Immuno COPY Flashcards
EBV and amoxicillin/ampicillin/cephalosporin
Causes hypersensitivity reaction in presence of EBV - not true allergy
Ibrutinib can be used in which leukemia?
CLL
Tx Psoriasis
Ustekinumab (anti IL-12/23)
Tx RA (not DDMARD/MTX)
Rituximab (anti CD20), anti-TNFa (etanercept or adalimumab), tocilizumab (anti-IL6)
Wegener’s with severe flare
Cyclophosphamide
Worsening Crohn’s, already on Azathioprine and Prednisolone, what tx?
Infliximab (Anti-TNFa)
Malignant melanoma medical treatment
Pembrolizumab
Rituximab
RA or Lymphoma
anti-CD20
Transplant drugs
Tacrolimus, Cyclosporin Azathioprine Mycophenolate Mofetil Antithymocyte globulin (ATG Prednisolone Basiliximab (anti-CD25/IL-2) (prophylactic)
Type I hypersensitivity
Allergy/Atopic eczema
Type II hypersensitivity
Auto-immune/auto-inflammatory e.g. Graves
Type III hypersensitivity
Complex mediated e.g. SLE
Type IV hypersensitivity
Delayed e.g. contact dermatitis, diabetes
CD40L associated
Hyper IgM
GPA’s other name
Wegener’s Granulomatosis
eGPA’s other name
Churg-Strauss Syndrome
Monitoring SLE
C3, C4
Chest and renal
Good-pasture’s classically but can be GPA/eGPA
Hyperacute rejection (transplant)
Minutes-hours
Pre-formed Abs activate complement
–> Thrombosis and necrosis
Prevent by cross-match and HLA typing
Acute cellular rejection (transplant)
Weeks-months
CD4 cells –> type IV hypersensitivity reaction –> cellular infiltrate
Tx: T-cell immunosuppression e.g. Steroids
Memory aid: T cell = T 4
Acute Ab-mediated rejection (transplant)
Weeks-months
B-cells --> antibodies --> attack vessels and endothelial cells --> vasculitis Complement deposition (C4d)
B-cell immunosuppression & remove Abs
Chronic rejection (transplant)
Months-years
Various immune+non-immune mechs –> fibrosis, GN, ischaemia –> Tx: minimise organ damage
RF: multiple acute rejections, HTN, hyperlipidaemia
GvHD
Days-weeks (T cell mediated)
Rash, bloody D&V, & jaundice
Tx: Immunosuppress with steroids
Acute vascular rejection
4-6 days post transplant after xenograft - presents similarly to hyperacute
H1 vs H2 antagonisst
H1 = antihistamines H2 = reducing gastric acid
Itchy skin when running in cold for an hour
Acute urticarial –> H1 antagonist
Hereditary angioedema treatment
C1q esterase inhibitor (reduces swelling)
Measure of mast cell degranulation
Mast cell tryptase levels
Chemokine promoting eoosinophil growth
IL-5
Tingly mouth after eating apples, melons etc.
OAS (Sxs limited to mouth)
Woman with flushed face, breathing problems (happened multiple times) and hepatomegaly
Hereditary angioedema
Tx: C1 esterase inhibitor
Kid with rash on extensor surfaces, IgE mediated
Atopic dermatitis
Hypertensive and diabetic with angioedema - potential cause?
ACE inhibitor
Absent T cells and normal B cells
X-linked SCID
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
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
Recurrent strep. pneumonia
FHx of having it and dying young
Complement deficiency (Encapsulated organism)
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
Loss of the terminal complement pathway
Encapsulated organisms
Recurrent meningitis
Complement deficiency (C5-9)
Encapsulated organism e.g. Hib or N. meningitidis
Recurrent infections, negative NBT test
Chronic Granulomatous disease
PID causing atypical granulomas
IFNy/IL12 or receptor deficiency
Predisposed to mycobacterial infections
Inability to form granulomas hence atypical
Recurrent infections
negative NBT test
negative dihydrorhodamine test
Chronic Granulomatous disease