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STEP1 > Immunology > Flashcards

Immunology Flashcards

1
Q

IL12

A

Pro
By APCs/DCs/Mq
Naive T —> helpers

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2
Q

Il10

A

Anti
By Treg
—X mq, Th

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3
Q

IL2

A

Pro
By active Th
T and B proliferation

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4
Q

CCL-

A

Inflammatory cell migration

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5
Q

IL8

A

Pro
Neutrophil migration
Endothelial adhesion viamore integrins

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6
Q

IFN

A

Antiviral
Growth regulation
Inhibition of angiogenesis

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7
Q

IL1

A

Pro
By Mq, N, epithelial, endothelial
Fever
Adhesion

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8
Q

IL6

A

Pro
Fever
Inflammation
Autoimmune
CRP

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9
Q

Tnf-alpha

A

. Pro
By most immune cells
Phagocytosis
Fever
Sepsis
Hypotension

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10
Q

TGF beta

A

Anti
Suppresses most immune cells

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11
Q

Complement

A

. MAC attack
Removal of apoptosis cells
B, dc, MQ recruitment.

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12
Q

Signals in anaphylaxis

A

C3a C4a C5a

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13
Q

Antibodies in classical complement

A

IgG and IgMactivate pw ‘’

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14
Q

C3a

A

. T cell activation
Angiogenesis

Chemotatis
mast cell de granulation
Macrophage activation

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15
Q

C3b

A

MAC induction
Opsonization

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16
Q

C5 thru 9

A

Form MAC

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17
Q

Complement inhibitors

A

C11Nh
C4BP
Factor H

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18
Q

C5 thru 9 deficiencies

A

Neisseria infections.
Ie. Recurrent meningitis

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19
Q

C3 deficiency

A

Severe and recurrent pyogenic sinus and respiratory infections

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20
Q

C1 inhibitor deficiency

A

Hereditary angioedema
Facial swelling May mimic anaphylaxis and compromise airways
Ace inhibitors contraindicated

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21
Q

CD55

A

Protects RBCs from complement

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22
Q

Ig that crossesplacenta

A

Ig G

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23
Q

HLADR3

A

Confers susceptibility to various autoimmune including T1DM, SLE, Graves, and myasthenia graves

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24
Q

Th1 cytokines

A

IFNg and IL2
Mq and T responses

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25
Q

Th2 cytokines

A

IL 4,5,13
B cells
Allergy and parasite

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26
Q

Th 17 cytokines

A

IL 17,22
Neutrophils
Autoimmune and inflammatory

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27
Q

B cell centraltolerance

A

Receptor editing of autoreactive cells in bm or apoptosis

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28
Q

Anergy

A

Due to loss ofcostim on other cell
Peripheral tolerance

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29
Q

Fas defect

A

Autoimmune lymphoproliferative syx

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30
Q

Alpha agonists

A

2 Nd line for seasonal allergy after antihistamines
Nasal oxymetazoline
Oral pseudophedrine

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31
Q

Fluticasone

A

Intranasal corticosteroid for seasonal allergy

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32
Q

Epinephrine

A

Bronchdilation and vasoconstrictor
Immediate and temporary

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33
Q

Hlaa3

A

Hemochromatosis

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34
Q

Hlab8

A

Addison, myasthenia graves, Graves

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35
Q

Hlab27

A

Psoriatica arthritis, ankalsosing spondylitis, IBD associated arthritis, reactivearthritis

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36
Q

Hladr2

A

MS, lupus,good pasture

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37
Q

Hladr3

A

T1DM, lopus,Graves,hashimotos,Addison.

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38
Q

HLADR4

A

Ra, T1DM, addison’s

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39
Q

Hladr5

A

Pernicious anemia,hashimotos

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40
Q

Rheumatic fever

A

’ streppyogenes
Molecular mimicry
Migratorypolyarthrits
Pancarditis
Skin nodules
Erythemamarginatum
Sydenham chorea

41
Q

Baker’s cyst

A

Seen in Ra

42
Q

Lung in lupus

A

Most commonly pleuritis
Ie chest pain worse when coughing laughing sneezing deep breathing
Also increased risk of pneumonia and pleural effusion

43
Q

Heart in lupus

A

Non-infectious endocarditis

44
Q

Sjorgen comorridity

A

Lymphoma
Fibromyalgia
Other autoimmune

45
Q

Siorgens symptoms

A

Dry eyes, dry mouth, e nlarged parody glands, raynauds, peripheral neuropathy, interstitial lung disease, synovitis,GERD

46
Q

Siorgens drugs

A

2nd line
Muscarinicagonists e.gpilocarpire

47
Q

Sjorgen path

A

CD4 vs gland ‘

48
Q

Most specificfest for Ra

A

Anti-CCP specific but less sensitive ~70%
Rf more sensitive but less spe üf

49
Q
A

Sarcoidosis

50
Q
A

Sarcoidosis
Reticular opacities

51
Q

Sarcoidosis sx

A

Lung
Skin
Constitutional

52
Q

Sarcoidosis Mx

A

Th1
Type 4 to occupational or environmental exposures
Nc Granulomas

53
Q

Nc granuloma causes

A

Sarcoidosis
Mycobacteriumeg Tb
Drug hypers-
Hypers- pneumonitis

54
Q

D x sarcoidosis

A

Clinical
X-ray
PFTs restrictive or normal
Lung and Ln biopsy

55
Q

Sarcadosis tx

A

Observe asymptom
NSAIDs mild
Short tolong course steroids severe

56
Q

Amyladosismx

A

Misfolded protein . aggregates
Beta pleated sheet
Production> degradation
Systemic or localized

57
Q

Primary amyladosis

A

Neoplastic plasmacells
Ig free light chain aggregates
Multiple myeloma or idiopathic

58
Q

Secondaryamyladosis

A

Serum amyloid A
= HDL associated apolipoprotein
Upregulated in acute inflammation
Can be Autoimmune complication

59
Q

Hereditaryamyloidosis

A

Various due to gene mutations causing misfolding

60
Q

Familial medditeranian fever

A

Amyloidosis d/t pyrin mutation

61
Q

Dialysis associated amyloid os is

A

Beta 2 microglobulin which is part of MHC class 2
Cannot be removed by dialysis
Newer machinessomewhat better

62
Q

Sx primary andsecondary amyladosis

A

General nonspecific ‘ vague
Esp. Kidneys and GI
Nephrotic syx
Malabsorption
Also can be tongue, cardiac, liver, spleen, carpal tunnel.
H x. of autoimmuneor cancer

63
Q

Amyladosis biopsy

A

. Congo red stain
Apple greenbirefringence on polarized light
Pink on he

64
Q

B

A
65
Q

DiGeorge syx

A

T cell deficiency mild to SCID,
Cardiac anomalies
Hypocalcemia
Defectivepharyngeal pouch development ie thymus and parathyad
22q11 deletion

66
Q

Adenosine deaminase deficient’s

A

-type of SCIDfrom accumulation of ADA in lymphocytes

67
Q

Chronic granulomatous disease

A

Neutrophil
Nadph oxidase
Bacterial and fungal
Mainly staph aureus,pseudomonas, nocardia, aspergillus;serratiamarcescans candida
Ie catalase positive bacteria that neutralize their own ros so thatneutrophils can’t use their own ros against them

68
Q

Chediak higashi syx

A

,bacterial infection,progressive neuro., albinism
Autosomal recessive
Lysosomal traffickingregulator gene
Giant azurophilic granules

69
Q

Myeloperoxidasedeficiency

A

Less severe neutrophil
Asymptomatic orcandida infection
Can besecondary todiabetes, cancer

70
Q

Glucocorticoid Mx

A

. Inhibit nf-kb among others
Needed for cytokineproduction
Band T
Eventual T apoptosis
Also reduce margination

71
Q

Cytostaticimmunosuppressante

A

In”hibit proliferation
Eg Methotrexate.
Cyclophosphamide
Azothioprine
Mycophenolate

Myelosuppression and pancytopenia

72
Q

Mycophenolate

A

Cytostatic immunosuppressant
Inhibits imp dehyarogenase ie purine synthesis.
Mostly transplant some autoimmune

73
Q

Azothioprine

A

Metabolite 6-mp inhibits prpp amidotransferase ie purinesynthesis
Nucleotide mimic

74
Q

Methotrexate

A

Inibits dhfr ie, pyramidine and de novo purine synthesis
Mostly thymidine
Folic acid analogue
Immunosippression, cancer, ectopic pre g.

75
Q

Cyclophosphamide

A

Cross links DNA
Mainly for cancers incl. Solid and heme

76
Q

Calcineurin inhibitors

A

Inhibit calcineurin and thereby NFATand there by ll 2 production

Eg tacrolimusand cyclosporine

Highly nephrotoxic

77
Q

Tacromilus

A

Binds fkbp thereby inhibiting calcineurin
Mainly transplant also topical inatopic dermatitis

78
Q

Cyclosporine

A

Binds cyclophilin inhibiting calcineurin
Transplant, severe psoriasis, and 2nd line in severe Ra flares

79
Q

Sirolimus

A

Aka rapamycin
Binds fkbp therby inhibiting mtor
Prevents IL2 response and thereby B and Tdifferentiation
Mainly transplant

80
Q

TN F alpha blockers

A

Infliximab
Adalimumab
Etanercept

Sfx impaired granuloma formation therefore Tb susceptibility

81
Q

Rituximab

A

Binds cd20
B cell apoptosis
Type 2 hypersens.

Release of cytokines during apoptosis may cause cytokine storm

82
Q

Natalizumab

A

Alpha 4 integrin
WBC extravasion
Ms and chroni’s

Encephalitissusceptibility

83
Q

Live attenuatedvaccines

A

Strongest,one dose
T and B response
Mmr, yellowfever, rotavirus
Flu i chickenpox, small pox polio bcg typhoid, typhus
Severe rxn in ic.

84
Q

Inactivated vaccines

A

Safer butmore doses needed
Rages, iv flu, Salk polio, hep A I typhoid,cholera

85
Q

Toxoid vaccines

A

us modified. toxin
Limited response,multiple doses
Diphtheria, tetanus

86
Q

Recombinantvaccines

A

DNA into cells
Strong and lasting
Hep B and hpv

87
Q

Capsular vaccines

A

T independent
Bacterial capsulepilysacchalides
Not as good in kids
Typhoid and pneumococcal

88
Q

Conjugate vaccines

A

, Weak x strongantigen
Band T
Potent, betterimmunity againstthe weak antigen
H flue B, diphtheria, meningococcus

89
Q

D antigen

A

Rh factor

90
Q

I Unit ofpacked rbc5 will raise hgb by about…

A

1 g/dl

91
Q

Blood productfor traumatichemmorrage

A

Whole blood(not packed)

92
Q

Histologicalsections of thymus and their functions

A

. Outer cortex=positive selection
Inner medulla- negativeselection

93
Q

Asplenia risks

A

Infection esp. With gram neg bacteria- h. Flu, strep preum, neisseria, kleibsella,salmonella

94
Q

Howell jollybodies

A

Indicates asplenia - dark dots in erythrocytes

95
Q

N

A
96
Q

Cgd

A

Nadph oxidase deficiency
Granulomas, bacterial and fungal infections
Especially catalasepositive

97
Q

Test for Cgd

A

Dihydrorhoda mine

98
Q

Prophylactic tx in cgd

A

Bact rim anditraconazole and if n gamma

STEP1 (15 decks)

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