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Year 1 - Respiratory (DP) > Immunology > Flashcards

Immunology Flashcards

0
Q

What are some common causes of secondary immunodeficiency?

A 
Age extremes
HIV
Immunosuppression/Chemo/Radiotherapy/Steroids
Malignancy
Malnutrition
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1
Q

What kind of infections indicate immune deficiency?

A

S - serious
P - persistent
U - unusual
R - recurrent

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2
Q

What is reticular dysgenesis?

A

Failure to differentiate along myeloid lineage - failure to produce neutrophils

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3
Q

What is Kostmann syndrome?

A

Severe congenital neutropaenia

Autosomal recessive

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4
Q

What brings about leukocyte adhesion deficiency?

A

Defect in leukocyte integrins (CD18)

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5
Q

What are the clinical features of leukocyte adhesion deficiency?

A

Leukocytosis
Deep tissue infections
No pus

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6
Q

What causes a chronic granulomatous disease?

A

Failure of oxidative killing mechanisms

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7
Q

How does a granuloma form?

A

Organisms are not cleared
Excessive inflammation
Persistent lymphocyte and phagocyte accumulation

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8
Q

Clinical features of chronic granulomatous disease?

A

Recurrent deep infections (staph, aspergillus, pseudomonas, myco)
Failure to thrive
Lymphadenopathy and hepatosplenomegaly

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9
Q

What does the Nitroblue Tetrazolium test test for?

A

Chronic granulomatous disease

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10
Q

What organisms hide from immune cells inside normal cells?

A

Salmonella
Chlamydia
Rickettsia

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11
Q

Where does Mycobacteria hide?

A

Inside immune cells

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12
Q

What infection prophylaxis is used in phagocyte deficiencies?

A

Co-trimoxazole

Itraconazole

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13
Q

What is the role of CD4+ cells?

A

Immunoregulatory
- Activate CD8+ and B cells
- Produce cytokines
HLA Class ii peptide recognition

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14
Q

What is the role of CD8+ cells?

A 
HLA Class i recognition (HLA-A/B/C)
Kill cells directly
- Produce perforin
- Trigger apoptosis
- Secrete INFgamma
Important in viral/tumour defence
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15
Q

How are B cells activated?

A

Encounter antigen in lymph node

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16
Q

What is SCID?

A

Failure of lymphocyte production

17
Q

Clinical presentation of SCID

A 
Unwell by 3 months
Persistent diarrhoea
Infections
Graft vs Host disease
FHx of early infant death
18
Q

What is the commonest form of SCID and how does it present?

A

X-linked
Very low/absent T cells
Normal/Raised B cells
Poorly developed lymphoid tissue and thymus

19
Q

Patient has:

  • Low set ears
  • High forehead
  • Cleft palate
  • Small mouth and jaw
  • Hypocalcaemia
A

DiGeorge syndrome

20
Q

What is type i hypersensitivity?

A

Immediate hypersensitivity (allergy)

21
Q

What is type ii hypersensitivity?

A

Direct cell killing

22
Q

What is type iii hypersensitivity?

A

Immune complex mediated

23
Q

What is type iv hypersensitivity?

A

Delayed type hypersensitivity

24
Q

What is an allergy?

A

An IgE-mediated response to external antigen

25
Q

What are the clinical features of Type i allergic disease?

A

Occurs quickly

Influenced by site of contact

26
Q

What is the pathophysiology of allergic disease?

A 
B cells recognise antigen and produce specific IgE
T cells help in IgE production
Mast cells
- IgE binds to FcEpsilon receptors
- Release histamine/tryptase/heparin
27
Q

What occurs in the inflammatory cascade?

A

Increased blood flow
Smooth muscle contraction
Increased vascular permeability
Increased mucosal secretions

28
Q

Is angioedema pitting or non-pitting?

A

Non-pitting

29
Q

What happens in Type ii hypersensitivity?

A 
Antibody binds to cell surface
Complement activated
- Cell lysis
- Opsonisation
Phagocytosis
30
Q

What do IgM and IgG act as in Type ii hypersensitivity?

A

Opsonins

31
Q

What are some clinical examples of Type ii hypersensitivity?

A

Transfusion reactions
Goopastures syndrome
Guillan Barre syndrome

32
Q

How can Type ii hypersensitivity reactions be managed?

A

Plasmapheresis

Immunosuppression

33
Q

What happens in type iii hypersensitivity?

A

Antigen binds to autoantibodies -> Immune complex
Complexes deposit in small vessels
Complement activation
Macrophage and neutrophil infiltration

34
Q

What are some examples of type iii hypersensitivity/hypersensitivity pneumonitis?

A

Farmers lung
Bird fanciers lung
Malt workers lung
Etc

35
Q

What are the symptoms of type iii hypersensitivity reactions and when do they occur?

A 
Dry cough
Pyrexia
SoB
Wheeze
4-8 hours after exposure
36
Q

Which immune cells mediate Type iv hypersensitivity?

A

T cells

37
Q

What happens in type iv hypersensitivity?

A 
Antigen sensitisation 
T cell priming
Subsequent exposure
- Activation of primed T cells
- Macrophage, neutrophil and lymphocyte recruitment
- Inflammation
38
Q

What are the two types of vaccination?

A

Active

Passive

39
Q

What are the two types of active vaccination?

A

Live attenuated

Inactive

40
Q

What are the three types of inactive vaccination?

A

Killed
Subunit
Toxoid

41
Q

What is passive immunity?

A

Protection transferred from another person/animal

Year 1 - Respiratory (DP) (16 decks)

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