol
- atenolol
686
Which pregnancy category is montelukast?
Category B
| Zileuton is category C
687
Which anti-leukotriene agent may have liver toxicity?
Zafirlukast
688
Which medications do you need to adjust while on Zileuton? ***
```
Theos War Prop :
Theophylline
Warfarin
Propranalol
- Zileuton inhibitis CYP1A2 - need to decrease the dose of above medications bc Zileuton increases their serum concentration
```
689
Muscarinic Receptor functions
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
First line bronchodilator in COPD?
SAMA - ipratropium
691
Steroid drug metabolism
```
INCREASE LEVELS:
Cathy TROLls UP the RITunda looking to Kates Birth Control
- Clarithromycin
- troleandromyecin
- increase steroid levels
- Ritonavir (Protease Inhibitor)
- Ketoconazole
- OCP
```
692
Does omalizumab increase or decrease total IgE?
Omalizumab increases total IgE but decreases free IgE
693
Where does IgE bind on FceRI?
IgE binds at the alpha chain of FcERI
694
What is the CD marker for CTLA4?
CD152
695
Which disease has Hurthle cells?
Hashimoto's aka Chronic Lymphocytic Thyroiditis
696
What disease is associated with antibodies against P antigen?
Paroxysmal cold hemoglobinuria
697
What cells enter the LN through high endothelial venules ?
Naive B and T cells enter through high endothelial venules
698
Asplenic patient: Prevnar or Menactra first?
Get Prevnar first
699
Thermoactinomyces sacchari vs vulgaris
- Thermoactinomyces Sacchari: Bagassosis, mold sugar cane
| - Thermoactinomyces vulgaris: Farmer's lung
700
Are CD4 or CD8 cells seen in the parotid biopsy of Sjogren's disease?
CD4 cells
701
How are prions removed from Ig replacement?
Cold ethanol fractionation (modified Cohn-Oncley cold ethanol fractionation)
702
What are the 3 criteria for aspirin desensitization?
1: FEV1> 70% predicted
2: Montelukast started 1 week prior
3: Patient should continue treatment of ICS +/- LABA Rx
703
What is the concentration of Epi for SQ/IM and IV administration?
- SQ/IM: 0.01mg/kg of 1:1000
| - IV: 0.01mg/kg of 1:10,000
704
Which vaccines have neomycin?
```
Neomycin:
MVP
- MMR
- Varicella and Herpes Zoster
- Polio
```
705
Japanese Encephalitis Vaccine Reaction
Delayed Urticaria and angiodema
706
MMR Vaccine Reaction
rash, thrombocytopenia, late fever (5-12 days)
707
Tetanus Vaccine Reaction
Brachial neuritis, arthus reaction
708
Pertussis Vaccine Reaction
Febrile seizures, inconsolable crying hypotonic hyporesponsive event
- vaccine contraindicated in patient who had encephalopathy <7 days after pertussis containing vaccine
709
Yellow Fever Vaccine Reaction
Encephalitis
710
Smallpox Vaccine Reaction
Myopericarditis, eczema vaccinatum
711
TB skin test vaccine CI
MMR given same day as TB or 4 weeks apart
712
Steroids and vaccines
<2 weeks on steroids, OK to get
| >2 weeks >20 mg/day, wait 1 month
713
Sulfa antibiotic versus antibiotic: what is the difference?
Non-antibiotic does not have the aromatic amine at the N4 position (and why there is little cross reactivity)
- Sulfa antibiotic: SO2NH2 moiety
714
Periostin is produced in response to which cytokine?
IL13
715
Reproducibility of FEV1 and FVC?
3 effort that should be within 150ml of each other
716
What are the SLE Ab?
| Which is the most Specific, which is the most Sensitive?
ANA - SNOUT - most sensitive
anti-dsDNA
anti-smith - SPIN - most specific
717
When can you get Tdap vaccine if pregnant?
Tdap during third trimester
718
How much bleach per water ratio for eczema?
1/3 cup 8.25% bleach per one tub
719
Which cell types are CD62L on?
CD62L are on B, T, and NK cells
| - on T memory cells, NOT effector cells ***
720
Which specific CD marker B cells are missing in BTK?
CD19+ B cells
721
NBT test : positive vs negative:
Positive: changes from yellow --> BLUE (can reduce NBT to formazan)
- negative: yellow - no change
722
AH50 vs CH50: sheep vs rabbit
- AH50: rAbbit - Alternative
| - CH50: sheep jumping over clouds - Classical
723
Which allergen confers honeybee and vespid cross reactivity?
Hyaluronidase
724
Which DNA measuring method is used to quantify TRECS?
quantitative PCR
725
Which viral infection can decrease the number of TRECs?
HIV1 - TREC numbers improve with HAART
726
Radiation of XRAY vs CT?
CT has 60-120 times more radiation
727
Food challenge: what amounts of wet and dry food?
Dry food: 10g
Wet food: 100ml
Double the amount for meat and fish
728
IgE value for 95% PPV for Soybean?
30 kAu/L
729
IgE value for 95% PPV for Wheat?
26 kAu/L
730
IgE value for 95% PPV for TreeNuts?
15 kAu/L
731
What are the NPV for ST for egg and PN?
= to 3mm
732
What are the NPV for Serum IgE for egg, milk and PN?
= to 2 (no reaction history to peanut)
| - reaction history to peanut =5)
733
What's the risk of peanut allergy in a child whose sibling is allergic to peanut?
7%
734
Atopic patient with eczema and food allergy, risk of being allergic to PN?
30%
735
Risk of being becoming allergic it cut out peanut?
1%
736
Major grass families
- Northern: Pooiedae
| - Southern: Chloridiodae, Panicoideae (Chlorine in the Pain)
737
How is aspirin made?
Aspirin is made from the bark of a willow tree
738
Mnemonic for Indoor molds
Indoor CAMPR
- Cladosporium (outdoor that moves indoor)
- Aspergillus
- Mucor
- Penicillium
- Rhizopsus
739
Which allergen cleaves CD25?
Der p 1 and Der p 2
740
Can DM mix with cockroach or mold?
Yes, DM which has high protease activity, can mix with cockroach or mold (but cockroach and mold cannot be mixed with pollens)
741
IPEX-like disorder mutation
STAT5b deficiency; low CD25 and low Treg;
742
What is the receptor for adenovirus?
CD46/MCP
743
Lifetime prevalence of eczema for school children?
17%
744
What immunodeficiency is seen in Ataxia Telangiectasia?
low IgA, low IgE
745
How do lymphocytes get to GALT?
GALT has no HEV, so lymphocytes get there via afferent lymphatics
746
What organization is responsible for AIT standardization?
CBER: Center for Biologics Eval and Research
747
Is RF an IgM or IgG?
RF is an IgM against IgG
| - think about how IgG is for antibody protection and IgM is for active Rheum or infection
