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JazRespiratory > Immunology > Flashcards

Immunology Flashcards

1
Q

Hallmarks of immune deficiency

A

SPUR infections

Serious Persistent Unusual Recurrent

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2
Q

Phagocyte deficiences cause

A

recurrent infections, in unusual sites, can be unusual bac (Burkholderia -this and CF only) or fungi infections

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3
Q

Reticular dysgenesis

A

no neutro, baso or eosinos or platelets
fatal unless bone marrow transplant
sufferers have a small thymus

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4
Q

Cyclic neutropaenia

A

neutropenia every 4-6wks

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5
Q

Kostmann syndrome

A

rare autosomal recessive severe chronic neutropaenia

presents w recurrent infections within 2 wks of birth

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6
Q

Leukocyte adhesion deficiency characterisitics

A 
rare - CD18 leukocyte integrin deficiency
recurrent bac and fungal infections
v high neutro count
deep tissue infections NO PUS
mouth infections
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7
Q

Failure in this causes mild disorders

A

pathogen recognition - as receptors functions overlap

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8
Q

Failure of oxidative killing mechanisms =

A

chronic granulomatous disease

no O2 respiratory burst can’t clear org.s -> chronic inflam

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9
Q

Test to diagnose chronic granulomatous disease

A

NBT (nitroblue tetrazolium) - give E. coli and dye sensitive to H2O2 and there will be no colour change

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10
Q

Commonest for of chronic granulomatous disease

A

X linked p47phox component of NADPH oxidase deficiency

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11
Q

defects in immune components activating others =>

A

tb reactivation, atypical mycobacterium infection, salmonella

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12
Q

SCID (defects in lymphoid precursors) characteristics:

A

unwell by 3 months, graft v host skin disease,

FtT, diarrhoea

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13
Q

commonest form of SCID

A

X-linked - mutation of component of IL-2 receptor
Can’t respond to cytokines NK and T dont develop and B cells immature
low/no T, normal/raised B

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14
Q

Defect in Thymus development

A

DiGeorge 22q11

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15
Q

DiGeorge characteristics:

A

FLK, cleft palate, cardiac problems, hypocalcaemia (seizures)
recurrent viral fungal and bac infections
T lymphopaenia, normal of increased B but decreased Igs

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16
Q

Antibody deficiencies cause ___ infections

A

recurrent bac infections and AI diseases

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17
Q

T cell deficiencies characteristics

A 
BCG infection after vaccination
tb and atypical pneumonia
deep fungal infections
recurrent infections
Malignancy in youth
AI
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18
Q

Bruton’s X-linked hypogammaimmunoglobulinaemia

A

no B cells in blood, no plasma cells, no circulating Ig after 6 months

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19
Q

Selective IgA deficiency

A

recurrent RTIs

Can cause false negative of coeliacs test

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20
Q

CVID

A

low IgE/A/G, AI often, granulomatous disease, recurrent bac infections, often persistent sinusitis, GI infections, bronchiectasis

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21
Q

Type 1 hypersensitivity reactions =

A

Allergic/Immediate/IgE mediated response to external antigen

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22
Q

Type 2 hypersentitivity reactions =

A

Direct cell killing

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23
Q

Type 3 hypersensitivity reactions =

A

Immune complex mediated

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24
Q

Type 4 hypersensitivity reactions =

A

Delayed/ Tcell mediated

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25
Q

Eg.s of Type 1 hypersensitivity

A

asthma, hayfever, angioedma, eczema, anaphylaxis

26
Q

Clinical features of Type 1 hypersensitivity

A

response occur quickly
>=1 organ system effected
stereotyped response

27
Q

Mediators and cells involved in type 1 hypersensitivity

A

T>B>IgE>mast cells>histamine and tryptase> cytokines> leukotrienes

28
Q

Samter’s triad =

A

asthma
nasal polyps
salicylate sensitivity

29
Q

Eg.s of Type 2 hypersensitivity

A 
transfusion reactions
AI haemolytic anaemia
Goodpasture's syndrome
myasthenia gravis
Grave's disease
idiopathic thromboctopaenic purpura
30
Q

Stages in a Type 2 hypersensitivity reaction

A

IgG/M bind to antigens > act. complement > membrane attack complex > osmotic cell lysis > chemotaxin > opsonisation > solubilisation - turn them off

31
Q

Characteristics of transfusion reaction (type 2)

A

immediate haemolytic reaction

pyrexia, rigor, tachycardia, tachypnoea, hypotension, dizzy, headaches

32
Q

Management of Type 2 hypersensitivity reactions

A

plasmaphoresis and immunosuppression

33
Q

Eg.s of type 3 hypersensitivity

A

Farmer’s/Bird Fancier’s Lung

SLE

34
Q

Stages in a type 3 hypersensitivity reaction

A

Ig binds to antigen > immune complex > deposited in small vessels > complement macro and neutro invade

35
Q

Pneumonitis (type 3) reaction symptoms and signs

A

wheeze, SOB, malaise, pyrexia, dry cough

normal exam usually

36
Q

SLE characteristics (Type 3)

A

arthralgia, renal dysfunction, fever, vasculitis purpura

37
Q

Diagnose type 3 sensitivity by ___

A

specific IgG

38
Q

Eg.s of type 4 hypersensitivity

A

AI - TID, psoriasis, rheumatoid arthritis

non-AI - nickel sensitivity, tb, leprosy, organ transplant rejection, Sarcoidosis, dust diseases, chronic stage of EAA

39
Q

Stages in type 4 hypersensitivity reaction

A

Initial sensitisation to antigen = Ts primed

Subsequent exposure> CD4-> cytokines->macros>CD8>cell mediated direct killing > granuloma

40
Q

Sarcoidosis characteristics

Management

A

multisystem non-casseating granulomatous disease

careful monitoring, NSAIDS and systemic corticosteroids

41
Q

All nucleated cells express ____ receptors to present antigens to T cells

A

HLA- A/B/C

42
Q

Specialised APCs express ___ receptors to present to T cells

A

HLA-DR/DQ/DP

43
Q

HLA matching (A/B/C) not done in ___ transplants

A

lung heart (limited donor pool) liver

44
Q

Acute cellular rejection of transplant occurs within __

Treat with ___

A

5-30 days

immunosuppression

45
Q

Acute cellular rejection of transplant stages

A

Ts> IL2> T proliferation>CD4> macros>CD8>phago.s>B cells

46
Q

Hyperacute rejection of transplant occurs within ___
When ___
Treatment ___

A

minutes to hours;
when already have pre-formed antibodies
pre-existing anti-donor HLA antibodies;
no treatment

47
Q

Acute vascular rejection is ___ mediated
Onset within ___
Treatment ___

A

Ig mediated (Type 2) = vasculitis
5-30 days
immunosuppressants

48
Q

Chronic allograft failure risk factors

A

hbp, hyperlipidaemia, HLA mismatch, recipient infection, non-compliance with immunosuppressants

49
Q

Active vaccination examples

A 
Live attenuated
Whole cell vaccine
Fractional vaccine
Toxoid
Pure polysaccharide vaccine
50
Q

`Killed/attenuated vaccine basis

A

Ig based not T based

51
Q

Whole cell vaccine eg.s

A

polio, Hep A, rabies, cholera

52
Q

Fractional vaccines eg.s

A

Hep B, influenza, HPV, acellular pertussis

53
Q

Toxoid vaccine eg.s

A

diphteria, tetanus

54
Q

Pure polysaccharide vaccine eg.s

A

pneumococcus, Meningitis C

Conjugated with toxin - H. influenzae type B, pneumococcus

55
Q

Live attenuated vaccine (immunity in 1 dose) eg.s

A

MMR, chickenpox, rotavirus, BCG, oral typhoid

56
Q

No vaccines against _____ (5)

A

influenza (rapidly evolving)

HIV, tb, herpes, Hep C (chronic/latent)

57
Q

Immune parts involved in mycobacterium tb

A

T cells and phagocytes

58
Q

Immune parts involved in bacterial infection

A 
phagocytes
complement
T
B
Ig
59
Q

Immune parts involved in viral infection

A

T
B
Ig

60
Q

Immune parts involved in fungal infection

A

phagocytes
eosinophils
T

61
Q

Immune parts involved in protozoal infections

A

T

eosinophils

62
Q

immune parts involved in helminth infections

A

Mast cells

Eosinophils

JazRespiratory (18 decks)

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