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Path EMQ 1 liners > Immunology > Flashcards

Immunology Flashcards

1
Q

Lactoferrin

A

Starves bacteria of iron

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2
Q

Polymorphonuclear cells

A

Neutrophils, eosinophils, basophils/mast cells

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3
Q

Monocytes/macrophages

A

Capable of presenting processed antigen to T cells after phagocytosis

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4
Q

Opsonisation

A

Makes more desirable for phagocytosis Pathogen covered by: Abs Complement Acute phase proteins e.g. CRP

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5
Q

Oxidative killing

A

NADPH oxidase Hydrochlorous acid

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6
Q

Non-oxidative killing

A

Bacteriocidal enzymes such as lysozyme and lactoferrin

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7
Q

Dendritic cells

A

Capable of phagocytosis Present process antigen T cells in LNs

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8
Q

Primary lymphoid organs

A

Where immune cells are developed BM: site of B cells maturation Thymus: site of T cell maturation. Involutes after puberty. Selects for low, intermediate and high affinity.

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9
Q

Secondary lymphoid organs

A

Sites of interaction between naive lymphocytes and pathogens Spleen, LNs, MALT

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10
Q

CD4 T helper cells

A

Recognise peptides presented on MHC2, extraceullar proteins Necessary for FULL B CELL RESPONSE Help CD8 T cell response

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11
Q

Th17

A

Autoimmune disease

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12
Q

CD8 cytotoxic T cells

A

MHC1 Kills cells directly: perforin (pore forming) and Fas ligand Viral infections and tumours - intracellular

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13
Q

B cell IgM class switching

A

Can isotype switch to IgG, IgA or IgE Ab

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14
Q

Ig Fab and Fc regions

A

Fab: interacts with pathogen Fc: interacts with immune system

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15
Q

Complement pathway

A

Classical pathway dependent on ACQUIRED immune response - formation of Ab-Ag complex results in change in Ab shape –> expression of binding site for C1

Mannose binding lectin pathway - not dependent on acquire immune response. Direct binding of bacterial manin

Alternative pathway - not dependent on acquired immune response. Directly tirggered by binding ofC3 to bacterial cell wall. Involves factors B, I and P

Membrane attack complex punches holes in bacterial membranes

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16
Q

Clinical features suggestive of immunodeficiency

A

SPUR

Serious

Persistent

Unusual

Recurrent

Runs in families

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17
Q

Oral allergy syndrome

A

Exposure to allergen induces allergy to food

Cross reactivity

e.g. birch pollen and rosacea fruit

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18
Q

Allergy

A

Th2 IgE type 1 hypersensitivity reaction

Majority of IgE bound to mast cells

Allergen crosslinks receptor –> release of preformed inflammatory mediators

FILLAGRIN mutation. Also defects in beta defensin predispose to staph aureus superinfection in infantile eczema. PUVA phototherapy..

Allregic march: eczema –> hay fever, asthma and food allergy

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19
Q

Allergy investigations

A

SPT: positive wheal = >2mm greater than negative control

Lab measurement of specific IgE : expensive; for patients who can’t stop anti-histamine, extensive eczema, history of anaphylxis, dermatographism

= radioimmunoassay test - RAST

Component resolved diagnostics: blood test to detect IgE to single protein components

Mast cell tryptase: biomarker for anaphylaxis. Peaks at 1-2 hours. Baseline at 6 hrs.

20
Q

Anaphylaxis emergency management

A

IM adrenaline

Sit up

Oxygen

Fluid replacement, increase BP

Inhlaed bronchodilators

Hydrocortisone 100mg IV (prevent late phase response)

Chlorpheniramine 10 mg IV (skin rash)

Future: epipen

21
Q

Contact dermatitis

A

Type 4 allergy

Patch test

22
Q

C9 deficiency results

A
23
Q

Latex food syndrome

A

T1HSR:

Some foods have latex like components

Chestnut, avocado….

24
Q

Allergic rhinitis

A

T1HSR:

Pollern, pets, house dust mite,

Mx: ani histamine, sodium cromoglycate eye drops, steroids, ipratropium nasal spray

25
Q

Autoimmune thrombocytopenic purpura antigen…

A

T2HSR:

Glycogprotein 2b/3a on Plts

26
Q

Goodpasture’s syndrome

Glomerulonephritis and pulmonary haemorrhage

A

T2HSR:

Ab to Type 4 collagen on BM

IgG deposits on BM

27
Q

Carbimazole and propylthiouracil treatment for…

A

Grave’s hyperthyroidism

28
Q

Myasthenia gravis Ab to…

A

T2HSR:

Acetylcholine receptor

Fatiguable muscle weakness, double vision

Mx: neostigmine, pyridostigmine

29
Q

Pemphigus vulgaris Ab to…

A

T2HSR:

Epidermal cadherin

30
Q

Rheumatic fever Abs to…

A

T2HSR:

M proteins on group A strep

Myocarditis, arthirits, syndenham’s chorea

Mx: aspirin, steroids, penicillin

31
Q

Type 1 hypersensitivity disorder

A

Immediate reaction provoked by re-exposure to allergen. IgE mediated: mast cells.

32
Q

Type 2 hypersensitivity disorder

A

IgM or IgG Abs reacts with cell or matrix associated SELF antigen

33
Q

Type 3 hypersensitivity disorder

A

IgG or IgM immune complex (Ab vs soluble Ag) mediated tissue damage

34
Q

Type 4 hypersensitivity reaction

A

Delayed, T cell mediated

Type1 DM - glutamate decarboxylase Abs, Islet cell Abs

MS - demyelinating disease. Abs to oligodendrocyte proteins

RA - Ab to antigen in synovial membrane. RhF, anti-CCP

Contact dermatitis

Crohn’s - Th1 mediated. NOD2 mutation

35
Q

Cryoglobulinaemia Ab to …

A

T3HSR:

IgM against IgG +/- hep C antigens

Joint pain, splenomegaly, skin, nerve, kidney involvement. Rash.

36
Q

SLE

A

T3HSR:

Abs to DNA, histones, RNP

C4 drops before C3

Increased ESR, normal CRP

37
Q

Serum sickness

A

T3HSR:

Reactions to proteins in antiserum

Rashes, itching, arthralgia, fever, malaise. 7-12 days to develop.

LOW C3.

38
Q

Polyarteritis nodosa

A

Abs to hep B, hep C

Fever, fatigue, weakness, arthralgia, skin, nerve, kidney, pericarditis.

39
Q

Limitted cutaneous scleroderma

A

CREST

Calcinosis

Raynauds

Esophogeal dysmotility

Sclerodactyly

Telangiectasia

(+ pulmonary hypertension)

Skin involvement up to forearms only and perioral

Anti-centromere Abs

40
Q

Diffuse cutaneous scleroderma

A

CREST

GIT involvement

Interstitial pulmonary disease

Renal problems

Anti topoisomerase/Scl70, RNA Pol 1,2,3, Fibrillarin Abs

41
Q

Anti Ro and anti La prevelant in …

A

Sjogrens

Schirmer test to measure production of tears

May get parotid or salivary gland enlargement

42
Q

IgA anti-endomysial Ab

IgA anti-transglutaminase Ab

IgG anti-gliadin Ab

A

Coeliac

IgA EMA Abs disappear with exclusion diet

Dermatitis herpetiformis

DQ2 or DQ8

43
Q

Important HIV receptors

A

gp120 initial binding

gp41 conformational change

CCR5 on macrophage

CXCR4 on macrophage

gag proteins - intrastructural support for HIV

44
Q

Abs produced in response to HIV infection

A

Anti-gp120

Anti-gp41

Anti p24 gag IgG

45
Q
A

Path EMQ 1 liners (8 decks)

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