Immuno

Question 1

Low B-cell count + Low IgA, IgM, IgG

Answer 1

Bruton’s agammaglobulinaemia

Question 2

Cleft lip / palate, hypocalcaemia, low T-cell count (+ cardiac abnormalities / thymic aplasia)

Answer 2

Di George’s syndrome (CATCH symptoms)

22q11 deletion

Question 3

Reduced IgM and raised IgA + IgE.

Clinically: Eczema / nosebleeds / bruising

Answer 3

Wiskott-Aldrich syndrome

Question 4

Mutation of MHC III + mild pneumonia

Answer 4

Common variable immunodeficiency

Question 5

Jaundice + hepatomegaly + sclerosing cholangitis with a defect in either MHC I (CD8+ T cells) or MCH II (CD4+ T Cells)

Answer 5

Bare lymphocyte syndrome

Question 6

Anti-cyclic citrullinated protein

Answer 6

Rheumatoid arthritis

Question 7

Anti-smooth muscle antibodies

Answer 7

autoimmune hepatitis / PSC

Question 8

Anti-Jo1

Answer 8

Dermatomyositis

Question 9

Anti-centromere

Answer 9

Limited systemic scleroderma (CREST syndrome)

Question 10

Anti-topoisomerase

Answer 10

Diffuse systemic scleroderma (more aggressive than limited systemic scleroderma (CREST)).

Pulmonary Fibrosis is defining feature

Question 11

Anti-Ro + Anti-La

Answer 11

Present in 50% of Sjogren’s patients

Question 12

Anti-glutamic acid decarboxylase

Answer 12

Type 1 Diabetes Mellitus

Question 13

‘Saddle-shaped’ nose

Answer 13

Wegner’s granulamatosis (Granulomatosis with polyangiitis (GPA))

Question 14

Anti-endomysial

Answer 14

Ceoliac

Question 15

CSF demonstrates oligoclonal bands of IgG on electrophoresis

Answer 15

Multiple Sclerosis (MS)

Question 16

Western blot test

Answer 16

HIV

Question 17

Kveim Test

Answer 17

Sarcoidosis

Question 18

Direct antiglobulin test (DAT) (aka Direct Coombs test)

Answer 18

Autoimmune haemolytic anaemia (AIHA)

Question 19

Skin prick test

Answer 19

Hypersensitivity reactions e.g. peanuts

Question 20

Recurrent mild pneumonias / diarrhoea but otherwise fine

Answer 20

Selective IgA deficiency

Question 21

CTL4- immunoglobulin fusion protein

Answer 21

Abatacept (used in long-standing rheumatoid arthritis)

Question 22

Anti-TNF α

Answer 22

Infliximab

Question 23

Drug - prevents guanine synthesis and induces immunosuppression

Answer 23

Mycophenolate mofetil

Question 24

HLA DQ2

Answer 24

Coeliac

Question 25

HLA B27

Answer 25

Ankylosing spondylitis

Question 26

HLA DR2

Answer 26

Goodpasture's syndrome

Question 27

HLA DR3

Answer 27

Graves', SLE, Myasthenia gravis

Question 28

HLA DR4

Answer 28

T1DM, rheumatoid arthritis

Question 29

NEGATIVE nitro-blue-tetrazolium (NBT) test (remains colourless)

Answer 29

Chronic granulomatous disease

Question 30

C1, C2, C4 deficiency

Answer 30

SLE

Question 31

Anti-GBM antibodies

Answer 31

Goodpasture's

Question 32

Anti-Ach receptor

Answer 32

Myasthenia Gravis

Question 33

Desmoglein 3

Answer 33

Pemphigus vulgaris

Question 34

Desmoglein 1

Answer 34

Pemphigus foliaecus

Question 35

Anti-voltage gated soidum channels

Answer 35

Lambert-Eaton (opposite of Myasthenia Gravis)

Question 36

Opiate overdose

Answer 36

Naloxone

Question 37

Aspirin / salicylates overdose

Answer 37

Activated charcoal or haemodialysis if >1 hour

Question 38

Organophosphates poisoning

Answer 38

Atropine

Question 39

CEA (Carcino Embryonic antigen)

Answer 39

Colorectal cancer

Question 40

Mutation in alpha-synuclein protein

Answer 40

Familial Parkinsons

Question 41

'Can't see, pee or climb a tree'

Answer 41

Reactive arthritis / Reiter's syndrome

Question 42

Old man, bone pain, raised ALP

Answer 42

Paget's

Question 43

Hereditary angioedema deficiency

Answer 43

C1 inhibitor esterase

Question 44

Potential genetic defect contributing to atopic dermatitis

Answer 44

Filaggrin mutation

Question 45

Irritability + neutrophils

Answer 45

Kostmann Syndrome (severe congenital neutropenia)

Question 46

How to monitor activity of SLE?

Answer 46

C3 + C4 levels

Question 47

Antibody used to diagnose someone with systemic sclerosis

Answer 47

Anti-SCL-70

Question 48

Treatment for Wegners

Answer 48

Cyclophosphamide

Question 49

Rheumatoid Arthritis DMARDS / Biologics

Answer 49

Start on anti-TNF alpha i.e. Etanercept, Adalimumab, infliximab. Move on to tocilizumab (anti-IL 6)

Question 50

DMARD used in Psoriasis

Answer 50

Ustekinemab (anti IL-12 / IL-23)

Question 51

DMARD used in CGD

Answer 51

IFN-gamma

Question 52

How to treat Hereditary angioedema 1. Patient can talk 2. Patient can't talk

Answer 52

1. IV C1 inhibitor | 2. Tracheostomy

Question 53

HIV: Neutralising antibodies are formed against which glycoprotein

Answer 53

gp120

Question 54

HIV: Non-neutralising antibodies are formed against which protein

Answer 54

p24

Question 55

Co-receptors required for HIV entry into cells

Answer 55

CCR5 or CXCR4

Question 56

6-month old boy with severe failure to thrive and recurrent infections. T-cells undetectable B-cells normal

Answer 56

SCID

Question 57

CD40L deficiency AKA...

Answer 57

Hyper-IgM

Question 58

What complements make up thr membrane attack system?

Answer 58

C5b, C6, C7, C8, C9

Question 59

CD found on activated T-cells, binds to IL-2

Answer 59

CD25

Question 60

Hep B Blood test - Positive following vaccination or previous infection

Answer 60

Anti-HBs

Question 61

Hep B Blood test - Positive in all Hep B carriers

Answer 61

HBsAg

Question 62

Hep B Blood test - Antigen which is positive in carriers with HIGH infectivity

Answer 62

HBeAG

Question 63

Hep B Blood test - Positive following previous infection but not following vaccination

Answer 63

Anti-HBc (c = caught)