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immunology Flashcards

1
Q

HLA-A3

A

hemochromatosis

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2
Q

HLA-B27

A

seronegative arthropathies

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3
Q

HLA-DQ2/DQ8

A

celiac dz

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4
Q

HLA-DR2

A

MS, hay fever, SLE, goodpastures

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5
Q

HLA-DR3

A

T1DM, SLE, graves, hashimotos

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6
Q

HLA-DR4

A

RA, T1DM

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7
Q

HLA-DR5

A

pernicious anemia, hashimotos

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8
Q

type I HSR

A

IgE -> mast cell and basophil degranulation -> vasodilation of postcapillary venules -> delayed response from arachidonic acid metabolites (leukotrienes)

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9
Q

type II HSR

A

IgM, IgG bind to Ag on enemy cell -> cytotoxic killing via opsonization, complement + Fc receptor-mediated, and Ab-mediated cellular dysfxn. coombs test. acute transfusion rxns, AIHA, GBS, graves, MG, rheumatic fever, etc.

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10
Q

type III HSR

A

Ag, Ab, and complement get stuck together -> neutrophils release lysosomal enzymes. serum sickness and arthus rxn are specific types. SLE, post-strep glomerulonephritis, etc.

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11
Q

type IV HSR

A

NOT Ab-relatedd. delayed. T cells bind Ag -> cytokines -> macrophage activation. transplant rejection, TB skin test, touching (contact dermatitis). MS.

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12
Q

febrile nonhemolytic transfusion rxn

A

type II HSR. host Abs against donor HLA and WBCs -> fever, h/a, chills, flushing

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13
Q

acute hemolytic transfusion rxn

A

type II HSR. ABO incompatibility -> intravascular hemolysis, host Ab rxn w/foreign Ags -> extravascular hemolysis -> fever, hypotension, tachypnea, tachycardia, flank pain, hemoglobinuria (intravascular), jaundice (extravascular).

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14
Q

why does complement deficiency increase risk of SLE?

A

b/c complement is necessary to remove Ag/Ab complexes

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15
Q

anti-basement membrane

A

goodpastures

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16
Q

anticardiolipin, lupus anticoagulant

A

SLE, antiphospholipid

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17
Q

anticentromere

A

limited scleroderma (CREST)

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18
Q

anti-desmosome, anti-desmoglein

A

pemphigus vulgaris

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19
Q

anti-smith

A

SLE

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20
Q

anti-glutamic acid decarboxylase (GAD-65)

A

T1DM

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21
Q

antihemidesmosome

A

bullous pemphigoid

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22
Q

anti-histone

A

drug-induced lupus

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23
Q

anti-Jo-1, anti-SRP, anti-Mi-2

A

polymyositis, dermatomyositis

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24
Q

antimicrosomal, antithyroglobulin

A

hashimotos

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25
Q

antimitochondrial

A

PBS

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26
Q

antinuclear Abs

A

SLE, nonspecific

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27
Q

antiparietal cell

A

pernicious anemia

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28
Q

anti-Scl-70, anti-DNA topoisomerase I

A

scleroderma (diffuse)

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29
Q

anti-SSA, anti-SSB (anti-Ro, anti-La)

A

sjogrens

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30
Q

anti-smooth muscle

A

autoimmune hepatitis

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31
Q

anti-TSH

A

graves

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32
Q

anti-U1 RNP (ribonucleoprotein)

A

mixed connective tissue dz

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33
Q

IgA anti-endomysial, IgA anti-tissue transglutaminase

34
Q

MPO-ANCA/p-ANCA

A

microscopic polyangiitis, eosinophilis granulomatosis w/polyangiitis (churg-strauss)

35
Q

PR3-ANCA/c-ANCA

A

granulomatosis w/polyangiitis (wegener)

36
Q

RF, anti-CCP

A

RA. RF = IgM against IgG Gc region. anti-CCP = more specific

37
Q

immunodeficiency that -> giardia, bacterial, enteroviral infxns after 6 mos

A

bruton’s agammaglobulinemia. no BTK -> no B cell maturation, so no plasma cells. absent/scanty lymph nodes

38
Q

immunodeficiency that -> recurrent mucosal infxns, esp. viral

A

selective IgA def. usually asymptomatic.

39
Q

immunodef. that -> bacterial, enterovirus, and giardia infxns acquired later

A

common variable immunodef. many causes (e.g. B cell or helper T cell defect) -> B cell maturation failure -> dec. plasma cells, immunoglobulins. inc. risk of autoimmune dz, bronchiectasis, lymphoma, sinopumonary infxns.

40
Q

IL-12 def.

A

dec. Th1 response. AR. -> disseminated mycobacterial and fungal infxns. may present after BCG vaccine. dec. IFN-gamma

41
Q

hyper-IgE syndrome

A

AD. job syndrome. STAT3 mutation -> Th17 def. -> impaired neutophil recruitment. course facies, cold (non-inflamed) staph abscesses, retained primary teeth, inc. IgE, dermatologic problems (eczema). low IFN-gamma

42
Q

no B cells ->

A

fungal + viral infxns

43
Q

no T cells ->

A

bacterial + protozoal infxns

44
Q

no IgA ->

A

enterovirus

45
Q

no C5-9 ->

46
Q

no C1 inhibiter ->

A

hereditary angioedema (esp. periorbital) + mucosal surfaces

47
Q

3 causes of SCID

A

cytokine receptor defects
adenosine deaminase deficiency
MHC II def. -> dec. CD4+ -> dec. T + B cells

48
Q

ataxia-telangiectasia

A

ATM gene defect -> failure to repair dsDNA breaks -> cell cycle arrest -> cerebellar defects, spider angiomas, IgA def. + inc. AFP, low IgA, IgG, IgE. lymphopenia.

49
Q

wiskott-aldrich

A

WAS mutation, XR -> T cells can’t reorganize actin cytoskeleton -> TTP, eczema, recurrent humoral + cellular infxns, inc risk of autoimmunity. low/nl IgG, IgM. inc. IgE, IgA. fewer, smaller plts.

50
Q

leukocyte adhesion deficiency type 1

A

AR. defect in LFA-1 integrin CD18 subunit -> impaired migration + chemotaxis of phagocytes -> delayed cord separation, recurrent bacterial + mucosal infxns w/o pus.

51
Q

chediak-higashi

A

AR defective lysosomal trafficking regulator gene (LYST). microtubule dysfxn -> lysosome + phagosome can’t fuse. -> recurrent pyogenic staph + strep infxns, partial albinism, long nerve neuropathy, infiltrative lymphohistiocytosis. giant granules in granulocytes + plts. pancytopenia (impaired cell division), mild coag defect (primary hemostasis problem)

52
Q

MPO deficiency

A

defective conversion of H2)2 -> HOCL -> inc. candida. normal NBT test

53
Q

cyclosporine

A

calcineurin inhibitor, binds cyclophilin. blocks T cell activation by preventing IL-2 transcription!! Tx for PPx transplant rejection, psoriasis, RA. nephrotoxic

54
Q

tacrolimus

A

= FK506. calcineurin inhibitor, binds FKBP. blocks T-call activation by preventing IL-2 transcription! Tx: PPx transplant rejection. nephrotoxic! inc. DM, neurotox. no gingival hyperplasia or hirsuitism

55
Q

sirolimus

A

= rapamycin. mTOR inhibitor; bind FKBP. blocks T cell activation/B cell differentiation by preventing response to IL-2! Tx: kidney tranplant recetion PPx. not nephrotoxic. cytopenias, insulin resistance, HL

56
Q

daclizumab, basiliximab

A

Abs block IL–2R. Tx: kidney tranplant PPx. edema, HTN, tremor

57
Q

azathioprine

A

antimetabolite precursor of 6-mercaptopurine. inhibits lymphocyte proliferation by blocking nucleotide synthesis. Tx: rejection PPx, autoimmune stuff. cytopenias. 6-MP is degraded by xanthine oxidase so allopurinol -> inc. toxicity.

58
Q

glucocorticoids

A

inhibit NF-kappaB. suppress B and T cells by dec. cytokine transcription.

59
Q

aldesleukin

A

= IL-2. use in renal cell CA, metastatic melanoma

60
Q

epoetin alfa

A

= erythropoietin.

61
Q

filgrastim

A

= G-CSF. use for bone marrow recovery

62
Q

sargramostim

A

= GM-CSF. use for bone marrow recovery

63
Q

IFN-alpha

A

use in chronic hep B + C, kaposi sarcoma, malignant melanoma.

64
Q

IFN-beta

65
Q

IFN-gamma

66
Q

romiplostim, eltrombopag

A

thrombocytopenia

67
Q

oprelvekin

A

= IL-11. use in thrombocytopenia

68
Q

alemtuzumab

A

targets CD52. use in CLL

69
Q

bevacizumab

A

targets VEGF. use for colorectal CA, renal cell CA. neovascular macular degeneration.

70
Q

cetuximab

A

targets EGFR. use in stage IV colorectal CA, head + neck CA

71
Q

rituximab

A

targets CD20. use in H-cell NH lymphoma, CLL, RA, ITP

72
Q

trastuzumab

A

targets HER2/neu

73
Q

adalimumab, infliximab

A

targets soluble TNF-alpha. use in IBD, RA, AK, psoriasis

74
Q

etanercept

A

decoy TNF-alpha receptor, not monoclonal Ab

75
Q

eculizumab

A

targets complement protein C5. use in paroxysmal nocturnal hemoglobinuria

76
Q

natalizumab

A

targets alpha4-integrin (WBC adhesion). use in MS, crohns. -> inc. risk of PML in pts w/JC virus.

77
Q

abciximab

A

targets plt glycoproteins IIb/IIIa. use to prevent ischemic complications during vascular cath.

78
Q

denosumab

A

targets RANKL. use in osteoporosis to inhibit osteoclast maturation.

79
Q

digoxin immune Fab

A

antidote for dig toxicity

80
Q

omalizumap

A

targets IgE. use for allergic asthma: prevents IgE binding to Fc-epsilon-RI

81
Q

palivizumap

A

targets RSV F protein. use as RSV PPx in high risk babies

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