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Step 1 > PP Immunology > Flashcards

PP Immunology Flashcards

0
Q

Which cytokines do Th cell stimulate?

A

Everything other than IL-1

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1
Q

Which cytokine do macrophages stimulate?

A

IL-1

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2
Q

Which enlarged lymph nodes are most likely malignant?

A

Supraclavicular
Epitrochlear ( above elbow)
Inguinal

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3
Q

What is CD8?

A

T(killer) or T(suppressor) cell

Respond to MHC-1(self)

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4
Q

Which of your cells express MHC-1?

A

All except RBC and platelets

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5
Q

What is CD4?

A

Th cell

Respond to MHC-2(non-self)

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6
Q

What type of immunity does TH1 provide?

A

Cell-mediated

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7
Q

What type of immunity does TH2 provide?

A

Humoral

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8
Q

What do B cell deficiency patients die of?

A

Bacterial infection

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9
Q

What is Common Variable Hypogammaglobulinemia?

A

Kids w/ B cell that don’t differentiate into plasma cell => low Ab

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10
Q

What is Bruton’s Agammaglobulinemia?

A

Young adults w/ defective Tyrosine Kinase => no Ab

X-linked recessive ( boys)

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11
Q

What is Job-Buckley Syndrome?

A

Redheaded females

Stuck in IgE stage

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12
Q

What is Multiple Myeloma?

A

Multiple osteolytic lesion
IgG
u light chains
Rouleax

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13
Q

What is Heavy Chain Disease?

A

IgA and multiple myeloma of GI tract

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14
Q

What is selective IgG2 Deficiency?

A

Recurrent encapsulated infections

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15
Q

What is selective IgA deficiency?

A

Transfusion anaphylaxis

Mucous mm infection

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16
Q

What is Hairy Cell Leukemia?

A

Fried egg/ sunburst appearance

TRAP +

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17
Q

What is Ataxia Telangiectasia?

A

Low IgA

Neuro problems

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18
Q

What is hyper IgM syndrome?

A

High IgM

Low all other Ab

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19
Q

What do T cell deficiency patients die of?

A

Viral infection

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20
Q

What is DiGeorge Syndrome?

A

No thymus / inferior parathyroids

Low Ca

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21
Q

What is Chronic Mucocutaneus Candidiasis?

A

Te cell defect against C. albicans

Chronic infection

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22
Q

What is SCID?

A

No thymus
Frayed long bones
Baby dies by 18mo

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23
Q

What is Wiscott-Aldrich?

A 
Low IgM
Low platelets
High IgA
Eczema
Petechiae
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24
Q

What does the CD4 count tell you?

A

Status of HIV (normal =1000)

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25
Q

What does the viral load tell you?

A

Progression of HIV

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26
Q

What organs have the most CD4 receptors?

A 
Blood vessels
Brain
Testicle
Cervix
Rectum
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27
Q

What are the 3 test used to screen for HIV?

A

ELISA: detects IgG Ab to p24 Ag
Western blood: see >2 proteins
PCR: detects virus ( use in babies)

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28
Q

What is the definition of AIDS?

A

CD4 < 200/uL or clinical symptoms

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29
Q

What are the live vaccine?

A

“Bring Your Own Very Small Virus + MMR”

  • BCG
  • Yellow fever
  • OPV (Sabin) = oral polio
  • Varicella
  • Smallpox
  • rota Virus
  • Measles= rubeola
  • Mumps
  • Rubella = German 3-day measles
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30
Q

What is 1 Biliary Cirrhosis?

A

Anti-mitochondrial Ab
Pruritis
Female

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31
Q

What is 1 Sclerosing Cholangitis?

A

p-ANCA Ab
Bile duct inflammation
Onion skinning
IBD

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32
Q

What is Type I Autoimmune Hepatitis?.

A

Anti-SM Ab

Young women

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33
Q

What is Type II Autoimmune Hepatitis?

A

Anti-LKM Ab

Kids

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34
Q

What is Bullous pemphigoid?

A

Anti-hemidesmosome Ab

Skin bullae

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35
Q

What is Celiac sprue?

A

Anti-gliaden Ab

Eating wheat => steatorrhea

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36
Q

What is CREST syndrome?

A

Anti-centomere Ab

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37
Q

What is Dermatitis herpetiformis?

A

Anti-BMZ Ab
Anti-endomysial Ab
Vesicles on anterior thigh

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38
Q

What is Dermatomyositis?

A 
Anti-Jo-1 Ab
Anti-GAD Ab
Polyuria
Polydipsia 
Weight loss
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39
Q

What is Drug-induced Lupus?

A

Anti-histones Ab

“HIPPPE” causes it

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40
Q

What is Gastritis Type A?

A

Anti-parietal cell Ab
Atrophic gastritis
AdenoCA

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41
Q

What is Goopasture’s disease?

A

Anti-GBM Ab
Attack lungs and kidney
RPGN

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42
Q

What is Graves’ disease?

A

Anti-TSHr Ab
Hyperthyroid
Bug eye
Pretibial myxedema

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43
Q

What is Guillain Barre?

A

Anti-ganglioside Ab
Ascending paralysis
2 w after URI

44
Q

What is Hashimoto’s?

A

Anti-microsomal Ab = TPO

Hypothyroid

45
Q

What is ITP?

A

Anti-platelet Ab
Anti-GP2b3a Ab
Thrombocytopenia

46
Q

What is Mixed CT disease?

A

Anti-RNP Ab

47
Q

What is Mononucleosis?

A

Heterophile Ab

Teenager w/ sore throat

48
Q

What is MPGN Type II?

A

Anti-C3 convertase Ab = C3 nephritic factor

49
Q

What is Multiple Sclerosis?

A

Anti-myelin Ab

Middle age female w/ vision problems

50
Q

What is Myasthenia gravis?

A

Anti-AChr Ab
Female w/ potsis
Weaker as the day goes by

51
Q

What is Paroxysmal hemolysis?

A

Donath Landosteines Ab

Bleeds when cold

52
Q

What is Pemphigus vulgaris?

A

Anti-desmosome Ab

Sking sloughs off when touched

53
Q

What is Pernicious anemia?

A

Anti-IF Ab

Vit B12 defi => Megaloblastic anemia

54
Q

What is Polyarteritis Nodosa?

A

p-ANCAS Ab
Attack gut and kidney
Hep B

55
Q

What is Post-strep GN?

A

ASO Ab

Nephritic w/ complement deposition

56
Q

What is Rheumatoid Arthritis?

A

Rheumatoid factor

Pain worst in the morning

57
Q

What is Scleroderma?

A

Anti-Scl70 = anti-TopoI
Fibrosis
Tight skin

58
Q

What is Sjögren’s?

A

Anti-SSA Ab
Dry eyes “sand in eye”
Dry mouth
Arthritis

59
Q

What is SLE?

A

Anti-ds DNA / Sm / Cardioliping, rash

60
Q

What is SLE cerebritis?

A

Anti-neuronal Ab

Anti-ribosomal Ab

61
Q

What is Vitiligo?

A

Anti-melanocyte Ab

White patches

62
Q

What is Warm hemolysis?

A

Anti-Rh Ab

Bleeds at body temp

63
Q

What is Wegener’s?

A

c-ANCA Ab
Attacks ENT
Lung
Kidney

64
Q

What is HSP?

A

IgA disease

2 weeks after common cold => Berger’s

65
Q

What is Berger’s?

A

IgA

2 weeks after vaccination => Serum sickness

66
Q

What is Alport’s?

A

IgA disease

2 weeks after diarrhea => HSP, polio

67
Q

Lymph node drainage of Upper limb and lateral breast?

68
Q

Lymph node drainage of the Stomach?

69
Q

Lymph node drainage of the Duodenum and jejunum?

A

Superior Mesenteric

70
Q

Lymph node drainage of the Sigmoid colon?

A

Colic -> Inferior Mesenteric

71
Q

Lymph node drainage of rectum?

A

Internal iliac

72
Q

Lymph node drainage of the anal canal above the pectinate line?

A

Internal iliac

73
Q

Lymph node drainage of the anal canal below the pectinate line?

A

Superficial inguinal

74
Q

Lymph node drainage of the Testes?

A

Para-aortic

75
Q

Lymph node drainage of the Scrotum?

A

Superficial inguinal

76
Q

Lymph node drainage of the Thigh?

A

Superficial inguinal

77
Q

Which are the capsulated Organism?

A

” Even Some Killers Have Pretty Nice Capsule”

  • E.coli
  • Strep. Pneumo
  • Klebsiella
  • H. Influenza
  • N. meningitidis
  • Cryptococcus neoformans
78
Q

Which are the antigen presenting cell?

A

Macrophage
B cells
Dendritic cell

79
Q

HLA A3 disease?

A

Hemochromatosis

80
Q

HLA A6 disease?

A

Hemochromatosis

81
Q

HLA B27 disease?

A 
" PAIR"
Psoriasis
Ankylosing spondylitis 
Inflammatory bowel disease
Reiter's syndrome
82
Q

HLA DR3 disease?

A

DM Type I

Graves’ disease

83
Q

HLA DR4 disease?

A

DM Type I

Rheumatoid arthritis

84
Q

What is Follicular Dendritic cell?

A

Has NO MHC

Important in the MATURATION and DIVERSIFICATION of the B cells

85
Q

Which are the 3 activation pathway in the Complement system?

A

Classical: IgG or IgM mediated [ C1]
Alternative: microbe surface molecule [ C3 ]
Lecitin: mannose or other sugar on microbial surface

86
Q

Which are the complement disorder?

A
  • C1 esterase inhibitor defi -> hereditary angioedema, increase Bradykinin
  • C3 defi -> recurrente sinus and respi tract infection, increase susceptibility to Type III hypersensitivity
  • C5-9 defi -> Nisseria bacteremia
  • DAF defi -> complement-mediated lysis of RBCs, PNH
87
Q

Which are the important IL?

A 
IL 1 : fever
IL 2 : T cell
IL3 : Bone marrow ( B cells) 
IL 4: IgE, IgG
IL5 : IgA, eosinophils 
IL12: induce Th1
88
Q

Which are the Chemotactic Agent?

A

IL-8
C5a
Leukotriene B4

89
Q

Which are the important Cytokines?

A

IL 2: T cell stimulation
IFN gama: stimulates macrophage, inhibits Th2
IL 10: inhibits T cell and macrophages ( Th1)
IL 4,5: B cell stimulation

90
Q

Interferon ( IFN)?

A

Give the macrophages the ability to go to different places
Alpha and beta -> inhibits VIRAL protein synthesis
Gamma -> increase MHC I and II expression and antigen presentation in all cells

91
Q

Which are the inactivated or killed vaccine?

A 
Cholera
Hep A
Polio ( injected)
Rabies
IM influenza
92
Q

What type of reaction induce the vaccine?

A

Live vaccine -> cell mediated { T cell }

Killed vaccine -> humoral mediated { B cell }

93
Q

Type of Hypersensitivity?

A

“ACID”

  • Anaphylactic and Atopic (Type I)
  • Cytotoxic ( Type II): antibody mediated
  • Immune complex ( Type III): antibody against soluble antigen
  • Delayed ( Type IV): T cell mediated
94
Q

Type II hypersensitivity disorder?

A 
Autoimmune hemolytic anemia
Pernicious anemia
Idiopathic thrombocytopenia purpura
Erythroblastosis fetalis
Acute hemolytic transfusion reaction
Rheumatic fever
Good pastures syndrome 
Bullous pemphigoid 
Pemphigus vulgaris
95
Q

Type III hypersensitivity disorder?

A 
SLE 
Polyarteritis Nodosa
Poststreptococcal glomerulonephritis
Serum sickness
Arthus reaction
96
Q

Type IV hypersensitivity disorder?

A 
Multiple sclerosis
Guillain-Barré syndrome
Graft vs host disease
PPd
Contact dermatitis
97
Q

Which are the B cell disorder?

A

Bruton’s ( X-linked agammaglobulinemia)
Selective IgA deficiency
Common variable immunodeficiency

98
Q

Which are the T cell disorder?

A

DiGorge syndrome
IL-12 receptor deficiency
Hyper-IgE syndrome ( Job’s syndrome)
Chronic Mucocutaneus Candisiasis

99
Q

Which are the B and T cell disorder?

A

SCID ( severe combined immunodeficiency ) { adenosine deaminase deficiency}
Ataxia-telangiectasia
Hyper-IgM syndrome
Wiskott-Aldrich syndrome

100
Q

Which are the X-linked immune deficiency?

A

“WACH”

  • Wiskott-Aldrich
  • Bruton’s
  • SCID, CGD
  • Hyper IgM
101
Q

Which are the phagocyte dysfunction?

A

Leukocyte adhesion deficiency
Chediak-Higashi syndrome
CGD

102
Q

Type of Transplant rejection?

A

Hyperacute -> minutes, antibody mediated, preformed anti-donor antibodies
Acute -> weeks, cell mediated due to CTLs reacting against foreign MHCs
Chronic -> month to years, irreversible
Graf vs host

103
Q

Which are the immunosuppressants?

A 
Cyclosporine
Tacrolimus ( FK-506)
Sirolimus ( rapamycin)
Azathioprine
Muromonab-CD3 (OKT3)
104
Q

Cyclosporine?

A
  • Binds to cyclophilins.Complex blocks the differentiation and activation of T cells by inhibiting Calcineurin, thus preventing the production of IL-2 and its receptors.
  • Supresses organ rejection
  • causes Nephrotoxicity
105
Q

Tacrolimus ( FK-506)?

A
  • Binds to FK-binding protein, inhibiting calcinerium and secretion of IL-2.
  • immunosuppressive used in organ transplant recipients
  • causes: Neurotoxicity and Nephrotoxicity
106
Q

Sirolimus (rapamycin)?

A
  • Inhibits mTOR. Inhibits T cell proliferation
  • Immunosuppression after kidney transplantation
  • causes: Hyperlipidemia, Trombocytopenia and Leukopenia
107
Q

Azathioprine?

A
  • Precursor of 6-mercaptopurine that interfers with the metabolism and synthesis of nucleic acids.
  • Use in kidney transplant
  • causes: Bone marrow suppression
108
Q

Muromonab-CD3 (OKT3)?

A
  • Antybody that binds to CD3 on surface of T cells. Blocks cellular interaction with CD3 protein responsible for T cell signal transduction
  • Immunosuppressant after kidney transplant
  • causes: Cytokine release syndrome

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