Immunology / Allergy Flashcards
Name 3 types of antigen presenting cells
Dendritic cells
Macrophages
B cells
What do antigen presenting cells present their antigen on? What class is this compared to all other cells?
MHC class II
What types of T cells recognise antigen presented on MHC class I and class II ?
CD8 cells recognise class I CD4 class II
What is the most likely diagnosis: 5 month boy Recurrent otitis media and pneumonia Absent lymph nodes and tonsils Low Ig for all groups Absent B cells
X linked agammaglobulinaemia
What is the treatment for XLA?
Immunoglobulin replacement
Aiming pre treatment trough IgG > 7
Intragam IV
Or
Evogam Sub cut
NB doesn’t correct IgA deficiency
What is the diagnosis? 7 yo boy Recurrent OM, pneumonia Family history of antibody def Bloods show decreased IgG and IgA but normal IgM Normal T cells
CVID
What type of hypersensitivity reaction is Steven Johnson syndrome ? What are some risk factors ?
Type IV
Delayed
Han Chinese descent
Carbamazepine
What are the 4 types of hypersensitivity reactions and an example of each ?
Type I - IgE mediated - anaphylaxis
Type II - IgG and IgM mediated -blood transfusion reaction, drug induced haemolytic anaemia, graft rejection
Type III - immune complex mediated - goodpastures, serum sickness
Type IV - delayed, T cell mediated - SJS
What vaccinations contain egg and which one should not be given to children anaphylactic to egg ?
Influenza contains egg but only very small amount so safe
yellow fever contains more so should consult immunologist
What is the most commonly reported food allergy in infants and young children?
Cow’s milk (2.5% of < 2yr olds)
Hen’s egg 1-2%
Peanut tree nut 0.4-1.3%
Wheat 0.4-1%
What is the diagnosis - Profuse diarrhoea from birth DKA on bloods Haemolytic anaemia Eczema
IPEX Immune dysregulation Polyendocrinopathy Enteropathy X linked
Fox P 3 gene
What is the diagnosis?
Chronic mucocutaneous candidiasis
Hypoparathyroidism
Vitiligo
APECED
Autoimmune
Polyendocrinopathy
Candidiasis
Ectodermal dysplasia
What is the diagnosis ? And what is the best diagnostic investigation ? Recurrent pneumonia Hepatic abscess Strep bacteraemia Fam hx recurrent infections
CGD
Chronic granulomatous disease
NAPDH deficiency
DHR test
What is the difference between XLA and CVID?
XLA no circulating B cells, lymphoid hypoplasia
CVID - presents later, more mild infections
Normal number B cells but unable to produce Immunoglobulins
What is the diagnosis ?
Bleeding from circumcision as a baby
Strep pneumonia sepsis
Eczema
Wiskott Aldrich syndrome
What is the diagnosis?
Hypertelorism
Dysmorphic facies
Pneumatocoele
Hyper IgE syndrome
What is the gold standard for food allergy testing for patients with eczema ?
Double blinded food challenge
Not skin prick
Which cell relies most on release of its mediators into extracellular fluid to carry out its role?
Eosinophils
What is a difference between Th2 and th1 Helper cells (interleukin)
Th2 secrete IL-5
What is the transcription factor mutation in Hyper IgE ?
STAT3
Which cytokine has an inactive state ?
IL1
What is the main Cytokine involved in recurrent fever syndromes?
IL1
Which organelle contains phox (phagocyte oxidase)
Phagolysosome
Within macrophage
What organisms are GHD patients susceptible to?
Catalase positive
(Can’t produce superoxide enzymes)
Staph aureus Nocardia B serratia Salmonella Fungus esp aspergillus
