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Step 2/Level 2 > Immunology > Flashcards

Immunology Flashcards

1
Q

What are the recommended treatments for a high-risk needle stick in a hospital worker?

A

Antiretroviral therapy with 3 drugs (Tenofovir, Emtricitabine, Raltegravir) for 4 weeks

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2
Q

Tx of oral/esophageal candidiasis?

A

Fluconazole

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3
Q

Tx of MAC?

A

Macrolides (Azithromycin or Clarithromycin) with Ethambutol +/- Rifampin

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4
Q

Tx of cryptococcal meningitis?

A

Amphotericin B IV + Flucytosine

-Then oral Fluconazole

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5
Q

Tx of CMV retinitis?

A

-Ganciclovir

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6
Q

Multiple ring enhancing lesions on head CT with CD4

A

Toxoplasmosis

-Tx: pyrimethamine + Sulfadiazine + leucovorin

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7
Q

What are some common symptoms of acute retroviral syndrome?

A

-fever, myalgia, fatigue, HA

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8
Q

Who gets anti-retrovirals?

A

Anyone with HIV

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9
Q

Which lab test can be helpful in a suspected acute HIV infection?

A

Viral load (too soon for Antibodies)

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10
Q

When should prophylactic ABX be given for MAC? What is given?

A

CD4

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11
Q

What does HAART include?

A

2 NRTIs and one other (protease inhibitor, integrase inhibitor, NNRTI)

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12
Q

Which antiretroviral class causes lactic acidosis?

A

NRTI (Abacavir, Zidovudine, Tenofovir)

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13
Q

Which antiretroviral class causes GI intolerance?

A

Protease inhibitors (-navir’s)

“Navir trust a protease”

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14
Q

Which antiretroviral class causes rash?

A

NNRTIs (Efairenz, Etravirine)

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15
Q

Which antiretroviral class causes hyperglycemia, DM and lipid abnormalities?

A

Protease inhibitors

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16
Q

Which antiretroviral causes bone marrow suppression and megaloblastic anemia?

A

Zidovudine (NRTI)

17
Q

Which antiretroviral causes potentially fatal hypersensitivity reaction?

A

Abacavir (NRTI)

18
Q

Which antiretroviral causes neuropsychiatric symptoms (depression and nightmares)?

A

Atazanavir (protease inhibitor)

19
Q

Which antiretroviral is teratogenic?

A

Efavirenz (NNRTI)

20
Q

Hypocalcemia and recurrent viral, fungal and protozoal infections? Test to diagnose?

A
  • DiGeorge syndrome (thymic aplasia)

- 90% have 22q11 deletion detectable with FISH

21
Q

Cause of recurrent candidiasis infections? Tx?

A

Chronic mucocutaneous candidiasis (T cell dysfunction)

-Tx: Ketoconazole

22
Q

Chronic diarrhea, recurrent infections (candida, RSV, HSV, measles, flu, parainfluenza, PCP pneumonia) and failure to thrive?

A

SCID (normally 2/2 an adenosine deaminase deficiency)

23
Q

Bruton agammaglominemia defect? At risk for?

A

-tyrosine kinase gene –> low levels of all immunoglobulins-at risk for bacterial infections

24
Q

Features of ataxia telangiectasia?

A 
ATAXIA
Ataxia
Telangiectasia
Acute leukemia/lyphoma
X-ray sensitivity
IgA deficiency 
AFP (inc after 8 months old)
25
Q

Symptoms of Wiskott-Aldrich syndrome?

A 
WAITER
Wiskott
Aldrich
Immunodeficiency 
Thrombocytopenia and purpura
Eczema 
Recurrent pyogenic infections
26
Q

Deficiency in NADPH oxidase? Susceptible to which bugs?

A

Chronic granulomatous disease

-S. aureus and Aspergillus

27
Q

Test for chronic granulomatous disease?

A

-Negative nitroblue tetrazolium (NBT) test (NO yellow to blue-black oxidation)

28
Q

Tf of chronic granulomatous disease?

A

PPX Bactrim and Itraconazole

29
Q

Partial albinism, recurrent respiratory tract and skin infections and neurologic disorders?

A

Chediak-Higashi syndrome (defective LYST gene –> no enzymes in PMNs)

30
Q

Eczema, recurrent COLD S. aureus abscesses, coarse facial features (may retain primary teeth)?

A

Hyper-IgE syndrome (Job syndrome)

31
Q

What does the rash for contact dermatitis look like? Which hypersensitivity type is this?

A
  • linear

- type IV (delayed)

32
Q

Which type of hypersensitivity are involved in Multiple sclerosis and hashimotos thyroiditis?

A

Type IV

33
Q

Transplant rejection within the initial 24 hours?

A

due to anti-donor antibodies. Poor donor matching

34
Q

Transplant rejection 6 days to 1 year after surgery? What is it caused by?

A
  • acute rejection
  • anti-donor T call proliferation
  • Immunosuppression can reverse this
35
Q

Rejection >1 year after transplant?

A

Chronic rejection

36
Q

Which medication should NOT be given with Azathioprine? Why?

A

Allopurinol

-Azathioprine is metabolized by xanthine oxidase

37
Q

What is a SE of Hydroxychloroquine? When is this used?

A
  • Visual disturbances.

- Used in RA, SLE and in transplant patients

38
Q

Tx of Graft-versus-Host disease?

A

Steroids
Tacrolimus
Mycophenolate

39
Q

SE of mycophenylate?

A
  • leukemia and lymphoma.

- Teratogen

Step 2/Level 2 (18 decks)

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