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3 CLASP & Transition Block > Immunology > Flashcards

Immunology Flashcards

1
Q

causes of secondary immune deficiency?

A 
infection
old age
drugs
malignancy
nutritional disorder
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2
Q

what is a granuloma?

A

an organised collection of activated macrophages and lymphocytes

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3
Q

why do granulomas sometimes form?

A

inflammatory response triggered by a stimulus
failure of removal of the stimulus results in persistent cytokine production
immune cells cluster in a circle

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4
Q

DDx lung granuloma

A 
TB
sarcoidosis
chronic hypersensitivity pneumonitis
dust diseases eg silicosis
foreign body
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5
Q

people with antibody deficiencies tend to get bacterial/viral infections

A

bacterial

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6
Q

how does antibody deficiency present

A

recurrent bacterial infections

antibody mediated autoimmune disease

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7
Q

selective IgA deficiency patients to tend to get infections in what system?

A

respiratory BUT most are asymptomatic

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8
Q

what is hypogammaglobulinaemia

A

decrease in gammaglobulins INCLUDING immunoglobulins

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9
Q

if you arent antibody deficient but you have hypogammaglobulinaemia what could be the cause?

A

protein loss or failure of protein synthesis eg by leukaemia

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10
Q

NK cells kill cells that lack what?

A

MHC

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11
Q

toll-like receptors respond to what?

A

PAMPS

pathogen associated molecular patterns

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12
Q

TLRs are expressed on..

A

phagocytes

dendrites

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13
Q

by activating TLRs, you will trigger the release of…

A

pro-inflam cytokines

type 1 interferon secretion

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14
Q

TNF inhibitors block…

A

pro-inflam cytokines

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15
Q

give an example of a TLR activating drug

A

imiquimod

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16
Q

why are biologic drugs not hepato or nephrotoxic?

A

are normal proteins so their metabolism doesnt depend on liver/renal function

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17
Q

what are biologic drugs made of?

A

artificial antibodies

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18
Q

name the fastest kind of transplant rejection; how long does it take to present?

A

hyperacute

minutes-hrs

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19
Q

acute cellular rejection is an example of type _ hypersensitivity

A

4

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20
Q

cells involved in acute cellular rejection?

A

CD4 and CD8 T cells

21
Q

acute vascular rejection is an example of type _ hypersensitivity

A

2

22
Q

name the types of transplant rejection that occur 5-30 days after transplant

A

acute cellular rejection

acute vascular rejection

23
Q

what transplant rejection can present with vasculitis?

A

acute vascular rejection

24
Q

what transplant rejections are treated? with what?

A

hyperacute - nil
acute cellular/vascular - immunosuppression
chronic allograft failure - treat symptoms

25
Q

pathophysiology of chronic allograft failure

A

fibrosis

scarring

26
Q

which transplant rejection occurs >30 days after transplant?

A

chronic allograft fracture

27
Q

2 types of active immunisation

A

live attenuated

inactive

28
Q

what kind of T cells become memory T cells

A

effector T cells

29
Q

how does the antibody response to infection change if there is memory?

A

IgG is produced at the same time as IgM instead of after

30
Q

why do inactivated vaccines require multiple injections?

A

dont stimulate clonal expansion of B and T cells

31
Q

give an example of a whole cell inactivated vaccine

A

polio
rabies
cholera
(think travel vaccines)

32
Q

give an example of a fractional inactivated vaccine

A 
hep B
flu
HPV
diphtheria
tetanus
HiB
33
Q

give an example of a live attenuated vaccine

A 
MMR
chicken pox
yellow fever
polio
BCG for TB
34
Q

test for ANA?

A

ELISA

35
Q

autoantibody Ix for SLE?

A
  1. ANA

2. dsDNA and ENA if the staining pattern of ANA matches that of SLE

36
Q

rheumatoid factor is an autoantibody directed to….

A

the Fc region of IgG

37
Q

what do c-ANCA and p-ANCA mean?

A 
c-ANCA = diffuse staining into Cytoplasm
p-ANCA = Peripheral staining around nuclei
38
Q

NK cells are part of the innate/adaptive immune system

A

innate

39
Q

what cells are part of adaptive immunity

A

T and B lymphocytes

40
Q

the formation of what accounts for the rapid production of IgG at re-exposure to a microbe after vaccination

A

memory B cells

41
Q

why is it good to have multiple vaccines at once?

A

produces memory

42
Q

how are biological drugs metabolised?

A

broken down into amino acids (dont need liver/renal function)

43
Q

biological therapy is a form of passive/active immunity

A

passive

44
Q

methotrexate is an example of an immunosuppressant T or F

A

F, its an anti inflammatory

45
Q

what receptor does methotrexate act on?

A

adenosine A2 receptor

46
Q

liver contraindications to methotrexate?

A

any chronic liver disease

alcoholism

47
Q

you should stop a biologic if you have low eGFR T or F

A

F, biologics dont affect the kidneys or liver

48
Q

if you take away TNF what are you at risk of?

A

reactivation of TB as the granuloma will break up

3 CLASP & Transition Block (20 decks)

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