immunology review

Question 1

3 things immune cells do when active?

Answer 1

1. Proliferate 2. Cytokine production 3. Adhesion molecules and trafficking

Question 2

Cytokines do what

Answer 2

Make TF that enters nucleus affect gene transcription profile of cell

Question 3

4 compartments of immune system

Answer 3

1. Complement - land mines
2. Phagocytes- the marines (neutrophils and macrophages)
3. B cells - Air Force make deploy missile
4. T cells - the generals, assasians, the psychologists

Question 4

Complement immune system 3 pathways

Answer 4

1. Classical (immune)
2. lectin (pathogen)
3. alternative (pathogen)

• All Activate c3 and form membrane attack complex (MAC)

Question 5

Encapsulated organism infections, or lupus or lupus like glomerulonephritis

Answer 5

Classical pathway early defect

Question 6

Invasive infections with neisserial species

Answer 6

Late complement pathway defect

Question 7

How test complement pathway of immune system, how treat?

Answer 7

• Measure number by serum c3 and c4
• measure function ch50 test (defect - absent response)
• treatment- fresh frozen plasma, Eculizumab (HUS, hemolytic uremic syndrome)

Question 8

C1q absent leads to?

Answer 8

• lupus 90% time
• early complement defect
• made in bone marrow, so bone marrow transplant cure

Question 9

Delayed separation umbilical cord

Answer 9

Leukocyte adhesion deficiency

Question 10

Phagocyte deficiency-chronic granulomatus disease commonly present with?

Answer 10

• Catalase + organism infections
• Staph aureus, serratia marcesans, aspergillus
• lack oxidative burst

Question 11

Absent CD18 means

Answer 11

Leukocyte adhesion deficiency

Question 12

Neutrophil oxidative burst absent means what

Answer 12

Patient has chronic granulomatous disease (phagocyte deficiency)

Question 13

Treatment that target neutrophils

Answer 13

• Colchicine- target microtubule formation
• treat gout and rheumatism

Question 14

• Infection with no pus (clear weepy fluid)
• very high circulating neutrophils (trapped can’t get out)

Answer 14

Leukocyte adhesion deficiency

Question 15

Patient has recurrent bacterial sinopulmonary infection (ear and sinus infection, bronchitis)

Answer 15

B cell pathology

Question 16

• 5 year old boy history of ear infections and diffuse bronchiectasis (scarring)
• labs: normal T cells, low B cells, low IgG, low IgM, low IgA

Answer 16

• X Linked Agammaglobulinemia
• BTK gene mutation, block B cell development

Question 17

8 year old boy with chronic cough and bronchoscopy show pneumocystis jirovecii

labs: normal T and Bcell count, low IgG, high IgM, low IgA

Answer 17

X linked hyper IgM syndrome (CD40 ligand deficiency)

Question 18

• 17 year old female with recurrent sinusitis 2-3 sinus infections per year for 3 years, 2 bacterial pneumonias last 3 years. Has chronic cough and exercise intolerance. Feels tired all the time.
• CXR show ground glass appearance in R lower lobe. Enlarged lymph nodes mediastinum
• normal T cell count, low B cell, low IgG, normal IgM, low IgA, low vaccine response

Answer 18

Common variable immunodeficiency

Question 19

• 7 month old boy episodic Otis media since 2 months, failure to thrive, now worsening respiratory status
• CXR patchy infiltrates
• Lab:lymphopneia, low T cell, normal B cell, low NK, Iow IgG, normal IgM, low IgG

Answer 19

Severe Combined Immune Deficiency (SCID)

Question 20

• 5 month old boy with petechiae since 3 months, has thrombocytopenia (low platelets) 14000-32000, prolonged bleeding for 24 hours after circumcision, wheezing, recurrent Otis media
• Mild eczema face
• Labs: normal IgG, IgM and IgA

Answer 20

Wiskott-Aldrich Syndrome

Question 21

Inflammatory cytokines

Answer 21

TNF-alpha, IL-1, IL-6

Question 22

Cytokine growth factors

Answer 22

• T cell: IL-2 and IL-7
• B cell: IL-4 and IL-5
• NK cells: IL-15
• Neutrophils: G-CSF
• Macrophages: GM-CSF
• erythocytes

Question 23

What immune system defect can cause virus infections?

Answer 23

Tydpe 1 interferons (IFN-alpha, beta), and type II interferon (IFN-gamma), they generate in response to viral infection

Question 24

What defect in immune system would cause myobacteria infections?

Answer 24

IL-12, and interferon gamma

Question 25

Recurrent candida infections on skin caused by defect in what immune cytokines?

Answer 25

IL-17, Th17, and IL -23