Immuno Flashcards

1
Q

Leukocytosis

A

an increase in the number of white cells in the blood, especially during an infection.

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2
Q

Left shift

A

immature white blood cells present such as bands, metamyelocytes, myelocytes, promyelocytes, and blasts

Usually band neutrophils

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3
Q

Lymphangitis

A

inflammation of lymphatic channels due to infectious or noninfectious causes

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4
Q

Lymphadenopathy

A

Swollen lymph nodes

Immune system glands that usually enlarge in response to a bacterial or viral infection, but sudden swelling of many lymph nodes may indicate cancer

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5
Q

Cytokines

A

Soluble mediators of immune response secreted by various cells and affect the activity of other cells (paracrone) or the secreting cell (autocrine)

Aids in communication between cells

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6
Q

Growth factors or CSF

A

Exogenous substances that stimulate hematopoietic precursors, uses recombinant DNA

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7
Q

Autoimmunity definition

A

Disturbance in immunologic tolerance with response to auto-antigens

IS of host usually often ignores autoantigens

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8
Q

Alloimmunity definition

A

IS of host mounts an IR to tissue of another individual

Ex: SOT or transfusion reactions

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9
Q

Drugs associated with allergic like reactions

A

Beta lactam antimicrobial agent (-cillin)
Aspirin
NSAIDs
Cancer chemo drugs
Biologics
Pharmaceutical additives (azo dyes, sulfites, parabens)
Sulfonaminde drugs (-azole)

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10
Q

Anaphylaxis criteria (1 of 3)

A
  1. Acute onset of symptoms in with involvement of skin and/or mucosa (generalized hives, flushing/pruritus, swollen tounge, lips, uvula and respiratory compromise dyspnea, strider, wheeze, bronchospams OR reduced BP or end organ dysfunction)
  2. Two or more: involvement of skin and/OR mucosa, respiratory compromise, reduced blood pressure, persistent GI symptoms
  3. Reduced BP after allergen exposure
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11
Q

Drugs that cause Serum Sickness

A

Animal Serums.
Bee venom injections.
Cefaclor.
Ciprofloxacin.
Insulin.
Iron Dextran.
IVIG.
Mab.
Penicillins.
Sulfonamides.

CRAP BC IM In School

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12
Q

Pharmacological causes of SJS

A

Co-trimoxazole, sulfasalazine (Sulfa drugs)
Ampicillin, amoxicillin, fluoroquinolones, cephalosporins (other abx)
Phenytoin, carbamazepine, phenobarbital, valproate, lamotrigene (anti-epileptics)
Periodically, allopurinol

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13
Q

CNI Metabolic Enzymes

A

CYP3A4 and PgP

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14
Q

CNI - Inhibition of CYP3A4 and PgP

A
  1. Calcium Channel Blockers: Diltiazem, Verapamil, Nicardipine
  2. Anti fungal: Itraconazole, Posaconazole, Ketoconazole, fluconazole, voriconazole
  3. Antibiotics: Clarithromycin, Erythromycin, Quinupristin
  4. Protease Inhibitors: Indinavir, ritonavir, nelfinavir, boceprevir
  5. Gastric acid Suppressors: Lansoprazole, omeprazole, cimetidine, magnesium and Al hydroxide antacids
  6. Grapefruit juice

RESULTS IN AUC INC AND TR INC

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15
Q

CNI - Induction of CYP3A4 and PgP

A
  1. Antibiotics: Nafcillin, Rifampin, Rifabutin
  2. Anti fungal: Caspofungin, terbinafine
  3. Anticonvulsants: Carbamazepine, oxcarbazepine, phenobarbital, phenytoin
  4. HERBALS: St Johns Wart, Echinacea
  5. Others: Octreotide, Ticlopidine, Bosentan, Orlistat

INC METABOLISM, DEC AUC AND DEC TROUGH

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16
Q

MPA DDI (Reducing AUC)

A

Mostly impact on Enterohepatic Circulation (EHC)
1. CYA inhibits MRP2 transporter — reducing EHC and AUC of EPA.
2. Cholestryamine & Bile Acid Resins — possible binding of MPAG
3. Antibiotics - Norfloxacin & Metronidazole, Ciprofloxacin, Augmentin, Rifampin
4. Glucocorticoids — proposed increased hepatic UGT enzymes

17
Q

MPA DDI (Increasing AUC and impact on other rx)

A
  1. TAC - minimal inhibition of MRP2
  2. Acyclovir/Ganiclovir - Increased concentration of MPAG (concern with adjusting renal function too)
  3. Co-trimoxazole - DS or SS (concern with adjusting renal function)
  4. COC - COC AUC was less, MMF has birth defects so BIG concerns. need a second barrier method
  5. Less Protein Binding of other Rx— Phenytoin, ASA. Therefore need to monitor.
18
Q

Glucocorticoid DDI - Decreased Absp

A

AUC Decreases
1. Cholestryamine
2. Antacids

19
Q

Glucocorticoid DDI - Metabolic Induction of Gluco

A

Glucocorticoid AUC DEC
1. Phenytoin
2. Phenobarbital
3. Rifampin
4. Carbamazepine
5. Ephedrine (defame the)

20
Q

Glucocorticoid DDI - Metabolic Inhibition of Gluco

A

Glucocorticoid AUC INCREASE (think ADE, HPA axis suppression)

  1. Oral Contraceptives
  2. Conjugates Estrogens
  3. Erythromycin
  4. Clarithromycin
  5. Ketoconazole
  6. Isoniazid
  7. Naproxen
  8. Cyclosporine

——- One of the ADE is hypoK——
with diuretic use or ampho B, hypoK more likely to happen
Also increased digitalis toxicity

21
Q

Glucocorticoid DDI - Metabolic Induction by Gluco

A

this causes below drugs to have lower concentrations
1. TAC
2. CYA (with Methyl Pred)
3. MPA (because of UGT enzymes)