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USMLE Organ Systems > Immunology > Flashcards

Immunology Flashcards

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USMLE® Step 1 flashcards
1
Q

SHiNE SKiS?

A
  • Streptococcus pneumoniae
  • Haemophilus influenzae type B
  • Neisseria meningitidis
  • Escherichia coli
  • Salmonella
  • Klebsiella pneumoniae
  • Group B Strep

[Encapsulated bacteria mnemonic]

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2
Q

You have no T cells: What pathogens get you?

A
  • Bacterial sepsis
  • CMV, EBV, JCV, VZV chronic resp. & GI viral infections
  • Candida, PCP
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3
Q

You have no B cells: What pathogens get you?

A
  • SHiNE SKiS
  • Enteroviral encephalitis, poliovirus (don’t use live vaccine!)
  • GI giardiasis (no IgA)
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4
Q

You have no granulocytes: What pathogens get you?

A
  • Staphylococcus, burkholderia cepacia, serratia, nocardia
  • n/a
  • candida, aspergillus
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5
Q

You have no complement: What pathogens get you?

A

-Neisseria (no MAC complexes)

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6
Q

Axillary lymph node drains?

A

breast, upper limb, skin above umbilicus

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7
Q

mediastinal lymph node drains?

A

trachea, esophagus

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8
Q

internal iliac lymph node drains?

A

lower rectum to anal canal (above pectinate line), bladder, vagina (middle third), prostate

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9
Q

para-aortic lymph node drains?

A

testes, ovaries, kidneys, uterus

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10
Q

superficial lymph node drains?

A

anal canal (below pectinate line), skin below umbilicus (except popliteal territory)

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11
Q

popliteal lymph node drains?

A

dorsolateral foot, posterior calf

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12
Q

right lymphatic duct drains?

A

right side of body above diaphragm

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13
Q

left lymphatic duct joins circulation where?

A

junction left subclavian & internal jugular vein

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14
Q

Post-splenectomy, a patient will show what blood abnormalities?

A

Howell-Jollly bodies (nuclear remnants. round dot.), target cells, thrombocytosis (cuz spleen sequesters thrombocytes)

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15
Q

IL-1 function?

A
  • endogenous PYROGEN
  • osteoclast-activating factor
  • acute inflamm
  • activates endothelium to express adhesion molecules
  • induces chemokine secretion to recruit leukocytes
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16
Q

IL-4 function?

A
  • STIMUILATES IgE production (by promoting differentiation into Th2 cells & class switching to IgE, IgG)
  • Stimulates growth of B cells
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17
Q

IL-5 function?

A
  • STIMULATES IgA production
  • Promotes differentiation of B cells
  • Stimulates growth, differentiation, attraction of eosinophils
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18
Q

IL-8 function?

A

-Attract NEUTROPHILS

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19
Q

IL-10 function?

A
  • INHIBITS INFLAMMATION
  • inhibits differentiation into Th1 cells
  • Secreted by Tregs
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20
Q

IL-12 function?

A

-BESTOWS Th1-ness, BRIGHTENS NK’s, Secreted by B CELLS also.

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21
Q

IL-14 function?

A

-SECRETED by Th2’s.

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22
Q

Cytokine mnemonic?

A

Hot T-Bone stEAK NIBS

1) Fever
2) T cell stim
3) Bone marrow stim
4) IgE stim
5) IgA stim
6) aKute phase protein stim
8) Neutrophil stim
10) Inhibit inflamm & Th1’s
12) Bestow Th1-ness, Brightnen NK’s, B cells secrete it.
13) Secreted by Th2’s

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23
Q

IL-6 function?

A
  • aKute phase protein production
  • pyrogen
  • Secreted by Th2’s
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24
Q

B cells have what CD’s?

A
  • Ig
  • CD19, 20, CD21 (eppstein receptor), 40
  • MHC II, B7
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25
Q

Macrophages have what CD’s?

A
  • CD14 (endotoxin receptor), 40
  • MHC II, B7
  • Fc & C3b receptors (opsonization receptor)
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26
Q

NK cells have what CD’s?

A

CD16 (binds Fc of IgG), 56 (unique marker for NK)

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27
Q

T cells have what CD’s?

A
  • TCR (binds MHC)
  • CD3 (associated w/ TCR for signal transduction)
  • CD28 (binds B7 on APC)
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28
Q

CD4 cells have what other CD?

A

CD40 ligand

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29
Q

Which bugs warrant use of IVIG?

A

-Tetanus
-Botulinum
-Hep B *
-Rabies *
“To Be Healed Rapidly”
* = Hep B or rabies get combined passive/active vaccination

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30
Q

Type 3 Hypersensitivity diseases?

A

-SLE
-Polyarteritis nodosa
-Post-strep glomerulonephritis
-Serum sickness & Arthus Rxn
[they make sense…]

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31
Q

Type 4 Hypersensitivity diseases?

A
  • Multiple Sclerosis
  • Guillain-Barre
  • Graft Versus Host
  • PPD
  • Contact dermatitis
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32
Q

Type 2 Hypersensitivity Dz?

A

Everything else not under 1,3, or 4.

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33
Q

Transfusion allergic rxn is?

A
  • Type 1 against plasma proteins in transfused blood

- Typical type 1 sx (tx is antihistamines)

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34
Q

Transfusion anaphylactic rxn is?

A

-IgA-deficient people->asthma + hypotension->shock

35
Q

Transfusion febrile nonhemolytic rxn is?

A
  • Type 2. Host Ab against donor HLA antigens & leukocytes.

- Fever, headache, chills, flushing

36
Q

Transfusion acute hemolytic rxn is?

A
  • Type 2:
    a) intravascular hemolysis=ABO incompatibility
    b) extravascular hemolysis=host Ab against foreign antigen on donor RBC’s
  • Fever, hypotension, tachypnea, tachycardia, FLANK PAIN, HEMOGLOBINEMIA (intravascular), JAUNDICE (extravascular hemolysis)
37
Q

Anti-cardiolipin, lupus anticoagulant (beta 2 glycoprotein 1): which dz?

A

SLE, antiphospholipid syndrome

38
Q

Anti-dsDNA, Anti-Smith, anti-snRP: which dz?

A

SLE (dsDNA is prognostic) and first 2 are specific

39
Q

Antinuclear antibodies (ANA): which dz?

A

SLE and NONSPECIFIC

40
Q

Anticentromere Ab: which dz?

A

Limited scleroderma (CREST)

41
Q

Anti-desmoglein: which dz?

A

Pemphigus vulgaris

42
Q

Anti-glutamate decarboxylase: which dz?

A

DM Type 1

43
Q

Anti-hemidesmosome Ab: which dz?

A

Bullious pemphigoid

44
Q

Antihistone Ab: which dz?

A

DRUG-INDUCED lupus

45
Q

Anti-Jo-1, anti-SRP, anti-Mi-2 Ab: which dz?

A

Polymyositis, dermatomyositis (Jo-1 is tRNA synthetase)

46
Q

Antimicrosomal, antithyroglobulin

A

Hashimoto thyroiditis (against TPO and/or thyroglobulin)

47
Q

Antimitochondrial Ab: which dz?

A

Primary biliary cirrhosis

48
Q

Anti-Scl-70 (anti-DNA topoisomerase 1) Ab: which dz?

A

Scleroderma (diffuse)

49
Q

Anti-smooth muscle Ab: which dz?

A

autoimmune hepatitis

50
Q

Anti-SSA, Anti-SSB (anti-Ro, anti-La) Ab: which dz?

A

Sjogren syndrome (or subacute SLE). Both are against ribonucleoproteins.

51
Q

Anti-TSH receptor Ab: which dz?

A

Graves

52
Q

Anti-U1 RNP (ribonucleoprotein) Ab: which dz?

A

mixed connective tissue dz

53
Q

c-ANCA alternate name is?

A

PR3-ANCA (Wegener)

54
Q

IgA antiendomysial, IgA TTG (tissue transglutaminase) Ab: which dz?

A

Celiac

55
Q

p-ANCA alternate name is?

A

MPO-ANCA (Microscopic polyangiitis, Churg-Strauss)

56
Q

anti-CCP Ab: which dz?

A

Rheumatoid arthritis

57
Q

Rheumatoid factor is most commonly what kind of Ab? What dz?

A
  • most commonly IgM, specific to IgG Fc region

- Rheumatoid arthritis

58
Q

Alemtuzumab? (1:target, 2: clinical, 3: notes)

A
  • CD52
  • CLL
  • “aLYMtuzumab” (chronic LYMphocytic leukemia)
59
Q

Bevacizumab? (1:target, 2: clinical, 3: notes)

A
  • VEGF

- colorectal cancer, renal cell carcinoma

60
Q

Cetuximab? (1:target, 2: clinical, 3: notes)

A
  • EGFR

- Stage 4 colorectal cancer, head & neck cancer

61
Q

Rituximab? (1:target, 2: clinical, 3: notes)

A
  • CD20

- B-cell non-Hodgkin lymphoma, rheumatoid arthritis (with MTX), ITP

62
Q

Natalizumab? (1:target, 2: clinical, 3: notes)

A
  • alpha4-integrin
  • multiple sclerosis, Crohn
  • alpha4 integrin: leukocyte adhesion. Risk of PML in patients w/ JC virus.
63
Q

Abciximab? (1:target, 2: clinical, 3: notes)

A
  • Glycoprotein IIb/IIIa
  • Atni-latelet agent for prevention of ischemic complications in percutaneous coronary interventions
  • “IIb times IIa equals abSIXimab”
64
Q

Denosumab? (1:target, 2: clinical, 3: notes)

A
  • RANKL
  • Osteoporosis; inhibits osteoclast maturation (mimics osteoprotegrin)
  • “DenOsumab for Osteoclasts”
65
Q

Omalizumab? (1:target, 2: clinical, 3: notes)

A
  • IgE

- Allergic asthma; prevents IgE binding to FcEpsilonRI

66
Q

Palivizumab? (1:target, 2: clinical, 3: notes)

A
  • RSV F protein
  • RSV prophylaxis for high-risk infants
  • “PaliVIzumab - VIrus”
67
Q

Epoetin alfa is a drug that mimics?

A

erythropoietin

68
Q

Oprelvekin mimics? Used for?

A
  • IL-11

- Thrombocytopenia

69
Q

Filgrastim mimics? Used for?

A
  • G-CSF

- recovery of marrow

70
Q

Sargramostim mimics? Used for?

A
  • GM-CSF

- recovery of marrow

71
Q

Aldesleukin mimics? Used for?

A
  • IL-2

- Renal cell carcinoma, metastatic melanoma

72
Q

IFN-Alpha use?

A

chronic Hep B, C, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma

73
Q

IFN-Beta use?

A

multiple sclerosis “Interferes w/ the BUTT of multiple sclerosis”

74
Q

IFN-Gamma use?

A

Chronic granulomatous dz

75
Q

HLA Associations: A3?

A

Hemochromatosis (picmon)

76
Q

HLA Associations: B27?

A 
PAIR (seronegative arthropathies)
Psoriatic arthritis
Ankylosing spondylitis
arthritis of Inflammatory bowel dz
Reactive arthritis (formerly Reiter syndrome)
77
Q

HLA Associations: DQ2, DQ8?

A

Celiac

“I got CELIAC TWICE after eating DQ EIGHT times in a row!”

78
Q

HLA Associations: DR2

A

Multiple sclerosis, hay fever, SLE, Goodpasture syndrome

79
Q

HLA Associations: DR3?

A

DM type 1, SLE, Graves

80
Q

HLA Associations: DR4?

A

RHEUMatoid arthritis, DM type 1

“4 walls in a rheum”

81
Q

HLA Associations: DR5?

A

Pernicious anemia -> B12 deficient

Hashimoto thyroiditis

82
Q

Anti-Ca channel antibody: what dz?

A

Eaton Lambert

83
Q

Order of Ig class switching?

A

M - D- G- E - A

Immunity Does Get Extra Awesome

USMLE Organ Systems (10 decks)

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