Immunology

Question 1

Pathophysiology:
What hypersensitivity reaction is urticaria?

Answer 1

Type 1 hypersensitivity

Question 2

Pathophysiology:
How does acute urticaria present?

Answer 2

Raised, pruritic, erythematous plaques with a rapid onset hypersensitivity (type 1)

Question 3

Pathophysiology:
What cells are activated in a type 1 hypersensitivity reaction?

Answer 3

Mast cells

Question 4

Immunology:
What are opsonins?

Answer 4

Immune system components that coat the surface of batters, tagging them for phagocytosis

Question 5

Immunology: Immunology
Which opsonins are the most important?
What is the consequence of not having them?

Answer 5

• IgG and C3b
• without them bacteria can evade the immune system via negatively charged repulsion and ppl are more prone to bacteria with a polysaccharide capsule, including S. Pneumoniae, N. Meningitidis, and S. Typhi

Question 6

Immunology: Pharmacology
What are the adverse effects of diphenhydramine?

Answer 6

Orthostatic hypotension (PF), orthostatic hypotension (PF), also urinary retention, dry mouth, CNS depression, dizziness, and delirium

Question 7

Immunology: Immunology
What is the inheritance for ADA deficiency type of SCID?

Answer 7

Autosomal recessive

Question 8

Pathophysiology:
What is the role of excessive Th2 activity in the case asthma?

Answer 8

Stimulates eosinophils to promote remodeling and hypersensitivity in the lungs

Question 9

Immunology Pharmacology:
What receptors are impacted by first-generation antihistamines?
What is the effect?

Answer 9

• Cholinergic, alpha-adrenergic, and seotonergic receptors
• Increased risk of neuropsychiatric side effects, including sedation, confusion, hallucination, and delirium

Question 10

Immunology Pathophysiology:
What type of hypersensitivity if contact dermatitis> ie poison ivy, oak, sumac, asiatic lacquer

Answer 10

Type 4 hypersensitivity mediated by T cells

Question 11

Immunology Pharmacology:
What are the adverse effects of cyclophosphamide?

Answer 11

• myelosuppression
• SIADH
• hemorrhagic cystitis

Question 12

Immunology Pharmacology:
What is the mechanism of action of cyclophosphamide?

Answer 12

Alkylating antineoplastic agent that crosslinks DNA at guanine bases

Question 13

Immunology Immunology:
What immunoglobulin is most abundant in breast milk?

Answer 13

IgA

Question 14

Immunology Pharmacology:
What is the mechanism of action of azathioprine?

Answer 14

• Thiopurine that acts as an immunosuppressant by inhibiting the purine metabolic
• its a prodrug form of 6-MP, preventing the proliferation of B and T lymphocytes
• combined with XO inhibitors potentiates the buildup of 6-MPl

Question 15

Immunology Pharmacology:
What is most concerning of azathioprine?

Answer 15

Bone marrow toxicity, avoid taking with XO inhibitors

Question 16

Immunology Pharmacology:
What are some examples of xanthine oxidase inhibitors?

Answer 16

Allopurinol and febuxostat

Question 17

Immunology:
What is the pathophysiology behind Hyper-IgM syndrome?

Answer 17

Impaired CD40L (Th cells) to CD40 (B cells) interaction, resulting in defective class switching of antibodies.

Question 18

Immunology:
What is the inheritance pattern of Hyper- IgM syndrome?

Answer 18

XLR

Question 19

Immunology Pathology:
What are the clinical features of Hyper- IgM syndrome?

Answer 19

• presents in infancy
• Severe recurrent infections:
  –> Pneumonia: Pneumocystis jirovecii or histoplasma
  –> Enteritis with cryptosporidium
  –> hepatitis with cytomegalovirus

Question 20

Immunology Pathology:
How would you diagnose Hyper- IgM syndrome?

Answer 20

Absent germinal center on lymph node biopsy.

Question 21

Immunology Pharmacology:
How do you treat Hyper IgM syndrome? 4

Answer 21

• IV Ig
• Prophylactic antibiotics
• Filgrastim
• Allogeneic stem cell transplant (curative)

Question 22

Microbio:
What is the stain for Tuberculosis?

Answer 22

Ziehl-Neelsen test