immunology

Question 1

what cells are involved in memory

Answer 1

CD4+ T cells, memory B cells, long lived plasma calls

Question 2

what is acute vaccination

Answer 2

protection provided by the persons OWN immune system

can stimulated by vaccination or naturally acquired infection

Question 3

what is passive vaccination

Answer 3

protection transferred from another person or animal

Question 4

what are sources of passive immunity

Answer 4

breast milk

via the placenta

Question 5

what are the hallmarks of immunodeficiency

Answer 5

SPUR

serious infections
Persistent infections
Unusual infections
Recurrent infection

Question 6

give examples of secondary immunodeficiencies

Answer 6

extremes of age
immunosupressive therapy/steroids  
anti-cancer treatment 
cancer 
malnutrition 
renal issues 
diabetes

Question 7

what is phagocyte deficiency

Answer 7

defect in phagocyte production, mobilisation and recruitment

Question 8

what is the first step in phagocyte production

Answer 8

mobilisation of phagocytes and precursors from bone marrow or within tissues

Question 9

what can go wrong in the 1st step of phagocyte production

Answer 9

failure of neutrophil differentiation = failure to produce neutrophils

Question 10

give examples of neutrophil maturation failure

Answer 10

kostmann syndrome

Question 11

what is Kostmann syndrome

Answer 11

rare autosomal recessive disorder which results in severe chronic neutropenia

Question 12

what is the treatment of Kostmann syndrome

Answer 12

stem cell transplant

Question 13

what is the 2nd step in phagocyte production

Answer 13

up regulation of endothelial adhesion markers which allows neutrophil adhesion and migration into tissues

Question 14

what can go wrong in the 2nd step of phagocyte production

Answer 14

failure to express leukocyte adhesion markers = leukocyte adhesion deficiency

Question 15

what is leukocyte adhesion deficiency

Answer 15

rare primary immunodeficiency

Question 16

what is the 3rd step of phagocyte production

Answer 16

recognition of the organism

Question 17

what can go wrong in the 3rd step of phagocyte production

Answer 17

antibody or complement deficiency

Question 18

what is the 4th step of phagocyte production

Answer 18

phagocytosis and organism killing

Question 19

what can go wrong in the 4th step of phagocyte production

Answer 19

failure of oxidative killing = chronic granulomatous disease

Question 20

what 5 things can wrong in the adaptive immune system

Answer 20

1. failure of lymphocyte precursors
2. failure of thymic development
3. failure of expression of HLA molecules
4. failure of signally, cytokine production and effector functions
5. failure of normal apoptosis

Question 21

give an example of failure of lymphocyte precursor disease

Answer 21

severe combined immunodeficiency

Question 22

what is severe combined immunodeficiency (SCID)

Answer 22

usually X-linked, mutation in IL-2 receptor which cause low/no T cells

Question 23

what is the treatment of SCID

Answer 23

stem cell transplant

Question 24

give an example of thyme development

Answer 24

DiGeorge syndrome

Question 25

what is DiGeorge syndrome

Answer 25

complex developmental disorder caused by deletion at 22q11 resulting in no/low T cells

Question 26

what are hypersensitivity diseases

Answer 26

immune response that results in bystander damage to self

Question 27

how many types of hypersensitivity disease are there

Answer 27

4

Question 28

what is type I hypersensitivity disease

Answer 28

immediate hypersensitivity

Question 29

what is type II hypersensitivity disease

Answer 29

direct cell killing

Question 30

what is type III hypersensitivity disease

Answer 30

immune complex mediated

Question 31

what is type IV hypersensitivity disease

Answer 31

delayed type hypersensitivity

Question 32

what Ig type is involved in type I

Answer 32

IgE

Question 33

examples of type I hypersensitivity disease

Answer 33

asthma hayfever anaphylaxis

Question 34

examples of type II hypersensitivity disease

Answer 34

transfusion reactions goodpastures guillan barre graves disease

Question 35

examples of type III hypersensitivity disease

Answer 35

farmers lung, bird fanciers lung etc | SLE

Question 36

examples of type IV hypersensitivity disease

Answer 36

type 1 diabetes psoriasis sarcoidosis TB

Question 37

features of type I hypersensitivity disease

Answer 37

occurs quickly after exposure to allergen (mins-1/2hrs) | presentation associated by site of contact

Question 38

what is the gold standard for allergic testing, what other tests are available

Answer 38

skin pick test ELISA/RAST tryptase levels = anaphylaxis

Question 39

features of type II hypersensitivity disease

Answer 39

antibody (IgG or IgM) binds to human cell surface antigen | occurs in 12-18hrs after exposure

Question 40

management of type II disease

Answer 40

plasmapheresis | immunosuppression

Question 41

what are the features of type III hypersensitivity diseases

Answer 41

antibody binds forming small immune complexes which are trapped in small vessels, joint, and glomeruli

Question 42

how are type III hypersensitivity diseases diagnosed

Answer 42

test for presence of specific IgG antibodies

Question 43

what are the features of type IV hypersensitivity diseases

Answer 43

T cell mediated | delayed

Question 44

what is the role of mast cells in allergic reactions

Answer 44

mast cells express receptors for Fc region of IgE and on contact with allergen B cells produce specific IgE antibody. with the residual IgE binding to the mast cells. when the allergen is re-encountered the allergen binds to the IgE coated mast cell and disrupts the membrane which causes release of cytokines, IL, and vasoactive mediators (histamine etc.)