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BPT > Immunology > Flashcards

Immunology Flashcards

1
Q

Azathioprine

A

MOA: Purine antimetabolite, impairs lymphocyte proliferation
Interacts with allopurinol and febuxostat 0> increased risk of bone marrow toxicity
Side Effects: Myelosuppression, mouth ulcers, oesophagitis, Hepatitis, photosensitivity, hypersensitivity syndrome (SJS/TEN, Pneumonitis), Interstitial Nephritis

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2
Q

Cyclophosphamide

A

MOA: Alkylating agent -> cytotoxic to lymphocytes by interfering with DNA cross linking

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3
Q

Immune response to live vaccine

A

Humoral and cellular response
High affinity antibodies with long term immune memory

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4
Q

Immune response to killed, subunit and toxoid vaccines

A

Response not as strong as live vaccines as pathogen can’t replicate. Primarily induce humoral response.

Need multiple doses to induce effective response, and boosters required.

Q fever vaccine can revert to wild type (exception to rule)

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5
Q

Immune response to conjugated vaccines

A

Polysaccharide + protein conjugate
T cell dependent response driven by conjugate

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6
Q

Vaccination and steroids

A

Live vaccines can be given if dose <20mg/day (or equivalent)
If given within one month of dose this high, risk of incomplete seroconversion.
After ceasing long term steroids (>2 weeks at >20mg/day), need to wait 1 month before vaccination

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7
Q

Management of accidental live vaccine administration to immunocompromised patient

A

Immunology input
IVIg to mop up vaccine

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8
Q

Mannose binding lectins

A

Pattern recognition molecules
Bind to mannose and N-acetyl glucosamine on microbes
Active complement cascade via lectin pathway

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9
Q

T cell negative selection

A

Removal of T cells at risk of causing autoimmunity by testing against self antigen by APCs

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10
Q

T cell positive selection

A

T cell receptors tested for ability to bind to MHC on APCs in thymus
If can’t bind to MHC, anergy triggered

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11
Q

MHC Class I

A

HLA-A, B, C
Present on all nucleated cells
Target for CD8+ cytotoxic T cells

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12
Q

MHC Class II

A

HLA- DR,DQ, DP
On antigen presenting cells
Target for CD4+ T helper cells

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13
Q

Immune response to intracellular pathogens, viral, bacterial infection

A

IL-12 and IFN-gamma release -> Th1 CD4+ T cell recruitment -> IFN-gamma and TNF-alpha release -> Macrophage recruitment

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14
Q

Immune response to Parasitic infection

A

IL-4 release -> Th2 CD4+ T cell recruitment -> IL-4, IL-5, IL-13 release -> Eosinophil recruitment

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15
Q

What type of infection are patients with asthma/atopy being treated with monoclonal antibodies at particular risk of?

A

Parasitic infection - most monoclonal antibodies block eosinophil activity

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16
Q

CD3

A

Present on all T cells

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17
Q

Role of C3a and C5a

A

Chemotaxis

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18
Q

Role of C3b

A

Opsonisation

19
Q

Role of C5b

A

Formation of MAC alongside C6-C9

20
Q

Triggers for alternative complement pathway

A

Endotoxins typically (lipopolysaccharides)

Others:
Aggregated Ig
Plant and bacterial polysaccharides
Radiographic contrast media
C3 nephritic factor
Some acute phase proteins

21
Q

What protects host cells against complement?

A

DAF (Decay accelerating factor) and MCP (membrane cofactor protein): breakdown C3 convertase

HRF (Homologous restriction factor) C8 binding protein and CD59: prevent formation of MAC on host cells

22
Q

NK Cell Regulation

A

Answer ####

23
Q

Roll of Toll Like Receptors

A

Help a dendritic cell determine whether antigens are related to damage or foreign material, and thus whether they need to be presented

24
Q

What is the key costimulation receptor for Dendritic Cells?

A

CD80/86 on DCs binds to CD28 on Naive Th cells in Lymph Node alongside interaction between MHC II and TCR

25
Q

What chromosome are the genes for HLA on?

A

Chromosome 6

26
Q

What is encoded as part of the HLA/MHC gene?

A

Class I: A, B, C, (E)
Class II: DP, DQ, DR
Class III: Complement C2 and C4, HSP70, TNF

27
Q

What is required for MHC-I expression?

A

Beta 2 microglublin

28
Q

What two receptors present on different immune cells have a very similar structure?

A

MHC-II and TCR

29
Q

Where are the antigens presented by MHC-II predominantly found?

A

Extracellular/exogenous

30
Q

Where are the antigens presented by MHC-I predominantly found?

A

Endogenous/intracellular/cytosol

31
Q

What interleukin is released by naive Th cells to stimulate replication?

A

IL-2

32
Q

What cytokines do Th1 cells produce?

A

IFN gamma, TNF-alpha

33
Q

What cytokines to Th2 cells produce?

A

IL-4, IL-5

34
Q

What cytokines do Th17 cells produce?

A

IL-17

35
Q

What mechanisms do cytotoxic T cells use to induce apoptosis

A

Granzyme activity via Perforins

CD95L/CD95 interaction

36
Q

What is the role of CTLA-4 and PD1/PDL1?

A

Bind to costimulatory receptors with greater affinity than their usual ligands to prevent activation of apoptotic signals

37
Q

CD5

A

Present on B1 subset, do not produce memory cells, only produce IgM

38
Q

What is the costimulatory signal for B cells?

A

CD40 on B cells binds to CD40L on Th cells alongside MHC-II/TCR interaction

39
Q

What are the light chain gene segments of antibodies?

A

Kappa and Lambda. Two present in each antibody, but will both be the same type (i.e. either two kappa or two lambda)

40
Q

What Ig bind most efficiently to complement?

A

IgM, IgG3 > IgG1 > IgG2

41
Q

What is antibody affinity and avidity?

A

Affinity: strong binding
Avidity: lots of binding sites (e.g. IgM’s pentameric structure binds with high avidity, but low affinity)

42
Q

IgA

A

Two types:
IgA1: in serum
IgA2: forms dimeric structure and found in mucosal areas with protective secretory piece which protects it from enzymatic activity

43
Q
A

BPT (16 decks)

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