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Monoclonal antibodies Flashcards

1
Q

What does secukinumab target?

A

IL-17 A

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2
Q

Side effect of seckinumab

A

Infection (TB)

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3
Q

Target of ustekinumab?

A

Anti-IL12 and anti-IL-23 (binds to p40 subunit)

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4
Q

What diseases can ustekinumab be used for?

A

Psoriasis, psoriatic arthritis

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5
Q

Denosumab target and use?

A

Anti-RANK ligand on osteoclasts. Used for osteporosis

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6
Q

Side effect of denosumab?

A

Avascular necorosis of the jaw, injection site reactions

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7
Q

Tocilizumab target of action?

A

Anti-IL6, reduce macrophage, T and B cell, neutrophil activation

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8
Q

What does secukinumab treat?

A

Psoriasis, psoriatic arhtirits, ankylosing spondylitis

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9
Q

Use of tocilizumab?

A

Treats RA and castleman’s disease

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10
Q

Target and use of sarilumab?

A

Anti-IL-6, reduce macrophage T and B cells.
Neutrophil activation. Treats RA

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11
Q

What is the target for guselkumab?

A

Anti-IL-23 (p19 alpha subunit)

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12
Q

Diseases treated by guselkumab?

A

Psoriasis, psoriatic arthritis

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13
Q

What is IL-1 blockade used to treat?

A

Familial mediterranean fever, gout, adult onset Still’s disease

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14
Q

What does IL-4/5/13 blockade treat?

A

Eczema, asthma, eosiniophilic asthma

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15
Q

What does Etanercept target?

A

TNF alpha/beta receptor. p75 IgG fusion protein, inhibits both cytokines

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16
Q

What does Etanercept treat?

A

RA, AS, psoriasis, psoriatic arthritis

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17
Q

What disease do certolizumab/golimumab treat?

A

IBD, familial mediterranean fever

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18
Q

What does infliximab target?

A

TNF-alpha

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19
Q

In which conditions can infliximab be used?

A

RA, AS, psoriasis, psoriatic arthritis, IBD, familial mediterranean fever

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20
Q

what malignancy can infliximab cause?

A

Lymphoma

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21
Q

List some TNF -alpha inhibitors

A

Infliximab, adalimumab, golilumab, certolizumab

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22
Q

What is the mode of action of basiliximab?

A

Anti-CD25 (alpha chain of Il-2 receptor). Inhibits T cell proliferation

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23
Q

Which monoclonal antibody targets CD25?

A

Basiliximab

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24
Q

Use of basiliximab?

A

Allograft rejection (prophylaxis)

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25
Q

Describe abatercept

A

Anti-CTLA4-Ig fusion protein, reduces co-stimulation of T cells via CD28

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26
Q

What condition can abatercept be given to treat?

A

Rheumatoid arthritis

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27
Q

Describe the action of rituximab

A

Anti-CD20, depletes mature B cells

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28
Q

What conditions is rituximab treatment utilised in?

A

Lymphoma, RA, SLE

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29
Q

Mode of action of Natalizumab

A

Anti-alpha-4 beta-1 integrin. Inhibits T cell migration

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30
Q

Diseases treated by natalizumab

A

Relapsing, remitting MS, Crohn’s disease

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31
Q

Name an important side effect of natalizumab

A

JC virus reactivation

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32
Q

Which monoclonal antibody is useful in treating IBD?

A

Vedolizumab

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33
Q

What is the mode of action of vedolizumab?

A

Anti-alpha-4-beta 7 integrin. Inhibits cell migration

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34
Q

Describe the mode of action of Muromonab-CD3

A

Blocks CD3 on T cells, mouse monoclonal antibody (OKT3)

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35
Q

Use of muromonab-CD3 and side effects

A

Active allograft transplantation rejection. SEs are fever and leucopenia

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36
Q

Antibody in CREST syndrome?

A

Anti-centromere

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37
Q

Treatment for ankylosing spondylitis?

A

etanercept

38
Q

Treatment for resistant psoriasis?

A

Etanercept

39
Q
  1. Chronic granulomatous disease treatment?
40
Q

C. What immune cells detects antigen in the periphery and moves to lymph node

A

Dendritic cells

41
Q

C. What immune cells detects antigen in the periphery and moves to lymph node

A

Dendritic cells

42
Q

D. What immune cell detects MHC1 and kills virus infected/cancer cells. Is inhibited by MHC I

43
Q
  1. 72 yr lady with stiff limb girdles (Polymyositis) (which antibody is seen)
44
Q
  1. SLE with recurrent clotting
A

Anti-cardiolipin antibodies

45
Q
  1. Bloated after drinking milk but not IgE mediated ?
A

Lactose intolerance

46
Q
  1. A teenage girl who when she goes cross country running gets an erythematous rash on her legs. It is well controlled by antihistamines
A

cold urticaria

47
Q
  1. Woman presents with aches all over and joint stiffness?
48
Q

60 year old lady with recurrent chest infections now has reduced total serum protein and has autoimmune thrombocytopenia

49
Q
  1. A 12 year old boy has recurrent chest infections and has an ear infection. He doesn’t have any B Cells
A

Bruton’s Agammaglobulinaemia

50
Q
  1. A Girl is found to have no CD4 cells, but CD8 cells and B cells are present
51
Q
  1. A boy’s father has TB. The same boy develops a mycobacterium infection, following their BCG?
A

Interferon gamma deficiency

52
Q
  1. Young girl with normal B cells, normal CD8+ but absence of CD4+
53
Q
  1. Young boy with normal B cell numbers and absence of CD8+ and CD4+
A

X-linked SCID

54
Q
  1. Lady with spinal fracture due to severe TB
A

Interferon gamma receptor deficiency

55
Q
  1. Patient with recurrent pneumococcal infections and meningitis
A

Complement deficiency

56
Q
  1. Used to treat malignant melanoma, involved in T cell checkpoints
A

Ipilimumab or Nivolumab

57
Q
  1. Used to prevent transplant rejection, by blocking T cell activation and
A

Tacrolimus or Cyclosporin

58
Q
  1. Used to treat severe ankylosing spondylitis not controlled by NSAIDs
A

Etanercept

59
Q
  1. In its immature form it is specialised to phagocytose pathogens, and in its mature form it is specialised to present to other cells
A

Dendritic cells

60
Q
  1. Mentioned FAS pathway
61
Q
  1. Nod2/CARD15
A

Crohn’s disease

62
Q
  1. Mentioned MEFV gene, periodic abdominal pain and ascites
A

Familial mediterranean fever

63
Q
  1. Hypertensive and diabetic, with angioedema
A

Drug reaction to ACEi

64
Q
  1. Woman with flushed face, problems breathing that has happened multiple times with enlarged liver
A

hereditary angioedema

65
Q
  1. Mechanism behind cellular rejection
A

T cell mediated

66
Q
  1. Mechanism behind antibody mediated rejection
A

B cell mediated

67
Q
  1. Mechanism behind GVHD
A

Donor WBCs attack host tissue

68
Q

Causes progressive multifocal leukoencephalopathy

69
Q
  1. What type of hypersensitivity (Gel and Coombs classification) is myasthenia gravis and what cell?
70
Q
  1. IPEX affects what type of immune cell?
71
Q
  1. 16 year old girl has pleuritic chest pain, joint pain, positive ANA and Anti-Sm, no liver enzyme derangement, raised ESR
72
Q
  1. Chimeric antigen receptor T-cell therapy against CD19: what type of haematological malignancy does it target?
A

ALL, some non-hodgkin lymphoma?

73
Q
  1. Ankylosing spondylitis – they’ve tried NSAID and TNF inhibitor, what else can you target?
74
Q
  1. 45yo woman with autoimmune diseases, low IgM, IgA and IgE; full blood count is normal?
75
Q
  1. Which immunoglobulin is found in mucosa?
76
Q
  1. Immunodeficiency with common gamma chain problem?
A

X-linked SCID

77
Q
  1. A woman is a donor for kidney to a child, what is the max number of HLA mismatches possible?
78
Q
  1. Someone with aphthous ulcers, conjunctivitis, diarrhoea & abdo pain
A

Crohn’s disease

79
Q
  1. Which type of cell does Rituximab target?
A

Mature B cells

80
Q
  1. cANCA positive man with glomerulonephritis and lung changes, what does he have?
A

Granulomatosis with polyangitis

81
Q

Antibody for Graves

A

Stimulatory anti-TSH receptor

82
Q
  1. Nivolumab is a PD1 inhibitor, what cells does it target?
83
Q
  1. Woman with periorbital purple rash (heliotrope) and rash on knees, which enzyme is elevated?
A

Creatinine kinase (dermatomyositis)

84
Q
  1. What Type Hypersensitivity causes serum sickness?
85
Q
  1. What is the effect of the gene mutation in familial Mediterranean fever?
A

Increased IL-1 production

86
Q
  1. Mechanism of hyperacute allograft rejection
A

preformed antibodies against HLA or ABO

87
Q
  1. Which of the following are most often used for prophylaxis against allograft rejection?
A

a. Mycophenolate mofetil, prednisolone, tacrolimus

88
Q
  1. Which of the following can be used to treat rheumatoid arthritis?
A

a. Adalimumab: TNFalpha

89
Q
  1. What cell in the body binds to MHC1?
90
Q
  1. Man has intermittent mouth & tongue swelling for the past 2 years, which is unresponsive to over-the-counter anti-histamines, is on aspirin and ACE inhibitor. What is the likely cause?
A

Drug induced reaction

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