Immunosuppresants + Bonuses

Question 1

cyclosporine (mechanism + toxicity)

Answer 1

calcineurin inhibitor –> prevents IL2 transcription –> no T cell activation.

nephrotoxic (hyperglycemia, tremor, hirsuitism, gingival hyperplasia)

Question 2

tacrolimus

Answer 2

calcineurin inhibitor. binds FKBP protein -> no IL-2 transcription –> no T cell activation

nephrotoxic, neurotoxic, DIABETES (no hirsutism / gingival hyperplasia)

Question 3

sirolimus / rapamycin

Answer 3

binds FKBP –> mTOR inhibition –> prevent IL-2 signal transduction –> no T-cell activation / B cell differentiation

1) NON-nephrotoxic.
2) pancytopenia
3) insulin resistance

Question 4

basiliximab

Answer 4

monoclonal Ab against Il-2R.

used for kidney transplant

edema, HTN, tremor

Question 5

azathioprine

Answer 5

precursor of 6mercaptopurine.

blocks nucleotide synthesis –> inhibited lymphocyte proliferation.

allopurinol INCREASES toxicity

pancytopenia

Question 6

glucocorticoids

Answer 6

inhibit NF-kB –> dec. transcription of cytokines –> suppress B / T cell function.

CUSHINGS, osteoporosis, psychosis, HTN, peptic ulcers

Question 7

IFN-y

Answer 7

Chronic granulomatous disease

Question 8

IFN-B

Answer 8

multiple sclerosis

Question 9

IFN-a

Answer 9

chronic hep B / C, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma

Question 10

IL-2 aldesleukin

Answer 10

renal cell carcinoma / metastaticmelanoma

Question 11

filgrastim / sargramostim

Answer 11

granulocyte colony stimulating factor –> recovers bone marrow

Question 12

oprelvekin

Answer 12

interluekin-11 –> treat thrombocytopenia

Question 13

antibody-dependent cellular cytotoxicity

Answer 13

method of killing that depends on the ability of the immune cell to recognize specific antibody bound to a cell and trigger the death of that cell without the use of complement (used by macrophages, NK, and eosinophils

Question 14

2 methods for eosinophils function

Answer 14

1) type 1 hypersensitivity: eosinohpihlic granules release histaminase, peroxidase, and leukotrienes
2) parasites: binding to free igE –> antigen-antibody complex to IgE Fc receptor –> MAJOR BASIC PROTEIN –> destroy via antibody-dependent cellular cytotoxicity

Question 15

organisms with capsules

Answer 15

polysaccharide that impairs opsonization + phagocytosis

1) s. pneumo
2) n. menigitidis
3) h. influenzae
4) cryptococcus neoformans

Question 16

staphylococcal protein A’s effect on the immune system

Answer 16

protein A binds Fc portion of IgG (moreso than bacterial surface antigens) –> prevent complement fixation against stapylococci

Question 17

N. menigitidis / gonorrheae’s effect on IgA

Answer 17

IgA protease –> loss of ability to bind the action of the pili / fimbrae that would normally mediated mucosal adherence / penetration

Question 18

what cells prevent the hematogenous spread of candida?

Answer 18

neutrophils. patients w/ impaired phagocytosis.