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Internal Medicine > Immunology > Flashcards

Immunology Flashcards

1
Q

Type 1 Hypersensitivity rxn:

A

Anaphylactic

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2
Q

Type 2 Hypersensitivity rxn:

A

Cytotoxic

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3
Q

Type 3 Hypersensitivity rxn:

A

Immune complex-mediated

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4
Q

Type 3 Hypersensitivity rxn:

A

Cell-mediated/delayed

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5
Q

Causes of Type 1 HS rxn

A

Anaphylaxis [food, bees, medications, rubber], atopy, hay fever, urticaria, allergic rhinitis,

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6
Q

Cause of angioedema?

A

C1 esterase inhibitor, C4 complement is low

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7
Q

Causes of Type 4 HS rxn

A

TB skin test, contact dermatitis [poison ivy, nickel earrings, cosmetics, medications], chronic transplant rejection, granulomas (sarcoidosis)

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8
Q

If a patient wants HIV testing because of recent risk-taking behavior and the initial test is negative, what should be done next?

A

Retest patient in 6 months since it takes up-to 12 weeks for antibodies to develop in patients recently exposed to HIV

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9
Q

HIV and pneumonia, dx?

A

PCP, look for patient with severe hypoxia, normal XR or diffuse bilateral interstitial infiltrates

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10
Q

Features of IgA deficiency

A

Most common primary immunodeficiency.
Recurrent respiratory and GI infections.
IgA low, IgG subclass 2 low.
Anaphylaxis to blood transfusion

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11
Q

Features of Bruton agammaglobulinemia

A

X-linked agammaglobulinemia:

  • X-linked recessive (affects males)
  • low or absent B cells
  • Infection begin after 6 months of age when maternal antibodies disappear
  • recurrent lung or sinus infections with Strep and Haemophilus species.
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12
Q

Cause of DiGeorge syndrome

A

Hypoplasia of the 3rd and 4th pharyngeal pouches

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13
Q

Presentation of DiGeorge syndrome

A 
Cleft palate
Abnormal facies 
Thymic aplasia -> t cell deficiency
Cardiac defects (Tetrology of Fallot or Transposition og GV) 
Hypocalcemia (p/w tetany) 
22q11
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14
Q

Most common cause of SCID

A

Adenosine deaminase deficienecy, AR, defects in B and T cells resulting in severe infections in the first few months of life.

  • W/o B-cells: risk of pyogenic infections to organisms with polysaccharide capsules (Strep pneumo, H influenzae, N meningitidis)
  • W/o T-cells: risk of opportunistic pathogens (PCP, Herpesviridae)
  • Absent or dysplastic THYMIC SHADOW and no lymph nodes
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15
Q

Classic Triad of Wiskott-Aldrich syndrome

A 
Wiskott
Aldrich 
Thrombocytopenia purpura
Eczema
Recurrent infections (usually respiratory)
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16
Q

Features of Chediak-Higashi syndrome

A

AR, problem with microtubule polymerization interrupting lysosomal trafficking b/c there is no phagosome-lysosome fusion resulting in GIANT granules in NEUTROPHILS, pyogenic infections, oculocutaneous ALBINISM, peripheral neuropathy

17
Q

Features of Chronic granulomatous disease

A

X-linked recessive, affecting males
Defect in NADPH oxidase
Recurrent infections with CATALASE-POSITIVE ORGs
Abnormal NBT dye reduction test NEGATIVE

18
Q

CATALASE-POSITIVE organisms

A 
Nocardia
Pseudomonas
Listeria
Asergillus
Candida
E. coli
S. aureus 
Serratia
19
Q

When do you start PCP ppx for HIV? With?

A

CD4 count

20
Q

PCP pneumonia can p/w?

A

Elevated LDH, interstitial infiltrates, hypoxia, nodular/papular lesions of external auditory meatus

21
Q

If patient is allergic to Bactrim (TMP-SMX), what alternative medications can they use?

A

Dapsone, aerosolized pentamidine, atovaquone

22
Q

When do you start Mycobacterium avium complex ppx?With?

A

CD4 count

23
Q

Recommended vaccines for HIV pts:

A
  • MMR vaccine (if CD4>200)
  • Varicella vaccine (if CD4>200)
  • Influenza yrly
  • Tdap + Td q10yrs
  • PCV13 + PPSV23
  • Hep A and Hep B
24
Q

Infants from HIV + mothers should receive what at birth?

A

Zidovudine for at least 6 weeks after delivery

25
Q

What stain is used on sputum to detect PCP?

A

Silver stain (Wright Geimsa or Geimsa)

26
Q

What pathogen causes chronic watery diarrhea in HIV patients?

A

Cryptosporidium

27
Q

Complement deficiencies of C5 and C9 through C9 recurrent infections with genus of bacteria?

A

Neisseria species

28
Q

Job-Buckley syndrome

A

Hyper IgE syndrome (T cell disorder)

  • coarse facies (fair skin)
  • cold staph abscess
  • retained primary teeth
  • ecezema (red hair)

Internal Medicine (12 decks)

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