Immunology

Question 1

What is a granuloma?

Answer 1

Collection of activated macrophages and lymphocytes

Question 2

What does a granuloma activate?

Answer 2

T lymphocytes

Question 3

Lung granuloma differential

Answer 3

Sarcoid
TB
Leprosy
Silicosis
Hypersensitivity pneumonitis
Foreign bodies

Question 4

Presentation of antibody deficiencies

Answer 4

Recurrent bacterial infections
Antibody mediated autoimmune diseases

Question 5

Primary antibody deficiency example (2)

Answer 5

CVID
IgA deficiency

Question 6

What is CVID?

Answer 6

Low IgG, M, A
Recurrent bacterial infections -> associated with autoimmune disease

Question 7

Are IgA deficiency people symptomatic?

Answer 7

only 1/3 are

Question 8

Differential of recurrent bacterial infections and hypogammaglobulinaemia

Answer 8

Primary: antibody deficiency, CVID, IgA, etc
Secondary: protein loss: nephritic syndrome, failure of protein synthesis: CLL, myeloma, non-hodgkins

Question 9

What are complement proteins?

Answer 9

Proteins secreted by the liver to act as a sticky coat for intruders in order to turbo-boost immediate immune defence

Question 10

Complement deficiency predisposes to

Answer 10

Bacterial infection

Question 11

IgGs are broken down by

Answer 11

Endothelial cells and recycled to have longer half life (NOT BROKEN DOWN BY LIVER!!!)

Question 12

What are NK cells?

Answer 12

Kill cells that lack MHC
No long term memory

Question 13

Can you give biologics to someone with liver cirrhosis ?

Answer 13

Yes, because not metabolized by the liver

Question 14

Biologics are essentially the same as

Answer 14

Antibodies

Question 15

NK cell defects predispose to

Answer 15

VZV, HSV, CMV, HPV

Question 16

What immunity are NK cells apart of

Answer 16

Innate
Remove cancer cells

Question 17

How does the innate recognition of invaders work?

Answer 17

They are Toll-Like-Receptors (TLRs)
Respond to PAMPS: pathogen associated molecular patterns

Question 18

TLRs are expressed on

Answer 18

Phagocytes and dendrites

Question 19

Outcome of TLR activation

Answer 19

Pro-inflammatory and type 1 interferon secretion

Question 20

TLR dysfunction

Answer 20

Too little: immunodeficiency
Too much: autoimmunity

Question 21

TNFa inhibitors block

Answer 21

Pro-inflammatory cytokines

Question 22

TNFa is an

Answer 22

Immediate early fire alarm signal in response to many stressors

Question 23

What cells activate TNFa

Answer 23

Macrophages
Neutrophils
Tcells
Endothelium
Mast cells

Question 24

Biologic drugs are artificial

Answer 24

Antibodies

Question 25

Biologic drugs act as passive/active immunization

Answer 25

Passive

Question 26

How are biologics administered?

Answer 26

By injection every couple of weeks

Question 27

4 types of transplant rejection

Answer 27

Hyperacute, acute cellular, acute vascular, chronic allograft

Question 28

Hyperacute is within

Answer 28

Minutes to hours T2 hypersensitivity, antibody and compliment fixation

Question 29

Acute cellular rejection happens within

Answer 29

5-30 days Type IV hypersensitivity, CD4 and 8 cells Treat with immunosupression

Question 30

Acute vascular rejection is within so long? What type of hypersensitivity?

Answer 30

5-30 days II hypersensitivity De novo antibody and complement fixation NEEDS LOTS OF IMMUNOSUPRESSION

Question 31

Chronic allograft failure time What is it due to?

Answer 31

>30 days Fibrosis, scarring

Question 32

Vaccination produces memory in

Answer 32

B and T cells

Question 33

What are created during primary immune responses?

Answer 33

Long-lived memory B cells

Question 34

What reactivates in response to a second encounter with the antigen?

Answer 34

Memory B cells

Question 35

Vaccination simulates

Answer 35

Rare naive T cells --> become effector T cells which either 1. die due to apoptosis in absence of persisting antigen 2. memory T cells are maintained at low frequency

Question 36

5 types of vaccines

Answer 36

Inactivated Live RNA DNA Viruses

Question 37

Example of inactivated

Answer 37

Polio, Hep A, Hep B HPV, Diphtheria, H influenza B, etc

Question 38

5 in 1 vaccine includes

Answer 38

Innactivated Polio Pertussis Diptheria Tetanus H inf B

Question 39

Live vaccines

Answer 39

MMR vaccine

Question 40

Chickenpox is

Answer 40

Live

Question 41

DNA/RNA vaccines direct

Answer 41

Assembly of the antigenic protein inside the host cell

Question 42

Example of DNA/RNA vaccines

Answer 42

COVID

Question 43

Virus vaccines are

Answer 43

Empty shells (capsids) made from viruses that have no DNA/RNA

Question 44

Examples of VLP vaccines

Answer 44

HPV and Hep B vaccines