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Immunology Flashcards

1
Q

gottrens papules

A

dermatomyositis

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2
Q

ANA diffuse type binding

A

SLE(or RA)

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3
Q

ANA nucleolar binding

A

Systemic sclerosis

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4
Q

ANA speckled binding

A

Mixed connective tissue disease

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5
Q

difference between diffuse and limited systemic sclerosis?

A

trunk involvement in Diffuse type(scl70)

They also get pulmonary interstitial disease and more liekly to have kidney involvement

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6
Q

causes of erythema nodosum

A

I:strep (scarlet/rheumatic fever), yersinia, campylobacter, tb
I: Sarcoidosis. IBD, bechets,
M: pre non hodgkins lymphoma

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7
Q

caseating granuloma

A

TB

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8
Q

bilateral parotid enlargement

A 
stones
HIV
mumps
sarcoidosis
alcohol
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9
Q

3 signs of sarcoidosis

A 
hypergammagolbulinaemia
hypercalcaemia (granulomas hydroxylate vit d, causing raised calcium)
Raised ACE (abnormality of capilliaries in lung where ACE made)
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10
Q

what is osteocalcin

A

measure of osteoblast activity

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11
Q

what infection is assocaited with polyarteritis nodosa

A

Hep B

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12
Q

‘palpable’ purpura

A

vasculitis

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13
Q

finding on temporal artery biopsy with GCA

A

lumen narrowing
multiple grandulomas with multinuclear giant cells
lymphocytic infiltration of the tunica media

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14
Q

3 areas of pathology in granulomatosis with polyangitis

A

ENT
Lung
Kidney

c-anca binds to proteinase 3

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15
Q

3 areas of pathology in eosinophilic granulomatosis with polyangitis

A 
Asthma
Eosinophilia
Vasculitis
perinuclear-anca(p-anca) binds to myeloperoxidase
(churg strauss)
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16
Q

when would you see an onion skin artery

A

systemic sclerosis

due to collagen deposisiton can cause hypertensive crisis due to high ACE

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17
Q

What infections are those with a neutrophil deficiency at risk of

A 
PLACESS
pseudomonas
listeria
aspergillus
candida
e.coli
staoh aureus
serratia
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18
Q

India ink stain

A

cryptococcus

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19
Q

groccott stain

A

actinomyces

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20
Q

which drugs have an ability to disrupt biofilms

A

rifampicin and ciprofloxacin to a lesser extent

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21
Q

What is the most important part of managing a prosthesis infection

A

Removal of the prosthesis if possible, and adequate debridement. sequestration causes walling off and remain quiescent. immune system doesnt clean the prosthetic material well. including heart valves etc

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22
Q

how many people crry c dif

A

5%
spore forming - germinate and multiple then toxins cause damage
alcohol gel doesnt kill them. drying is what kills bacteria normally.

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23
Q

what are the indicators of a sever c dif infection

A 
HR>90
WCC>15
indications of colitis
T>38.5
rising creatinine - renal failure diue to dehydration

ribotype 027 is severe causes more toxin release

NOT bristol stool chart

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24
Q

C.dif treatment?

A

Metronidazole - 400mg TDS
severe - Vancomycin 125mg QDS
Very sever with ileus or vom - both higher dose with colonic dilation

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25
C.dif treatment?
Metronidazole - 400mg TDS severe - Vancomycin 125mg QDS Very sever with ileus or vom - both higher dose with colonic dilation
26
what does pseudomembarnous colitis look like?
wet cornflakes
27
What test would you do to confirm IgE sensitivity DURING an acute episode?
mast cell tryptase
28
Anaphylaxis management?
``` oxygen adrenaline antihistamines - chlophenamine bronchodilators steroids fluids ```
29
What complement changes do you see in SLE
low levels of C3 and c4
30
HLA of ank spond
HLA b27
31
HLA of goodpastures
DR2 and DR15
32
HLA of graves and SLE
DR3
33
HLA of T1DM
dr3/4
34
HLA of RA
DR4
35
What do you have to measure before starting azothioprine
tpmt
36
What disease should you not use anti-tnf therapy in?
lupus - can precipitate
37
What causes serum sickness
penicillin | symptoms come on after a few days
38
What do you need to consider when assessing if someone is likely to have an immunodeficiency?
``` Recurrent illness Severe illnesses unusual organisms opportunistic organisms unusual sites of infection other problems such as end organ damage or failure to thrive, family history. ```
39
What is the treatment for brutons
every 3 weeks give human serum poolked immunoglobulin
40
1858t allele
PTPN22 increases RA, SLE, type 1 diabetes
41
What antibody is associated with PSC? what would you see on USS?
p anca bile duct dilatation - these are the preserved segments while the others have undergone stricturing and scarring. bile duct beading
42
what does anti GAD stand for
glutamic acid decarboxylase
43
saddle shaped nose
wegeeners
44
rejection of transplant in minutes/hours?
hyperacute rejection - pre formed antibodies and is prevnted by HLA cross matching
45
what is protein losing enteropathy
can occur as a result of gastrointestinal disease such as IBD or coeliac and causes loss of protein whihc in turn reduces production of immunogloblin and causes increased number of infections
46
MHC class 3 deficiency
common variable immunodeficicney | aswell as c2 and c4 and factor B
47
myelin basic protein? what is th eother protein?
MS proteolipid protein IgG attack of oligodendrocytes CSF banding electrophoresis
48
what is attacked in ITP? treatment?
glp2b/3a on platelets steroids anti D
49
anagrelide is treatment for what?
ET
50
treatment for SLE
corticosteroids then cyclophosphamide or other anti proliferative agents
51
which anti proliferative agent affects B cells and which affects t cells predominantly?
``` cyclo B myco T (and azo) ```
52
dermatomyositis autoantibody? | symptoms?
anti JO-1 heliotrope rash around the eyes gottrens papules on fingers proximal limb weakness.
53
which anti prolif alkylates guanine and which blocks synthesis de novo
cyclo - alk | myco and azo - novo
54
what is cresenteric glomerulonephritis also known as?
rapidly progressive GN
55
What is th emost common cytokine deficiency and what does it predispoe to?
il12/r and IFNgamma/r bcg, mycobacterium, salmonella
56
what is a kuppfer cell
macrophage
57
what is a dendritic cells function
to phagocytose and be an APC and primes the adaptive immune system
58
difference between autoinflam and autoimmune
innate - A inflammatory adaptive - A immune
59
MONOgenic autoinflam diseases
NLRP3 - cryopyrin TNF recepter (associated periodic syndrome) familial med - MEFV - pyrin marenostrin (recessive)
60
MEFV
pyrin marenostrin (negative regulator of procaspase 1 which drives IL1 and nfkappa b which all activate tnf alpha Jews periodic fevers abdo pain due to peritonitis
61
Colchicine MOA
binds to tubulin in neutrophils making it difficult for them to migrate and secrete chemokines
62
what other treatments can be used in mediterranian fever
tnf alpha blockers such as etanercept
63
AIRE gene
responsible for presentation of self antigens APECED - adisons, hypothyroid, candidiasis due to il17 and 22 loss
64
FAS associated disease
no apoptosis ALPS syndrome autoimmune lymphoproliferative syndrome TNFR6 get cytopenias
65
FOXp3 gene
IPEX - immune dysregulation polyendocrinopathy , enteropathy x linked t reg development. peripheral tolerance
66
genes associated with chrons
IBD1 - CARD15 - NOD2 - | NFkBpredisposition
67
what diseasesa are associated with CTLA4 and PTPN22
RA, SLE, t1DM, autoimmune thyroid disease
68
PADI enzymes
RA
69
Anti phospholipid antibodies
anti cardiolipin and lupus anticoagulant.(not an anticoagulant in the body)
70
difuse scleroderma
anti topoisomerase scl70
71
limited scleroderma
anti centromere
72
jo-1 (t-RNA synthetase)
dermatomyositis
73
anti - mi2
myositis (derm over poly)
74
Chuyrg strauss antibodies?
eosinophilic granulomatosis with polyangitis P ANCA myeloperoxidase
75
other name for wegeners
GPA - granulomatosis with polyangitis
76
P-ANCA
MPA/eGPA
77
Central memory characteristics
CCR7 positive | tend to be in CD4 population in the lymph nodes and tonsils and produce IL2 to help other cells
78
Effector memory characteristics
NEGATIVE for CCR7 and have low CD62 and so are not in lymph nodes they are found in CD8 cells and produce perforin and ifn gamma
79
what do CCR7 and CD62L do?
help mediate extravasation and rolling and so these cells are found in lymph rather than the liver lungs and gut.
80
water in oil emulsion containing mycobacterial cell wall componemnts
Complete freunds adjuvant - used in animals as painful in humans
81
adjuvant which provides slow release, activating Gr1 positive cells to produce IL4 and prime the b cell response
ALUM
82
adjuvant activating TLRs on APCs to stimulate expression of costimulatory moleculesq
CpG
83
What is the most important HLA type in transplant prediction
DR then B then A
84
Direct presentation
comes from the donars APCs
85
Indirect
comes from your own APCs
86
Acute rejection uses what type of antigen presentation
direct. from the donar APCs
87
what does hypertension do in the context of transplat
increases likelihood of rejection
88
What are the 3 phases of rejection?
recognition activation Effector phase
89
What are the main 2 ways in which rejection occurs
t cell and antibody
90
how do t cells kill transplant cells
granzyme b perforin, fas ligand this is a type 4 sensitivity reaction
91
how do macrophages assist in transplant rejection
proteolytic enzyme release and oxygen and nitrogen radicals and cytokins
92
How do antibodies cause rejection
bind to graft endothelium - capillaries etc. they also recruite complement
93
What drugs should be given to induce transplant immunosuppresion
anti-CD25 - basiliximab | Anti-CD52 - alemtuzamab
94
What should be given throiughout the life of the recipient for transplant
usually calcineurin inhibitors or anti proliferatives such as cyclophosphamide, mycophenylate, or azothiprine
95
What should be given in acute t cell mediated rejection
steroids frst anti thymocyte globulim muromonab
96
What should be given in antibody mediated rejection
b cell depletion : IvIg plasma exchange anti cd20 and anti C5 (eculizumab)
97
What does bechets affect
all small and large vessels causes: ulcers, anterior uveitis, joint pain maybe
98
one use for interferon beta
MS highly relaps9ing remitting PAST

Joshua's Path (9 decks)

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