Immunology

Question 1

IgG - Complement

Answer 1

IgG1 = Moderate

IgG2 = Weak

IgG3 = Strong

IgG4 = None

Question 2

IgG - Allergens

Answer 2

IgG1 = Weak

IgG2 = None

IgG3 = None

IgG4 = Strong

Question 3

Complement - Classic Pathway

Answer 3

C1, C2, C4

Question 4

Complement - Membrane Attack Complex

Answer 4

C5b-C9

Question 5

Complement - Alternative Pathway

Answer 5

C3 + Factor B, D, H, I

Question 6

Anti-centromere

Answer 6

CREST (Limited cutaneous systemic sclerosis)

Question 7

anti-Jo-1

Answer 7

Inflammatory myopathies

Question 8

anti-SS-A (Ro)

Answer 8

Sjogrens (less specific), Lupus

Question 9

anti-SS-B (La)

Answer 9

Sjogrens (more specific)

Question 10

anti-dsDNA

Answer 10

SLE (specific)

Question 11

anti-Scl-70

Answer 11

Systemic scleroderma

Question 12

anti-Smooth muscle

Answer 12

Chronic immune hepatitis

Question 13

anti-histone

Answer 13

Drug induced lupius

Question 14

anti-gliadin

Answer 14

Celiac (also anti-endomysial)

Question 15

anti-mitochondrial

Answer 15

Primary biliary cirrhosis

Question 16

anti-RNP

Answer 16

Mixed connective tissue disease

Question 17

anti-Smith

Answer 17

SLE (specific)

Question 18

anti-trasnglutaminase

Answer 18

Celiac, dermatitis herpetiformis

Question 19

c-ANCA

Answer 19

Wegner’s granulomatosis
(anti Proteinase 3)

Question 20

p-ANCA

Answer 20

microscopic polyangiitis, Churg-Strauss, ssytemic vasculitides
(anti MPO)

Question 21

Rheumatoid factor

Answer 21

Rheumatoid arthritis (less specific)
IgM anti-IgG

Question 22

anti-CCP (citrulline)

Answer 22

Rheumatoid arthritis (more specific)

Question 23

anti-SRP

Answer 23

Polymyositis, scleromyositis, myasthenia gravis

Question 24

anti-LKM (liver-kidney-microsomal)

Answer 24

Autoimmune chronic active hepatitis

Question 25

BTK Defic - Labs, Genetics, Sx, Tx

Answer 25

BTK Defic
- Low to absent immunoglobulin, CD19+ cells absent
- X linked
- Upper resp, Giardia
- Tx = IVIG

Question 26

IgA Defic - Labs, Sx

Answer 26

IgA defic
- Only IgA low (maybe IgG2)
- Mostly none, but some UTIs. Risk for allergic nonhemolytic transfusion rxn

Question 27

IgG subclass defic - Dx, Sx

Answer 27

IgG Subclass Defic
- Presents at any age, resp infections, encapsulated organisms
- Dx = monitor Ig response to vaccines

Question 28

CD40L defic - genetics, mechanism, labs

Answer 28

CD40L defic
- X linked, prevents T cel induced B cell class switcihng
- IgM normal/high, rest low

Question 29

DiGeorge Syndrome - genetics, labs, sx

Answer 29

DiGeorge Syndrme
- 22q11 missing
- Low absent CD3 cells
- Presents with hypoparathyroid and congenital heart disease, opporutnistic infections (Pneumo, Candida)

Question 30

Severe Combined Immunodefic - genetics-labs pairings, sx

Answer 30

SCID
- X-linked IL2 - T- and NK+/-
- AR Adenosine deaminase - T- B- NK-
- JAK3 defic - T-

All forms pathogen infections

Question 31

Wiskott-Aldrich - genetics, sx, labs

Answer 31

Wiskott-Aldrich
- X-linked WASP mutation
- Recurrent pyogenic infections, eczema, thrombocytopenia
- Low IgM, elevated IgA and possibly IgE

Question 32

Chronic granulomatous disease - genetics, sx, dx

Answer 32

CGD
- 2/3 X linked 1/3 AR - defect in NADPH oxidase
- Lymphadenitis, hepatosplenomegaly, pneumonia
- Dx = Nitroblue tetrazolium test, or flow

Question 33

Type 1 cryoglobulinemia

Ig type
Associations

Answer 33

Type 1 Cryoglobulinemia

Monoclonal IgG
Malignancy (multiple myeloma, Waldestrom)

Question 34

Type 2 cryoglobulinemia

Ig type
Associations

Answer 34

Type 2 cryoglobulinemia

Monoclonal IgM (with anti-IgG activity) and polyclonal IgG
Hep C

Question 35

Type 3 cryoglobulinemia

Ig type
Associations

Answer 35

Type 3 cryoglobulinemia

Polyclonal with anti-IgG of one component
Hep C