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USMLE > Immuno physiology > Flashcards

Immuno physiology Flashcards

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USMLE® Step 1 flashcards
1
Q

What type of Hypersensitivity reaction is Acute Hemolytic Transfusion Reaction

A

Type II (antibody-mediated)

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2
Q

Describe the clinical presentation of a patient with acute hemolytic transfusion reaction

A

fever and chills, hypotension, chest/back pain and hemoglobinuria (red- to brown-colored urine) after blood transfusion

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3
Q

What is the mechanism behind acute hemolytic transfusion reaction?

A

Recipient Anti-ABO antibodies bind donor erythrocyte antigens. Activate complement-mediated cell lysis (C5-C9)

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4
Q

Hemolytic disease of the newborn is what type of hypersensitivity reaction?

A

Type II

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5
Q

Which humoral components are involved in a Type II hypersensitivity reaction?

A

IgG and IgM autoantibodies and complement

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6
Q

What is the etiology of hyperacute transplant rejection

A

Preformed antibodies against graft in recipient’s circulation

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7
Q

What is the morphology of hyperacute transplant rejection reaction

A

Gross mottling and cyanosis; arterial fibrinoid necrosis and capillary thrombotic occlusion

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8
Q

What is the etiology of acute transplant rejection?

A

Exposure to donor antigens induces humoral/cellular activation of naive immune cells in recipient

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9
Q

What is the morphology of humoral mediated acute transplant rejection?

A

C4d deposition, neutrophilic infiltrate, necrotizing vasculitis

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10
Q

What is the morphology of cellular acute transplant rejection?

A

Lymphocytic interstitial infiltrates and endotheliitis

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11
Q

What is the etiology of chronic transplant rejection?

A

Chronic, low-grade immune response refractory to immunosuppressants

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12
Q

What is the clinical presentation of chronic renal allograft rejection?

A

Worsening hypertension, progressive rise in serum creatinine and proteinuria with normal urinary sediment

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13
Q

What is the morphology of chronic transplant rejection?

A

Vascular wall thickening and luminal narrowing; interstitial fibrosis and parenchyma atrophy (obliterative vascular fibrosis)

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14
Q

Which bacterial genus lacks peptidoglycan cell wall?

A

Mycoplasma (including Ureaplasma urealyticum)

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15
Q

What is the best treatment for Mycoplasma infections?

A

Anti-ribosomal agents (tetracycline, macrolides)

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16
Q

Why does blood in left atrium and ventricle have slightly lower pO2 than in pulmonary capillaries?

A

Mixing of deoxygenated blood from pulmonary veins carrying blood from bronchial blood supply and cardiac (thesbian) blood supply

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17
Q

List 4 causes of diffusion limited exchange

A

pulmonary fibrosis, ARDS, emphysema, hyaline membrane dz in infant

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18
Q

What is the function of IL-3 secreted by helper T cells

A

promote growth and differentiation of bone marrow stem cells

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19
Q

Function of IL-1 secreted by macrophage

A

stimulates T cells to proliferate and secrete cytokines

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20
Q

Which cytokine is responsible for fibrosis?

A

TGF-beta

21
Q

IFN-gamma

A

activates macrophages and may stimulate CD8 T cells

22
Q

What is the structure of MHC I

A

Heavy chain and beta 2 microglobulin

23
Q

What is the structure of MHC II

A

alpha and beta polypeptide chains

24
Q

Which MHC molecules respond to tumors

A

MHC I

25
Q

What does antigen presentation by MHC I result in

A

apoptosis of presenting cell

26
Q

What does antigen presentation from MHC II result in

A

Activation of TH cells, which stimulate humoral and cell-mediated response

27
Q

How do a mainstem bronchus obstruction and pleural effusion present on CXR

A

entire lobe white opacities with tracheal deviation (completely opacified hemithroax)

28
Q

How to distinguish between mainstem bronchus lung collapse and pleural effusion

A

In lung collapse, trachea shifts towards injured lung (white); in pleural effusion, trachea shifts away from injured lung

29
Q

Viruses that lose their infectivity upon exposure to ether are likely

A

Enveloped

30
Q

Which part of the immune response is integral to response against mycobacteria?

A

Cell-mediated (macrophage, neutrophils, etc)

31
Q

Which fungal infection found in the Central US appears as ovoid cells within macrophages?

A

Histoplasma capsulatum

32
Q

Which fungal infection endemic to SW US appears as multinucleated spherules?

A

Coccidiodes

33
Q

Which fungi takes form of budding yeast with thick capsule

A

Cryptococcus neoformans

34
Q

Which yeasts form pseudohyphae and blastoconidia

A

Candida species

35
Q

Which fungus is seen in tissue sections as septae hyphae and dichotamous branching

A

Aspergillus

36
Q

Which enzyme is mutated in chronic granulomatous disease?

A

NADPH oxidase

37
Q

NADPH oxidase deficiency in CGD leads to

A

impaired respiratory burst (intracellular killing)

38
Q

Three primary clinical manifestations of Chronic Granulomatous Disease

A

Recurrent infections by catalase-positive organisms, infections of skin and lymph nodes; diffuse granuloma formation

39
Q

Dihydrorhodamine flow cytometry testing that reveals an absence of green fluorescnece characteristic of normal neutrophils likely diagnoses

A

Chronic Granulomatous Disease

40
Q

A Nitroblue tetrazolium test that does not turn blue likely confirms

A

Myeloperoxidase deficiency

41
Q

Which yeast species gives rise to “germ tubes”

A

Candida (colonizes mucous membranes of mouth, vagina, skin, intestine)

42
Q

Which yeast forms a “fungus ball” in lung cavities and causes cough and hemoptysis

A

Aspergillus fumigatus

43
Q

Which parts of the pulm system are normally sterile?

A

Trachea and small bronchi

44
Q

What is the tetrad of septic shock?

A

Hypotension, tachycardia, tachypnea and fever

45
Q

Which molecule is the mediator of septic shock?

A

TNF-alpha

46
Q

TNF-alpha (cachectin) mediates which consequence of inflammation?

A

Necrosis of tumors and cachexia (generalized muscle wasting) of host

47
Q

Which cytokine mediates sepsis and causes hepatic release of acute-phase reactants

A

TNF-alpha

48
Q

Which cytokine has antiviral and antitumor activity

A

Interferon alpha

USMLE (36 decks)

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