Immunology 👾 Flashcards
1
Q
Cells with specialized antigen presenting functions-
A
BMD – B lymphocytes, Macrophages, Dendritic cells
2
Q
Most abundant antibody in serum
A
IgG
3
Q
Which antibody can cross placenta-
A
IgG
4
Q
Which antibody acts as an opsonin-
A
IgG1 & IgG3
(Fc segments)
5
Q
Which antibody is particularly important in defence against polysaccharide antigens-
A
IgG2
6
Q
Highly effective at neutralizing toxins-
A
IgA
7
Q
Which antibody is most abundant in external secretions-
A
IgA
8
Q
Antibodies present in external secretion
A
GAM
9
Q
Antibodies that act through complement activation-
A
GM
10
Q
Which antibody is most efficient in complement activation-
A
IgM
11
Q
Which antibody has highest molecular weight-
A
IgM
12
Q
Important in defence against parasite infection-
A
IgE
13
Q
Function in B cell development-
A
IgD
14
Q
First antibody that is produced following exposure to a new antigen-
A
IgM
15
Q
IgM appears in serum after-
A
5-10 days
16
Q
Following subsequent re-exposure, lag time between exposure and production of antibody is decreased to-
A
2-3 days
17
Q
During re exposure with same antigen, antibody response is dominated by-
A
IgG
18
Q
After production of IgM, production of other antibodies takes –
A
1-2 weeks
19
Q
Additional input from T lymphocyte to produce antibodies is required in-
A
Primary antibody response
20
Q
Predominant antibody in mucosal surface-
A
IgA
21
Q
Direct biomarker of acute inflammation-
A
CRP
22
Q
CRP is synthesized by-
A
Liver
23
Q
CRP acts as-
A
BAO
( biomarker, APR, Opsonin)
24
Q
Following an inflammatory stimulus, circulating concentrations of CRP rises within –
A
6 hours
25
Half life of CRP-
18 hours
26
Sequential measurements of CRP is useful for-
monitoring disease activity
27
Sensitive early indicator of acute phase response-
CRP
28
Indirect measure of inflammation-
ESR
29
Reliable marker of inflammation-
Plasma viscosity
30
Conditions associated with normal CRP & raised ESR:
LUPUS OME
L= SLE
U= Ulcerative Colitis
P= Pregnancy
U
S=Sjogren Syndrome
O= Old age
M=Multiple Myeloma
E=ESRD
31
Conditions associated with raised CRP & raised ESR:
Bacterial infection ( Acute, Necrotising,Chronic)
Viral infection (Acute)
Fungal infection (Acute,Chronic)
Localized abscess
Bacterial endocarditis
Tuberculosis
Crohn’s Disease
Polymyalgia Rheumatica
Inflammatory Arthritis
Acute inflammatory diseases
32
Anti inflammatory cytokines are-
Interleukin-4
Interleukin-10
TGF-B
33
Pro inflammatory cytokines are-
Interleukin-1,2,6,8,17,23
TNF-Alpha
Interferon-Gamma
34
Interleukins causing fever-
IL-1
IL-6
TNF-alpha
35
T cell deficiency causes infection with which bacterias?
Mycobacterium tuberculosis
Atypical mycobacteria
36
T cell deficiency causes infection with which fungi-
Candida
Aspergillus
Pneumocystis jirovecii
37
Infection with M.tb or atypical mycobacteria may suggest which immunodeficiency?
T lymphocyte deficiency
Phagocyte deficiency
38
Staph aureus infection occurs in which immunodeficiency
1)Phagocyte deficiency
2)Antibody deficiency
39
Phagocyte deficiency causes infection with:
No(Nocardia)
Burkha (Burkholderia)
Stephanie (Staph A)
Candy (Candida)
To
Sera (Serratia)
As per (Aspergillus)
Pseudo (Pseudomonas)
Tv (TB-Mtb+atypical)
40
T cell deficiency causes infection with-
L= lung( Aspergillus)
Y
M= MTB+ atypical TB
P=Pneumocystis jirovecii
H=HZV, HPV, HHV ( not HIV)
O
C=Candida
Cytomegalovirus
Cryptosporidia
Y
T=Toxoplasma gondii
E= EBV
41
Complement deficiency causes infection with
NHS
Neisseria meningitis
Neisseria gonorrhoeae
Hemophilus influenzae
Streptococcus pneumoniae
42
Antibody deficiency causes infection with-
HSSG
Hemophilus influenzae
Streptococcus pneumoniae
Staphylococcus aureus
Giardia lamblia
43
common sites of chronic granuloma formation-
BULLS
Lung, lymph nodes, soft tissue, bone, skin, urinary tract
44
Most common site of granuloma-
Lungs
45
Most common primary antibody deficiency
Selective IgA deficiency
46
Recognized complication of common variable immune deficiency
Bronchiectasis
47
Diseases associated with common variable immune deficiency
ITP
Autoimmune Hemolytic Anemia
Lymphoproliferative Diseases
48
In all Primary immune deficiency which vaccines should be avoided-
Live
49
Treatment of choice in severe combined immune deficiency?
Stem cell transplantation
50
Patients in whom T lymphocyte deficiency is suspected,they should be screened for-
HIV
51
Half life of IgG
21 days
52
Hyperimmune globulin is used in-
R-PET VH-PEP C-PI
1) Rabies (post exposure treatment)
2) Hepatitis B (post exposure prophylaxis)
3) Varicella Zoster ( post exposure prophylaxis)
4)Cytomegalovirus ( as prophylaxis in immunosuppressed/transplant patients)
53
Recurrent cough+ diarrhea=?
Selective IgA deficiency
54
Defective/No antibody response to polysaccharide antigen
Specific antibody deficiency
55
Patients with complement deficiency should be vaccinated with-
Meningococcal vaccine
Pneumococcal vaccine
H.influenzae B vaccine
56
Prevention of meningococcal infection-
Lifelong prophylactic penicillin
57
Patients with T lymphocyte deficiency should be considered for –
Anti-pneumocystis and anti-fungal prophylaxis
58
Physiological causes of secondary immune deficiency-
Age
Pregnancy
Prematurity
59
Infections causing secondary immune deficiency-
HIV
Measles
Mycobacterial infections
60
Drugs causing secondary immune deficiency-
Anti-epileptic drugs
Stem cell transplantation
Radiation injury
Immunosuppressants
Anti cancer drugs
Glucocorticoids
61
Sources of Interferon-alpha?
T cell
Macrophage
(ATM)
62
Sources of interferon-gamma?
T cell
NK cell
(GTN)
63
Resident cells of lymph node?
Cortex- B cell
Paracortex- T cell, Dendritic cell
Medulla-Plasma cell,Macrophages
64
Primary/Azurophil granules of the neutrophils contain which enzymes?
Myeloperoxidase
65
Secondary granules of the neutrophil contain-
LLC
L= Lysozyme
L=Lactoferrin
C=Collagenase
66
Opsonins include-
CRP
IgG
C3b
67
Phagocytes include-
Macrophage
Monocyte
Neutrophil
68
Cells of the innate immunity system-
1)Neutrophil
2)Eosinophil
3)Basophil
4)Monocyte
5)Macrophage
6)Mast cell
7)Natural Killer cell
69
Cells of the adaptive immune system-
1)B cell
2)T cell
3)Antigen presenting cell
70
Components of both innate & adaptive immune system-
1)NK cell
2)Macrophage
3)Complement
71
Mucosal immunity-
Th17
72
Acute/Positive phase reactants are-
CRP
Amyloid A
Fibrinogen
Alpha-1 Antitrypsin
Alpha-1 Antichymotrypsin
Haptoglobin
Manganese Superoxide Dismutase
Ferritin
Lactoferrin
(CAFe LaTTe)
73
Negative phase reactants-
(Increased in chronic inflammation)
Albumin
Urea
74
Factors helping in Resolution of inflammation-
TGF-Beta
PDGF
75
Chronic inflammation is frequently associated with-
Normocytic normochromic anemia
(anemia of chronic disease)
76
Which mineral deficiencies cause secondary immune deficiency
Iron
Zinc
77
Examples of periodic fever syndromes-
1)FMF
2)Mevalonate Kinase Deficiency
3)TNF Receptor Associated Periodic Syndrome (TRAPS)
4)Cryopyrin Associated Periodic Syndrome (CAPS)
78
Most common form of familial periodic fever-
FMF
79
FMF occurs due to mutation in-
MEFV gene
Pyrin protein
80
Recurrent episodes of fever lasting for hours to 4 days which is painful + abdominal pain+ chest pain+ arthritis + markedly elevated CRP =?
FMF
81
Major complication of FMF
AA Amyloidosis
82
Treatment of FMF:
1) Colchicine
2) Anakinra
3)Canalikumab
83
H/O chronic infection ( TB, Bronchiectasis, OM) or chronic inflammation( RA, FMF) + features of nephrotic syndrome=?
Reactive (AA) Amyloidosis
84
Multiple myeloma
+ SOB, features of HF ( R.Cardiomyopathy)
+ Tingling numbness (peripheral neuropathy) =?
Light chain amyloidosis (AL)
85
Known case of ESRD + pathological fracture+ joint pain + carpal tunnel syndrome=?
Dialysis associated Amyloidosis
(AB2M)
86
Pathognomonic feature of light chain amyloidosis
Macroglossia 👅
87
Hereditary amyloidosis inheritance pattern-
AD
88
Diagnosis of amyloidosis is established by-
Rectal or subcutaneous biopsy
89
Pathognomonic Histological finding of amyloidosis
🍏Apple green birefringence of amyloids when stained with congo red dye 🍷
90
Diseases associated with type 3 cryoglobulinemia
Hepatitis C
Rheumatoid arthritis
SLE
91
Type 3 cryoglobulin is
Polyclonal IgM or IgG formed against constant region of IgG then forming immune complex
92
Key investigation in the assessment of patient suspected of having allergy
Skin prick testing
93
Disadvantages of skin prick testing-
1) Remote risk of severe allergic reaction
2) Unreliable result in patients with extensive skin disease
3) Antihistamines inhibit the magnitude of response
4) Antihistamines should be discontinued for at least 3 days before test
5) Low dose glucocorticoids do NOT influence test results
6) Amitriptyline , Risperidone gives false negative results
94
Extremely useful in investigating a possible anaphylactic event
Serum mast cell tryptase
95
Following a systemic allergic reaction,Circulating levels of mast cell degranulation products rise dramatically to peak after-
1-2 hours
96
MOA of Omalizumab
Monoclonal antibody directed against IgE
97
Properties of angioedema
Episodic
Localized
Non pitting swelling of submucous or subcutaneous tissue
98
Key mediator of idiopathic angioedema
Histamine
99
Key mediator of hereditary angioedema
Bradykinin
100
Key mediator of ACEI associated angioedema
Bradykinin
101
Causes of idiopathic angioedema-
Hypothyroidism
NSAIDS
Opioids
Radiocontrast media
102
Inheritance pattern of hereditary angioedema-
AD
103
Pathophysiology of hereditary angioedema
Inherited C1 inhibitor deficiency
104
Adolescent male + facial swelling +/- SOB w H/O dental procedure or trauma or infection+ Family H positive=?
Hereditary Angioedema
105
Investigation for hereditary angioedema?
Acute- C4 levels : low
Confirm dx- C1 inhibitor levels
106
Treatment of hereditary angioedema
Acute attack:
1) C1 inhibitor concentrate
2) Bradykinin receptor antagonist: Icatibant
Prevent attack: Anabolic steroid- Danazol
Prophylaxis: Tranexamic acid
107
Classification of transplant rejection according to time
Minutes to hours- Hyperacute
5-30 days- Acute cellular
5-30 days- Acute Vascular
>30 days- Chronic
108
Pathological finding of hyperacute rejection
Thrombosis
Necrosis
109
Pathological findings of chronic allograft failure
Fibrosis
Scarring
110
Most common form of graft rejection
Acute cellular rejection
111
Major adverse effects of calcineurin inhibitors-
1)Increased susceptibility to infection
2)Hypertension
3)Nephrotoxicity
4)Diabetogenic (specially Tacrolimus)
5)Gingival hypertrophy (Ciclosporin)
6)Hirsutism (Ciclosporin)
112
Major complications of long term immunosuppression
Infection
Malignancy
