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A-Level Flashcards on various topics > Immuno - case studies > Flashcards

Immuno - case studies Flashcards

1
Q

2 types of latex allergy

A

Type I - spectrum of severity from wheeze + urticaria –> anaphylaxis

Type IV - CONTACT DERMATITIS

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2
Q

Immediate management of anaphylaxis - 7 points

A
  1. Airway management
  2. O2
  3. IM adrenaline 500mcg
  4. IV fluids
  5. IV chlorpeniramine +
  6. hydrocortisone
  7. Inhaled salbutamol
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3
Q

Specific pt groups at risk of Type I allergy to latex

A

PREM
Indwelling latex devices (eg for hydrocephalus)
Multiple urological proedures

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4
Q

Why is tropical fruit allergy significant in latex allergy

A

Cross reactivity

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5
Q

Eg of latex containing products in healthcare setting

A 
BP cuff
Gloves
Catheters
Face masks
Bandages
Steth
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6
Q

For which allergens is desensitisation actually useful? state 2

A

Insect venom

Grass pollen

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7
Q

Disorders associated with recurrent meningococcal meningitis

A

Complement deficiency
Antibody deficiency

Any disruption to BBB

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8
Q

What kinda infections make you suspicious of an immunodeficiency?

A 
SPUR 
Serious
Persistent
Unusual 
Recurrent
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9
Q

Suspected complement deficiency - what Ix are ordered?

A

C3
C4
CH50
AP50

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10
Q

Complement components in classical pathway

A

C1
C2
C4

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11
Q

Complement components of the alternate pathway

A

Factor B H I (from bacterial cells wall)

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12
Q

Complement components of the final common pathway

A

C5-9

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13
Q

Normal C3
Normal C4
Absent CH50
Absent AP50

What does this indicate?

A

Deficiency in final common pathway

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14
Q

Tests to investigate lupus nephritis?

A

Urinalysis (proteinuria + haematuria)

urine microscopy - red cells + casts

Renal biopsy

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15
Q

SLE - what kinda hypersensitivity disorder is it?

A

Type III: immune complex mediated

antinuclear antibodies bind to bare cells. these complexes activate complement + attract WBCs

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16
Q

wtf is adalimumab

A

humanised anti-TNFalpha

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17
Q

MOA of cyclophosphamide?

Which cells are most affected

A

Alkylates guanine

- affects B cells>T cells

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18
Q

Rituximab - which cells does it deplete?

A

mature B cells (but not plasma cells)

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19
Q

MMF - which cells does it affect?

A

T cells>B cells

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20
Q

Azathioprine - which cells does it affect

A

T cells

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21
Q

Penicillin for CAP –> 3 days later:

Fever, arthralgia, vasculitic skin rash, proteinuria, haematuria, raised transaminases, disorientation

A

Serum sickness

22
Q

WTF is the pathophysiology behind serum sickness

A

Penicillin is recognised as a neo-antigen: SENSITISATION. stimulates a strong IgG response

On next exposure –> IMMUNE COMPLEX FORMATION w circulating penicillin + mass IgG production –> complex deposits in glomeruli + skin + joints

23
Q

Clinical features of serum sickness

A

Arthralgia
Renal dysfunction
Purpuric rash

(immune complex deposition in small vessels)

24
Q

Ix to confirm Dx of serum sickness

A
  • complement levels - LOW due to immune complex activation
  • specific IgG to penicillin
  • Skin and kidney biopsies
25
Serum sickness: Type of hypersensitivity disorder
Type III
26
FTT +recurrent infections (tonsillitis, pneumonia, ROM, cellulitis): Ddx?
``` CF DM Bruton's SCID Hyper IgM Cytokine deficiency ``` having ATOPIC DISEASE
27
Evaluation of lymphocyte immunodeficiency - which Ix?
T-cells (CD4 + 8) B-cells IgM, IgA, IgG
28
Ix for suspected phagocyte deficiency
NBT Neutrophil count Leukocyte adhesion markers
29
Treatment of Bruton's
Immunoglobulin replacement every 3 weeks
30
Why are multiple myeloma patients susceptible to infections
The mass clonal proliferation of one plasma cell --> suppresses production of normal Ig
31
Why are multiple myeloma patients often anemics?
Crowding out of normal RBCs in bone marrow by plasma cells Tumour releases cytokines which inhibits normal bone marrow function
32
Why is ESR elevated in Multiple Myeloma
High protein content in plasma --> increases attractant charge RBCs tend to clump together so they fall more quickly through plasma.
33
X-ray lesions in multiple myeloma
lytic lesions "punched out"
34
How is recent childbirth significant in rheumatoid arthritis
In pregnancy, Th2 cells tend to predominate and then return to Th1 post-partum
35
Which class of Ig is rheumatoid factor? what does rheumatoid factor target
Rheumatoid factor is an IgM which targets Fc portion of human IgG
36
what does anti-CCP stand for
anti-cyclic citrullinated protein
37
what is CCP? how are they formed?
arginine residues are converted to citrulline residues by PADI enzymes
38
What can affect the degree of CCP generation?
Polymorphisms in PADI enzymes - type 2 and 4
39
2 HLA associations with Rheumatoid arthritis?
DR1 DR4 (Dw4, 14, 15)
40
PADI stands for?
Peptidylarginine deiminase
41
PADI enzymes are important cosssss whyyyy
PADI enzymes act to turn arginine residues into citrulline residues Polymorphisms (type 2 and 4) lof PADI --> more citrulline resiudes --> more likely to develop RA
42
PTPN22 is an enzyme important in rheumatoid arthritis. what is its function?
PTPN22 - suppresses T cell activation In RA, the 1858T allele increases RA susceptibility
43
Genetic predisposition to Rheumatoid arthritis
- HLA DR1 + 4 - PTPN22 - 1858T allele - PADI enzyme (PMs type 2 + 4)
44
1st line tx of rheumatoid arthritis
DMARDs inc methotrexate
45
If methotrexate is not tolerated - which DMARds are used for rheumatoid arthritis
Sulphasalazine | Hydroxychloroquine
46
name 2 anti-TNFalpha agents
infliximab | Adalimumab
47
Tocilizumab - MOA? use?
Anti-IL6 receptor | Rheumatoid arthritis
48
Beyond DMARDs - state 4 diff drugs used to treat Rheumatoid arthritis
Infliximab (anti-TNFa) Abatacept (anti-CTLA4) Tocilizumab (anti-IL6) Rituximab (depletes B cells, anti-CD20)
49
Natalizumab - MOA? use?
MOA: anti-alpha4 intern Use: relapsing remitting MS
50
Use for basiliximab
prevention of transplant rejection

A-Level Flashcards on various topics (69 decks)

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