Past paper corrections Immunology Flashcards
What infection is associated with P1104A variant of the TYK2
name another mutation that causes this infection
Tuberculosis
mutation in IL12
What is the most common HLA association for a seronegative spondyloarthropathy? -
HLA B27
What autoimmune condition is associated with a mutation on the “shared epiptope” on HLA-DR1 and HLA-DR4!!? -
rhuematoid arthritis
(4 walls in a rheum)
HLA DR3 is associated with what conditions?
Grav3s disease, SLE
three letters in SLE
HLA DR15 is associated with what condition?
goodpastures syndrome
HLA DR3/DR4 is associated with what condition?
Type 1 diabetes
HLA DQ2/DQ8 is associated with what condition
coeliac disease -> i 8 2 much
what does FAS mutation cause?
Expansion of lymphocytes/ ALPS
most likely HLA association coeliac disease?
DQ2!
(More common than DQ8)
pathophysiology of Hyper igM syndrome?
mutation in CD40L
IpiLimumab is a licensed therapy in the treatment of metastatic melanoma. But which receptor does it bind to
CTLA4
(Nivolumab and pembrolizumab bind PD1 - indicated in metastatic melanoma AND renal cell carcinoma
Which MHC is most important when matching donors?
DR (HLA-DR > B > A). D for donor
Live attenuated vaccines
MMR-VBOY = MMR, Varicella, BCG, Oral polio (sabin), Oral Typhoig, yellow fever. Not safe in immunocopromised. However MMR save in HIV
;7
Which type of transplant rejection can be treated with plasmapheresis?
antibody mediated transplant rejection
Conjugate vaccines?
NHS = N meningitidis, H influenzae, Strep peneumonia. Effective against encapsulated bacteria
Child with no B cell, no ig, but t cells
x linked agammaglobulinemia
describe 2 treatments for malignant melanoma and their mechanisms
PD1\Nivolumab = prevents T cell death
CTLA4 / ipilimumab = allows T cell activation
Crohn’s treatment (monoclonal antibody)
Vedolizumab
Which of these is a polysaccharide vaccine?
hemophilus influenzae
Question about ulcerative colitis and having used aminosalicylates but without any improvement. What is the next choice of drug?
Vedolizumab
Which cytokine is key in promoting the development and terminal differentiation of eosinophils?
IL5
A 38 year old male develops fluctuating muscle wean and ptosis. His symptoms improve following an injection of tensilon. Which autoantibody plays a role in the pathogenesis of this condition? -
anti-postsynaptic ACH receptor
Antibodies bind to which cell type during the effector phase of antibody mediated rejection of solid organ allografts?
natural killer cells
familial mediterranean fever treatment?
colchicine
45F develops weakness involving proximal muscles of arms and legs. Blood test results for FBC, renal function and LFT are all normal. Futher ix below. Dx?
IX
ESR – 25 (<20)
CRP – 4 (<5)
Creatine kinase – 3540 (25-175)
ENA (extractable nuclear antigen) screen – positive
Poylmyositis!!!
“inflammation of muscles” = raised CK
also ENA is positive!!
Which biologic disease modifying anti- rheumatic drug (DMARD) targeting a specific cytokine pathway would be expected to show efficacy in RA but not psoriatic arthritis?
Tocilizumahb (anti-interleukin 6 receptor antibody) - and sarilumab another IL6
n a disease such a phenylketonuria, which term describes the number of true negatives divided by the total number of people that do not have the disease?
specificity
Which condition is caused by reactivation of human polyoma virus 2 (John Cunningham (JC) virus) in immunosuppressed people? -
progressive multifocal leukoencephalopathy
Doctors should measure the level/activity of which enzyme before prescribing azathioprine?
TMPT = thiopurine methyltransferase
Which one of the following agents is effective as a biological disease modifying anti-rheumatic drug (b-DMARD) as part of rheumatoid arthritis management?A
Adalimumab (anti-TNFalpha)
Nivolumab is a PD1 inhibitor, what cells does it target?
t regulatory cell
What is the effect of the gene mutation in familial mediterranean fever?
increased IL-1 production
Mother is a donor for kidney to a child, what is the max number of mismatches possible with HLA class I? -
3/6
In a histology slide showing antibody mediated rejection of a renal allograft, where is the inflammatory infiltrate seen?
capillaries
Renal transplant recipients on long term immunosuppression have an increased risk of which lymphoid cancer?
EBV associated Diffuse large B cell lymphoma (DLBCL)!!
Viral conditions after transplant are most common!!!, so Kaposi sarcoma, EBV!!
What does Denosumab target?
Receptor activator of nuclear factor kappa-B Ligand (RANKL – But do not use acronyms!)
Which common condition can be treated with drugs that target with TNF, IL-17 and IL-12/23?
psoriasis
What is true about skin prick testing:
95% negative predictive values (poor positive predictive value) - immunology q
low thiopurine methyltransferase which drug do you not give?
Azathioprine
it is metabolised by TMPT
= toxic buildup
Woman who has mouth/lip swelling following a dental procedure, and her mother reports a similar history in the past.
what is the diagnosis?
hereditary angioedema/ C1 inhibitor deficiency
triggers: stress, Minor trauma surgery or dental procedure, Infection, Hormonal influences
