Immunology

Question 1

What is a granuloma?

Answer 1

Organised collection of activated macrophages and lymphocytes

Question 2

Outline the pathogenesis of granuloma formation

Answer 2

• Inflam response triggered
• T cells and macrophages activated
• Failure of removal of stimulus leads to persistent cytokine production

Question 3

Give examples of things that cause granuloma

Answer 3

Sarcoid
TB
Leprosy
Foreign bodies
Silicosis 
Chronic hypersensitivity pneumonitis

Question 4

How do antibody deficiencies present?

Answer 4

Recurrent bacterial infections

Question 5

What is the most common antibody deficiency?

Answer 5

IgA

Question 6

How may secondary hypogammaglobulinaemia come about?

Answer 6

Protein loss - nephrotic syndrome

Failure of protein synthesis - lymphoproliferative disease (CLL, NHL, MM)

Question 7

What is the complement system?

Answer 7

Proteins secreted by the liver to act as a “sticky coat” for foreign bodies to boost the immune defense

Question 8

What are the three main actions of the complement system?

Answer 8

Opsonisation
Lysis
Chemotaxis and anaphylatoxin release

Question 9

C3 is responsible for opsonisation

true/false

Answer 9

True

C3b

Question 10

C3 alone is responsible for cells lysis

true/false

Answer 10

False

C3 and C5

Question 11

C3 and C5 are responsible for chemotaxis and anaphylatoxin release
true/false

Answer 11

True

C3a and C5a

Question 12

What is the function of NK cells?

Answer 12

Kill cells which lack MHC molecules on surface

Question 13

NK cells require antigen specificity

true/false

Answer 13

False - this is what “natural” refers to

Question 14

NK cells have an extensive long term memory

true/false

Answer 14

False

No long term memory

Question 15

What are toll-like receptors?

Answer 15

Receptors expressed on phagocytes and dendrites to alert to microbe presence

Question 16

What occurs following activation of toll-like receptors?

Answer 16

Pro-inflammatory cytokines and type 1 interform secretion

Question 17

Biologic drugs as less effective in renal impairment

true/false

Answer 17

False

They are normal proteins and their mechanism if not dependent on hepatic or renal function

Question 18

What is the molecular target of adalimumab?

Answer 18

TNF

Question 19

What is the molecular target of pembrolizumab?

Answer 19

PD1

Question 20

What is the molecular target of secukinumab?

Answer 20

IL-17

Question 21

What is the main action of adalimumab?

Answer 21

Anti-inflammatory

Question 22

What is the main action of pembrolizumab?

Answer 22

Activates T cells

Question 23

What is the main action of secukinumab?

Answer 23

Blocks a specific inflammation pathway

Question 24

What is adalimumab used in?

Answer 24

Rheumatic and inflam diseases

Question 25

What is pembrolizumab used in?

Answer 25

Malignant cancer

Question 26

What is secukinumab used in?

Answer 26

Psoriasis MS Arthritis

Question 27

Within how long does a hyperacute transplant rejection occur?

Answer 27

Mins-hours

Question 28

Within how long does an acute cellular or vascular rejection of a transplant occur?

Answer 28

5-30 days

Question 29

Within how long does chronic allograft failure present?

Answer 29

>30 days

Question 30

Which type of reaction is involved with hyperacute rejection of transplant?

Answer 30

Type II

Question 31

Which type of reaction is involved in acute cellular rejection of a transplant?

Answer 31

Type IV

Question 32

Which type of reaction is involved in acute vascular rejection of a transplant?

Answer 32

Type II

Question 33

What is the pathology present in chronic allograft failure?

Answer 33

Fibrosis | Scarring

Question 34

Describe the mechanism of hyperacute transplant rejection

Answer 34

Preformed antibody and complement fixation

Question 35

Describe the mechanism of acute cellular rejection

Answer 35

T cell, CD4 and CD8 cell mediated reaction

Question 36

Describe the mechanism of acute vascular rejection

Answer 36

De novo antibody and complement fixation

Question 37

What is the treatment for acute cellular and vascular transplant rejection?

Answer 37

Immunosuppresion

Question 38

Which cell type does vaccination mostly produce?

Answer 38

Memory B cells

Question 39

Which antibody is the first to respond in primary infection?

Answer 39

IgM

Question 40

Which antibody is the second to react in primary infectin?

Answer 40

IgG

Question 41

What are the advantages of inactivated vaccines?

Answer 41

Quick to make Easy to store Safe

Question 42

What are the disadv of inactivated vaccines?

Answer 42

Not very potent Need multiple injections Boost shots needed

Question 43

Give examples of whole cell, inactivated vaccines

Answer 43

Polio Hep A Rabies Cholera

Question 44

Give examples of toxoid, inactivated vaccines

Answer 44

Diptheria | Tetanus

Question 45

Give examples of subunit, inactivated vaccines

Answer 45

Hep B Flu HPV Anthrax

Question 46

What are the adv of live vaccines?

Answer 46

Strong response All cell types activated Single dose

Question 47

What are the disadv of vaccines?

Answer 47

Unsafe in some | Stored and handled carefully

Question 48

Give examples of live vaccines

Answer 48

Measles Mumps Rubella