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USMLE Step 1 > Immunology > Flashcards

Immunology Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the causes of Severe Combined Immunodeficiency (SCID)?

A

Mutations in genes encoding gamma chain of IL-2, 4, 7, 9, 15, 21

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2
Q

What are the symptoms of SCID?

A

Chronic diarrhea, thrush, recurrent infections

-B cells may be normal, impaired Ts

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3
Q

An allergic rxn that occurs 48-72hrs after exposure is what kind of hypersensitivity rxn?

A

Type IV: T-cell mediated destruction of tissue via macros

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4
Q

Multinucleated giant cells in leprosy possess which CD designation?

A

CD14

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5
Q

What do Th1 cells secrete?

A

IFN-gamma, IL-2

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6
Q

What do Th2 cells secrete?

A

IL-4, 5, 13

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7
Q

Autoinfection from ascaris lumbricoides leads to what immunological rxn?

A

IgE and eosinophilia (type I hypersensitivity)

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8
Q

What is the most important immunological tool against orgs with capsule as their major virulence factor?

A

IgG-mediated opsonization and/or C3b

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9
Q

Recurrent Neisserial infections are indicative of what deficiency?

A

Deficiency of complement factor C6, C7, or C8 (the ones that make MAC)

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10
Q

Which cells would be most numerous in granulomas?

A

macros

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11
Q

Which cytokine would show increased conc in Multiple Sclerosis?

A

Interferon-gamma

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12
Q

What causes chronic graft rejection?

A

T-cells sensitized against the graft (immunosuppressive agents directed towards T-cells)

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13
Q

What are the immunological symptoms of DiGeorge Syndrome?

A

decreased T-cells = absent type IV hypersensitivity; recurrent viral/fungal infections

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14
Q

What is leukocyte adhesion deficiency?

A

Defect in LFA-1 integrin (CD18) = impairs migration and chemotaxis

  • no pus formation
  • delayed separation of umbilical cord
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15
Q

Which cell would be address malaria in the erythrocytic stage?

A

NK cells bc RBCs dont have MHC

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16
Q

Which tests are used to detect anti-Rh antibodies in mother and fetus?

A

Indirect Coombs: IgG anti-Rh in mother’s serum

Direct Coombs: IgG antibodies bound to fetal RBCs

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17
Q

What are the antibodies and effector cells in: Type I hypersensitivity?

A

IgE; basophils and mast cells

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18
Q

What are the antibodies and effector cells in: Type II hypersensitivity (cytotoxic)?

A 
Always autoimmune (=complement)!
IgG/IgM; leukos/macros/NKs
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19
Q

What are the antibodies and effector cells in: Type II hypersensitivity (non-cyto)?

A

IgG; None

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20
Q

What are the antibodies and effector cells in: Type III hypersensitivity?

A

IgG/IgM; leukos/macros

+ complement

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21
Q

What are the antibodies and effector cells in: Type IV hypersensitivity?

A

None; CTL/Th1/macros

22
Q

Which hypersensitivity rxn causes rheumatic fever?

A

Type II (autoimmune abs against strep)

23
Q

What is chronic granulomatous disease?

A

Def in NADPH oxidase = susceptibility to catalase (+) orgs [staph, candida, aspergillus

24
Q

What deficiency leads to decreased removal of immune complexes?

A

C3 def = defect in opsonization –> decreased removal of ICs

25
Q

Which immuno cell is needed for s. pneumo infection?

A

neutrophil

26
Q

In which disease do you find p-ANCA?

A

Churg-Strauss: vasculitis, asthma, eosinophilia

Churg-Strauss = PAVE

27
Q

What is Goodpasture Syndrome?

A

Type II (autoimmune) hypersensitivity = abs against collagen type IV in glomerular/lung basement membrane

28
Q

What is the histological manifestation of Goodpasture Syndrome?

A

Direct fluorescence of abs shows linear pattern of IgG deposition in gloms

29
Q

What type of hypersensitivity is the rxn to poison ivy?

A

Type IV: Th1 –> IFN-gamma –> macros

30
Q

What is hemolytic disease of the newborn?

A

Maternal anti-Rh IgG abs and causes hemolytic anemia in fetus

31
Q

What type of hypersensitivity is hemolytic disease of the newborn?

A

Type II (cytotoxic) = auotimmune

32
Q

What do cytotoxic T cells require to eliminate tumor cells?

A

MHC class I molecules on the tumor surface

33
Q

Which immuno process is needed to remove immune complexes?

A

Classical complement pathway –> C3b

34
Q

Which complement factor chemoattracts neutros?

A

C5a

35
Q

What is Hyper-IgM syndrome?

A

Deficiency due to inability to isotype switch bc Th2 cells lack CD40L = lots IgM, no others

36
Q

Which cell surface marker indicates macros?

A

CD14

37
Q

Graves disease is considered what type of hypersensitivity?

A

Type II (non-cytotoxic) bc abs are against TSH receptors, not tissues

38
Q

What are the 2 most important chemotactic factors for neutros?

A

C5a and IL-8

39
Q

What is Eaton-Lambert Syndrome (like MS)?

A

Abs against the presynaptic Ca channels at the NMJ, leading to inhibition of Ach release
- proximal muscles especially of the lower limbs

40
Q

What are the hallmarks of Antiphospholipid antibody syndrome?

A

Often w SLE; History of hypercoagulability and miscarriage + prolonged PTT

41
Q

Which immuno cell gets rid of mycobacteria?

A

neutros

42
Q

What is the function of myeloperoxidase?

A

convert hydrogen peroxide into hyalide radicals

43
Q

What protein is assoc w Ankylosing spondylitis?

A

HLA-B27 (MHC I)

44
Q

What is Chédiak-Higashi disease?

A

defect in LYST: Microtubule dysfunction in phagosome-lysosome fusion = Recurrent staph/streptococci infections,
partial albinism*
-neutropenia, giant granules in neutros

45
Q

What happens with aspirin-induced-asthma?

A

aspirin triggers the attack by inhibiting the production of prostaglandins = arachidonic acid converted to leukotrienes by the enzyme lipooxygenase –> bronchoconstriction

46
Q

What causes chronic graft rejection?

A

arteriolosclerosis of the engrafted organ

47
Q

What is chronic granulomatous disease? Its 2 biggest hallmarks?

A

NADPH oxidase deficiency

  1. susceptible to oxidase + orgs (s. aureus, e.coli, listeria, etc)
  2. Nitroblue tetrazolium dye reduction test is ⊝
48
Q

Your pt has recurrent bacterial and viral infections and has albinistic features, what disease do you suspect?

A

Chediak-Higashi

49
Q

What is the drug of choice for pregnant pts with RMSF?

A

chloramphenicol (only concern is grey baby syndrome near term)

50
Q

Which factors mediate neutrophil chemotaxis?

A 
"Clean up on isle (IL) 8 B4 5 A.m."
Il-8
Leukotriene-B4
C5a
formyl-methionyl peptides

USMLE Step 1 (13 decks)

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