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USMLE Step 1 > Immunology > Flashcards

Immunology 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
Which immuno cell is needed for s. pneumo infection?
neutrophil
26
In which disease do you find p-ANCA?
Churg-Strauss: vasculitis, asthma, eosinophilia Churg-Strauss = PAVE
27
What is Goodpasture Syndrome?
Type II (autoimmune) hypersensitivity = abs against collagen type IV in glomerular/lung basement membrane
28
What is the histological manifestation of Goodpasture Syndrome?
Direct fluorescence of abs shows linear pattern of IgG deposition in gloms
29
What type of hypersensitivity is the rxn to poison ivy?
Type IV: Th1 --> IFN-gamma --> macros
30
What is hemolytic disease of the newborn?
Maternal anti-Rh IgG abs and causes hemolytic anemia in fetus
31
What type of hypersensitivity is hemolytic disease of the newborn?
Type II (cytotoxic) = auotimmune
32
What do cytotoxic T cells require to eliminate tumor cells?
MHC class I molecules on the tumor surface
33
Which immuno process is needed to remove immune complexes?
Classical complement pathway --> C3b
34
Which complement factor chemoattracts neutros?
C5a
35
What is Hyper-IgM syndrome?
Deficiency due to inability to isotype switch bc Th2 cells lack CD40L = lots IgM, no others
36
Which cell surface marker indicates macros?
CD14
37
Graves disease is considered what type of hypersensitivity?
Type II (non-cytotoxic) bc abs are against TSH receptors, not tissues
38
What are the 2 most important chemotactic factors for neutros?
C5a and IL-8
39
What is Eaton-Lambert Syndrome (like MS)?
Abs against the presynaptic Ca channels at the NMJ, leading to inhibition of Ach release - proximal muscles especially of the lower limbs
40
What are the hallmarks of Antiphospholipid antibody syndrome?
Often w SLE; History of hypercoagulability and miscarriage + prolonged PTT
41
Which immuno cell gets rid of mycobacteria?
neutros
42
What is the function of myeloperoxidase?
convert hydrogen peroxide into hyalide radicals
43
What protein is assoc w Ankylosing spondylitis?
HLA-B27 (MHC I)
44
What is Chédiak-Higashi disease?
defect in LYST: Microtubule dysfunction in phagosome-lysosome fusion = Recurrent staph/streptococci infections, partial albinism* -neutropenia, giant granules in neutros
45
What happens with aspirin-induced-asthma?
aspirin triggers the attack by inhibiting the production of prostaglandins = arachidonic acid converted to leukotrienes by the enzyme lipooxygenase --> bronchoconstriction
46
What causes chronic graft rejection?
arteriolosclerosis of the engrafted organ
47
What is chronic granulomatous disease? Its 2 biggest hallmarks?
NADPH oxidase deficiency 1. susceptible to oxidase + orgs (s. aureus, e.coli, listeria, etc) 2. Nitroblue tetrazolium dye reduction test is ⊝
48
Your pt has recurrent bacterial and viral infections and has albinistic features, what disease do you suspect?
Chediak-Higashi
49
What is the drug of choice for pregnant pts with RMSF?
chloramphenicol (only concern is grey baby syndrome near term)
50
Which factors mediate neutrophil chemotaxis?
``` "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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