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Year 2 - CP > Immunology Summary > Flashcards

Immunology Summary Flashcards

1
Q

What are individuals with chronic granulomatous disease at risk of?

A

Staphlococcus infections

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2
Q

Name two broad spectrum antibiotics used for neutropenic prophylaxis

A

Penicillin and gentamicin

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3
Q

What does granulocyte stimulating factor do?

A

Stimulates bone marrow to make neutrophils

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4
Q

Name two antivirals used as prophylaxis for T cell deficient patients

A

Acyclovir and Gangcyclovir

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5
Q

List three causes of T cell deficiencies

A

Congenital T helper cell dysfunction
Drugs e.g. cyclosporin
Viruses e.g. HIV

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6
Q

What are hypogammaglobulinaemias?

A

Not enough antibodies

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7
Q

List three causes of hypogammaglobulinaemia?

A

Congential X linked
Multiple Myeloma
Burns

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8
Q

What are individuals with hypogammaglobulinaemias at risk of?

A 
Strep Pneumoniae infections (encapsulated)
Giardia Lambia (parasite)
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9
Q

Are compliment deficiencies common?

A

No

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10
Q

What bacteria are individuals with a compliment deficiency of C5 - C8 at risk of?

A

N.meningititdis and S.pnemonia

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11
Q

What are people who have had a splenectomy at risk of?

A

S.pnemonia, N meningitides and HIB

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12
Q

What do pattern recognition receptors on neutrophils and macrophages recognise?

A

PAMPS e.g. lipopolysaccharides

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13
Q

Give an example of a patter recognition receptor

A

Toll like receptors

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14
Q

What do TLR3 and TLR4 recognise

A

TLR3: Viral RNA (associated with HSV encephalitis)
TLR4: Lipopolysaccharides

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15
Q

What molecules are involved from TLR recognising PAMPS –> cytokine release?

A

IRAK4 and MYD88

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16
Q

What can deficiencies in IRAK4 and MYD88 result in

A

Poor inflammation réponse often with low CRP levels

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17
Q

What gene do neutrophils and macrophages require to make hydrochloric acid in the phagolysosome?

A

GP91 (phox)

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18
Q

What happens if neutrophils and macrophages don’t have GP91 (phox)?

A

You get a build up of non functioning macrophages (granuloma) = chronic granulomatous disease

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19
Q

Give two features of chronic granulomatous disease

A

Liver Bone and Lung abscesses

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20
Q

What are the common bacteria causing chronic granulomatous disease?

A

Staphlococcus and klebsiella

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21
Q

How is chronic granulomatous disease treated?

A

BM transplant

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22
Q

Give two ways to test for chronic granulomatous disease

A

Measure dihydrohadamine reduction

Nitro blue dye (healthy people will turn dye purple)

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23
Q

What does a deficiency in complement factors C2 and C4 result in?

A

SLE

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24
Q

What does a defect in Brutons Tyrosine Kinase cause?

A

X linked ammaglobulinaemia

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25
Q

What is Brutons Tyrosine Kinase needed for?

A

B cell signalling and maturation

Without B cell can’t leave bone marrow and mature

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26
Q

What is more serious low IgG or IgA

A

IgG requires IV antibiotics for life

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27
Q

What does rituximab target?

A

CD20 receptors on B cells

28
Q

Are deficits in B cell or T cells more severe?

A

T cells as they are needed to signal B cells

29
Q

Name two defects in T cells?

A

SCID (severe combined immune deficiency)

DOCK8

30
Q

What is SCID

A

Defect in T cells

Paediatric emergency

31
Q

Give two types of Immunomodulators

A

Monoclonal antibodies or Fusion Proteins

32
Q

What is immunopotentiation

A

Enhancing the immune response

33
Q

Give three general ways of immunopotentiation

A

Vaccination (active and passive)
Replacement Therapies
Immune Stimulants

34
Q

Give five immunopotentiation replacement therapies

A 
Alpha interferon (hep c)
Beta interferon (MS)
Gamma interferon (Chronic granulomatous disease)
G-CSF (enocourages BM to increase neutrophils)
Pooled human immunoglobulin (antibody deficiency states)
35
Q

Give four general ways of immunosuppresion

A

Corticosteroids
Cytotoxic Agents
Anti proliferation agents
DMARDS

36
Q

How do calcineurin inhibitors act as immunosuppressants with examples

A

Cyclosporin A and Tacrolimus (FK506)
Stop factors that stimulate IL2 and INFgamma
Means less T cell activation

37
Q

How do M-TOR inhibitors act as immunosuppressants with examples

A

Siroliumus (Rapamycin) - Macrolide antibiotic
Inhibits M-TOR and therefor IL2 production
Stops T cell cycle arrest at G1-S phase

38
Q

How do antimetabolites act as immunosuppressants with examples

A

AZA, Methotrexate and Cyclophosphamide

Interrupt metabolites needed for cell production so impaired DNA in T and B cells

39
Q

What is AZA, methotrexate and Clyclophosphamide used for?

A

AZA: Automine and allograft
Methorexate: RA
Cyclophospamide: Wegners Vasculitis

40
Q

What ILs can DMARDS target

A

IL1 and IL6

41
Q

What does DMARD targeting TNF increase the risk of

A

TB

42
Q

What type of drug is Rituximab

A

DMARD
Targets CD20 receptors on B cell surface so they can’t mature
Used in lymphomas and leukaemia

43
Q

Give two examples of immunomodulators

A

Anti IgE: Omalizumab (used in asthma)

Anti IL5: Mepolizumab

44
Q

What are ANAs

A

Antinuclear antibodies

Recognised structure of nucleus of body and attack it = AI disorder

45
Q

What are ENAs?

A

Extractable nucelar agents

ANAs target

46
Q

Give two examples of ENAs

A

RNP (ribonuclear protein) RO and LA

Double stranded DNA

47
Q

What pattern do anti DNA ANAs show on fluorescence?

A

Homogenous pattern

48
Q

What pattern do anti histone and DNP show on fluorescence?

A

Homogenous pattern

49
Q

What pattern do anti RHO and LA show on fluorescence?

A

Speckled

50
Q

What tests do you do to look for double stranded DNA antibodies

A

Cirthidia Luciae Assay
Farr assay
ELISA

51
Q

What tests do you to do identify ENA

A

Immunoblots
ELISA
Combination agents

52
Q

What antibodies is rheumatoid factor agaisnt

A

IgG

53
Q

How specific and sensitive is RF test

A

70%

54
Q

Where can RF also be seen

A

Hep B and vasculitis

55
Q

How specific and sensitive is anti CCP test

A

95% specific 70% sensitive

56
Q

What is ANCA

A

anti neutrophilic cytoplasmic antibody

57
Q

What two types of ANCA can you have?

A

Cytoplasmic ANCA

Perinuclear ANCA

58
Q

What do cytoplasmic ANCA and Perinuclae ANCA tagrte

A

CANCA: PR3 antigent
PANCA: MPO antigen

59
Q

What diseases is ANCA present in?

A 
Wegners granulomatosis (PR3)
Micro Polyangitis (MPO)
Churgstrauss Syndrom (MPO)
60
Q

What is the gold standard for recognising weighers granulomatosis, micro polyagnitis and churgstrauss syndrome?

A

Histology

ANCA is good but not gold standard

61
Q

What antibodies does primary billiary sclerosis show?

A

anti mictochorndiral antibodies

62
Q

Give examples of class 1 and class 2 HLA

A

Class 1: HLA A, B , C

Class 2: HLA DR, DQ and DP

63
Q

Where are class 1 and class 2 HLA found?

A

Class 1: all nucleated cells

Class 2: B and T cells

64
Q

How are HLA’s categorised for transplants?

A

HLA (broad) for Tissue
HLA (Split)
HLA (allele) for BM

65
Q

Describe Direct and indirect rejection in transplants

A

Direct: donor cells present themselves to recipients T cell
Indirect: B cells take up donor antigens and present them to T cells

66
Q

Give two tests for donor matching

A

cRF (calculation reaction frequency)

Cross match test (donor lymphocytes and recipients serum and see if any binding)

Year 2 - CP (4 decks)

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