Immunology

Question 1

Splenic dysfunction impact

Answer 1

increased encapsulated organism risk

decreased IgM causes less C3b opsonization

Question 2

Positive selection of T lymphocytes

Answer 2

in cortex of thymus

Question 3

Negative selection of T cells

Answer 3

medulla of thymus

Question 4

Recombination of pathogen receptors genes

Answer 4

VDJ in lymphocyte development

Question 5

MHC I characteristics

Answer 5

HLA-A,B,C
all nucleated cells
pairs with beta-microglobulin
loaded in RER with intracellular peptides

Question 6

MCH II characteristics

Answer 6

only on APCs
HLA-DR,DP,DQ
loaded following release of invariant chain

Question 7

HLA B27 assc

Answer 7

psoriasis
ankylosing spondylitits
IBD

Question 8

HLA DR2 assc

Answer 8

MS
SLE
Goodpasture’s

Question 9

Activation of naive T cells

Answer 9

B7 and CD28 interaction

Question 10

B cell activation for class switching

Answer 10

CD40 receptor on B cells bound by CD40L of T cell

Question 11

Regulatory T cell markers

Answer 11

CD3
CD4
CD25

Question 12

Complement binding site on Abs

Answer 12

Fc region

determines isotype of Ig

Question 13

Ab diversity gene

Answer 13

V(D)J heavy chain genes
VJ light chain genes
done by somatic hypermutation

Question 14

Activation of complement

Answer 14

IgG and IgM

Question 15

Opsonization in complement system

Answer 15

C3b and IgG

Question 16

Neutrophil chemotaxis in complement system

Answer 16

C5a

Question 17

MAC cell lysis in complement

Answer 17

C5b-C9

Question 18

Result of C5-C9 deficiency

Answer 18

Recurrent Neisseria infections

Question 19

Ig differentiation cytokines

Answer 19

IL-4 does IgE and IgG production

IL-5 does IgA production

Question 20

Role of interferon alpha and beta

Answer 20

inhibits viral protein synthesis

Question 21

Role of intefereon gamma

Answer 21

increase MHC I and II expression

Question 22

B cell surface markers

Answer 22

CD19
CD20
CD21 (for EBV receptor)
CD40 (for acivation)

Question 23

Bugs with antigenic variation (5)

Answer 23

Salmonella
Borrelia
N. gonorrheae (maltose (-))
influenza
trypanosomes

Question 24

Impact of live attenuated vaccine

Answer 24

cellular response

life-long immunity

Question 25

Impact of killed vaccine

Answer 25

humoral immunity by surface antigen response

needs booster shot

Question 26

Type II hypersensitivity rxn diseases

Answer 26

Pernicious anemia
Rheumatic fever
Goodpasture’s syndrome

Question 27

Type IV hypersensitivity rxn diseases

Answer 27

MS
Guillian-Barre syndrome
PPD test

Question 28

Type III hypersensitivity rxn diseases

Answer 28

SLE

poststrep glomerulonephritis

Question 29

HS type of blood transfusion acute hemolytic or febrile nonhemolytic transfusion rxns

Answer 29

type II HS

Question 30

Anti-dsDNA/anti-Smith disease

Answer 30

SLE

Question 31

Anti-Scl-70 disease/anti-centromere

Answer 31

scleroderma

Question 32

Anti-basement membrane disease

Answer 32

Goodpasture’s

Question 33

Anti-SSA/SSB disease

Answer 33

Sjogren’s syndrome

Question 34

c-ANCA disease

Answer 34

Wegener’s granulomatosis

Question 35

p-ANCA disease

Answer 35

Churg-Strauss/microscopic polyangiitis

Question 36

Tyrosine kinase gene defect

recurrent bacterial infections after 6 months

Answer 36

X linked (bruton's) apammaglobulinemia
defect in BTK
no B cell maturation
opsonization defect

Question 37

Hypocalcemia
recurrent viral/fungal infections
no T cells

Answer 37

Digeorge’s syndrome
no thymus
22q11 deletion
3rd and 4th pharyngeal pouches

Question 38

Failure to thrive
recurrent infections of all types
low T cells

Answer 38

SCID

defective IL-2 receptor (X-linked) or adenosine deaminase defect

Question 39

Cerebellar defects
IgA deficiency
spider angiomas

Answer 39

Ataxia-telangiectasia
ATM gene defect
DNA repair enzymes

Question 40

Increased IgM

severe pyogenic infection in infancy

Answer 40

Hyper IgM syndrome
defect in CD40L on T helper cells
no class switching

Question 41

Thrombocytopenic purpura
infections
eczema
X-linked

Answer 41

Wiskott Aldrich syndrome
WAS gene
T cells cannot reogranize actin

Question 42

Recurrent infections

no pus formation

Answer 42

Leukocyte adhesion deficiency

defect in LFA-1 integrin (CD18)

Question 43

Partial albinism
recurrent pyogenic infections (staph/strep)
giant neutrophil granules

Answer 43

Chediak-Higashi syndrome
AR
defect in LYST
microtubule dysfunction of lysosome fusion

Question 44

Increased S aureus/E. coli/aspergillus infections

Answer 44

Chronic granulomatous disease
lack of NADPH oxidase
no respiratory burst in neutrophils

Question 45

Hyperacute transplant rejection

Answer 45

within minutes
Type II HS
preformed anti-donor Abs
ischemia/necrosis

Question 46

Acute transplant rejection

Answer 46

within weeks
cell mediated to CTL against foreign MHC’s
immunosuppressants work

Question 47

Chronic transplant rejection

Answer 47

month-yrs
class MHC-1 on donor detected as nonself, T cells destroy donor cells
irreversible/fibrosis

Question 48

Graft vs Host disease

Answer 48

immunocompetent cells donated attack host organs
maculopapular rash
hepatosplenomegaly
diarrhea

Question 49

MOA of cyclosporine

Answer 49

blocks T cell activation by calcineurin inhibition

Question 50

MOA of tracolimus

Answer 50

binds FK-binding protein

inhibits calcineurin and IL-2 secretion

Question 51

MOA of sirolimus

Answer 51

inhibits mTOR

no T cell proliferation via IL-2

Question 52

MOA azathioprine

Answer 52

6-MCP precursor

nucleic acid syntehsis inhibitor

Question 53

IgA Antiendomysial

Answer 53

Celiac disease

Question 54

Antimitochondrial Abs

Answer 54

Primary biliary cirrhosis

Question 55

Antimicrosomal Abs

Answer 55

Hashimoto’s thyroiditis

Question 56

Antismooth muscle Abs

Answer 56

autoimmune hepatitis

Question 57

Anti-glutamate decarboxylase

Answer 57

type I DM