Immunology

Question 1

Churg-Strauss syndrome:

1. Vessel size
2. Autoantibody and pathology
3. Treatment

Answer 1

Medium and small vessel vasculitis

P-ANCA with eosinophilic granulomas

Prednisolone, azathioprine and cyclophosphamide

Question 2

Wegner’s granulomatosis:

1. Vessel size
2. Pathology
3. Autoantibody
4. Treatment

Answer 2

Small and medium vessel vasculitis

Lung cavitation, cresenteric glomerulonephritis and haemorrhage

C-ANCA

Corticosteroids and cyclophosphamide

Question 3

Microscopic polyangitis

1 vessel size
2 signs and symptoms
3 autoantibody
4 treatment

Answer 3

Small vessel vasculitis

Purpura and livedo

P-ANCA against IgE

Prednisolone and azathioprine

Question 4

What are the four types of type three hypersensitivity?

Answer 4

1. Mixed essential cryoglobulinaemia
2. Serum sickness
3. Polyarteritis nodosa
4. SLE

Question 5

Polyarteritis nodosa

1. Cause
2. Symptoms
3. Investigations
4. Treatment

Answer 5

Hepatitis B/C

Fever, skin, nerves and kidney affected

Raised ESR, WCC, CRP and “rosary sign”

Prednisolone and cyclophosphamide

Question 6

Fever and raised CRP/ESR with rosary sign. Seen in patients exposed to hepatitis b or c

Answer 6

Polyarteritis nodosa

Question 7

2 vasculitis with P-ANCA

Answer 7

Churg strauss

Microscopic polyangitis

Question 8

Cresenteric glomerulonephritis - disease and autoantibody

Answer 8

C-ANCA

Wegeners granulomatosis

Question 9

Low c4, raised ESR and a normal CRP in a lady with a photosensitive rash and ulcers

Answer 9

SLE

Question 10

Define type three hypersensitivity

Answer 10

IgG/M immune complex mediated tissue damage

Question 11

Define type four hypersensitivity

Answer 11

Delayed T cell mediated hypersensitivity

Question 12

Five examples of type four hypersensitivity reactions

Answer 12

1 type one diabetes 
2 multiple sclerosis 
3 rheumatoid arthritis 
4 contact dermatitis 
5 Crohn's disease

Question 13

Oligoclonal bands of IgG with transient visual loss and left sides weakness

Answer 13

Multiple sclerosis

Question 14

What investigation would you do for multiple sclerosis and what would you expect to see

Answer 14

Oligoclonal IgG bands on electrophoresis

Question 15

Skip lesions and Th1 mediated inflammation

Answer 15

Crohn’s disease

Question 16

HLA B27

Answer 16

Ankylosing spondylitis

Question 17

DR15/DR2

Answer 17

Goodpastures

Question 18

HLA DR3

Answer 18

SLE

Question 19

HLA DR4

Answer 19

Rheumatoid arthritis

Question 20

Features of limited cutaneous scleroderma

Answer 20

Calcinosis 
Raynauds
Oesophageal dysmotility
Sclerodactyl 
Telangectasia 

And pulmonary hypertension

Question 21

Anti centromere antibodies

Answer 21

Limited cutaneous scleroderma

Question 22

Features of diffuse cutaneous scleroderma

Answer 22

CREST plus GIR/interstitial pulmonary disease/renal

Question 23

Anti topoisomerase antibodies

Answer 23

Diffuse cutaneous scleroderma

Question 24

Scl70/RNA polymerase I/II/III

Answer 24

Diffuse cutaneous scleroderma

Question 25

Anti Ro and La antibodies

Answer 25

Sjogren syndrome

Question 26

Test for Sjogren syndrome

Answer 26

Schirmer test