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😤exam prep > immunology Qs from case study > Flashcards

immunology Qs from case study Flashcards

1
Q

What is a type 2 hypersensitivity reaction?

A

the result of antibody dependent cytotoxicity

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2
Q

3 important ddx of haemoptysis?

A
  1. Chest infection e.g. pneumonia, tuberculosis, bronchiectasis
  2. Pulmonary embolism
  3. Lung carcinoma

Pulmonary oedema is another possible cause of alveolar haemorrhage.

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3
Q

what tests would you do if someone presents with haemoptysis?

A
  • Full blood count (FBC)
  • Urea and electrolytes (U&E)
  • Liver function tests (LFTs)
  • Inflammatory markers e.g. CRP, ESR
  • Coagulation screen (PT, APTT, fibrinogen) given his haemoptysis
  • Group and save given his haemoptysis
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4
Q

other tests to consider if has pyrexia and haemoptysis

A
  • Septic screen (including blood cultures, serum lactate)

* Arterial blood gas (to investigate for respiratory failure and acid-balance)

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5
Q

what are the 3 classifications of causes of AKI?

A

Pre-renal
renal
post-renal

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6
Q

cause of pre-renal AKI?

A

inadequate blood supply!!!

sooo…..

Dehydration
Hypotension (shock)
Heart failure

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7
Q

renal causes of AKI?

A

Intrinsic disease!!!

soooo…..

Glomerulonephritis
Interstitial nephritis
Acute tubular necrosis

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8
Q

post-renal causes of AKI?

A

obstruction to the outflow!!!!

soooooo…….

Kidney stones

Masses such as cancer in the abdomen or pelvis

Ureter or uretral strictures

Enlarged prostate or prostate cancer

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9
Q

SHOUT acronym for causes of AKI

A 
Sepsis
Hypovaolaemia
Obstruction
Urine analysis
Toxins
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10
Q

what is pulmonary renal syndrome?

A

respiratory and renal failure caused by rapidly progressive glomerulonephritis and diffuse alveolar haemorrhage

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11
Q

immune aetiology of pulmonary, renal disorder?

A

ANCA associated vascultitis (70%)

Anti GBM disease (15-20%) (Goodpasture’s disease)

Systemic lupus erythematosus

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12
Q

infectious causes of pulmonary-renal disorder?

A

Post streptococal glomerulonephritis

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13
Q

causes of alveolar haemorrhage that can cause AKI?

A

Severe lung infection with sepsis

Pulmonary oedema with circulatory collapse

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14
Q

what investigations should you do if think pulmonary-renal disease and want to check immunological causes?

A

A. Serum anti-nuclear antibodies (ANA)

B. Cytoplasmic anti-nuclear cytoplasmic antibody (C-ANCA)

C. Peri-nuclear anti-nuclear cytoplasmic antibody (P-ANCA)

D. Anti-glomerular basement membrane antibodies (anti-GBM)

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15
Q

antigen and antibody behind SLE?

A

ds DNA

Anti-ds DNA

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16
Q

antigen and antibody behind Granulomatous with polyangiitis (GPA)
small vessel vasculitis

A

antigen Proteinase 3 (PR3)

antibody- C-ANCA

17
Q

what is pleuritic chest pain?

A

Chest pain which is exacerbated by breathing and cough

infers the underlying pathology namely inflammation of the parietal pleura which can be due to a number of causes.

18
Q

3 causes of pleuritic chest pain

A
  1. Pulmonary embolism
  2. Pneumothorax
  3. Pneumonia
19
Q

patient has low eGFR tests u should do?

A
  1. Urinalysis for presence of haematuria, proteinuria or signs of infection (leukocytosis, nitrates). If proteinuria present, quantify this with a urinary protein : creatinine ratio.
  2. Urine culture to exclude a urinary tract infection
20
Q

patient has low Hb count- and normocytic anaemia

A
  1. Haematinics
    • Serum folate
    • Serum vitamin B12
    • Serum ferritin
  2. Blood film to assess cell morphology
  3. Reticulocyte count ?red cell haemolysis or bleeding
21
Q

what is high serum ferritin indicitive of?

A

elevated in inflammation

22
Q

what does Rouleaux formation of blood film indicate?

A

suggesting on ongoing inflammation

23
Q

what are Haemolytic anaemia blood test and blood film results?

A

normochromic, normocytic anemia, but with a raised reticulocyte count, and often supportive rbc changes on the blood film.

24
Q

iron def anaemia blood test and blood film findings?

A

hypochromic, microcytic anaemia picture, characteristic rbc findings on blood film, and the diagnosis is usually supported by a low serum ferritin (sometimes falsely high if concurrent infection or inflammation).

25
Q

megablastic anaemia blood test and blood film findings?

A

macrocytic anaemia, and can be caused by low serum folate and/or B12.

26
Q

what type of hypersensitivity reaction is lupus?

A

Type 3

27
Q

what is the pathophysiology of a type 3 hypersensivity reaction?

A

Immune complex deposition

28
Q

main subclass of autoantibodies in type 3 hypersensitivity reaction?

A

ANA

29
Q

do you get mast cell degranulation in lupus?

A

yes.

type 3 stimulates a systemic inflammatory reaction by activating complement, recruiting inflammatory cells and leading to mast cell degranulation. This explains the clinical features seen in SLE.

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