Immuno

Question 1

Dongenital neutropenia

Answer 1

Recurrent bacterial infections, e.g., gingivitis, otitis media, respiratory infections, and cellulitis due to Streptococcus and Staphylococcus

Question 2

Lambert eaton vs myasthenia gravis

Answer 2

However, patients with LEMS typically have diminished deep tendon reflexes and weakness that is worse in the morning, with symptoms usually improving by the end of the day and muscle strength increasing with repea

Question 3

will digeorge preent with oral candiadisis

Answer 3

yes and t cells dysfunction presents with oral candiasis, list the tc ell dysfunctions

Question 4

how does disseminated mycobacterial infection present with

Answer 4

HSM/LAD and constitutional symotoms

Question 5

discharging neck sinus congenital cause

Answer 5

brachial cleft cyst

Question 6

wherd do you see cleft palate

Answer 6

chromosomal trisomies (e.g., Patau syndrome), 22q11.2 deletion syndrome, sonic hedgehog signaling defects, Pierre Robin sequence, or drug teratogenicity (e.g., isotretinoin, antiepileptics).

Question 7

what is a complication of CVID

Answer 7

gastric adenocarcinoma

Question 8

disseminated tb

Answer 8

il12 recetpro deficiency

Question 9

is the nodules in strep pyogenes painful or painless

Answer 9

painless

Question 10

which factor of GAS is responsible for necrotizing fascitis

Answer 10

hyaluronidase, another GAS virulence factor that facilitates tissue invas

Question 11

which interleukin secreted by dendriti cells in viral infection

Answer 11

il28

Question 12

a person with psoartic arthirits comes to you he takes adalilumab later there is decreased effectivety of treatment why

Answer 12

because neutralising antibodies form against tnf apha

Question 13

patients with il12 deficieny are at risk of what infections

Answer 13

mycobacterium and salmonella disseminated

no cytotoxicity in cells infected with intracellular pathogens (

Question 14

a women comes with tampon what complication can she have how would she present? TSST symtoms

Answer 14

tsss, associated with erythroderma This leads to the typical symptoms of high fever, rash, altered mental status, and shock. A

Question 15

EXPlain maturation of B Cells and t cells

Answer 15

B cells get matured

Question 16

what is affinity maturation

Answer 16

A process in which B cells interact with Th cells within the germinal center of secondary lymphoid tissue in order to secrete immunoglobulins with higher affinity for specific antigens.

Question 17

2 mechanisms of affinity maturation

Answer 17

somatic hypermutation/clonal selection

Question 18

what stimulates IGM secretion by plasma cells

Answer 18

IgM is also secreted by plasma cells (stimulated by IL-6)

Question 19

where does t cell activation occur

Answer 19

paracortex

Question 20

which protein required for HIV genome transcription

Answer 20

TAT gene

Question 21

what codes for p24 and p17 gene on hiv

Answer 21

gag

Question 22

what is rev for

Answer 22

he rev gene encodes a regulatory protein that acts to induce the transition from the early to the late phase of HIV gene expression

Question 23

pathophys of giant cell arteritis

Answer 23

Giant cell arteritis (GCA) is thought to be caused by a cell-mediated immune response to endothelial injury that results in the activation of dendritic cells in the adventitia of blood vessel walls and the recruitment of T lymphocytes (Th1 and CD8+ cells) and monocytes. Monocytes differentiate into macrophages and giant cells that produce cytokines such as interleukin-6 (IL-6). IL-6 is an acute phase reactant that is highly expressed in GCA lesions and functions to sustain the inflammatory activity. IL-6 also mediates the systemic symptoms seen in GCA (e.g., fever, weight loss) and is responsible for this patient’s elevated ESR. Tocilizumab is an IL-6 receptor inhibitor shown to reduce relapses and lower the dose of glucocorticoids required to maintain disease remission.

Question 24

pathophys of delayed hypersensitivity reaction

Answer 24

w

Question 25

what is the hallmark of type 1 hypersensitivity reaction

Answer 25

eosnophilic infiltration | PAF promotoes that

Question 26

type 3 hypersensitivity reaction damage caused by

Answer 26

neutrophils

Question 27

a patient recieves a amoxicilin, differentiate between | serum sickness, delayed hypersensitivy, anaphylactic,dress syndrome,erythema multiforme

Answer 27

anaphylactic is sudden, SSLR is after 2 weeks low grade fever more common,DRESS,common in sulfonamides, minocycline, and vancomycin; occurs after 2-8 weeks

Question 28

differentiate between serum sickness and sslr

Answer 28

Symptoms of true serum sickness are typically more severe (e.g., high-grade fever), with an acute or subacute onset, while symptoms of SSLR are usually less severe (e.g., low-grade fever), with a more insidious onset.

Question 29

a baby is born with these vitals 172/min, respirations are 58/min, and blood pressure is 74/45 mm and IL6 what does she have

Answer 29

neonatal sepsis

Question 30

function of macrophage csf

Answer 30

Also has a role in bone remodeling by activating precursor osteoclasts to undergo further differentiation.

Question 31

a person has Hiv infection and developes acute meningoencephalitis

Answer 31

which cells are infected

Question 32

why patients with CGD only get infected by catalase +ve organism

Answer 32

failure of superoxide free radicals due to NADPH oxidase deficiency, leads to bacteria to produce h2o2 as metabolic waste this h2o2 kills the bacteria however catalase bacteria digest h2o2

Question 33

tuberculousus skin test is in hiv is limited by

Answer 33

anergy

Question 34

give a review of all HIV associated conditions

Answer 34

w

Question 35

what is the mcc of cerebral abscee in Hiv

Answer 35

toxoplasmosis

Question 36

isoproisas

Answer 36

Watery diarrhea, abdominal pains, fever, weight loss

Question 37

hiv associated encephalopathy

Answer 37

``` Subcortical dementia (memory loss, depression, movement disorders) Progression to severe neurologic deficits (impaired vigilance, aphasia, gait disturbances) ```

Question 38

HIV associated using ring enhancing lesions

Answer 38

if rapid progressive=pml if multiple rings=toxo if single ring-lymphoma

Question 39

explain pathophysiological changes in LAD1 deficiency

Answer 39

Leukocyte adhesion deficiency type 1 (LAD1) is caused by an autosomal recessive defect in CD18 (beta-2 integrin), which prevents leukocytes from migrating to the site of infection. As a result, patients have recurrent mucocutaneous infections that can progress to sepsis and a characteristic absence of pus or neutrophils at the site of infection. Other features of the condition include poor wound healing with large skin ulcers, delayed separation of the umbilical cord due to omphalitis, and severe periodontitis/gingivitis. A very high neutrophil count (as high as 100,000/mm3 during active infection) is seen because neutrophil activation and recruitment of neutrophils from the non-circulating pool occurs. However, neutrophils are unable to extravasate into tissues, causing pooling within the circulation. ADDITIONAL INFORMATION

Question 40

which immunodeficiency can cause gi obstruction/urinary retention

Answer 40

e GI obstruction and urinary retention caused by granulomas. NADPH oxidase

Question 41

which disease can lead to systemic candiadisis

Answer 41

anything causing neutropenia( precepitates with candida, asperigollus mucor and rhizophus chediak hegashi

Question 42

cheidak hegashi what cancer can it cause

Answer 42

Hemophagocytic lymphohistiocytosis (can occur in the accelerated phase and is potentially fatal)

Question 43

explain formation of granulomas in tb

Answer 43

After replication, the following sequence in mycobacterial infection is transportation of bacterial peptides to the regional lymph nodes, migration of T-helper cells to the lungs, production of interferon-gamma by T-helper cells, and formation of a nodular tubercle in the lung. TUBERCULOSIS

Question 44

cutaneus b cell lymphoma vs sezary

Answer 44

cutaneous B-cell lymphoma.confiend to skin non puritic and localised

Question 45

immune changes due to aging

Answer 45

Impaired immune response and regulation of inflammation predispose individuals to recurrent infection, impaired wound healing, malignancy, and autoimmune disease. Decreased antibody and cell-mediated immune responses to a new antigen A decline in the counts of most subsets of B cells and T cells (exception: memory T-cell and memory B-cell counts increase) Decreased affinity of antibodies for new antigens Decrease in the variety of B-cell receptors for antigens Increase in the proportion of monoclonal cell lines Impaired affinity maturation and impaired V(D)J recombination Total immunoglobulin level remains the same. Macrophage and neutrophil co

Question 46

why do b cells decrease in aging

Answer 46

microenvironment of the bone marrow and impaired responsiveness to growth-stimulating cytokines.

Question 47

why autoimmune disease common in elderly

Answer 47

synthesis of Treg cells decreases and the synthesis of autoantibodies increases.

Question 48

mjtation in Mutations in the Fas receptor (CD95 receptor)

Answer 48

e Fas ligand can cause autoimmune lymphoproliferative syndrome (ALPS). Fas-FasL signaling is essential for proper thymic medullary negative selection, whereby caspases are activated, initiating apoptosis of T lymphocytes. Defects in this pathway lead to proliferation of antigen-specific, autoreactive lymphocyte lineages and result in hepatomegaly, generalized lymphadenopathy, and splenomegaly as well. AUtoimmune cytopenia common manifestation

Question 49

langerhans cell histocytosis

Answer 49

Langerhans cells are macrophages of the skin and lymphoid tissue that present antigens to other cells of the immune system. Clonal proliferation of these cells results in Langerhans cell histiocytosis, a condition that causes lytic skull lesions and a skin rash, as seen in this patient. Recurrent otitis media can occur if the mastoid process is involved. Langerhans cells express CD1a, which mediates antigen presentation, and S-100, which is used as a tumor marker for cells derived from the neural crest.

Question 50

which biochemical process impaired in osteogensis imperfecta

Answer 50

glycosylation

Question 51

how do you diffeentiate between phenylalanine hydroxlase deficiency and tyrosinase deficiency

Answer 51

neurological defects and msuty odoru, high phenylaanine inhibti tyrosinase

Question 52

how do you diffeentiate between phenylalanine hydroxlase deficiency and tyrosinase deficiency

Answer 52

neurological defects and msuty odoru, high phenylaanine inhibti tyrosinase

Question 53

common complaint in patient with gullian barre syndrome

Answer 53

. Finally, patients with GBS often complain of facial and/or oropharyngeal weakness, which is absent in this patien

Question 54

when does charcot marie tooth disease manifest

Answer 54

3rd decade of life

Question 55

hypothyroid neuropathy

Answer 55

hypothyroid neuropathy is a symmetric loss of sensation and deep tendon reflexes in the distal extremities, resulting in numbness, tingling, and painful dysesthesias, which is seen in this patient. Patients with hypothyroidism also often complain of constipation. However, weakness is rarely seen a

Question 56

vincristine medication manifests with what cause of syndrome

Answer 56

typically mixed sensory and motor Over time, symptoms progress to muscle weakness that is more marked in the hands and feet

Question 57

vincristine neuropathy s due to

Answer 57

disturbance in axoplasmic neuronal transport.

Question 58

toxic metabolite of cyclophosphamide

Answer 58

acrolein

Question 59

a person has severe oral mucositis what i would give him/her

Answer 59

palifmerin

Question 60

ototoxicity of chemotherapetic

Answer 60

dose dependant

Question 61

complications of vincristine

Answer 61

onstipation, paralytic ileus, and neurotoxicity

Question 62

which phase vincristine acts on

Answer 62

g2-m why? | inhibits mitosis or microtiubule formation

Question 63

what is hand food syndrome where do you see it

Answer 63

Erythema and swelling of the palms and soles with pain, paresthesias, and desquamation of skin. It typically occurs as an adverse effect of antineoplastic drugs such as 5-fluorouracil, capecitabine, cytarabine, doxorubicin, and docetaxel.

Question 64

how does proteosome inhibtor work

Answer 64

When the ubiquitin-proteasome system is inhibited by proteasome inhibitors such as bortezomib, misfolded proteins that have undergone ubiquitination are unable to be degraded in the proteasome. This leads to cell damage and death through a variety of mechanisms, including an accumulation of apoptotic proteins such as p53.

Question 65

which drug cross links purine bases

Answer 65

Alkylating agents such as cyclophosphamide and ifosfamide impair DNA replication by crosslinking DNA at the N7 site on guanine.

Question 66

what does methotrexate inhibit

Answer 66

also inhibits AICAR transformylase leading to increased intracellular concentrations of adenosine and adenine nucleotides.

Question 67

which phase growth factor inhibitors work on

Answer 67

g1 phase because thats where rna. cell organelles are grown

Question 68

side effect of etoposide and irotecan

Answer 68

alopecia and diarrhea

Question 69

what is the difference between topoisomerase 1 and 2

Answer 69

topoisomerase 1 cuts one strand however 2 cuts 2 strands

Question 70

why if i give folic acid with 5FU will increase its toxicity

Answer 70

5-FU can bind to thymidylate synthase only in the presence of methylene-tetrahydrofolate, which a derivative of folic acid and a cofactor of thymidylate synthase. Therefore, the administration of folic acid concurrently with 5-FU or capecitabine augments the effects of these drugs by increasing their binding to thymidylate synthase and simultaneously increases the risk of adverse effects (e.g., myelotoxicity).