Immuno COPY Flashcards
1
Q
EBV and amoxicillin/ampicillin/cephalosporin
A
Causes hypersensitivity reaction in presence of EBV - not true allergy
2
Q
Ibrutinib can be used in which leukemia?
A
CLL
3
Q
Tx Psoriasis
A
Ustekinumab (anti IL-12/23)
4
Q
Tx RA (not DDMARD/MTX)
A
Rituximab (anti CD20), anti-TNFa (etanercept or adalimumab), tocilizumab (anti-IL6)
5
Q
Wegener’s with severe flare
A
Cyclophosphamide
6
Q
Worsening Crohn’s, already on Azathioprine and Prednisolone, what tx?
A
Infliximab (Anti-TNFa)
7
Q
Malignant melanoma medical treatment
A
Pembrolizumab
8
Q
Rituximab
A
RA or Lymphoma
anti-CD20
9
Q
Transplant drugs
A
Tacrolimus, Cyclosporin Azathioprine Mycophenolate Mofetil Antithymocyte globulin (ATG Prednisolone Basiliximab (anti-CD25/IL-2) (prophylactic)
10
Q
Type I hypersensitivity
A
Allergy/Atopic eczema
11
Q
Type II hypersensitivity
A
Auto-immune/auto-inflammatory e.g. Graves
12
Q
Type III hypersensitivity
A
Complex mediated e.g. SLE
13
Q
Type IV hypersensitivity
A
Delayed e.g. contact dermatitis, diabetes
14
Q
CD40L associated
A
Hyper IgM
15
Q
GPA’s other name
A
Wegener’s Granulomatosis
16
Q
eGPA’s other name
A
Churg-Strauss Syndrome
17
Q
Monitoring SLE
A
C3, C4
18
Q
Chest and renal
A
Good-pasture’s classically but can be GPA/eGPA
19
Q
Hyperacute rejection (transplant)
A
Minutes-hours
Pre-formed Abs activate complement
–> Thrombosis and necrosis
Prevent by cross-match and HLA typing
20
Q
Acute cellular rejection (transplant)
A
Weeks-months
CD4 cells –> type IV hypersensitivity reaction –> cellular infiltrate
Tx: T-cell immunosuppression e.g. Steroids
Memory aid: T cell = T 4
21
Q
Acute Ab-mediated rejection (transplant)
A
Weeks-months
B-cells --> antibodies --> attack vessels and endothelial cells --> vasculitis Complement deposition (C4d)
B-cell immunosuppression & remove Abs
22
Q
Chronic rejection (transplant)
A
Months-years
Various immune+non-immune mechs –> fibrosis, GN, ischaemia –> Tx: minimise organ damage
RF: multiple acute rejections, HTN, hyperlipidaemia
23
Q
GvHD
A
Days-weeks (T cell mediated)
Rash, bloody D&V, & jaundice
Tx: Immunosuppress with steroids
24
Q
Acute vascular rejection
A
4-6 days post transplant after xenograft - presents similarly to hyperacute
25
H1 vs H2 antagonisst
```
H1 = antihistamines
H2 = reducing gastric acid
```
26
Itchy skin when running in cold for an hour
Acute urticarial --> H1 antagonist
27
Hereditary angioedema treatment
C1q esterase inhibitor (reduces swelling)
28
Measure of mast cell degranulation
Mast cell tryptase levels
29
Chemokine promoting eoosinophil growth
IL-5
30
Tingly mouth after eating apples, melons etc.
OAS (Sxs limited to mouth)
31
Woman with flushed face, breathing problems (happened multiple times) and hepatomegaly
Hereditary angioedema
| Tx: C1 esterase inhibitor
32
Kid with rash on extensor surfaces, IgE mediated
Atopic dermatitis
33
Hypertensive and diabetic with angioedema - potential cause?
ACE inhibitor
34
Absent T cells and normal B cells
X-linked SCID
35
1m baby, serious bacterial infections
Normal CD8, no CD4
B cells present
IgM present, IgG absent
Bare Lymphocyte Syndrome (Type 2)
Absent expression of MHC Class II molecules
36
```
Jaundiced 4m baby, FTT, recurrent infections
raised ALP, low CD4, defect protein regulates MHC class 2
```
Bare Lymphocyte Syndrome (Type 2)
Associated with sclerosing cholangitis --> jaundice
37
Recurrent strep. pneumonia
| FHx of having it and dying young
```
Complement deficiency
(Encapsulated organism)
```
38
Child with recurrent infections, improved with age, now delay in language and speech
DiGeorge
Immune function improves with age
Can be associated with lots of speech/language issues and LDs as well as rest of CATCH-22
39
Loss of the terminal complement pathway
Encapsulated organisms
40
Recurrent meningitis
Complement deficiency (C5-9)
Encapsulated organism e.g. Hib or N. meningitidis
41
Recurrent infections, negative NBT test
Chronic Granulomatous disease
42
PID causing atypical granulomas
IFNy/IL12 or receptor deficiency
Predisposed to mycobacterial infections
Inability to form granulomas hence atypical
43
Recurrent infections
negative NBT test
negative dihydrorhodamine test
Chronic Granulomatous disease
44
6m boy, sevete FTT & recurrent infections
| No T cells, B cells normal
X linked SCID
45
Alternative complement pathway components
Factor B, I & P
| "BIP"
46
Alternative complement pathway components
Factor B, I & P
| "BIP"
47
Lady with spinal fracture due to TB
IFNy/IL12 or receptor deficiency
Mycobacteria susceptible --> Pott's disease
48
Felty's syndrome (3 features)
RA, neutropenia and splenomegaly
49
Rheumatoid arthritis and splenomegaly
Felty's
50
Monocytes in peripheral skin cells
Langerhands
51
Cells that express Foxp3 and CD25
Treg
52
Responsible for killing cancerous cells + inhibited by MHC-I
NK cells
53
PEP exists against (3)
Rabies, HIV, tetanus
54
Routine vaccine that is not given to immunocompromised patients
MMR
If oral steroids in past 3 months delay vaccine
55
Vaccine target HA
Influenza
56
Every 5 years post splenectomy
Pneumococcal
57
Adaptive response to HIV:
Neutralising antibodies against what?
anti-gp120 and anti-gp41
58
Adaptive response to HIV:
Non-neutralising antibodies against what?
anti-p24 & gag IgG
59
Co-receptor required for HIV entry into CD4
CCR5 & CXCR4
60
HIV binding to CD4
1. Initial binding
2. Conformational change
3. Co-receptors
4. What are they co-receptors on?
1. gp120
2. gp41
3. CCR4 & CXCR5
4. Macrophages
61
Intrastructural support for HIV
gag protein
62
Chemokines which block CCR5 (inhibit HIV entry into cell)
MIP-1a, MIP-1b, and RANTES
63
HIV enzyme that copies with errors
RT
64
AIRE gene - which condition?
AIPS2 (APECED)
65
FAS gene mutation causes which condition?
ALPS (autoimmune lymphoproliferative syndrome)
66
MEFV gene, periodic abdominal pain and ascites
Familial Mediterranean Fever
67
Nod2/CARD15
Crohn's
68
DR4 and CCP
RA
69
HLA-B27
Ank spond
70
What should you check before starting azathioprine?
TPMT levels (enzyme)
71
Serum sickness = what type of hypersensitivity?
Type 3 Hypersensitivity
72
Adult with bronchiectasis, recurrent sinusitis, diarrhoea and development of atypical SLE
CVID
73
What does IPEX stand for?
Immune dysregulation (autoimmune conditions)
Polyendocrinopathy
Enteropathy
X-linked inheritance syndrome
Absolute deficiency of Treg cells (Foxp3 mutation)
BMT is only cure
74
CTLA4 receptor on t cells
associated with AI conditions like diabetes and thyroid disease
75
PTPN22
Tyrosine phosphatase associated with RA
76
CTD screening antibody
ANA
77
CGD treatment type
IFN gamma
78
SE of cyclophosphamide
infertility
79
SE of azathioprine
neutropenia (especially if TPMT is low)
80
SE of cyclosporin
Hypertension
81
SE of Mycofenolate Mofetil
Progressive multifocal leukencephalopathy (caused by JC virus)
82
60yo develops rash while under general anaesthetic, what do you do?
Measure mast cell tryptase
83
75yo man with hypertension, tongue and periorbital swelling. Cause of swelling?
ACEi
84
Complement deficiency and nephritis factor
Membranoproliferative nephritis and bacterial infections
85
C1q deficiency
Skin conditions, childhood onset SLE (severe), infections, kidney disease
86
anti-CD25
Basilixumab
87
anti IL12/23
Ustekinumab
88
anti IL-6
Tocilizumab
89
AI hep/PSC antibody
Anti smooth muscle Ab
90
Goodpasteurs connective tissue thing
Type IV collagen
91
Mouldy hay
EAA
92
Oligoclonal bands of IgG on CSF with myelin basic protein
MS
93
OKT3
A mab for hyperacute rejection
94
Calcineurin inhibitor
Cyclosporin (reduces IL-2)
95
Medication that inhibits DNA synthesis in an attempt to prevent proliferation of T cells (post transplant)
Azathioprine
96
IVDU who has multiple aneurysms
Hep B is associated with PAN
97
SLE pt develops bleeding from gums and nose bleeds, with low platelet count
1. Antibody target
2. name of condition developed
1. Glycoprotein IIb-IIIa
| 2. Autoimmune thrombocytopenic purpura
98
Drug that prevents cell replication by damaging DNA (B cells more than T cells)
Cyclophosphamide
Used in SLE, wegeners, leukemias, CTD
99
CTLA4-immunoglobulin fusion protein
Abatacept (rheumatoid arthritis)
100
Mycophenylate Mofetil MoA
Guanine synthesis (IMPDH is the enzyme)
101
Kveim test
Sarcoidosis
102
Test for HSP
immunofluoresence
103
Increased CH50
acute inflammation e.g. RA
104
Pot strep rheumatoid fever (mechanism)
Molecular mimicry
105
1st exposure to allergen IL
IL-12
106
Cyclosporin MoA
Calcineurin inhibitor
107
Dermatomyositis appearance on immunofluoresence
Speckled (Anti-Jo1)
108
Lipiduria
Minimal change disease (increase in lipids to try to maintain oncotic pressure)
109
TNF-ß is central in diagnosis of which condition?
CREST
