Transition block: immunology Flashcards
What is methotrextate?
a DMARD
How often is methotrexate given?
once a week
When can methotrexate not be used?
liver disease
What is a granuloma?
an organised collection of activated macrophages and lymphocytes
When are granulomas seen in the lungs
Sarcoidosis
Mycobacterial disease, e.g. Tuberculosis, leprosy
Leprosy (some forms)
Berylliosis, silicosis and other dust diseases
Chronic stage of hypersensitivity pneumonitis
Foreign bodies
How does antibody deficiency present?
recurrent bacterial infection (RTI and GI)
antibody mediated autoimmune disease (ITP and autoimmune haemolytic anaemia)
Are primary antibody deficiencies common?
yes
selective IgA deficiency is seen in 1:600
What is common variable immune defiency (CVID)?
low IgG, IgA and IgM results in recurrent bacterial infection
Name some secondary causes of hypogammaglobulinaemia
protein loss (eg nephrotic syndrome) or failure of protein synthesis (eg. lymphoproliferative disorders)
What is opsonization?
the process by which the pathogen is marked for ingestion and eliminated by the phagocytes
What does complement deficiency predispose to ?
bacterial infection esp meningitis
What is a NK cell?
part of the innate immune system
kills cells that lack MHC
What are toll-like receptors?
receptors on phagocytes that are activated by microbes to release pro-inflammatory cytokines and type 1 interferon secretion
What do toll-like receptors respond to?
PAMPS
pathogen associated molecular patterns
What do TNF-inhibitors block?
pro-inflammatory cytokines
Can the body form antibodies against TNF-inhibitors?
yes as they are foreign proteins
what are biologic drugs?
artificial antibodies that block the body’s own proteins
Are biologic drugs renal or hepatotoxic?
no
Name a biologic and its target
adalimumab
anti-TNF
Are biologic drugs active or passive immunization?
passive so have to be injected every couple of weeks
What does vaccination produce?
effector T cells
memory B cells which will undergo clonal expansion when re-exposed and produce IgG
Give a pro and a con for an inactivated vaccine
made quickly and are safe
not very potent so requires boosters
Give some inactivated vaccines
polio, hep B, pertussis, diptheria, tetanus, h. influenzae B
Give a pro and a con for a live attenuated vaccine
relevant mechanisms and strong response
may cause infection in immuno-compromised, fragile
