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Phase 2A Med Concise > Immunology > Flashcards

Immunology Flashcards

1
Q

All cells of immune system originally derived from

A

Multipotent haematopoetic stem cell

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2
Q

Multipotent haematopoetic stem cell splits into one of 2 cells depending on chemical signal involved

A

Myeloid stem cell

Lymphoid stem cell

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3
Q

Myeloid stem cell has potential to form 6 types of cell - PEMP (one P=3 Phils)

A

Erythrocyte
Platelet
Phils (Neutro, Baso, Eosino)
Macrophage

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4
Q

Lymphoid stem cell has potential to form 2 types of cell

A

Natural killer cell

Lymphocytes (T and B)

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5
Q

4 Lymphoid organs (STDL)

A

Lymph nodes
Spleen
Thymus
Diffuse lymphoid tissue (MALTs - Mucosa Associated Lymphoid Tissue) such as tonsils and peyer’s patches

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6
Q

Lymph nodes

A

Neck, armpit and groin

Contain T cells

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7
Q

Spleen has 2 pulps

A

Red pulp - Old RBCs destroyed

White pulp - Filters blood and antibody-coated bacteria

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8
Q

Thymus

A

Active in neonatal, then atrophies after puberty

Involved in development of T cells (Autoimmune T cells are destroyed here)

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9
Q

Innate immune response

A 
Present at birth
Non-specific
No memory
Phagocytes
Complement proteins
PAMPS
Limited PR receptors
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10
Q

Adaptive immune response

A 
Built over time
Specific 
Memory 
Lymphocytes
Antibodies
Diverse PR receptors
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11
Q

4 components of innate immunity

A

PRR
Complement
Phagocytosis (Neutrophils and macrophages)
NK and mast cells, baso and eosinophils

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12
Q

2 Types of PRR

A

Secreted/circulating (Lectins and collectins)

Cell-associated (Toll-like R and nod-like R)

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13
Q

2 AMPS (Associated Molecular Patterns) which PRR recognise

A

PAMPS (Pathogen) - Lipopolysaccharides (LPS) endotoxins on gram negative bacteria
DAMPS (Damage)

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14
Q

5 step mechanism of PRR action

A

Trigger innate immune response and inflammatory response:

1) Opsonise pathogen
2) Activate complement
3) Activate inflammatory mediators
4) Secrete interferons and cytokines
5) Induce Apoptosis

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15
Q

3 Complement activation pathways - CAL

A

Classical pathway - AbAn complexes
Alternative pathway - Foreign An
Lectin pathway - Mannose-binding lectin (Mannose residues on pathogen surface)

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16
Q

3 Mechanisms of Complement action (LIP)

A

Lysis of microbe (MAC - Membrane attack complex)
Inflammation
Phagocytosis

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17
Q

Action of natural killer cells

A

Apoptosis of own cells that are infected/cancerous

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18
Q

Actions of mast cells, baso and eosinophils

A 
Mast cells (Release histamine, heparin and cytokines)
Baso and eosinophils (Release histamine in hypersensitivity reactions (raised in allergy))
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19
Q

6 components of adaptive immunity

A 
Humoral (B cell) and cell-mediated (T cell) immune system:
APC
Major histocompatibility complex (MHC) 
T helper cell
Cytotoxic T cell
B cell
Ab
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20
Q

What is major histocompatiblity complex (MHC)?`

A

Proteins that mark a cell as self

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21
Q

2 Classes of MHC

A

Class 1 - All cells

Class 2 - APCs

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22
Q

5 Immunoglobulin classes

A 
IgG - Most common/Secondary response
IgA - Mucus membranes
IgM - Primary response
IgE - Allergic reactions
IgD - B cell activation
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23
Q

Allergy

A

Abnormal response to harmless foreign material

24
Q

Atopy

A

Tendency to develop allergies

25
Q

Anaphylaxis

A

Acute allergic reaction to Ag where body has become hypersensitive

26
Q

Pathogenesis of allergy/hypersensitivity

A

IgE
MLS cells (Mast cell, Lymphocyte and Smooth muscle cell)
Mediators - Histamine, cytokines, prostaglandins
Genetic factors

27
Q

Which of basophils and mast cells circulates and which is in tissues?

A

Basophils - Circulate

MasT cells - Tissues

28
Q

5 Mast cell components in allergy/hypersensitivity

A

Histamine (Arteriolar dilation, bronchoconstriction)
Leukotrienes (LT) (Capillary contraction, increase vascular permeability)
Prostaglandin (Smooth muscle contraction)
Platelet aggregation factor (PAF) (Platelet aggregation increases vascular permeability)
Cytokines - IgE production

29
Q

5 Allergic diseases - AARCI

A 
Anaphylaxis 
Asthma
Rhinitis (Hay fever)
Contact dermatitis 
Insect venom
30
Q

Anaphylaxis

A 
Elevated histamine due to mast cell/basophil activation (serum)
Lowered BP (Vasodilation)
Bronchial contraction 
Rash and swelling (Skin)
Pain and vomiting (GI)
31
Q

Asthma

A

Eosinophil influx into lungs

Long term treatment - immune suppression

32
Q

6 Treatment methods for allergy/hypersensitivity

A

1) Avoid allergens
2) Desensitisation to allergens (by increasing dose to Ag)
3) Lumiliximab (prevents IgE production)
4) Omalizumab (prevents IgE interaction with receptor - binds and inactivates)
5) Prednisolone - corticosteroid (prevents mast cell activation)
6) LT/PG antagonist (inhibit mast cell products)

33
Q

What is systemic lupus erythematosus an example of?

A

Immunodeficiency

34
Q

Systemic lupus erythematosus - Epidemiology 2 facts

A

More common in women>men

More common in african american

35
Q

4 Hypersensitivity types

A

Type 1 - Allergy - IgE, mast cells and histamine (Asthma, Anaphylaxis)
Type 2 - Cytotoxic - IgM binds to Ag and kills cell via complement (Haemolytic anaemia)
Type 3 - Immune complex disease - IgG binds to Ag to form Ab-Ag complex which deposits in tissue and causes inflammation (Reactive arthritis)
Type 4 - Delayed type hypersensitivity - T helper cells and macrophages lead to inflammation

36
Q

Systemic lupus erythematosus - Aetiology

A

Genetics - complement deficiencies
Hereditary - 1st degree affected relatives
Sex hormones - pre-menopause women
UV light

37
Q

Systemic lupus erythematosus - Pathophysiology

A

1) Apoptosis leaves remnants of cells
2) Remnants not cleared, instead taken up by APC as Ag
3) B cells respond with Ab to form Ab-Ag complex
4) Ab-Ag complex deposited anywhere in body
5) Complement system activated (inflammation)
6) Ab binds to Ag on cell surface of RBC/WBCs which activates complement also

38
Q

Systemic lupus erythematosus - Signs and symptoms (SOAP BRAIN MD)

A

Serositis
Oral ulcers
Arthritis
Photosensitivity - UV light causes rash

Blood disorder - Low RBC, WBC, platelets
Renal disorder - Lupus nephritis 
Antinuclear Ab
Immunological disorder 
Neurological disorder - Cerebral lupus

Malar rash - fixed erythema over malar (red cheeks due to increased blood flow)
Discoid rash - Erythematous raised patches with scarring

39
Q

Systemic lupus erythematosus - 1 Complication

A

Lupus nephritis can lead to end stage renal failure if left untreated

40
Q

Systemic lupus erythematosus - 3 Differential diagnoses (RAG)

A

Rheumatoid arthritis
Anti-phospholipid syndrome
Glomerulonephritis

41
Q

Systemic lupus erythematosus - Diagnostic test

A

More than 3 signs from SOAP BRAIN MD = 95% specific

42
Q

Systemic lupus erythematosus - Treatment

A

Lifestyle advice - UV protection
If no organ involvement - Hydrocortisone
If major organ involvement - Methyprednisolone

43
Q

HIV - Epidemiology 3 facts

A

Male:Female = 3:1
UK prevalance = 100,000
Incidence falling due to antivirals

44
Q

HIV - Medical science 3 steps

A

1) Protein on virus binds to Th cell
2) Viral Th cell proliferates in lymph nodes (Viral proliferation)
3) Reduced T cell function leads to infections

45
Q

HIV - Aetiology 3 (SMC)

A

Sexual intercourse
Mother to child (Trans placental or breast feeding)
Contaminated needles/blood

46
Q

HIV - Pathophysiology

A

1) Decline in T cells leads to dysregulation of B cells
2) Dysregulation of Ab production leads to dysregulation of Ag response
3) Unable to respond to infections

47
Q

HIV - 4 Signs and symptoms

A 
Fever 
Night sweats 
Diarrhoea 
Weight loss
Opportunistic infections - Oral candida, oral hairy leucoplakia, recurrent herpes simplex
48
Q

HIV - 4 Complications

A

Candidiasis
HSV
Kaposi sarcoma
Pneumocystis jiroveci pneumonia

49
Q

Is there a differential diagnosis for HIV?

A

No

50
Q

HIV - Diagnostic test

A

Adults - Serum HIV Ab levels

Babies - Ab levels test would be inaccurate because maternal Ab might be present, instead perform PCR or viral culture

51
Q

HIV - Treatment (3 Lifestyle modifications and 1 medical therapy)

A

Sex education
Avoid sexual partners
Partner notification

HAART (Highly active anti-retroviral therapy)

52
Q

HIV - Monitoring 3

A

CD4 T cell count
HIV RNA
Serum U&E and LFT

53
Q

3 Physical/chemical barriers as part of innate immunity (SBG)

A

Skin
Bronchi - mucus and cilia
Gut - acid

54
Q

What drug for peanut allergy?

A

Noradrenaline (Epipen)

55
Q

What drug for anaphylaxis?

A

IV Hydrocortisone

Phase 2A Med Concise (18 decks)

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