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Flashcards in Clinical Immunology Deck (37):
1

What chromosome are the HLA class 1 genes on?

Chromosome 6

2

Name the HLA class 1 groups

HLA-A, HLA-B, HLA-C

3

Name the HLA class 2 types

HLA-DP, HLA-DQ, HLA-DR

4

How man HLA alleles are there?

Hundreds. 1 in 70 million chance of having identical match.

5

Explain direct recognition in donor rejection

Donor APCs migrate to lymph nodes where they are recognised by t- cells that are stimulated by HLA proteins on APC cell surface = ALLOREACTIVE RECIPIENT T-CELLS

6

Explain indirect recognition in donor rejection

Proteins from donor tissue that are allelicly different to recipient are processed by recipient APCs

7

Explain SPUR

Serious
Persistent
Unusual/opportunistic
Recurrent

Infections in immune deficiency

8

What is associated with antibody defects?

Bacterial infection

9

What is associated with T cell defects?

Fungi, viruses and GvHD

10

What causes GvHD?

Happens in bone marrow transplantation-caused by T cells in BM

11

What infections are associated with phagocytic defects?

Abscesses

12

What is associated with terminal complement defects?

Neisseria

13

What is associated with classical complement defects?

Bacteria

14

What is an example of an antibody deficiency?

Agammaglobulinaemia/ brutans syndrome. Due to a mutation in a tyrosine kinase essential for B cell formation

15

What happens b-cells if yo lack tyrosine kinase?

B cells can't be generated from immature B cells in bone marrow

16

What happens if you have an IgA deficiency?

Susceptible to infections

17

What causes hyper IgM?

Can't undergo class switching. May lack cd40 expression of B cells that allows it to interact with t helper cells

18

What causes secondary antibody deficiencies?

Lymphoproliferative disease- leukaemias. Malnutrition

19

What causes transient hypogammaglobinaemia in infancy?

Transplacental transfer takes place in last 3 months of pregnancy- if baby is immature may lack IgG

20

What is the effect of di George syndrome/thymic hypoplasia?

Genetic defects that cause developmental defects of 3rd and 4th pharyngeal arches

21

What is the effect of di George on the parathyroids?

Hypocalcaemia

22

What is the effect of di George on the great vessels?

Congenital heart disease

23

What is the effect of di George on the thymus?

T cell deficiency - fungal, viral infections, graft vs host

24

What is the HIV target?

Infects helper T cells by binding to cd4 molecules

25

What is seroconversion illness?

10-15% of patients infected with hiv. Body produces antibodies to virus.

26

How is AIDS defined

By Th appearance of opportunistic infections

27

How many HIV viruses are there?

Two. Hiv-1 and his-2

28

AIDS is defined as a cd4 t Cell count of what?

Less than 200 microlitres

29

How does HIV escape detection?

Original detected by cytotoxic T cells but virus creates subtypes as it replicates so it escapes detection- as t helper cells are killed off- no adaptive immunity

30

What does HART stand for?

Highly active retroviral therapys

31

What is multiple kaposi's sarcoma?

Cancer caused by herpes virus found in AIDS

32

What is severe combined immune deficiency? (SCID)

Inherited stem cell deficiency- lack of function in t and B cells

33

What is kostnanns syndrome?

Primary disorder of neutrophils. Reduced production

34

What is leucocyte adhesion deficiency?

Defect in production of integrins required for neutrophils to stick to blood vessels to get to infected tissues

35

Chronic granulomatous disease?

Primary disorder of neutrophils- can't kill microbes- can't generate reactive oxygen species required for killing bacteria)

36

What do defects in c1q, c2 or c4 cause?

Immune complex disease. Complement complexes can't be cleared from spleen or liver - damages tissue eg kidney

37

What are iatrogenic causes of secondary immune deficiency?

Immunosuppressive treatment. Removal of lymphoid tissue