Immunology

Question 1

HLA class 1 presents to

Answer 1

CD8 - cytotoxic T cells

Question 2

HLA class 2 presents to

Answer 2

CD4 - helper T cells

Question 3

hypersensivity

Answer 3

immune response is exaggerated or inappropriate to harmless environmental antigens

Question 4

Ab in type 1 hypersensitivity, also called?

Answer 4

IgE

also called allergy and atopy

Question 5

allergy is a result of

Answer 5

end result of complex interplay of a number of factors - atopy, environment, immune reactivity

Question 6

pathogenesis of allergy

Answer 6

mast cells + IgE - stimulate mediators to cause secretions, vasodilation, mucosal oedema

Question 7

diagnosis of allergy

Answer 7

hx , ex, skin prick tests

IgE (RAST test)

Question 8

type 2 hypersensitivity

Answer 8

IgG.or IgM

self or exogenous stimulator

Question 9

examples of type 2 self hypersensitivity

Answer 9

graves
myasthenia gravis
goodpastures

Question 10

examples of type 2 exogenous hypersensitivity

Answer 10

blood transfusion - haemolytic reaction

HDN

hyper acute graft rejection

Question 11

type 3 hypersensitivity

Answer 11

antibody antigen complex disposition in tissues = immune complex recruits inflammatory cells - tissue damage

Question 12

two outcomes from hypersensitivity type 3

Answer 12

serum sickness

arthrus reaction

Question 13

serum sickness?

Answer 13

systemic illness where immune complexes form in the circulation and are deposited in a widespread fashion throughout many tissues

Question 14

arthrus reaction

Answer 14

a more localised disorder where complexes are actually formed locally in tissues rather being deposited from the blood

Question 15

e.g. of Hypersensitivity 3

Answer 15

EAA
post strep GN
SLE

Question 16

type IV hypersensitivity mediated by

Answer 16

T helper cell mediated and its cytokine products IL2 , gamma interferon

Question 17

type 4 examples

Answer 17

Mantoux test

contact dermatitis

Question 18

autoimmunity due to

Answer 18

loss of tolerance - therefore autoreactive T and B cells are able to mature

Question 19

primary defects of innate immunity

Answer 19

chronic granulomatous disease: problem with intracellular killing

leucocyte adhesion def (LAD): neutrophils unable to attach to endothelium

Question 20

complement deficiencies?

C1-c4?

C3?

C5-C9?

Answer 20

C1-C4: immune complex disease, infection (strep, haemophilia, meningococcus)

C3: recurrent above infections

C5-C9: recurrent neisserial infection

Question 21

hereditary angioedema

Answer 21

similar presentation to anaphylaxis - but not itchy, or painful

deficiency of C1 inhibitor (control protein)

tx - infusion of C1 inhibitor

Question 22

SCID?

Answer 22

severe combined immune deficiency

dysfunction with T AND B cells

Question 23

SCID pc?

Answer 23

well for first 3 months

persistent superficial candida

diarrhoea and failure to thrive

then cross line –> chronic bronchitis, interstitial pneumonitis, bacterial seps

Question 24

TX for SCID

Answer 24

supportive until suitable bone marrow donor

earlier the better

Question 25

measurement of complement

Answer 25

functional assessment of pathways with functional assays for genetic deficiencies

Question 26

allograft?

Answer 26

transfer between genetically non identical members of the same species

Question 27

xenograft

Answer 27

transfer between species

Question 28

GVHD?

Answer 28

graft versus host disease

Question 29

prevention of graft rejection?

Answer 29

ABO matching
Close tissue matching - Class 1 and 2 HLA: especially HLA-A, HLA-B & HLA-DR loci

prophylactic immunosuppressive therapy

Question 30

GVHD path

Answer 30

principally occurs with bone marrow transplantation - due to:
- presence of functioning immunocompetent donor T cells in the graft

• HLA differences

Question 31

early signs of GVHD?

Answer 31

erythematous rash on hands and soles of feet - significant diarrhoea

Question 32

current immunotherapies three main groups

Answer 32

immunosuppressive/immunomodulatory drugs, alternatives to drug therapy and immunoglobulin therapy

Question 33

examples of immunosuppressive drugs

Answer 33

steroids in combination with Azathioprine and Cyclophosphamide