Immunology

Question 1

What do these stand for and what is their func ? … DAMPs ,PAMPs

Answer 1

-Damage associate molecular patterns
pathogen associated molecular patterns
-they act as danger signals within the body

Question 2

Describe SIRS ?

Answer 2

-SIRS stands for systemic inflammatory response syndrome
-its a dysregulated , self amplifying inflammatory response across whole body in response to multiple things e.g LPS ( from gram positive bacteria ) , bacteria toxins , burns , neoplasia and pancreatitis

Question 3

Describe sepsis .

Answer 3

-Sepsis is SIRS with an infection
-pro and anti inflammatory mediators have been exacerbated
-can get severe and septic shock

Question 4

Describe MODS .

Answer 4

-stands for multi-organ disfunction syndrome
- organ dysfunction to point where homeostasis can’t be maintained without intervention
-in acutely ill animals
-can get primary and secondary

Question 5

Describe DIC .

Answer 5

-stands for disseminated intravascular coagulation
-pathological activation of coagulation

Question 6

What’s the difference between Primary and secondary immunodeficiencies ?

Answer 6

Primary (CLAD and SCID) is inherited and secondary isn’t usually seen in healthy older animals that have had a physiological or pathological change to their immune system e.g older animal gets has less CD8 + receptors

Question 7

How to test for TB ?

Answer 7

Single intradermal comparative cervical tuberculin test ( SICCT )

Question 8

State some Inflammatory markers .

Answer 8

-fibrinogen
-C-reactive protein -in dog and pig
-serum amyloid A (SAA) - cat, horse , cow
-pig-MAP - in pigs

Question 9

Name and briefly describe the different types of viral vaccines.

Answer 9

-inactivated - inactive virus still has antigens so still causes a response and promotes formation of antibodies
-attenuated - the virulence of a live virus is reduced so still causes response but not so much that it causes full blown infection
-sub-unit - just made up of the antigen e.g toxin
-Vectored - use modified virus with genetic material inside for the antigen so body makes antigen itself
-DNA - deliver the genetic material via a plasmid
-mRNA

Question 10

Name and briefly describe bacterial vaccines .

Answer 10

-inactivated /killed - dead bacteria still has antigen
-attenuated - reduced infectiousness
-subunit - just use antigen e.g inactive toxins
-recombinant - modify bacteria to include gene that codes for antigen

Question 11

What is an adjuvant ?

Answer 11

non-antigen component of a vaccine that enhances immunogenicity

Question 12

Name some safety consideration with vaccines

Answer 12

-pre-licensing tests
-marketing authorisation license -VMD
-post licensing testing

Question 13

Outline some adverse effects of vaccines .

Answer 13

-Feline injection site sarcoma (FISS)
-hypersensitivity reactions type 1(anaphylaxis ),2(bovine neonatal pancytopenia BNP, renal autoantibodies in cats ),3( cutaneous vasculitis -from rabies vaccine ) ,4 ( granuloma )

Question 14

Why are some vaccines ineffective in neonatal/aged animals ?

Answer 14

-some neonates have a period called the immunity gap where their maternal antibodies stop inhibiting the antibodies they are producing . The maternal antibodies need to reduce in order to stop the inhibition so for a period of time they have a low amount of antibodies this is known as the immunity gap.
-senior cats -consider giving herpesvirus vaccine every year when older instead of every 3 as immune system is less effective the older their age

Question 15

Name the different types of inflammatory disease with examples

Answer 15

-congenital e.g incomplete ossification of cuboidal bones
-developmental e.g osteochondritis dissecans , subchondral bone cyst
-degenerative e.g osteoarthritis , osteochondral fragmentation
-immune mediated e.g canine immune mediated polyarthritis
-infectious e.g septic arthritis

Question 16

Name and briefly explain 3 ways joint sepsis is caused

Answer 16

-traumatic wound
-iatrogenic - when we inject into the wound - for that reason take aseptic precaution
-haematogenous -infection elsewhere causes bacteria in blood stream , bacteraemia and so migrates into joints as capillaries around joints are small so blood travels past slowly and bacteria adhere to membrane and get into joint , occurs in neonates

Question 17

Name some common infections in the neonate that commonly cause bacteraemia .

Answer 17

umbilicus infection
lung infection
gut infection ( dirty stomach tubes )

Question 18

How common is joint sepsis in each companion animal and what’s the common routes ?

Answer 18

-horse - common - trauma , haematogenous , iatrogenic
-farm - common - haematogenous
-SA- rare

Question 19

How would you approach OA ? systemic , intraarticular

Answer 19

systemic
-NSAIDS
-Bisphosphonates ( equine )
-glycosaminoglycan derivatives - supplement joint cartilage

Intra-articular
-corticosteroids -some licensed horses
-glycosaminoglycan derivatives - poor evidence
-synthetic hydrogels -poor evidence
-biological products ( stem cells, IRAP, PRP)

Question 20

How would you approach joint sepsis ? systemic, intra-articular , regional

Answer 20

systemic options
-antibiotics
-NSAIDS

Intra-articular options
-antibiotics
-opiods

Regional options ( intravenous regional perfusion )
-antibiotics

Question 21

How would you approach immune mediated joint disease ? systemic

Answer 21

-corticosteroids
-immunomodulators

Question 22

What’s something to consider when treating horse joint problems ?

Answer 22

withdrawal times

Question 23

What two ways can an immune mediated disease come about ? with examples

Answer 23

-immune response targets body’s own healthy cells e.g pemphigus foliaceus - body attacks desmosomes in epithelium of skin
-failure of innate/adaptive immunity e.g complement C3 deficiency

Question 24

state and briefly describe some examples of immune mediated disease in dogs

Answer 24

-auto-immune or immune-mediated haemolytic anaemia = damage to red cells
-immune-mediated thrombocytopenia - damage to platelets
-Immune-mediated polyarthritis - damage joint capsule
-addisons disease /hyperadrenocorticism - destruction of adrenal glands no mineral or gluco corticoids
-type 1 diabetes - destruction of pancreatic tissue no insulin
-hypothyroidism - destruction of thyroid follicular epithelium no thyroid hormone
-exocrine pancreatic insufficient - destruction of pancreatic exocrine glands no pancreatic digestive enzymes

Question 25

examples of IMD type 2 hypersensitivity ( immune mediated disease )

Answer 25

-IMHA - immune mediated haemoragic anemia
-Myasthenia gravis

Question 26

examples of IMD type 3 hypersensitivity ( immune mediated disease )

Answer 26

-complexes can deposit in wall of small capillaries e.g glomerulus ( causing glomerulitis ) , synovium =synovial basement membrane ( causing polyarthritis ) , uveal tract ( causing uveitis)

Question 27

example of IMD type 4 hypersensitivity ( immune mediated disease )

Answer 27

-hyperthyroidism

Question 28

Why does immune mediated disease cause hypersensitivity reactions ?

Answer 28

a failure of peripheral tolerance means there at CD4+ t cells in the blood that are self-reactive

Question 29

what triggers can cause secondary immune mediated disease ?

Answer 29

-drugs
e.g trimethoprim sulphonamides ( antibiotic ) bind to cells triggering a targeted immune response
carbimazole and methimazole
-neoplastic disease - ( triggers in IMHA and IMT )
-inflammation
-infection

Question 30

What reasons can animals get immune mediated disease ?

Answer 30

ultimately something effecting immune tolerance
-age - older less t cells
- no trigger / idiopathic
-tiggered - drugs , neoplasia ,inflammation

Question 31

what is the most common cause of immune mediated polyarthritis ?

Answer 31

idiopathic = type 1

Question 32

What is an immunomodulatory drug ?

Answer 32

a drug that stimulates , supresses or modifies the immune system

Question 33

Give some examples of immunomodulatory drugs ( specific and broad ) and briefly describe their action

Answer 33

-steroids - supress - supress leukocytes ,down-regulate expression of Fc receptors ( binding site for antibodies ) supress T cell func , B cell func , reduce antibody
-azathioprine - suppress
-chlorambucil
-mycophenolate - suppresses
-ciclosporin - specific T cell supressor
-leflunomide - inhibits DHODH

Question 34

Name some naturally occuring supplements for IMD .

Answer 34

-omega 3 fatty acids - reduce production of inflammatory mediators
-vitamin E - antioxidative
-vitamin D - enhances innate immunity and modulates adaptive
-glutamine

Question 35

Things to consider when giving Immunomodulatory drugs .

Answer 35

• is the damage in humoral mechanisms - antibodies
  -is it in cellular mechanisms - T cell

Question 36

How does pregnancy effect ADME ?

Answer 36

Absorption - reduced abdominal space , increased gastric ph
Distribution - additional compartment - change plasma volume , drugs high volume of distribution more likely to cross placenta
Metabolism - altered metabolism due to additional need for detoxification
Excretion - alkanosis/acidosis in dam can lead to alter excretion

Question 37

What are some other consideration when selecting drugs for a pregnant patient ?

Answer 37

-licensed
-ion trapping - ions trapped in fetal blood from drug
-if absorbed orally likely to be trans-placental transfer

Question 38

Considerations regarding lactation when selecting a drug .

Answer 38

• milk for human consumption - milk withdrawls
  -licensing
  -metabolic status of dam
  -effect on neonate
• lactation is a new route of elimination

Question 39

What are the 3 underlying causes of joint sepsis in farm animals ?

Answer 39

-haematogenous spread
-trauma
-pathogens that target joints

Question 40

What things would you consider before giving a vaccine ? SA

Answer 40

• age
  -pregnancy/ lactation
  -has caused problem before ?
  -medical problems /allergies

Question 41

What things would you consider before giving a vaccine ? farm

Answer 41

-pregnancy/lactation
-milk/meat withdrawals
-prev vaccinations
-disease status of herd/flock
-risk of infection
- timing - calving/lambing
-handler circumstances - pregnant , immunocompromised
-cost

Question 42

What things would you consider before giving a vaccine ? equine

Answer 42

-competition animals - timing ,withdrawal
-prev vaccinations
-risk of infection - tetanus
-gov requirements