Immunology

Question 1

How does antigen loading for MHC II work?

Answer 1

Antigen loaded following release of invariant chain in acidified endosome

Question 2

How does antigen loading work for MHC I?

Answer 2

Antigen peptides loaded onto MHC 1 in RER after delivery via TAP peptide transporter

Question 3

What diseases associated with DR2?

Answer 3

Multiple sclerosis, Goodpasture, hay fever, SLE

Question 4

What diseased associated with DR3?

Answer 4

SLE, DM type 1, Grave’s

Question 5

What is allotype?

Answer 5

Minor changes in constant region of antibodies that are different in each person. Hence, IgG in one person will be different from another. Used for paternity testing

Question 6

What is isotype?

Answer 6

The class of antibody: IgG vs IgM vs IgA etc.

Question 7

What is idiotype?

Answer 7

What epitope/antigen the antibody binds

Question 8

What happens when IgE is released due to presence of helminths, parasites?

Answer 8

Causes killing by ADCC

Question 9

What happens when IgE is released because of hypersensitivity?

Answer 9

Causes mast cells (mostly) and basophil degranualation

Question 10

What is primarily responsible for killing gram negative bacteria?

Answer 10

MAC because gram - bacteria doesn’t have good peptides for presentation by MHC

Question 11

What does IL-5 do?

Answer 11

Promote differentiation of B cells, enhance IgA class switching, stimulate differentiation/growth of eosinophils

Question 12

What do interferon alpha and beta do?

Answer 12

They prime locally uninfected cells so that when virus invades, it activates RNAase L (degradation of mRNA) and protein kinase (inhibition of protein synthesis) resulting in apoptosis.

Question 13

What is arthus reaction?

Answer 13

Intradermal injection of antigen causes antibodies to form resulting in ag-ab complexe in skin. Causes edema, necrosis, activation of complement.

Question 14

What is the diagnosis if you see a child with hepatic abscess without cause?

Answer 14

CGD

Question 15

What drug does allopurinol increase the toxicity of?

Answer 15

Azathioprine (metabolized by xanthine oxidase)

Question 16

What does natalizumab increase the risk for?

Answer 16

PML

Question 17

What is the treatment for MS?

Answer 17

IFN-beta and Natalizumab

Question 18

What is Alemtuzumab?

Answer 18

CD52 antibody for CLL

Question 19

What is tryptase specific for?

Answer 19

Mast cells

Question 20

What else can you have if you have reactive arthritis?

Answer 20

Sacroilitis because of the HLA-B27 assocation

Question 21

What is the problem in Hyper IgM?

Answer 21

CD40L mutation (AR) so can’t class switch. Get severe pyogenic infections early in life.

Question 22

What is XLA (bruton)?

Answer 22

No antibodies so susceptible to bacteria and enteroviral infections after 6 months. Don’t see germinal centers

Question 23

How to macrophages repsond to LPS?

Answer 23

Activate TNF

Question 24

Where is complement made?

Answer 24

Liver

Question 25

C3 deficiency makes you susceptible to what?

Answer 25

Encapsulate bacteria

Question 26

What is IL-8 for?

Answer 26

Neutrophil chemotaxis particularly for pus formation

Question 27

What does IL-3 do?

Answer 27

GM-CSF stimulation

Question 28

Which are antiinflammatory?

Answer 28

TGFbeta and IL10

Question 29

What is for diapedesis?

Answer 29

PECAM

Question 30

What is messed up in SCID?

Answer 30

XR: defective IL-2R gamma chain AR: adenosine deaminase deficiency

Question 31

What needs to happen for MHC II to present?

Answer 31

Need to fuse with acidified phagolysosomes with antigen

Question 32

Pregnant women should get what vaccine?

Answer 32

Tetanus so they can transfer protective antibodies to child

Question 33

Why is pus and sputum green?

Answer 33

MPO production

Question 34

What do you get cerebellar atrophy, ataxia, spider angiomas, sinopulmonary infections with?

Answer 34

Ataxia-telangiectasia; also increases risk for cancer

Question 35

Do eosinophils do protozoa?

Answer 35

NO

Question 36

What causes septic shock?

Answer 36

TNF-alpha

Question 37

What can drug infusion cause?

Answer 37

Serum sickness leading to hypocomplementemia

Question 38

What does LTB4 do?

Answer 38

Neutrophil chemotaxis

Question 39

What is prostacyclin?

Answer 39

PGI2 (inhibits platelet aggregation)

Question 40

What mediates cachexia?

Answer 40

TNF-alpha (aka cachectin; mainly), IFN-gamma, IL-6

Question 41

What is it if you see lymphadenopathy, facial edema, diffuse skin rash after 2-8 weeks taking sulfa drugs?

Answer 41

DRESS: usually with anticonvulsants, allopurinol, sulfa drugs, and antibiotics. Also get eosinophila

Question 42

What do you see on CBC with DRESS?

Answer 42

Eosiniophilia

Question 43

What type of hypersensitivity is acute hemolytic transfusion?

Answer 43

Type II: complement mediated

Question 44

What disease do you see DNA hypersensitivity to ionizing radiation?

Answer 44

Ataxia- Telangiectasia due to DNA double strand breaks

Question 45

What does chronic rejection of heart look like?

Answer 45

Atherosclerosis

Question 46

What does chronic rejection of lung look like?

Answer 46

Bronchiolitis obliterans

Question 47

What does chronic rejection of liver look like?

Answer 47

Vanishing bile ducts

Question 48

What does chronic rejection of kidney look like?

Answer 48

Vascular fibrosis, glomerulopathy

Question 49

Diagnosis: maculopapular rash, jaundice, diarrhea, hepatosplenomegaly post transplant?

Answer 49

GVHD

Question 50

Where do the dorsolateral foot and posterior calf drain?

Answer 50

Popliteal LN

Question 51

What causes edema in patient with fluctuant lesion from scrape on tree branch?

Answer 51

Separation of endothelial junction (allows migration of cells)