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Stage 4: CSIM 2 > Week 1: Immunology > Flashcards

Week 1: Immunology Flashcards

1
Q

Describe central tolerance

A

Occurs within thymus/ BM

Removes T cells which bind strongly with self MHC (ie might cause autoimmune dz) or don’t bind at all with MHC

Some of the T cells which bind too strongly become Treg cells

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2
Q

Describe peripheral tolerance

A

AIRE gene checks if T cells (in periphery) are self-reactive

Prevents mature T cells from reacting to self antigens without co-stimulation/ in immune priveleged sites

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3
Q

Which are the 3 immune priveleged sites

A
  1. Eye
  2. Brain
  3. Testes
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4
Q

CD4/8 cells interact with MHC 1/2

A

CD4: MHC 2

CD8: MHC 1

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5
Q

How might disorders of immune system organs/ genes/ cells result in failure/loss of self-tolerance

A
  1. Thymic deletion
  2. AIRE deficiency
  3. Disorder of Treg cells (IPEX)
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6
Q

How might bacteria result in failure/loss of self-tolerance

A
  1. Bacterial Ag has homology to self Ag

2. Chronic bacterial infection leads to chronic APC stimulation

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7
Q

How might medication result in failure/loss of self-tolerance

A
  1. Immunosuppressive medication (downregulates Treg cells)

2. IFN medication (stimulates immune system, leads to chronic APC stimulation)

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8
Q

Describe Type 1 hypersensitivity

  • cells/immunoglobulins involved
  • mechanism of tissue injury
A

IgE mediated

Mast cell degranulation -> releases mediators -> inflammation

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9
Q

Describe Type 2 hypersensitivity

  • cells/immunoglobulins involved
  • mechanism of tissue injury
A

IgM/IgG against cell surface Ag

Cells are opsonised and phagocytosed

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10
Q

Describe Type 3 hypersensitivity

  • cells/immunoglobulins involved
  • mechanism of tissue injury
A

IgM/IgG against circulating Ag

Neutrophils and macrophages are activated.

Immune complex deposition in tissues (leading to inflammation)

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11
Q

Describe Type 4 hypersensitivity

  • cells/immunoglobulins involved
  • mechanism of tissue injury
A

T cell mediated

T helper cells are activated by APC. When Ag is met again in future, memory T cells activate macrophages and neutrophils -> cause inflammation

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12
Q

Describe Type 5 hypersensitivity

  • cells/immunoglobulins involved
  • mechanism of tissue injury
A

Similar to type 2, except IgG/IgM are targeting cell surface RECEPTOR instead of the cell surface

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13
Q

ALLERGIES are a type what hypersensitivity

if relevant, what is the target Ag

A

Type 1

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14
Q

RHEUMATOID ARTHRITIS is a type what hypersensitivity

if relevant, what is the target Ag

A

Type 3

Ag = Proteins that are protective against joint inflammation eg follistatin

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15
Q

SLE is a type what hypersensitivity

if relevant, what is the target Ag

A

Type 3

Ag = nuclear components of cell

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16
Q

GOODPASTURE’S is a type what hypersensitivity

if relevant, what is the target Ag

A

Type 2

Ag = Type 4 collagen which makes up the GBM

17
Q

HYPERSENSITIVITY PNEUMONITIS is a type what hypersensitivity

if relevant, what is the target Ag

A

Type 3/ Type 4

Ag = mould/ haydust/ other occupational lung irritants

18
Q

CONTACT DERMATITIS is a type what hypersensitivity

if relevant, what is the target Ag

A

Type 4

Ag = whatever the skin has been exposed to

19
Q

GRAVES DISEASE is a type what hypersensitivity

if relevant, what is the target Ag

A

Type 5

Ag = TSH receptors

20
Q

MYASTHENIA GRAVIS is a type what hypersensitivity

if relevant, what is the target Ag

A

Type 5

Ag = Ach receptors

21
Q

CHRONIC TRANSPLANT REJECTION is a type what hypersensitivity

if relevant, what is the target Ag

A

Type 4

Ag = donor organ

22
Q

Effects of histamine on:

respi tract

A
  1. Bronchoconstriction

2. Mucous secretion

23
Q

Effects of histamine on:

blood vessels

A
  1. Increased vascular permeability
  2. Vasoconstriction (reduced blood to tissues)
  3. Venodilation (reduced blood to heart)
24
Q

Effects of histamine on:

heart

A

Reduced cardiac contractility

25
Q

What should always be measured in an anaphylactic reaction

A

Serum tryptase

26
Q

What dose/ mode of administration of adrenaline is given during anaphylaxis

A

0.5mg Adrenaline IM

27
Q

When should tryptase levels be measured in an anaphylactic event?

When are do levels peak?

A

Within 1-2h of event, and up to <4h

Levels peak at 1-2h

28
Q

Where are complement factors made

A

Liver (not BM)

29
Q

Half life of antibodies

A

3 weeks

30
Q

What kind of infections are pts with complement deficiency susceptible to

A
  1. Strep
  2. Hib
  3. Meningococcal (if deficiency in C5-9)

as opsonisation is critical for removal

31
Q

Immediate management of allergic reaction

A

IV chlorphenamine

Stage 4: CSIM 2 (47 decks)

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