Patho-Immune

Question 1

TYPE OF HYPERSENSITIVITY

Anaphylaxis
Bronchial asthma
Hay fever
Food allergies

Answer 1

I

Eosinophils
IL-5 fron TH2

Question 2

TYPE OF HYPERSENSITIVITY

Myasthenia Gravis
Graves Disease
Acute Rheumatic fever
Goodpastures syndrome

Answer 2

II

C3b opsonization

NK cells and macrophage phagocytosis

C3a and C5a inflammation (anaphylatoxins)

Question 3

TYPE OF HYPERSENSITIVITY

Pernicious anemia
ITP
Autoimmunoe hemolytic anemia
ANCA vasculitis

Answer 3

II

Question 4

TYPE OF HYPERSENSITIVITY

Pemphigus vulgaris
Insulin resistant DN

Answer 4

II

Question 5

TYPE OF HYPERSENSITIVITY

Arthus reaction
Reactive arthritis

Answer 5

III

Immune complex
Kidneys, joints, small blood vessels

Question 6

TYPE OF HYPERSENSITIVITY

SLE
Serum sickness

Answer 6

III

Question 7

TYPE OF HYPERSENSITIVITY

PSAGN
Polyarteritis nodosa

Answer 7

III

Question 8

TYPE OF HYPERSENSITIVITY

Rheumatoid arthritis
Psoriasis
Multiple aclerosis
Type I DM
Inflammatory bowel disease
Contact sensitivity

Answer 8

IV

CD4
IFNy from TH1
IL17 from TH17

CD8
Perforins>granzymes, cytotoxic t cells

Question 9

Hallmark of SLE:

Best screening test:

Specific for SLE:

Lupus nephritis class:
Mesangial - I, II
Subendothelial- III (focal <50), IV (diffuse >50)
Subepithelial: V, VI (>90, sclerosis)

Answer 9

Autoantibodies

ANA

Anti-Sm and Anti-dsDNA

Question 10

TRIAD

Keratoconjunctivitis sicca
Xerostomia
Arthritis

Most important and most commin autoantibodies detected?

Diagnostic:

Type of reaction:

Answer 10

SJOGREN SYNDROME

Tcell CD4

Lip biopsy

Anti-ro (ss-a) and Anti-la (ss-b)

Lymphocytic infiltration in glands > atrophy, fibrosis, hyalinization > may transform to lymphoma

Tx: pilocarpine, cevimeline

Question 11

CREST Syndrome

Autoimmunity > chronic inflammation > damage to small blood vessels > perivascular fibrosis in skin and organs

Most notable antibodies:

Answer 11

SYSTEMIC SCLEROSIS / SCLERODERMA

Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasia

diffuse: early visceral involvement, anti-DNA topoisomerase I (anti Scl70)
limited: late, anti centromere

Question 12

Most common cause of death in scleroderma

Effecf in esophagus

Answer 12

Interstitial fibrosis

Rubber-hose-like inflexibility in esophagus

Question 13

ALLORECOGNITION PATHWAYS

CD8 > Cytotoxic T cells

Answer 13

MHC Class I

Direct: Donor to recipient

Question 14

ALLORECOGNITION PATHWAYS

CD4 > TH1 and TH17

Answer 14

MHC Class II

Direct

Question 15

ALLORECOGNITION PATHWAYS

Recipient APC to donor organ

Answer 15

Indirect

Question 16

ALLORECOGNITION

T cell mediated

Acute cellular rejection - tubules
Chronic rejection - interstitial fibrosis

Answer 16

Antibody mediated

Hyperacute rejection - bloody urine
Acute humoral rejection - glomerulous

Question 17

Insufficient INTEGRINS

Leukocytes Stuck in vascular walls

Answer 17

Leukocyte Adhesion Deficiency

Question 18

Impaired phagolysosome function

Neutrophils cannot merge with lysosome

Answer 18

Chediak-Higashi syndrome

Question 19

Inherited defect jn microbicidal activity

Absent NADPH oxidase

Answer 19

Chronic granulomatous disease

Question 20

TRIAD

Thrombocytopenia
Infections (Immunodeficiency)
Eczema

Depleted T cells in peripheral organs

Answer 20

WISKOTT-ALDRICH SYNDROME

Tx: HSC transplantation

Question 21

Deletion of Ch22 or TBX1

Failure of development of 3rd and 4th pharyngeal pouches

Absent thymus

Decreased T cell lymphocytes

Susceptible to viral and fungal infections

CATCH 22

Answer 21

DIGEORGE SYNDROME

Cardiac anomalies
Abnormal facies
Thymic hypoplasia
Cleft lip/palate
Hypocalcemia
Chromosome 22

Question 22

X linked recessive

Poor maturation if B cells

Decreased immunoglobulins

Absent germinal centers in lymph nodes, peyer patches, tonsils, appendix, absent plasma cells

Common infections: H. Influenza, S. Pneumonia, S. Aureus, enterovirus, giardia

Answer 22

BRUTON AGAMMAGLOBULINEMIA

Ig replacement

Question 23

Starch like misfolded proteins

Pressure atrophy on adjacent cells

Congo red on ordinary light
Apple green birefringence under polarized light (B sheet conformation)

Answer 23

AMYLOIDOSIS

most common and seriously affected organ: kidney