Flashcards in Allergy/immunology Deck (73):
Resolution food allergy
Cows milk 85% by 8
Venom allergic reaction risk next event anaphylactic
Last 6-12h and in 0.3%
Percent of infants with food allergy
Anaphylaxis to egg and influenza vaccine
Do in hospital with 1/10th of dose
Adrenaline for anaphylaxis
1;1,000 / 0.3-0.5mg
Primary immunodeficiency presenting with recurrent sinopulm infections
CVID, XLA, transient hypogammaglobulinemia of infancy, complement def
Tx with ivig 4 weekly or subcutaneous ig weekly (300-600mg/kg/month) aim for igG 7-8g/L (doesn't correct igA def)
XL hypogammaglobulinaemia caused by
Present at 6-8m when maternal levels fall
Bruton kinase def with absent B cells and low immunoglobulins (all)
No LN (lymphoid hypoplasia)
Poor response to vaccine
Low IgG and decrease in IgA or IgM
Poor antibody response to vaccine
Broad infections, FTT, persistent diarrhoea, by 3m, no thymic shadow on cxr, total lymphocytes < 2.5
Fatal by 1 year
T and B cell failure
1/50,000 (45% XL)
XL hyper IgM syndrome presentation
40% pneumocystis jiroveci, cryptosporidium
T cell defect
CD40 ligand is the affected protein (can't class switch)
With BMT 70% survival
CGD signs and treatment
Defect in NADPH dep oxidase pathway
Adenopathy, HSM, gingivitis, stomitis, abscess, diarrhoea, colitis
Raised Igs (Kell sratis in XL)
Catalase positive organisms
Dx: nitroblue tetrazolium test
Tx: Cotrimox and itraconazole prophylaxis
Leukocyte adhesion def 1 presentation
Most common with <1% normal expression CD18, delay cord, high leuks (WCC over 15)
Severe necrotising bacterial infections
Half life 60 microsecond, opsonisation, solubilises immune complexes, enhances killing via MAC, potential humoral response
Which cytokines causes T cell proliferation
Digeorge Tx for immunodeficiency
BMT, thymic transplant curative
Selective IgA def clinically
Occ Resp and Gi infections
Anaphylaxis to blood products cos contain IgA
Assoc autoimmune disorders
IL-1 - 6 rolls
Hot T-bone sTEAk
IL-1 HOT (fever)made by macrophages causes fever, lymphocyte proliferation
IL-2 stimulates T cells (secreted by T)
IL-3 stimulatess bone marrow (secreted by T)
IL-4 induces Th2 and stimulates IgE production
IL-5 stimulates IgA production (proliferates eosinophils) Th2
IL-6 regulates CRP
Half life neutrophils
Symptoms of langerhans cell histocytosis
Common symptoms of LCH in children are recurrent rash, diabetes insipidus (24%) and
bone lesions (lytic usually scalp)
SCID specific tests
Lymphocyte phenotype (i.e. numbers of T cells/subsets, B cells)
Lymphocyte proliferation responses (i.e. lymphocyte function)
Which IL causes T cell proliferation
Milk and egg allergy percent tolerate it baked
Will next allergic reaction be worse
It's a myth
Cow’s milk resolution age and percent
85% by age 8
Serum sickness reaction is a type 1-4?
Type III hypersensitivity reaction (immune complex mediated)
Also retaliated to autoimmune conditions
Steven johnsons syndrome and chronic renal transplant rejection are what type of hypersensitivity reaction
Type IV delayed type when sensitised Th1 cells activat and release cytokines and bind causing increase in macrophages and cytotoxic T cells
Type 1 and 2 hypersensitivity reactions are? Which illnesses
1: immediate IgE in anaphylaxis or hay fever
2: antibody mediated in haemolytic anaemia of newborn or graves
Double row of teeth with what syndrome
Hyper IgE triad
Abscesses, increased IgE and pneumatocoele pneumonia
Immune cell important in transplant rejection
T cell (t for transplant)
If brother allergic to peanuts sibling risk
Anaphylaxis to penicillin risk with cephalosporins
<5% (likely less than 1%)
Serum sickness triad (eg adter thymoglobulin)
Migratory poly arthritis (joints)
Half life of serum IgM
Cows milk allergy 80% outgrow by
Milk too allergen then egg second
IgE receptors mostly on
(Th2 cell sends IL3/4/5/9 to mast and eosinophils
What cell produced antibodies
T cell CD4 (MHC II) and CD8 (MHC I)
Mutation in NBN
Microcephalic immune def and increased cancer risk in
Nijmegen breakage syndrome
Eye telegectasia and ataxia and risk infection
Test and dx?
Which of the following immunoglobulins fix complement when they bind to antigen?
A. Only IgG.
B. IgG and IgA.
C. IgG, IgA and IgM.
D. IgG and IgM.
E. Only IgM.
acts as a growth and differentiation factor for both B cells and eosinophils
Interleukin 1 (IL-1) is primarily produced by
CVID risk of what infections
Encapsulated bacteria such as S pneumoniae, S pyogenes, and H influenzae are the most common pathogens.
Moderate reaction to bee likelihood of anaphylaxis next time
30-60% if previous anaphylaxis
Food allergy afftcys what percent NZ infants
10% (5% overall)
Present with recurrent sinopulmonary infections DDx
A type 2 helper T lymphocyte (Th2 cell) differs most from a type 1 helper T lymphocyte (Th1 cell) in which one
of the following?
A. Production of interleukin 3 (IL-3).
B. Production of interleukin 5 (IL-5).
C. Responsiveness to antigen presented by macrophages.
D. Surface expression of CD4.
E. Surface expression of major histocompatibility complex (MHC) class II molecules.
All IL starting with T and F secreted by T cells (Th1 secretes IFN gamma)
Which one of the following major immunoglobulin classes in the human fixes the alternate complement
FcER1 receptor is on what cell
Mast cell derived from CD4 haematopoetic progenitor cell
CGD catalase positive organisms are
CGD Catalase-positive organisms: PLACESS for CATs
Pseudomonas, Listeria, Aspergillus, Candida, E-coli, S. aureus, Serratia
Interferon one and two and TNF alpha
Type I (alpha and beta):
o Antiviral agents mainly produced by fibroblasts and
monocytes. Inhibit viral RNA and DNA production,
increase expression of MHC1 leading to enhanced lysis
by cytotoxic T lymphocytes.
o Antiproliferative function.
Type II (gamma):
o Gamma interferon activates macrophage and
neutrophil intracellular killing, stimulates NK cells and
enhances T cell responses by increasing MHCII
TNFAlpha: increases phagocyte funct
What cell in terminal centres predominate
Half life igG
What is in a mast cell graunule
histamine, various cytokines (such as tumour necrosis factor (TNF), IL-4) and mast cell-specific proteases (such as chymases, tryptases and carboxypeptidase A3 (CPA3) chondroitin, heparin
Measles exposure (5 days prior and after onset rash) prophylaxis for 1 year old? Pregnant woman?
Can consider MMR in infant over 6m but need a second booster 4 weeks laster
immunocompromised or immune-deficient people
susceptible pregnant women
immune-competent infants aged under 6 months where there is no evidence of maternal immunity (presence of maternal antibody, or documentation of two MMR doses or previous history of measles infection) immune-competent children aged between 6 and 15 months, who are outside the 72-hour exposure window for MMR vaccine.
Half life IgA IgM and IgE
5-7 days M and A
IgE 3 days
Complement for chemotaxsis
What protects complement cascade from inactivation
Initially all immature T cells (CD3) become CD4 or 8 what do these both do?
CD 4 are T helper cells which bind to MHC2 on APC and activate B cells to make immunoglobulins, activate macrophages
CD8 cells are NK cells and bind MHC1-Ag and kill viral infected and tumour cells
Half life neutrophils
Complement pathway how does it work? What does a and b do
Usual cascade if known antigen
C3 randomly splits on own if unknown antigen
Then C5 joins C6,7,8,9 to form MAC (membrane attack complex)
A parts signal allergy like response and b parts bind proteins
HPV and Hep B what type of vaccine?
HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58.
Pneumococcus vaccine type
Dihydrorhodamine (DHR) flow cytometric analysis is used to evaluate
granulocyte oxidative bursts and is the test of choice for the diagnosis of chronic granulomatous disease (CGD)
12-24 month old with low albumin, protein losing enteropathy and microcytic anaemia possible cause?
Cow milk protein induced
IL 7-18 rolls?
Maturation is Key at 21st for All Party Games
IL-7: maturation from marrow
IL-8: chemotaxsis neutrophils
IL-10: decrease IL-2
IL-12: make Th1
IL-17: pro inflammatory
IL-18: IFgamna production
Name the antigen or sending cells with MHC class two molecules?
SCID screening from
No detected TREC T cell receptor excision circle
STAT3 mutation in
FoxP3 affected in
Adult range IgA IgG complements and IgM
IgM and complement 12m