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Medicine 🩺 > Immunology 👾 > Flashcards

Immunology 👾 Flashcards

1
Q

Cells with specialized antigen presenting functions-

A

BMD – B lymphocytes, Macrophages, Dendritic cells

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2
Q

Most abundant antibody in serum

A

IgG

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3
Q

Which antibody can cross placenta-

A

IgG

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4
Q

Which antibody acts as an opsonin-

A

IgG1 & IgG3
(Fc segments)

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5
Q

Which antibody is particularly important in defence against polysaccharide antigens-

A

IgG2

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6
Q

Highly effective at neutralizing toxins-

A

IgA

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7
Q

Which antibody is most abundant in external secretions-

A

IgA

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8
Q

Antibodies present in external secretion

A

GAM

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9
Q

Antibodies that act through complement activation-

A

GM

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10
Q

Which antibody is most efficient in complement activation-

A

IgM

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11
Q

Which antibody has highest molecular weight-

A

IgM

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12
Q

Important in defence against parasite infection-

A

IgE

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13
Q

Function in B cell development-

A

IgD

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14
Q

First antibody that is produced following exposure to a new antigen-

A

IgM

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15
Q

IgM appears in serum after-

A

5-10 days

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16
Q

Following subsequent re-exposure, lag time between exposure and production of antibody is decreased to-

A

2-3 days

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17
Q

During re exposure with same antigen, antibody response is dominated by-

A

IgG

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18
Q

After production of IgM, production of other antibodies takes –

A

1-2 weeks

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19
Q

Additional input from T lymphocyte to produce antibodies is required in-

A

Primary antibody response

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20
Q

Predominant antibody in mucosal surface-

A

IgA

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21
Q

Direct biomarker of acute inflammation-

A

CRP

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22
Q

CRP is synthesized by-

A

Liver

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23
Q

CRP acts as-

A

BAO
( biomarker, APR, Opsonin)

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24
Q

Following an inflammatory stimulus, circulating concentrations of CRP rises within –

A

6 hours

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25
Q

Half life of CRP-

A

18 hours

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26
Q

Sequential measurements of CRP is useful for-

A

monitoring disease activity

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27
Q

Sensitive early indicator of acute phase response-

A

CRP

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28
Q

Indirect measure of inflammation-

A

ESR

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29
Q

Reliable marker of inflammation-

A

Plasma viscosity

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30
Q

Conditions associated with normal CRP & raised ESR:

A

LUPUS OME
L= SLE
U= Ulcerative Colitis
P= Pregnancy
U
S=Sjogren Syndrome

O= Old age
M=Multiple Myeloma
E=ESRD

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31
Q

Conditions associated with raised CRP & raised ESR:

A

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

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32
Q

Anti inflammatory cytokines are-

A

Interleukin-4
Interleukin-10
TGF-B

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33
Q

Pro inflammatory cytokines are-

A

Interleukin-1,2,6,8,17,23
TNF-Alpha
Interferon-Gamma

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34
Q

Interleukins causing fever-

A

IL-1
IL-6
TNF-alpha

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35
Q

T cell deficiency causes infection with which bacterias?

A

Mycobacterium tuberculosis
Atypical mycobacteria

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36
Q

T cell deficiency causes infection with which fungi-

A

Candida
Aspergillus
Pneumocystis jirovecii

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37
Q

Infection with M.tb or atypical mycobacteria may suggest which immunodeficiency?

A

T lymphocyte deficiency
Phagocyte deficiency

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38
Q

Staph aureus infection occurs in which immunodeficiency

A

1)Phagocyte deficiency
2)Antibody deficiency

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39
Q

Phagocyte deficiency causes infection with:

A

No(Nocardia)
Burkha (Burkholderia)
Stephanie (Staph A)
Candy (Candida)
To
Sera (Serratia)
As per (Aspergillus)
Pseudo (Pseudomonas)
Tv (TB-Mtb+atypical)

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40
Q

T cell deficiency causes infection with-

A

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

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41
Q

Complement deficiency causes infection with

A

NHS
Neisseria meningitis
Neisseria gonorrhoeae
Hemophilus influenzae
Streptococcus pneumoniae

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42
Q

Antibody deficiency causes infection with-

A

HSSG
Hemophilus influenzae
Streptococcus pneumoniae
Staphylococcus aureus
Giardia lamblia

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43
Q

common sites of chronic granuloma formation-

A

BULLS
Lung, lymph nodes, soft tissue, bone, skin, urinary tract

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44
Q

Most common site of granuloma-

A

Lungs

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45
Q

Most common primary antibody deficiency

A

Selective IgA deficiency

46
Q

Recognized complication of common variable immune deficiency

A

Bronchiectasis

47
Q

Diseases associated with common variable immune deficiency

A

ITP
Autoimmune Hemolytic Anemia
Lymphoproliferative Diseases

48
Q

In all Primary immune deficiency which vaccines should be avoided-

A

Live

49
Q

Treatment of choice in severe combined immune deficiency?

A

Stem cell transplantation

50
Q

Patients in whom T lymphocyte deficiency is suspected,they should be screened for-

A

HIV

51
Q

Half life of IgG

A

21 days

52
Q

Hyperimmune globulin is used in-

A

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
Q

Recurrent cough+ diarrhea=?

A

Selective IgA deficiency

54
Q

Defective/No antibody response to polysaccharide antigen

A

Specific antibody deficiency

55
Q

Patients with complement deficiency should be vaccinated with-

A

Meningococcal vaccine
Pneumococcal vaccine
H.influenzae B vaccine

56
Q

Prevention of meningococcal infection-

A

Lifelong prophylactic penicillin

57
Q

Patients with T lymphocyte deficiency should be considered for –

A

Anti-pneumocystis and anti-fungal prophylaxis

58
Q

Physiological causes of secondary immune deficiency-

A

Age
Pregnancy
Prematurity

59
Q

Infections causing secondary immune deficiency-

A

HIV
Measles
Mycobacterial infections

60
Q

Drugs causing secondary immune deficiency-

A

Anti-epileptic drugs
Stem cell transplantation
Radiation injury
Immunosuppressants
Anti cancer drugs
Glucocorticoids

61
Q

Sources of Interferon-alpha?

A

T cell
Macrophage
(ATM)

62
Q

Sources of interferon-gamma?

A

T cell
NK cell
(GTN)

63
Q

Resident cells of lymph node?

A

Cortex- B cell
Paracortex- T cell, Dendritic cell
Medulla-Plasma cell,Macrophages

64
Q

Primary/Azurophil granules of the neutrophils contain which enzymes?

A

Myeloperoxidase

65
Q

Secondary granules of the neutrophil contain-

A

LLC
L= Lysozyme
L=Lactoferrin
C=Collagenase

66
Q

Opsonins include-

A

CRP
IgG
C3b

67
Q

Phagocytes include-

A

Macrophage
Monocyte
Neutrophil

68
Q

Cells of the innate immunity system-

A

1)Neutrophil
2)Eosinophil
3)Basophil
4)Monocyte
5)Macrophage
6)Mast cell
7)Natural Killer cell

69
Q

Cells of the adaptive immune system-

A

1)B cell
2)T cell
3)Antigen presenting cell

70
Q

Components of both innate & adaptive immune system-

A

1)NK cell
2)Macrophage
3)Complement

71
Q

Mucosal immunity-

A

Th17

72
Q

Acute/Positive phase reactants are-

A

CRP
Amyloid A
Fibrinogen
Alpha-1 Antitrypsin
Alpha-1 Antichymotrypsin
Haptoglobin
Manganese Superoxide Dismutase
Ferritin
Lactoferrin
(CAFe LaTTe)

73
Q

Negative phase reactants-
(Increased in chronic inflammation)

A

Albumin
Urea

74
Q

Factors helping in Resolution of inflammation-

A

TGF-Beta
PDGF

75
Q

Chronic inflammation is frequently associated with-

A

Normocytic normochromic anemia
(anemia of chronic disease)

76
Q

Which mineral deficiencies cause secondary immune deficiency

A

Iron
Zinc

77
Q

Examples of periodic fever syndromes-

A

1)FMF
2)Mevalonate Kinase Deficiency
3)TNF Receptor Associated Periodic Syndrome (TRAPS)
4)Cryopyrin Associated Periodic Syndrome (CAPS)

78
Q

Most common form of familial periodic fever-

A

FMF

79
Q

FMF occurs due to mutation in-

A

MEFV gene
Pyrin protein

80
Q

Recurrent episodes of fever lasting for hours to 4 days which is painful + abdominal pain+ chest pain+ arthritis + markedly elevated CRP =?

A

FMF

81
Q

Major complication of FMF

A

AA Amyloidosis

82
Q

Treatment of FMF:

A

1) Colchicine
2) Anakinra
3)Canalikumab

83
Q

H/O chronic infection ( TB, Bronchiectasis, OM) or chronic inflammation( RA, FMF) + features of nephrotic syndrome=?

A

Reactive (AA) Amyloidosis

84
Q

Multiple myeloma
+ SOB, features of HF ( R.Cardiomyopathy)
+ Tingling numbness (peripheral neuropathy) =?

A

Light chain amyloidosis (AL)

85
Q

Known case of ESRD + pathological fracture+ joint pain + carpal tunnel syndrome=?

A

Dialysis associated Amyloidosis
(AB2M)

86
Q

Pathognomonic feature of light chain amyloidosis

A

Macroglossia 👅

87
Q

Hereditary amyloidosis inheritance pattern-

A

AD

88
Q

Diagnosis of amyloidosis is established by-

A

Rectal or subcutaneous biopsy

89
Q

Pathognomonic Histological finding of amyloidosis

A

🍏Apple green birefringence of amyloids when stained with congo red dye 🍷

90
Q

Diseases associated with type 3 cryoglobulinemia

A

Hepatitis C
Rheumatoid arthritis
SLE

91
Q

Type 3 cryoglobulin is

A

Polyclonal IgM or IgG formed against constant region of IgG then forming immune complex

92
Q

Key investigation in the assessment of patient suspected of having allergy

A

Skin prick testing

93
Q

Disadvantages of skin prick testing-

A

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
Q

Extremely useful in investigating a possible anaphylactic event

A

Serum mast cell tryptase

95
Q

Following a systemic allergic reaction,Circulating levels of mast cell degranulation products rise dramatically to peak after-

A

1-2 hours

96
Q

MOA of Omalizumab

A

Monoclonal antibody directed against IgE

97
Q

Properties of angioedema

A

Episodic
Localized
Non pitting swelling of submucous or subcutaneous tissue

98
Q

Key mediator of idiopathic angioedema

A

Histamine

99
Q

Key mediator of hereditary angioedema

A

Bradykinin

100
Q

Key mediator of ACEI associated angioedema

A

Bradykinin

101
Q

Causes of idiopathic angioedema-

A

Hypothyroidism
NSAIDS
Opioids
Radiocontrast media

102
Q

Inheritance pattern of hereditary angioedema-

A

AD

103
Q

Pathophysiology of hereditary angioedema

A

Inherited C1 inhibitor deficiency

104
Q

Adolescent male + facial swelling +/- SOB w H/O dental procedure or trauma or infection+ Family H positive=?

A

Hereditary Angioedema

105
Q

Investigation for hereditary angioedema?

A

Acute- C4 levels : low
Confirm dx- C1 inhibitor levels

106
Q

Treatment of hereditary angioedema

A

Acute attack:
1) C1 inhibitor concentrate
2) Bradykinin receptor antagonist: Icatibant

Prevent attack: Anabolic steroid- Danazol

Prophylaxis: Tranexamic acid

107
Q

Classification of transplant rejection according to time

A

Minutes to hours- Hyperacute
5-30 days- Acute cellular
5-30 days- Acute Vascular
>30 days- Chronic

108
Q

Pathological finding of hyperacute rejection

A

Thrombosis
Necrosis

109
Q

Pathological findings of chronic allograft failure

A

Fibrosis
Scarring

110
Q

Most common form of graft rejection

A

Acute cellular rejection

111
Q

Major adverse effects of calcineurin inhibitors-

A

1)Increased susceptibility to infection
2)Hypertension
3)Nephrotoxicity
4)Diabetogenic (specially Tacrolimus)
5)Gingival hypertrophy (Ciclosporin)
6)Hirsutism (Ciclosporin)

112
Q

Major complications of long term immunosuppression

A

Infection
Malignancy

Medicine 🩺 (19 decks)

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