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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
Anaphylaxis
Acute allergic reaction to Ag where body has become hypersensitive
26
Pathogenesis of allergy/hypersensitivity
IgE MLS cells (Mast cell, Lymphocyte and Smooth muscle cell) Mediators - Histamine, cytokines, prostaglandins Genetic factors
27
Which of basophils and mast cells circulates and which is in tissues?
Basophils - Circulate | MasT cells - Tissues
28
5 Mast cell components in allergy/hypersensitivity
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
5 Allergic diseases - AARCI
``` Anaphylaxis Asthma Rhinitis (Hay fever) Contact dermatitis Insect venom ```
30
Anaphylaxis
``` Elevated histamine due to mast cell/basophil activation (serum) Lowered BP (Vasodilation) Bronchial contraction Rash and swelling (Skin) Pain and vomiting (GI) ```
31
Asthma
Eosinophil influx into lungs | Long term treatment - immune suppression
32
6 Treatment methods for allergy/hypersensitivity
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
What is systemic lupus erythematosus an example of?
Immunodeficiency
34
Systemic lupus erythematosus - Epidemiology 2 facts
More common in women>men | More common in african american
35
4 Hypersensitivity types
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
Systemic lupus erythematosus - Aetiology
Genetics - complement deficiencies Hereditary - 1st degree affected relatives Sex hormones - pre-menopause women UV light
37
Systemic lupus erythematosus - Pathophysiology
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
Systemic lupus erythematosus - Signs and symptoms (SOAP BRAIN MD)
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
Systemic lupus erythematosus - 1 Complication
Lupus nephritis can lead to end stage renal failure if left untreated
40
Systemic lupus erythematosus - 3 Differential diagnoses (RAG)
Rheumatoid arthritis Anti-phospholipid syndrome Glomerulonephritis
41
Systemic lupus erythematosus - Diagnostic test
More than 3 signs from SOAP BRAIN MD = 95% specific
42
Systemic lupus erythematosus - Treatment
Lifestyle advice - UV protection If no organ involvement - Hydrocortisone If major organ involvement - Methyprednisolone
43
HIV - Epidemiology 3 facts
Male:Female = 3:1 UK prevalance = 100,000 Incidence falling due to antivirals
44
HIV - Medical science 3 steps
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
HIV - Aetiology 3 (SMC)
Sexual intercourse Mother to child (Trans placental or breast feeding) Contaminated needles/blood
46
HIV - Pathophysiology
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
HIV - 4 Signs and symptoms
``` Fever Night sweats Diarrhoea Weight loss Opportunistic infections - Oral candida, oral hairy leucoplakia, recurrent herpes simplex ```
48
HIV - 4 Complications
Candidiasis HSV Kaposi sarcoma Pneumocystis jiroveci pneumonia
49
Is there a differential diagnosis for HIV?
No
50
HIV - Diagnostic test
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
HIV - Treatment (3 Lifestyle modifications and 1 medical therapy)
Sex education Avoid sexual partners Partner notification HAART (Highly active anti-retroviral therapy)
52
HIV - Monitoring 3
CD4 T cell count HIV RNA Serum U&E and LFT
53
3 Physical/chemical barriers as part of innate immunity (SBG)
Skin Bronchi - mucus and cilia Gut - acid
54
What drug for peanut allergy?
Noradrenaline (Epipen)
55
What drug for anaphylaxis?
IV Hydrocortisone

Phase 2A Med Concise (18 decks)

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