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1MRCP Part 1 > Immunology > Flashcards

Immunology Flashcards

1
Q

IL associated with pyrexia

A

IL-1
IL-6

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2
Q

IL associated with neutrophil chemotaxis

A

IL-8

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3
Q

IL associated with B cell differentiation

A

IL-6

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4
Q

Site of action of IL-1
Action

A

Macrophages
Fever

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5
Q

Site of action of IL- 8
Action

A

Macrophages
Neutrophil chemotaxis

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6
Q

Site of action of IL-6
Action

A

Macrophages
Fever
B-cell differentiation

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7
Q

Mastocytosis
- What is it?
- What are the symptoms?

A

= proliferation of mast cells, neoplasm
Symptoms of carcinoid + urticaria

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8
Q

Marker in hereditary angioedema
Deficiency

A

C4 (because we have been there BEFORE)
Deficient = C1
C1 = vascular permeability > leaky vessels

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9
Q

CD4 T cells
- Express
- Also known as

A

MHC Class II
T helper cells

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10
Q

CD8 T cells
- Express
- Also known as

A

MHC Class I
Cytotoxic T cells

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11
Q

Further subdivision of CD4 cells
- How can they be told apart?

A

Th1 and Th2 cells
Classification depends on cytokines released
Th2 = humoral immunity (cytokines focus on Ab release)
Th1 = cell mediated immunity (cytokines focus on killing T cells)

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12
Q

How does IL-1 mediate the sepsis response?

A

Activates platelet activating factor, prostaglandin and nitric oxide
= potent vasodilators

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13
Q

Action of IL-5

A

Production and activation of eosinophilsA

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14
Q

Action of G-CSF

A

Allows development and activation of neutrophils

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15
Q

Action of TNF-alpha

A

Fever
Macrophage activation

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16
Q

Action of INF-gamma

A

Activation of macrophages

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17
Q

Cytokines which result in fever (3)

A

IL-1
IL-6
TNF-alpha

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18
Q

Action of INF-alpha

A

Activates macrophages

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19
Q

What activates the classical complement pathway?

A

IgM antibodies
IgG antibodies

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20
Q

What activates the alternative complement pathyway?

A

IgA
Endotoxin - LPS released from lysis of bacterial cell wall

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21
Q

Complement deficiency associated with immune complex disease
- Examples (3)

A

C2 and C4
- SLE, HSP, glomerulonephritis

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22
Q

Complement deficiency in recurrent infections

A

C5-C9

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23
Q

Alternative pathway

A

C3

24
Q

Classical pathway

A

C1 > C4 > C2 > C3 > C5-9

25
Q

Which antibody is the most abundant?

A

IgG

26
Q

Can IgG cross the placenta?

A

Yes - hence issue with anti-D IgG antibodies in future pregnancy

27
Q

Monomer antibodies (2)

A

IgG
IgD

28
Q

Pentamer antibody

A

IgM

29
Q

Which antibody activates the alternative complement pathway?

A

IgA

30
Q

Autoimmune haemolytic anaemia
- Cold
- Warm

A

Cold = IgM because cold is Miserable: intravascular
Warm = IgG

31
Q

Cryoglobulinaemia
Type 1
Type 2
Type 3

A

Type 1 = monoclonal
Type 2 = mixed monoclonal, polyclonal
Type 3 = polyclonal

32
Q

Association with Type 1 cryoglobulinaemia (2)

A

Myeloma, Waldenstroms
- one clonal cell proliferating

33
Q

Association with Type 2 cryoglobulinaemia (2)

A

Hepatitis C, Lymphoma

34
Q

Type II hypersensitivity
- problem
- example (5)

A

Cell bound = antibody binds to cell surface
e.g. autoimmune haemolytic anaemia, transfusion reaction, post-streptococcal glomerulonephritis, goodpastures, ITP

35
Q

What type of hypersensitivity is Grave’s disease?

A

Type II - TSH antibody binds to receptor, causing thyroid effects

36
Q

Type III hypersensitivity
- problem
- example (4)

A

Immune complex = antibodies, free antigen and complement bind together to form complexes
e.g. drug induced haemolytic anaemia, hypersensitivity pneumonia, malaria, SLE

37
Q

Direct Coomb’s Test
- aim of test
- example

A

Aim = looking for antibodies bound to red blood cells
- AIHA - will be positive

38
Q

Indirect Coomb’s Test
- aim of test
- application

A

Looking for free antibodies in serum
e.g. prior to transfusion, pregnancy for anti-D/other sensitising antibodies

38
Q

What mediates hyperacute organ rejection?

A

B cell mediated - antibodies attack and destroy graft
- Present due to previous sensitisation event

39
Q

What mediates acute organ refection?

A

T cell mediated - T cells migrate out of graft, processed then invade

40
Q

Pathogenesis of graft vs host disease

A

Donor lymphocytes attack antigen of recipient

41
Q

B cell only disorders (4)

A

IgA deficiency
Common variable immunodeficiency
Bruton’s
Hypogammaglobulinaemia

42
Q

Infection pattern in B cell disorders

A

Pyogenic bacteria
Yeasts
Giardia

43
Q

Bruton’s immunodeficiency
- genetics
- presentation age
- problem

A

X-linked inheritance
Under 6 months at presentation
No B cells present

44
Q

Combined B cell and T cell deficiencies (3)

A

Severe combined immunodeficiency
Ataxic Telangiectasia
Wiskott-Aldrich

45
Q

Ataxic Telangiectasia
- genetics
- presentation (4)

A

Autosomal recessive
Cerebellar ataxia, occular telangiectasia
ENT, chest infections

46
Q

Wiskott-Aldrich Syndrome
- genetics
- infection

A

X-linked recessive
Pyogenic infections

47
Q

Infection pattern in T cell disorders

A

Opportunistic infections

48
Q

T cell disorder (1)

A

DiGeorge Syndrome

49
Q

DiGeorge syndrome
- genetic mutation
- pathogenesis
- presentation (3)

A

22q11 deletion - part of long arm Ch 22 is missing
- Absence of a thymus due to issue with 3rd/4th pharyngeal pouch
Hypoparathyroidism, CV problems, opportunistic infections

50
Q

Infection pattern in neutrophil disorders

A

Gram -VE bacteria
Staph aureus
Viral infections
Aspergillus

51
Q

Chronic Granulomatous Disease
- genetics
- pathogenesis
- when presents?

A

X-linked
Defect in NADPH oxidase axis
Presents in first 2 years of life

52
Q

What kind of hypersensitivity reaction is ITP?

A

Type II - antibodies bind to platelets

53
Q

Function of IgD antibodies

A

Activate B cells

54
Q

Hyperacute transplant rejection mediated by which antibody?

A

IgG

1MRCP Part 1 (20 decks)

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