Immuno Fun Facts Flashcards
If a patient is prescribed opioids and her kid ODs should you report this?
no because it was secreted in the colostrum (remember this is through IgA)
Anti-CD20 antibody, which is better for repeated use?
Human then humanized (these are much less immunogenic)
Drugs and antibodies think
IgG
If a patient is transplanted with an animal organ ,what type of transplant is this?
Xenograft
remember the isograft/homograft is from identical twins
autograft is self and allograft is within species
If antibodies are treated with papain what can still happen?
Digestion with papain yields three molecules, two copies of a single antigen binding region, F(ab) and one readily crystallizable fragment (Fc) that cannot bind antigen. Digestion of antibodies with pepsin generates one molecule possessing two antigen binding sites Fab2. In pepsin digests, the Fc portion is proteolytically degraded.
If a transplant is given to a patient and the doctor is not worried about an immune response, then what disease does the patient have?
DiGeorge’s
few or no circulating T cells
patient is continually infected with Candida, get thrush (white tongue) what do they have?
Chronic mucocutaneous candidiasis
hole in the T cell repertorie to candida albicans
infection to yeast due to lack of antigen/MHC expression thus affecting T cells and inability to activate B cells
Deficiency in the MAC complex formation, results in what type of infections?
Neisseria infections
X-SCID is deficiency in what?
CD132–> common chain in cytokine receptors for IL-2, IL-4, IL-7, IL-9, IL-15, IL-21
what infections are common with X-SCID?
viral, fungal, and bacterial infections
SCID what is the defect?
Lymphoid progenitor cells defect due to Adenosine Deaminase (ADA) deficiency –> Highest lymphocytes activity –> increase metabolites of deoxy ATP and deoxyadenosine.
Absence of CD132
Deficiency of C3 convertase but can still make what?
C3a and C4a (anaphylia toxins)
C4b and C2a and Bb and C3b (pathway enzymes)
How do NK cells get an inhibitory signal?
MHC I
What vaccine is associated with the lowest risk ?
Synthetic vaccines (recombinant) due to the not all virulent organisms that are removed from preparation Safe for immunocompromised ppl
patient is in the area where tetanus is an issue however she is vaccinated and wants her kid immune, what would you give the patient?
Tetanus Toxoid not Ab
think about it you dont want to give a live vaccine to an unborn fetus with no immune system
Hemolytic Disease of Newborn (erythblastosis fetalis) is what? and associated with what hypersensitivity?
negative Rh mom with a positive Rh progeny (mom will then be exposed after any placental transfer)
Type II Antibody mediated antibody to cell surface reaction
Goodpasteur’s Syndrome/Kidney Disposition is associated with what hypersensitivity?
Type II antibody mediated antibody to cell surface reaction
Epinephrine prevents the release of histamine and is given for Type I hypersensitivity reactions what other drug can you give someone that works by preventing the release of histamine?
Sodium Cromoglycate –> stabilizes mast cells and/or basophil membranes
(would not give an Anti-Histamine these have no effect on bronchoconstriction just stop the histamine that is already released)
A 45-year-old man presents to a physician with complaints of double vision and ptosis. The patient has noticed that these problems are minor in the early morning, but become
progressively more severe during the course of the day. Symptoms markedly improve after a test dose of edrophonium. This condition is usually related to autoantibodies directed against which of the following
AcH receptor–> myasthenia gravis (MG)
Blocks AcH at the receptor
A 21-year-old female presents with a three week history of symmetrical swelling of the small joints of the hands and feet and morning stiffness of one and one-half hour duration. Tests indicate IgM autoantibodies specific for Fc portion of IgG. This patient most likely has
Rheumatoid Arthritis (RA) IgM (or IgA/IgG) antibodies that recognize Fc of autologous IgG
All of the following are associated with Hashimotos Thyroiditis except:
Anti Thyroglobulin, gland destruction, Anti-microsomal, low levels of TSH, NO Anti-TSH-Receptor
Type IV hypersensitivity (release of auto antibodies)
what upregulates Tregs?
TGF-B
Patient has Helminth infection, what would you not want to give them
Anti- IL5
IFNgamma, IFNbeta and IFNalpha all upregulate what?
Enhance expression of class II MHC antigen on nucleated cells Inhibits T cell proliferation
Described angioedema, puffy lips, what is deficient
C1 INH deficiency
Hereditary Angioneuretic Edema (HANE) –> uncontrolled C1 activity –> leads to increase activation of Kallikrein
overproduction of C2b (prokinin), C4a and bradykin
ACE inhibitors make this condition worse
A young boy has had repeated infections with Staphylococcus aureus. His laboratory data reveals that he has normal numbers of white blood cells with a normal distribution by differential counting. His immunoglobulin levels are normal and he responds to Candida skin
test antigen with a positive DTH reaction. Which one of the following types of immune deficiency do you suspect
Granulocyte disorder (Type 4 HS)
- A 27-year-old housewife presents to her family physician with a 3 month history of fatigue, and a facial rash which is aggravated by sun exposure. Laboratory tests reveal anemia of 10-gm/dl (normal is 12-14) and immune testing reveals auto-antibodies against double stranded DNA. What is the most likely diagnosis
SLE
A precocious kindergarten child, decided to take her three week old baby brother out of the carriage so that she could play “mother”. Unfortunately she tripped, and the baby fell onto an old tin can which the dog had dragged onto the front lawn. Since the baby received a laceration, the mother rushed him to the doctor. Which of the following would be the preferred treatment
A tetanus immune globulin (human) injection this visit, with an injection of tetanus toxoid several weeks later.
Immune surveillance should provide the mechanism for the elimination of tumors that express tumor specific antigens. However, the presence of tumors in patients indicate that there are factors that enable the tumor to escape the immune system, as listed below. Which one of the
following is INCORRECT
Tumor antigens may be recognized by T-cells in the absence of MHC
Mr. Arnold was mowing in his back yard when a bee stung him. He has a known allergy to bee venom, having been stung twice before. He immediately went inside and gave himself an injection with his Epinephrine pen. This saved his life. Which one of the following is true
Arnold has previously been sensitized and has IgE antibodies specific for bee venom
A 4-year-old child suffering from repeated bacterial infections was found to have normal phagocytic function and cell mediated immune responses. Lymph node biopsy would probably reveal
paucity (low levels) of plasma cells
A patient walks into your clinic complaining of a chronic cough and general fatigue. Upon examination you diagnose him to have small cell lung cancer. Since the patient has a very aggressive form of cancer, that has been unresponsive to medication or radiation, you decide to enroll him in a new clinical trial that is using gene therapy to treat lung cancer. The theory behind the trial is to use gene therapy to express a protein on the tumor cell surface that will stimulate T-cell proliferation. Which of the following would be the most effective co-stimulatory protein to be expressed on the tumor cell in this clinical trial
CD80/CD86 (on dendritic cell) with CD28 on the T cells
HJ is a young (4 year old) boy with recurrent sinus infections over the last few years. In preparation for a planned trip to the Far East he began a series of vaccinations with recombinant Hep B vaccine. Before the third vaccination, you test his titer of IgG antibody (from the previous immunizations) to assess the efficacy of the vaccination, and find he has extraordinarily low
titers (barely above the nonimmune level), with relatively high IgM titers. You would expect him to also to
develop a normal immune response to pneumococcal polysaccharide vaccine
- A 3-year-old boy has a history of repeated pyogenic (pus-forming) infections. He had normal antibody responses following childhood immunizations and normal recovery from chickenpox and measles.Decreased numbers or functional defects in which of the following cells best explains the cause of his infections
Neutrophils
Which of the following best describes the differences between the classic and alternate complement pathways
The classical pathway requires antibody for initiation, and the alternate pathway is antibody-independent.
An antigen found in relatively high concentration in the plasma of normal fetuses and a high proportion of patients testicular cancer is
alpha-fetoprotein
A woman comes into your office complaining of lesions on her legs. The lesion is a plaque with irregular raised, indurated brown areas. In all other respects she is asymptomatic. You decide to run a serological test. The presence of which antigen would you expect to find
MAGE 1-3
What can also be used to immunize for Mycobacterium Tuberculosis
Mycobacterium Bovis
Live attenuated bacteria vaccine
Anti-CD20 takes out everything except for
Pro B cells
Steven is 19 years old and had a severe episode of meningitis. The physicians are still awaiting culture results to identify the organism. Blood tests reveal his C3 and C4 levels are normal. His IgG level is at the lower limit of normal and he is not anemic. His CD4 to CD8 ratio is normal but the total CD4 count is still pending. The overall activity of the classical pathway of complement assay (CH50) is below the lower limit of normal. The most likely diagnosis is a deficiency in
A MAC complex protein
You are in the process of developing novel antibodies for use in autoimmune disorders. After extensive studies in patients with Multiple Sclerosis (MS), you conclude a major (unknown) antigen incites expansion of a family of Vβ8 T cells. You believe that infusion of anti-Vβ8 antibodies would benefit the patient because the treatment would
eliminate - several clones of Vβ8 CD8+ T cells and Vβ8 CD4+ T cells irrespective of the specificity
You are coordinating a community-clinic-based program, which has just started testing a novel antibiotic that offers promise for treating community-acquired bacterial pneumonia. After 200 patients have been treated successfully with no apparent adverse effects, you discover that two of the newer patients enrolled in the trial have developed anemia after taking the drug for seven days
anti-hapten (drug metabolite) antibodies
Three hundred thirty nine patients with active rheumatoid arthritis were given a placebo or CTLA4Ig at either 2mg/kgm body weight or 10mg/kgm body weight. Treatment with CTLA4Ig was well tolerated. Patients receiving 10mg/kgm body weight showed statistically significant improvement in all scales of outcome measures. (All 339 patients received methotrexate as well). With which molecule(s) would this soluble fusion protein bind on antigen presenting cells
CD80/ CD86/B7-1/B7-2/All of the above
About 10 QUESTIONS on the whole th0 to th1 cytokines pathway via IFNgamma from NK cells IL12 and IL10 inhibits, and th0 to th2 cytokines via IL4, know the th0/1/2 cytokines
yay!
What enhances NK cells killing
IL12
Know that innate immunity is Natural killer cells, mast cells, eosinophils, basophils; and the phagocytic cells including macrophages, neutrophils and dendritic cells
YAY
What downregulates macrophage mobilization
Anti IL1/TNF
