IMMUNOLOGY

Question 1

What morphology will you see in hyperacute vs acute vs chornic transplant rejection?

Answer 1

hyperacute - gross motelling, fibronoid necrosis, thrombosis
acute - dense interstitial lymphocytic infiltrate
chronic - vascular thickening, interstitial fibrosis

Question 2

what heart infection presents with pervascular infiltrate and abundant eosinophils

Answer 2

hypersensitivity myocarditis
(response often to new drug)

Question 3

which ‘mab’ drugs inhibit PD-1 and PD-L1 action of tumour cells?

Answer 3

PD-1:
cemiplimab
nivolumab
pembrolizumab
PD-L1:
atezolizumab
durvalumab
avelumab

PD-1 / PD-L1 secreted by tumour cells to inhibit T cells. = evade

Question 4

Do ACEi increase or decrease bradykinin? What is the side effect?

Answer 4

yes - increases it (prevents its breakdown)
angioedema
vasodilation -> vascular permeability -> oedema

Question 5

If a live attenuated polio vaccine is given orally and an inactivated vaccine is given intramuscularly, which polio antibodies will show the greatest difference between the two patients?

Answer 5

duodenal luminal IgA
mucosal immunity
sabin (live) produces stronger musocal immunity response than killed (salk) vaccine.

Question 6

what 2 things happen to mast cells / basophils to induce release of - histamine and tryptase

Answer 6

*IgE *receptor (on mast cells / basophils) binds Fc portion of circulating antibodies
receptors cross-link and cause agglutination
causes degranulatiON - release of preformed mediators (histamine, tryptase)

Question 7

what is the reactant in delayed haemolytic transfusion reaction?

Answer 7

**minor glood group antigens **
i.e. RhD
from exposure from pregnancy, transfusions, IVDU

onset 24hrs - occurs 1-2 weeks

Question 8

what valve deformity presents with ealry systolic sound with faint ejection murmur

Answer 8

bicuspid aortic valve
turner syndrome
(also assoc. with coarctition of aorta)

Question 9

List the contents of the aortic arches 1-6
‘max stops common subway people’

Answer 9

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