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USMLE Step 1 Quick Notes > Immunology > Flashcards

Immunology Flashcards

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USMLE® Step 1 flashcards
1
Q

How does antigen loading for MHC II work?

A

Antigen loaded following release of invariant chain in acidified endosome

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2
Q

How does antigen loading work for MHC I?

A

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

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3
Q

What diseases associated with DR2?

A

Multiple sclerosis, Goodpasture, hay fever, SLE

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4
Q

What diseased associated with DR3?

A

SLE, DM type 1, Grave’s

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5
Q

What is allotype?

A

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

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6
Q

What is isotype?

A

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

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7
Q

What is idiotype?

A

What epitope/antigen the antibody binds

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8
Q

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

A

Causes killing by ADCC

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9
Q

What happens when IgE is released because of hypersensitivity?

A

Causes mast cells (mostly) and basophil degranualation

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10
Q

What is primarily responsible for killing gram negative bacteria?

A

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

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11
Q

What does IL-5 do?

A

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

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12
Q

What do interferon alpha and beta do?

A

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.

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13
Q

What is arthus reaction?

A

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

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14
Q

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

A

CGD

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15
Q

What drug does allopurinol increase the toxicity of?

A

Azathioprine (metabolized by xanthine oxidase)

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16
Q

What does natalizumab increase the risk for?

A

PML

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17
Q

What is the treatment for MS?

A

IFN-beta and Natalizumab

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18
Q

What is Alemtuzumab?

A

CD52 antibody for CLL

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19
Q

What is tryptase specific for?

A

Mast cells

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20
Q

What else can you have if you have reactive arthritis?

A

Sacroilitis because of the HLA-B27 assocation

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21
Q

What is the problem in Hyper IgM?

A

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

22
Q

What is XLA (bruton)?

A

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

23
Q

How to macrophages repsond to LPS?

A

Activate TNF

24
Q

Where is complement made?

A

Liver

25
Q

C3 deficiency makes you susceptible to what?

A

Encapsulate bacteria

26
Q

What is IL-8 for?

A

Neutrophil chemotaxis particularly for pus formation

27
Q

What does IL-3 do?

A

GM-CSF stimulation

28
Q

Which are antiinflammatory?

A

TGFbeta and IL10

29
Q

What is for diapedesis?

A

PECAM

30
Q

What is messed up in SCID?

A

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

31
Q

What needs to happen for MHC II to present?

A

Need to fuse with acidified phagolysosomes with antigen

32
Q

Pregnant women should get what vaccine?

A

Tetanus so they can transfer protective antibodies to child

33
Q

Why is pus and sputum green?

A

MPO production

34
Q

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

A

Ataxia-telangiectasia; also increases risk for cancer

35
Q

Do eosinophils do protozoa?

A

NO

36
Q

What causes septic shock?

A

TNF-alpha

37
Q

What can drug infusion cause?

A

Serum sickness leading to hypocomplementemia

38
Q

What does LTB4 do?

A

Neutrophil chemotaxis

39
Q

What is prostacyclin?

A

PGI2 (inhibits platelet aggregation)

40
Q

What mediates cachexia?

A

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

41
Q

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

A

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

42
Q

What do you see on CBC with DRESS?

A

Eosiniophilia

43
Q

What type of hypersensitivity is acute hemolytic transfusion?

A

Type II: complement mediated

44
Q

What disease do you see DNA hypersensitivity to ionizing radiation?

A

Ataxia- Telangiectasia due to DNA double strand breaks

45
Q

What does chronic rejection of heart look like?

A

Atherosclerosis

46
Q

What does chronic rejection of lung look like?

A

Bronchiolitis obliterans

47
Q

What does chronic rejection of liver look like?

A

Vanishing bile ducts

48
Q

What does chronic rejection of kidney look like?

A

Vascular fibrosis, glomerulopathy

49
Q

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

A

GVHD

50
Q

Where do the dorsolateral foot and posterior calf drain?

A

Popliteal LN

51
Q

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

A

Separation of endothelial junction (allows migration of cells)

USMLE Step 1 Quick Notes (17 decks)

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