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ALL SBAS PATH > immunology_flashcards > Flashcards

immunology_flashcards

1
Q

What are the primary lymphoid organs?

A

Include both the bone marrow and thymus; sites of B and T cell development

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2
Q

What is the thoracic duct?

A

Carries lymphocytes from lymph nodes back to blood circulation

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3
Q

What is the thymus?

A

Site of deletion of T cells with inappropriately high or low affinity for HLA molecules and of maturation of T cells into CD4+ or CD8+ cells

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4
Q

What is the germinal centre?

A

Area within secondary lymphoid tissue where B cells proliferate and undergo affinity maturation and isotope switching

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5
Q

Which medication is most likely to have caused antibody deficiency?

A

Rituximab

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6
Q

What is the most likely diagnosis for a patient with recurrent chest infections, antibody deficiency, and absent B cell count?

A

Thymoma with antibody deficiency / Goods syndrome

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7
Q

Which conditions are most likely to present in patients with CD4 T cell counts of >350?

A

Shingles, pulmonary TB, pneumococcal pneumonia

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8
Q

Recurrent infections with high neutrophil count but no abscess formation. What is the diagnosis?

A

Leukocyte adhesion deficiency

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9
Q

Recurrent infections with hepatosplenomegaly and abnormal dihydrorhodamine test (does not fluoresce). What is the diagnosis?

A

Chronic granulomatous disease

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10
Q

Recurrent infections with no neutrophils on FBC. What is the diagnosis?

A

Kostmann syndrome

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11
Q

Infection with atypical mycobacterium and normal FBC. What is the diagnosis?

A

IFN gamma receptor deficiency

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12
Q

Severe chicken pox, disseminated CMV infection. What is the diagnosis?

A

Classical natural killer cell deficiency

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13
Q

Meningococcus meningitis with family history of sibling dying of same condition aged 6. What is the diagnosis?

A

C7 deficiency

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14
Q

Membranoproliferative nephritis and abnormal fat distribution. What is the diagnosis?

A

C3 deficiency with presence of a nephritic factor

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15
Q

Severe childhood onset SLE with normal levels of C3 and C4. What is the diagnosis?

A

C1q deficiency

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16
Q

Recurrent infections when neutropenic following chemotherapy but previously well. What is the diagnosis?

A

MBL deficiency

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17
Q

Severe recurrent infections from 3 months, CD4 and CD8 T cells absent, B cells present, Igs low. Normal facial features and cardiac echocardiogram. What is the diagnosis?

A

X-linked SCID

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18
Q

Young adult with chronic infection with Mycobacterium marinum. What is the diagnosis?

A

IFN gamma receptor deficiency

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19
Q

Recurrent infections in childhood, abnormal facial features, congenital heart disease, normal B cells, low T cells, low IgA and IgG. What is the diagnosis?

A

22q 11.2 deletion syndrome

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20
Q

6 month baby with two recent serious bacterial infections. T cells present – but only CD8+ population. B cells present. IgM present but IgG low. What is the diagnosis?

A

Bare lymphocyte syndrome type II

21
Q

Adult with bronchiectasis, recurrent sinusitis and development of atypical SLE. What is the diagnosis?

A

Common variable immunodeficiency

22
Q

Recurrent bacterial infections in a child, episode of pneumocystis pneumonia, high IgM, absent IgA and IgG. What is the diagnosis?

A

X linked hyper IgM syndrome due to CD40 ligand mutation

23
Q

1 year old boy. Recurrent bacterial infections. CD4 and CD8 T cells present. B cells absent, IgG, IgA, IgM absent. What is the diagnosis?

A

Bruton’s X linked hypogammaglobulinaemia

24
Q

Recurrent respiratory tract infections, absent IgA, normal IgM and IgG. What is the diagnosis?

A

IgA deficiency

25
Q

What proportion of the world population has kidney disease?

A

11%

26
Q

5 years on, what are the chances of survival for a patient who has just started dialysis for end stage kidney failure?

A

35%

27
Q

The most important antigenic determinant of rejection in current clinical practice for kidney transplantation is:

A

Human leucocyte antigens / major histocompatibility complex

28
Q

A potential donor is described as being 1:1:0 MM. What does this mean?

A

1 MM A locus, 1 MM B locus, 0 MM DR locus

29
Q

The main effector cells in T-cell mediated rejection are

A

T cells and monocytes / macrophages

30
Q

A patient has an episode of acute T cell-mediated rejection 2 months post transplantation. What additional drug would most commonly be administered?

A

Corticosteroids

31
Q

Which cell is injured in the effector phase of antibody-mediated rejection?

A

Endothelial

32
Q

What pathology is this image showing?

A

c. Hypertensive arteriosclerosis

33
Q

You are given the HLA genotype of a potential live donor and a recipient, and the recipient’s anti-HLA serology. Do you agree? Do you agree the liver donor could be the recipient’s son?

There is one mismatch for each HLA type. 50% match.

A

Yes

34
Q

Would a standard transplant procedure go smoothly?

A

No - There are antibodies already detected against some of the donors HLA epitopes.

35
Q

Would the recipient benefit from treatment to remove the anti-DR1 and DQ5 before transplantation?

A

Yes

36
Q

Which of the following is an example of a monogenic auto-inflammatory disease?

A

Familial Mediterranean fever

37
Q

Which of the following is an example of a monogenic auto-immune disease?

A

IPEX syndrome due to FoxP3 mutation

38
Q

Which of the following is an example of a polygenic auto-inflammatory disease?

A

Crohn’s disease

39
Q

Which of the following is an example of Gel and Coombs type III hypersensitivity?

A

SLE

40
Q

Which of the following antibodies are characteristically found in Myasthenia Gravis?

A

Anti-acetylcholine receptor antibody

41
Q

Which of the following antibodies are characteristically found in Pernicious Anaemia?

A

Anti-intrinsic factor antibody

42
Q

What is the diagnosis with Positive antinuclear antibodies (ANA), Anti-dsDNA+ve, Low C3 and C4, High ESR, Negative for Ro, La, Sm, RNP, SCL70, Centromere, Jo-1, ANCA?

A

Systemic lupus erythematosus

43
Q

What is the diagnosis with Positive anti-neutrophil cytoplasmic antibodies (ANCA), Negative ANA, Normal complement, Raised ESR and CRP?

A

ANCA associated vasculitis

44
Q

The purpose of vaccination is to stimulate and enhance immunological memory. Which type of cells mediate immunological memory?

A

B and T lymphocytes

45
Q

Which of the following vaccines should NOT be given to an immunosuppressed individual?

A

BCG - bacilli Calmette-Guerin

46
Q

A 23 year old has metastatic melanoma. Which of the following may reduce disease progression?

A

Nivolumab, an antibody specific for PD-1

47
Q

Which drug is likely to have caused osteoporosis, weight loss, easy bruising, and high blood glucose in a young woman with SLE?

A

Prednisolone

48
Q

For which disease is Rituximab, a monoclonal antibody specific for CD20 on B cells, an effective treatment?

A

Rheumatoid arthritis

49
Q

Which of the following are true about management of psoriasis and psoriatic arthritis?

A

Treatment options include inhibition of TNF alpha, IL23 or IL17A or use of a PD4 blocker or ciclosporin

ALL SBAS PATH (18 decks)

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