primary immunodeficiency Flashcards

1
Q

secondary immunodeficiency causes

A
malnutrition 
infection 
diabetes
malignancy 
immunosuppressive Rx
chronic renal failure
burns, surgery 
splenectomy
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2
Q

primary immunodeficiency

A

part of immune system missing/not working
often genetic, can be autoimmune
predispose to infection, tumours

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3
Q

1ry: abnormality may be in

A

response of mature lymphocytes to antigenic stimulation
components of innate immune system
stages of lymphocyte development

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4
Q

primary defects of innate system

A

phagocyte defects

complement defects

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5
Q

phagocyte defects may be in

A

phagocytosis
phagocyte adhesion to epithelium
intracellular killing
chemotaxis

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6
Q

ex phagocyte defects

A

chronic granulomatous disease

leucocyte adhesion deficiency

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7
Q

features of phagocyte defects

A
liver abscess
skin/mucous membrane infection 
suppuration of lymph nodes
osteomyelitis
pneumonia
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8
Q

complement pathway defects may be in

A

classical pathway
alternative pathway
terminal pathway
proteins that control activity of complement system

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9
Q

clinical features complement pathway defect

A

immune complex disease

infection: staph, Hib, meningococcal

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10
Q

primary defects adaptive immunity

A

SCID
antibody deficiency
T cell deficiency
T and B cell deficiency

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11
Q

what is repeated infection with encapsulated bacteria a sign of

A

defective antibody production

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12
Q

causes of primary immunodeficiency

A

mutations e.g. SCID
polymorphisms: HLA, mannan-binding lectin
polygenic disorders e.g. CVID
autoimmunity e.g. APECED

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13
Q

common variable immunodeficiency

A

polygenic disorder
low IgG
variable levels of IgA, IgM, B cells and T cells
recurrent resp tract infections

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14
Q

APECED

A

autoimmune polyendocrinopathy candidiasis ectodermal dysplasia

severe recurrent candidia infection
defect in central tolerance

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15
Q

SCID

A

low t cells and B cells

can be defects in: pluripotent stem cells, lymphoid stem cells, T + B cells

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16
Q

features of SCID

A

infections in 1st few weeks life: candida, bacterial sepsis, bronchiolitis
rashes
diarrhoea
FTT

17
Q

SCID FH

A

neonatal death

consanguinity

18
Q

SCID lymphocyte count

A

very low total lymphocyte count <1

measured by flow cytometry

19
Q

SCID supportive Rx

A

prophylactic antib, antiv, antif
avoid live vaccines
Ig replacement
nutritional support

20
Q

SCID definitive Rx

A

stem cell transplant (earlier the better)

gene therapy if no suitable STC donor

21
Q

for gene therapy to be successfull…

A
  • genetic mutation must be identified and evidence correcting it will improve outcome
  • transfected gene must confer proliferative/survival advantage
  • gene therapy must’t cause Ca
22
Q

when does antibody deficiency usually present

A

later in life
(babies born w maternal Ig)

CVID doesnt present till adulthood

23
Q

Di George syndrome - what is it result of

A

defective fusion of 3rd and 4th pharyngeal pouches

24
Q

Di George syndrome CATCH-22

A
cardiac abnormalities
abnormal face
thymic hypoplasia - T cell dysfunction 
cleft palate
hypocalcaemia

chromosome 22 abnormalities

25
Q

immune deficiency: infections SPUR

A

serious
persistent
unusual
recurrent