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First Aid Stuff I Don't Know > Vol. II - Immunology and Pathology > Flashcards

Vol. II - Immunology and Pathology Flashcards

1
Q

Colon from splenic flexure to upper rectum drains tohy

A

Inferior mesenteric nodes

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2
Q

SCID causes

A

defective IL-2R gamma chain (x linked, most common), adenosine deaminase deficiency (AR), RAG mutation

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3
Q

Pathogenesis of hyperacute transplant rejection

A

preformed antibodies (type II hypersensitivity) –> rejection within minutes

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4
Q

IFN-gamma

A

stimulates macrophages to kill phagocytosed pathogens. Induces IgG switching.

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5
Q

TH2 cytokines

A

IL-4, 5, 6, 10, 13 –> activate eos and IgE production

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6
Q

Tumor markers: Calcitonin

A

Medullary thyroid carcinoma

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7
Q

Job syndrome presentation

A

ABCDEF: Abscesses, retained Baby teeth, Coarse facies, Derm problems, high IgE, Fractures

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8
Q

IL-1

A

Fever and acute inflammation. Activates adhesion molecule expression on endothelium.

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9
Q

Leukocyte adhesion deficiency (type 1)

A

defect in LFA-1 integrin (CD18) –> impaired migration and chemotaxis

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10
Q

Thymic aplasia syndromes

A

Di George and velocardiofacial

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11
Q

IL-12 receptor deficiency

A

Autosomal recessive causing decreased Th1 response –> decreased IFN-gamma –> mycobacterial and fungal susceptibility

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12
Q

Hyper IgM syndrome

A

Usually X linked defect of CD40L on T cells –> defective class switching –> severe pyogenic, opportunistic, and CMV infections –> no germinal centers or other Ig classes

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13
Q

TH17 cytokines

A

IL-17, 21, 22 –> induce neutrophil inflammation

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14
Q

Tumor markers: Chromogranin

A

neuroendocrine tumors

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15
Q

Rapamycin indication

A

kidney transplant rejection prophylaxis

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16
Q

NK cell activity is enhanced by

A

IL-2, IL-12, IFN alpha and beta

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17
Q

mechanism if fever in acute inflammation

A

Pyrogens –> magrophages produce IL-1 and TNF –> increased COX in anterior hypothalamus –> increased PGE2 –> increased temp set point

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18
Q

Wiskott-Aldrich presentation

A

WATER: Wiskott-Aldrich causes Thrombocytopenia, Eczema, and Recurrent pyogenic infections

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19
Q

Most common primary immunodeficiency

A

Selective IgA deficiency

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20
Q

Tumor markers: alkaline phosphotase

A

Mets to bone and liver, Paget’s disease, seminoma

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21
Q

testes, ovaries, and kidneys drain to

A

para-aortic nodes

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22
Q

HLA DR4 association

A

rheumatoid arthritis and DM1

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23
Q

Pathogenesis of chronic transplant rejection

A

CD4s respond to donor peptide –> type II and type IV reaction –> fibrosis etc, dominated by arteriosclerosis –> rejection in months to years

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24
Q

Tacrolimus indication

A

immunospression after solid organ transplant

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25
Q

T-cell costimulation is

A

B7 on DC binds CD28 on T cell

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26
Q

Type I hypersensitivity

A

anaphylactic and atopic

IgE mediated degranulation of presensitized mast cells

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27
Q

Treg cytokines

A

TGF-beta, IL-10, 35

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28
Q

Sirolimus (Rapamycin) MOA

A

mTOR inhibitor –> prevents response to IL-2

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29
Q

Protein product in proliferative phase of wound healing

A

Collagen Type III

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30
Q

X linked (Bruton) agammaglobulinemia

A

BTK defect –> no B cell maturation –> decrease in all Ig types –> recurrent bacterial infections (after 6 months b/c maternal Abs)

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31
Q

cervix, superior bladder, body of uterus drain to

A

external iliac nodes

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32
Q

What tissue does not undergo coagulative necrosis after infarct

A

brain

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33
Q

IL-6

A

causes fever and production of acute phase proteins

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34
Q

TH1 cytokines

A

IFN-gamma and IL-2 –> activate macrophages and CTLs

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35
Q

C5-C9 deficiency

A

increased Neisseria bacteremia susceptibility

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36
Q

role of leukotrienes in inflammation

A

endothelial contraction –> swelling

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37
Q

Chediak-Higashi presentation

A

PLAIN: progressive neurodegeneration, lymphohistiocytosis, Albinism, recurrent pyogenic Infections, peripheral Neuropathy

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38
Q

Type II hypersensitivity

A

Antibody mediated

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39
Q

Actue phase reactants

A

FFiSHH P in the C: Ferritin, Fibrinogen, Serum amyloid A, Hepcidin, Haptoglobin, Procalcitonin, C-reactive protein

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40
Q

Azathioprine MOA

A

precursor of 6-MP –> blocks PRPP amidotransferase –> reduced purine synthesis –> inhibits lymphocyte proliferation

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41
Q

fibril protein in hereditary amylodoses

A

mutated transthyretin (ATTR)

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42
Q

B cell costimulation is

A

CD40 binds CD40L on Th cell

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43
Q

Tumor markers: CA 27-29

A

Breas Cancer

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44
Q

Ataxia Telangiectasia

A

ATM defect –> Can’t detect DNA damage –> accumulation of mutations –> increased AFP / risk of lymphoma and decreased IgA, IgG, and IgE + lymphopenia

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45
Q

Chronic Granulomatous Disease presentation

A

increased susceptibility to catalase positives, recurrent infections and granulomas, Dx on flow or nitroblue tetrazolium

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46
Q

Warm autoimmune hemolytic anemia association

A

IgG

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47
Q

Paroxysmal Nocturnal Hemoglobinuria cause

A

PIGA defect –> loss of GPI anchors –> no DAF –> MAC mediated hemolysis –> decreased haptoglobin and dark urine

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48
Q

BCL-2 is overexpressed in what disease?

A

follicular lymphoma (t[14:18])

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49
Q

Alternate macrophage activation

A

Th2 secretion of IL-4 and IL-13 –> repair and anti inflammatory

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50
Q

MHC I antigen loading occurs in

A

rough ER

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51
Q

HLA DR3 association

A

SLE and DM1

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52
Q

IL-12

A

induces Th1 differentiation and activates NK cells

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53
Q

MAC components

A

C5b-9

54
Q

Predominant cell late in acute inflammation

A

macrophages (2-3 days)

55
Q

Cyclosporin indication

A

psoriasis and RA

56
Q

MAC defends against

A

Gram - bacteria, esp Neisseria

57
Q

C3b function

A

opsonization and clearance of Ab complexes

58
Q

IL-5

A

Class switching to IgA. Stimulates eos.

59
Q

Which Ig suptype is a dimer

A

IgA

60
Q

role of bradykinin in inflammation presentation

A

vasodilation –> redness and warmth, sensitization of nerve endings –> pain

61
Q

Deficiency in Leukocyte Adhesion Deficiency type 2

A

sialyl lewis X –> loss of margination and rolling

62
Q

Tumor markers: CA 15-3

A

Breast Cancer

63
Q

Autosomal dominant hyper-IgE syndrome (Job syndrome)

A

STAT3 mutation –> deficiency of Th17 cells –> impaired neutrophil recruitment –> high IgE and eos

64
Q

Cause of chronic mucocutaneous candidiasis

A

AIRE defect –> T cell dysfunction

65
Q

earliest manifestation of cellular injury

A

swelling

66
Q

C5a function

A

neutrophil chemotaxis

67
Q

Mycophenylate Mofetil MOA

A

reversibly inhibits IMP dehydrogenase –> prevents purine synthesis

68
Q

Lower duodenum, jejunum, ileum, and colon to splenic flexure drain to

A

superior mesenteric nodes

69
Q

Direct Coombs test

A

Ab bound to RBCs

70
Q

Which Ig subtype crosses the placenta

A

IgG

71
Q

Tumor markers: CA 125

A

Ovarian Cancer

72
Q

HLA B57 is associated with

A

Abacavir hypersensitivity

73
Q

C3 convertase is

A

C4bC2b

74
Q

Thymic aplasia presentation

A

CATCH-22: Cardiac defects, Abnormal Facies, Thymic hypoplasia, Cleft palate, Hypocalcemia caused by 22q11 microdeletion

75
Q

Tumor markers: CEA

A

colorectal and pancreatic cancer

76
Q

Classic complement activation is by

A

IgG or IgM

77
Q

Ovarian teratoma paraneoplastic syndrome

A

Anti-NMDA receptor encephalitis

78
Q

Deficiency in chronic granulomatous disease

A

NADPH oxidase

79
Q

Thymus epithelium is derived from

A

3rd pharyngeal pouch

80
Q

loss of AIRE causes

A

autoimmune polyendocrine syndrome (PT, adrenal, and candida infection)

81
Q

Common variable immunodeficiency

A

Defect in B cell maturation, decreased plasma cells and Ig, increased risk of AI and lymphoma

82
Q

delay in proliferative phase of wound healing is caused be

A

Vitamin C and copper deficiency

83
Q

Type III hypersensitivity

A

Immune complex mediated

84
Q

Cold autoimmune hemolytic anemia association

A

IgM

85
Q

Classical macrophage activation

A

Th1 secretion if IFN-gamma –> pro inflammatory

86
Q

Wilson’s disease is accumulation of…

A

copper

87
Q

Thymic aplasia

A

22q11 microdeletion –> failure fo 3rd and 4th pharyngeal pouches –> no thymus or parathyroids –> low T cells, PTH, and Ca

88
Q

Mycophenylate Mofetil indication

A

glucocorticoid sparing agent in RA (but associated with CMV infection)

89
Q

Glucocorticoid MOA

A

Inhibit NF-kappaB –> decreased cytokine production and increased T cell apoptosis

90
Q

Tumor markers: alpha-fetoprotein

A

hepatocellular carcinoma, yolk sac tumor, mixed germ cell tumor

91
Q

Which Ig subtype is a pentamer

A

IgM

92
Q

Predominant cell early in acute inflammation

A

neutrophils

93
Q

Azathioprine indications

A

RA, Crohns, glomerulonephritis, AI in general

94
Q

Cytokines mediated cachexia

A

TNF-alpha, INF-gamma, IL-1, IL-6

95
Q

Thymus dependent antigens

A

contain a protein component –> immunological memory

96
Q

diapedesis is mediated by

A

PECAM-1 (CD31)

97
Q

Basilixamab MOA

A

Blocks IL-2R

98
Q

Deficiency in Leukocyte Adhesion Deficiency type 1

A

CD18 integrin –> failure of tight binding

99
Q

cortex zones most susceptible to infarct

A

3, 5, 6

100
Q

Celiac disease HLA subtypes

A

DQ2/DQ8 - I 8 2 much gluten at DQ

101
Q

splenectomy increases vulnerability to

A

encapsulated organisms (via decreased IgM and complement mediated opsonization)

102
Q

liver, stomach, spleen, pancreas, and upper duodenum drain to

A

Celiac nodes

103
Q

Chediak-Higashi syndrome

A

defect in lysosomal trafficking regulator (LYST) –> microtubule dysfunction in phagosome-lysosome fusion –> giant granules, pancytopenia, mild coag defects

104
Q

Type IV hypersensitivity

A

delayed type, T cell mediated

105
Q

Cancer associated with liver fluke

A

cholangiocarcinoma

106
Q

Wiskott-Aldrich syndrome

A

X linked mutation in WAS –> unable to reorganize actin –> defective antigen presentation –> low to normal IgM and IgG, few and small platelets

107
Q

C1 esterase inhibitor deficiency

A

Causes hereditary angioedema due to unregulated activation of bradykinin –> ACE inhibitors contraindicated

108
Q

IL-8

A

major chemotactic factor for neutrophils

109
Q

complement is synthesized in

A

the liver

110
Q

Tumor markers: LDH

A

Germ cell tumors

111
Q

Pathogenesis of acute transplant rejection

A

Can be cellular or humoral response to donor antigens –> rejection in weeks to months

112
Q

Vinyl chloride causes (PVC pipes)

A

hepatic angiosarcoma

113
Q

MHC II antigen loading occurs in

A

acidified endosome

114
Q

Basalixamab indication

A

kidney transplant rejection prophylaxis

115
Q

C1-C4 deficiency

A

increased risk fo severe, recurrent, pyogenic sinus and respiratory tract infections. Increased risk of SLE.

116
Q

dominant cell in chronic inflammation

A

macrophages

117
Q

Protein product in remodeling phase of wound healing

A

Collagen Type I

118
Q

IPEX syndrome is caused by

A

deficiency of FOXP3

119
Q

Tumor markers: hCG

A

choriocarcinomas, testicular cancer, mixed germ cell tumor

120
Q

Psammoma bodies are seen in

A

PSAMMOMaS: Papillary Carcinoma of thyroid, Somatostatinoma, Adrenals, Meningioma, Mesothelioma, Ovarian serous carcinoma, Prolactinoma (Milk), Serous endometrial carcinoma

121
Q

Tumor markers: CA 19-9

A

Pancreatic Adenocarcinoma

122
Q

HLA B27 disease

A

seronegative arthropathies: psoriatic arthritis, ankylosing spondylitis, IBD-associated arthritis, Reactive arthritis

123
Q

lower rectum, bladder, middle vagina, cervix, and prostate drain to

A

internal iliac nodes

124
Q

Most abundantly produced Ig

A

IgA (but low in serum b/c it is secreted at epithelium)

125
Q

IL-4

A

Th2 differentiation and class switching to IgG and IgE

126
Q

cancer associated with Schistosoma

A

squamous cell bladder cancer

127
Q

Delay in remodeling phase of wound healing is caused by

A

zinc deficiency (required by collagenases)

128
Q

Rapamycin toxicity

A

pancytopenia, insulin resistance and hyperlipidemia

129
Q

Selective IgA deficiency

A

cause unknown, often asymptomatic, increased giardiasis susceptibility, anaphylaxis to IgA in blood products

130
Q

Calceineurin inhibitor toxicity

A

nephrotoxicity, hypertension, hyperlipidemia, neurotoxicity (and gums and hair for Cyclosporin)

131
Q

anal canal below pectinate line, scrotum, and vulva drain to

A

superficial inguinal nodes

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