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Flashcards in IMMUNO Deck (747):
1

What are the major criteria for the API

parental asthma, sensitization of aeroallergen, Dr dx of AD

2

What are the minor criteria for the API

food sensitization, >4% Eos, wheezing apart from colds

3

What is considered a positive API

one major OR two minor criteria

4

Chemokines important in AD

- CTACK aka CCL27 (cutaneous T-lymphocyte attracting chemokine)
- TARC (thymus and activation-regulated chemokine)

5

What does TSLP stand for?

TSLP: Thymic Stromal Lymphopoeitin

6

Which cells contain Birbeck Granules

Langerhans cells

7

Prolamin superfamily types of foods and proteins

seed storage proteins, lipid transfer protein, alpha-amylase/protein inhibitors

8

Cupin superfamily (may only give numbers)

7s vicillin and 11s globulins (7/11!)

9

PR10 protein family

Bet v 1, birch

10

Atopy leads to increased risk for which agents anayphlayxis?

My EX RADdy was a LATE IDIOt
- Exercise induced anaphylaxis
- Radiocontrast
- Latex
- Idiopathic anaphylaxis

11

Which agent does pre-treatment not help in anaphylaxis risk?

Latex

12

Which agents does pre-treatment HELP in anaphylaxis risk?

radiocontrast, cold and flueorescien-related anaphylaxis

13

Farmer's lung

thermophilic actinomyteces (sacchropolyspora rectivirgula, thermoactinomyces vulgaris); Mycopolyspora - moldy hay, grain, compost

14

Bagassosis bacteria and what is the agent it's found in?

Thermoactinomyceses sacchari; moldy sugar cane
- Think of a bag and a SACK (sach) of moldy sugar cane

15

Humidifier fever/AC lung

Thermoactinomyces (T. Vulgarin, T. sacchiri, T candidus); Klebsiella, Acanthamoeba
- KAT loves the humid AC

16

Hot tub lung

Mycobacterium avian complex (MAC) or Cladosporium - from contaminated water
"Mac clad into the Hot tub"

17

Basement shower lung

Epicoccum nigrum; mold growing in unventilated showers

18

Malt worker's lung

aspergillus species
- exposure can be malt, tobacco, soy

19

Cheese worker's lung

Penicillium casei - exposure to moldy cheese

20

Machine operators lung

Pseudomonas, Acinetobacter, Mycobacter
-PAM operates MY PSEUDO ACting

21

Bird fancier's lung, pigeon breeder's lung

Avian proteins - exposure to droppings, feathers, serum

22

Detergent worker's lung

Bacillus subtilis
- also seen in egg worker

23

Woodworker's lung

Alternaria - moldy wood dust

24

Winegrower's lung

Botrytis cinerea - mold on grapes

25

Summer type HP

Trichosporium cutaneum - contaminated houses, common in Japan

26

El niño lung

Pezizia - exposure to mushroom fungus after heavy rainfall
- let's eat pizza during el Nino

27

Saxophonist lung

Candida albicans
- Think Bill Clinton has a yeast infection

28

Wheat weevil lung/miller's lung

Sitophilus - contaminated flour
- think sito --> silo, wheat in silo

29

Chemical worker's lung

TDI (toluene diisocyanate), MDI (diphenylmethane diisocyanate)

30

Epoxy Resin worker's lung

Phthalic Acid

31

Plastic Worker's lung

Trimelittic anhydride

32

Cocamidopropyl betaine

in shampoos, facial cleaners and bath products; one of the MCC contact sensitivity

33

Paraphenylenediame is related to which occupation?

MCC cause of contact HSN in hair dressers

34

Glycerol thioglycolate

Permanent wave solution; one of the MCC contact sensitivity
- does not become less allergenic with washing hair out

35

Ethylenediamine dihydrochloride
What to avoid if sensitive

in topical creams; need to avoid nystatin, aminophylline, and piperazine antihistamines (meclizine and cyclizine)
- does NOT cross react with EDTA: ethylenediamine dihydrochloride

36

Allergen in Henna

paraphenylenediamine (same as hair dresser contact derm)

37

Only long term/prophylaxis medication for HAE?

Cinryze: plasma derived C1-INH
(I can see the CINRYZE (sunrise) in the long run"

38

Which HAE medication has a risk for anaphylaxis:

Kalbitor (kallikrien inhibitor ecallantide) - "Kalli has anaphylaxis"

39

Live Vaccines Mnemonic

ROME Is MY Very Best Place to go AlwayS
Rubella/Rotavirus
Oral Polio
Measles
Endemic Typhus
Mumps
Yellow Fever
Varicella Zoster (chickenpox) and Herpes Zoster(shingles)
BCG
Plague (Yersinia Pestis)
Adenovirus
Shingles

40

Which two sinuses have the most complications in sinusitis?

sphenoid, frontal
"My Sweet Friend is complicated"

41

Which sinuses are most likely to have polyps?

Ethmoid sinuses
- "PolEEps"

42

Which allergen is CRS w polyps more likely to be sensitive to?

DM

43

Kabuki syndrome: mutation and seen in which disease?

A type of CVID - KMT2D mutation

44

WHIM syndrome mutation

CXCR4 mutation AD - GOF

45

Where do neutrophil precursors arrest in severe congenital neutropenia

promyelocyte-myelocyte phase

46

Molecular defect for SCN1

ELANE defect - AD

47

Molecular defect for SCN2

GFII

48

Molecular defect for SCN3

HAX1

49

Molecular defect for SCN4

G6PC3

50

Molecular defect for SCN5

VPS45

51

Which 2 micro bugs is CGD NOT associated with?

Streptococcus PNA, Pneumocystis (PJP) infections

52

Which infectious bugs is CGD associated with? MUST KNOW ALL; also which type of infections? Mnemonic

CATALASE POSITIVE; S3CNAB Philly Franc G
- staph aureus
- serratia marcescens
- salmonella
- chromobacter violaceum
- nocardia spp
- aspergillus fumigatus; aspergillus nidulans
- burkholderia cepacia
- Philomegaria Fransicella
- Granulibacter Bethesdensis

53

CCL5 : aka / receptor

CCL5 aka RANTES -- receptor CCR 1, 3, 5

54

CCL11: aka / receptor

CCL11 aka Eotaxin -- receptor CCR3

55

CCL17: aka / receptor

CCL17 aka TARC-- receptor CCR4
(1+7 = 8 / 2 = 4)

56

CXCL8: aka / receptor

CXCL8 aka IL8 -- receptor CXCR1, 2

57

Spina bifida antigens for latex

Hev b1, Hev b 3

58

Where does latex allergen come from?

Cytoplasmic exudate of the hevea brasiliensis tree, Hev b 1-13

59

Hev b 2 assoc food?

Bell pepper, olive

60

Hev b 5 assoc food?

kiwi, potato, sugar beet
5kpb

61

Hev b 6 assoc food?

banana, avocado, chestnut, sweet pepper

62

Hev b 7 assoc food?

Hev b 7 = "patatin like proteins"; potato and tomato

63

Hev b 13 assoc food?

Potato

64

MCC of biting insect systemic run?

Triatoma - painless bite

65

What do Asain Lady Beetle cross react with?

Asian lady beetle (Harmonia Axydris) - cross reactive with cockroach

66

Order of sinus development? Mnemonic

My Extremely Sweet Friend: Maxillary, Ethmoid, Sphenoid, Frontal

67

Sinus drainage - Mnemonic?

FM AM, PS SS
Frontal, Maxillary, Ant Ethmoid - Middle meatus
Post Ethmoids, Sphenoid - Sphenoethmoid recess=above Superior turbinate

68

What does the middle meatus open into?

Hiatus Semilunaris

69

Which mutation is seen in Myeloproliferative HES?

PDGFRB, FGFR1 rearrangements; Deletion of 4q12 --> FIP1L1-PDGFRA fusion

70

What is the mutation and inheritance in familial HES?

5q 31-33 , AD

71

Well's syndrome is...

eosinophilic cellulitis

72

How do you treat myeloproliferative HES?

Imatinib: tyrosine kinase inhibitor

73

What is the ligand for CD117? (what is CD117 aka?)

CD117 aka C-kit - ligand is stem cell factor, which is also required for mast cell survival

74

What CD markers are mast cells in mastocytosis identified with?

+ CD2 AND/OR +CD25, +CD117

75

What is the spirochetal infection causing Lyme disease?

Borrelia burgdorferi

76

What tick does Borrelia burgdorferi infect?

Ixodes ricinus

77

Rx for Lyme?

Doxy, cefuroxime, amoxicillin (>8 years old)

78

Human Monocyte Ehrlichiosis infectious cause?

Ehrlichiosis chaffeensis

79

Principle vector tick for Ehrlichiosis is?

Amblyomma americanum

80

Treatment for Ehrlichiosis?

Tetracycline and chlroamphenicol

81

Human Granulocyte Anaplasmosis infectious agent?

Anaplasma phagocytophilum is infectious agent

82

Human Granulocyte Anaplasmosis vector?

Ixodes scapularis is Human Granulocyte Anaplasmosis vector

83

Infectious agent causing babesiosis?

Babesia microti

84

Babesiosis vector?

Ixodes scapularis

85

Babesiosis symptoms/lab findings

Babesiosis: fatigue, fever; hematologic and liver Abn

86

Is p-anca or c-anca more specific in Wegener's (granulomatosis w polyangiitis)?

C-ANCA/PR3 (proteinase 3)

DONT CONFUSE WITH EGPA

87

Which vaccines are considered protein vaccines?

Tetanus and Diphtheria (T cell dependent)

88

Which vaccines are considered polysaccharide vaccines?

Meningococcal and Pneumococcal (Pneumovax); T cell independent

89

Which type of Ag do NKT and gamma/delta T cells respond to?

Lipid antigens

90

The meningococcal and pneumococcal vaccines are considered what type of vaccines?

Polysaccharide; conjugated

91

What are the cytokines of MHC1

IFN alpha, beta, gamma

92

What are the cytokines of MHC2

IFNgamma

93

Which components are part of the MHC1 processing pathway?

proteasome, TAP

94

Calnexin, Calreticulin, Erp57, and tapasin are "chaperone proteins" in which MHC pathway?

MHC1

95

Where on chromosome 6 are TAP proteins encoded?

Class 2 locus

96

Where on chromosome 6 are LMPs from the proteasome encoded?

Class 2 locus

97

What are components of the MHC2 processing pathway?

cathepsins, Ii (invariant chain), CLIP (class 2 invariant chain peptide), HLA-DM

98

What molecule removes CLIP for peptides to bind MHC2?

HLA-DM removed CLIP

99

MHC2 def: what factors is usually deficient?

transcription factors for MHC2: MHC2TA, RFX5, FRXAP, FRXANK

100

Types of infections in MHC class 1 def?

sinopulmonary, granulomatous skin lesions, necrobiosis lipoidica

101

Types of infections in MHC class 2 def?

diarrhea, hepatosplenomegaly, transaminitis, sclerosis cholangitis (Crypto); pulm infxn: PJP, encapsulated bacteria, herpes, RSV; meningitis

102

Treatment of MHC1 vs MHC 2?

MHC2: HSCT; MHC1: aggressive infection Rx

103

What is the inheritance of MHC 1+2?

AR

104

What 2 factors determine lymphocyte tolerance?

Antigen concentration and Antigen affinity determine tolerance; high [ ] and affinity promote negative selection

105

What markers do Tregs express?

Tregs: CD4, CD25, FOXP3

106

What is the other name for CD25?

IL2Ra chain

107

What 3 cytokines do Tregs depend on?

IL2, TGFB;
IL10 helps maintain tolerance

108

Which cytokines are released in super antigen stimulation?

IFNg and TNFa

109

What kind of cells express AIRE?

AIRE is expressed by thymus medullary epithelial cells

110

BAFF

TNF family member, signal for B cell homeostasis

111

What enzyme is class switching mediated by?

Class switching is mediated by AID instead of RAG

112

How much Ig does the adult human produce in 1 day?

2-3 grams of Ig per day

113

Which Ig fixes complement the best?

IgM fixes complement the best

114

Which Ig has the highest total body concentration?

IgA

115

Which Ig has the most daily production?

IgA

116

Best Ig for ADCC?

IgG1

117

IgG subtype with shortest half life?

IgG3

118

IgA1 vs IgA2 in location?

IgA1: serum and respiratory tract
IgAs: lower GI tract

119

Ig with shortest half life?

IgE: 2 days

120

Class switch recombination changes which region: V vc C?

Class switch changes C region

121

Somatic hypermutation changes which region: V or C?

Somatic hypermutation changes the V region

122

What kind of T cells does IL2 stimulate?

Antigen activated T cells; and Treg

123

Which chromosome is C1-INH on?

Chromosome 11 - SERPING1 gene

124

Molecular mimicry: Coxsackie B virus

Glutamic decarboxylase

125

Molecular mimicry: Hep B virus

Major Basic Protein

126

Molecular mimicry: HSV

Ach receptor

127

What are the 5 types of PRR?

LRR, RLR, Ddx, Pyphin, CLR

128

What does TIR stand for?

Toll IL-1R domain (on LRR)

129

Which TLR is triggered by influenza?

TLR10

130

Which TLR is triggered by flagellin?

TLR5 = flaggelin

131

Which TLRs are associated with Heat Shock proteins?

TLR 2, 4, 6 (all extracellular)

132

Which is the TLR that does not use IRAK4?

TLR3 does not use IRAK4/IRAK1/IRAK2

133

What is the next step after MyD88 stimulation in the pathway?

MyD88 --> IRAK4/2/1 --> TRAF6 --> NEMO --> NFkB

134

Which TLR is associated with CD14?

TLR 4 is associated with CD14 (there is a #4 in both)

135

Which NLR is associated with Crohn's disease?

NOD2 is mutated in Crohn's disease
- also the mutation in Blau's syndrome

136

What does STING stand for?

STING: Stimulator of INF Genes protein; abn in SAVI

137

What does NALP stand for?

Nacht domain leucine-rich repeat and PYD containing proteins

138

What does RLR stand for?

RNA-sensing RIG-I-like receptors

139

What does SAVI stand for?

SAVI: STING-associated vasculopathy with onset in infancy

140

What kind of mutation leads to SAVI?

GOF mutations of STING leads to SAVI

141

What is the function of Dectin 1/2?

Dectin 1/2 is a CLR receptor: recognize the fungal cell wall B glucan to facilitate mold allergen uptake

142

What is the function of DC sign?

DC sign is a CLR receptor: receptor to facilitate entry for Ara h 1 / Der p 1/2

143

What is the function of mannose receptor?

Mannose receptor is a CLR receptor: recognizes candida; allows for entry of Ara h 1 / Der p 1/2

144

What happens when there is a breakdown CLR anti-candida pattern?

Chronic non-invasive candidate infections

145

What is the difference bw Dectin 1 and CARD9 mutation?

Dectin 1: strictly mucocutaneous
CARD9: some invasive infection, dermatophytes

146

What cells are CD3- and CD56 +

NK cells

147

Which cytokine do NK cells require for DEVELOPMENT?

NK cells require IL-15, EOMES

148

Which HLA is prominent in gestational trophoblasts?

HLA-G (babies say gaga)
- HLA-G and F are present on extravillous trophoblast to protect fetus from maternal immune rejection

149

Which lymphocyte is most prevalent in pregnant decidua

The NK cell

150

Which chromosome is KIR inherited on?

Chromosome 19

151

Which chromosome is MHC inherited on?

Chromosome 6 (order: Class II, III, I ; 2, 3, 1)

152

What are the transcription factors needed for ALL ILCs?

NIFL3, TOX, Id2 (NIFty TOXic IDeas)

153

What infections are TLR3 deficiency more prone to?

TLR3 def: HSV encephalitis; influenza cerebritis (CNS inflammation, decrease in IFN-lambda production)

154

What is the inheritance of TLR3 def?

AD

155

What is deficient in production in TLR3 def?

INF alpha, beta, lambda

156

UNC93B def inheritance?

AR

157

UNC93B infections?

HSV encephalitis

158

TRIF/TRAF3/TBK1/IRF3 def infections?

HSV encephalitis

159

What does Dectin1/2 induce in CMCC?

Induces Syk/CARD9

160

Which diseases present with Oculocutaneous albinism?

Oculocutaenous albinism: Chediak Higashi, Griscelli syndrome, Hermansky Pudlak

161

How to differentiate Chediak Higashi, Griscelli syndrome, Hermansky Pudlak ?

BLEEDING in Hermansky Pudlok because of platelet granule defect

162

CNKD1 mutation and inheritance?

GATA2 - AD

163

CNKD2 mutation and inheritance?

MCM4 (mini chromosome maintenance complex 4)- AR

164

FNKD1 mutation and inheritance; which cytokine?

FCGR3A (CD16) - AR

165

What is missing in GATA2 def? CD 56 dim or CD56 bright?

CD56 bright are missing from GATA2 def (CNKCD1)

166

What kind of killing is affected in FNKC def?

ADCC intact; spontaneous cytotoxicity decreased; EBV cells not killed

167

What are the Src family kinases?

lyn, lck, fyn

168

What are the Syk family kinases?

Syk, ZAP-70

169

What are the Btk family kinases?

Btk, Itk

170

What are the inhibitory phosphatases of ITIM?

SHP-1, SHP-2, SHIP

171

Generation of which molecule leads to the intracellular increase in Ca in the TCR pathway?

Generation of IP3 (Which is generated after PIP2 is hydrolyzed by PLCg and produces IP3 and DAG)

172

IL-12RB1 mutation leads to which type of infections?

IL-12RB1 def leads to salmonella and atypical mycobacteria

173

What kind of infections does IRAK4 def lead to ?

IRAK4 def: pyogenic infections: Strep pneumo

174

Castleman's disease: hyper production of what and what symptoms?

Castleman's disease: Hyper IL6 productions: fever, microcytic anemia, normal BM, hypo albumin, elevated CRP

175

What type of cell does IL2 promote and in which function?

IL2 promotes survival and function of Treg cells

176

IL5, what does it promote (cell and Ig)?

IL5 promotes eosinophils and production of IgA Ab

177

Which two cytokines promote IgE class switching?

IL4 and IL13

178

Which cytokines promotes mucus formation?

IL13

179

How does BAFF work?

Upregulates Bcl2 which is an anti-apoptotic protein

180

How does APRIL work?

Upregulates Bcl2 which is an anti-apoptotic protein

181

What is the basophil differentiating cytokine?

IL3 --> basophils

182

What is the other name for CD23 and what does it bind to?

CD23 (FceRII) binds to IgE AND B cells

183

What does the basophil activation test evaluate?

Basophil activation: evaluates for CD63 or CD203c

184

What is the tryptase measurement calculation?

>/=1.2x baseline tryptase + 2 microgram/mL
- proposed to assess for mast cell activation event

185

How to test for NK cell cytotoxicity?

Chromium release assay (Cr51); check for CD107a

186

Deficiency of what part of the complement system leads to recurrent encapsulated infections and autoimmunity?

Defects in early complement C1q, C2, C4, C3 --> encapsulated bacteria and autoimmunity

187

Deficiency of what part of the complement system leads to recurrent meningococcal infections?

Defects in terminal complement C5-C9 --> meningococcal infections

188

Which part of the IL2R makes it high affinity?

IL2Ra

189

What IL receptors is gamma chain (gc) a part of?

gc = IL2, IL4, IL7, IL9, IL15, IL21

190

What two components are part of the IL13R?

IL4Ra and IL13R

191

What two components are part of the TSLPR?

IL7Ra and TSLPR

192

IL-18 aka? Which IL is is similar to?

IL18 aka IFN-g inducing factor ; most similar to IL1b

193

Which adhesion marker does IL18 induce?

ICAM1

194

What diseases have elevated IL6?

Castleman's dz; Atrial myxoma; MM; RA, JIA

195

IFNg deficiency inheritance and results in susceptibility to which types of infections?

- AD STAT 1 deficiency
M. tb and other intracellular bacteria

196

What receptor does dupilumab act?

IL4Ra which is on IL4 and IL13

197

What are the chemokines for lymphocyte homing to LN?

CCL19/CCL21 --> CCR7

198

What are the chemokines for pro Th2 response?

CCL17/CCL22 --> CCR4 (seen more on Th2 cells)

199

What is the function of E selectin?

E selectin: on the endothelium; homing of T lymphocytes to peripheral sites of inflammation; E = extremity (far away/peripheral)

200

What is the function of L selectin?

L selectin; on Lymphocytes and Leukocytes; GLYCAM - to LN HEV; and MadCAM to PMN rolling

201

What is the importance of B integrin family a4b7?

Binds to MADCAM - important for gut homing

202

ICAM1 CD name

ICAM1 = CD54 (think 5=4 = 9, which is almost 10)

203

ICAM2 CD name

ICAM2 = CD102 (has a 2 in the name)

204

ICAM3 CD name

ICAM3 = CD 50 (3 and 5 both prime numbers)

205

ICAM4 CD name

ICAM4 = CD242 (242 has 4 and 4 is a multiple of 2)

206

What does ICAM1 bind?

LFA1, MAC1, rhinovirus

207

What does ICAM2 bind?

LFA1

208

What does ICAM3 bind?

LFA1 and CD18

209

What does ICAM4 bind?

LFA1 and CD18

210

What is the CD name for VCAM1?

VCAM1 = CD106

211

What does VCAM1 bind?

VCAM1 binds VLA4 - vascular

212

What does PECAM bind?

CD31 and CD38 - platelets

213

What is the CD name for PECAM?

PECAM = CD31 (which it also binds, and E looked like backwards 3)

214

What does MadCam bind?

MadCAM binds a4b7 - mucosa

215

What does NCAM bind?

Binds VLA4 (a4b1)

216

What is the CD name for NCAM?

CD56

217

What are the important chemokines in allergy?

CCL2, 5, 7, 11; CXCL8

218

What proteins inhibit the formation of MAC?

S protein and CD59

219

Which molecules are considered anaphylotoxins? Which is the most potent for basophil and mast cell degranulation?

C5a> C3a > C4a

220

What is C3a chemotactic for?

eosinophils ONLY

221

What is the CD name for CR1?

CR1 aka CD35

222

What is the CD name for CR2?

CR2 aka CD21 (#2 in both)

223

What is the other name for CR3?

CR3 aka Mac-1, CD11b/CD18

224

What is the other name for CR4?

CR4 aka gp 150/95, CD11c/CD18

225

What is the other name for CD46?

CD46 aka MCP = membrane cofactor protein

226

What is the other name for CD55?

CD55 = DAF (decay accelerating factor)

227

What is the other name for CD59?

CD59 = protectin

228

What is the ligand for CR1?

C3b, C4b, iC3b (B1)

229

What is the ligand for CR2?

C3d, iC3b, C3dg (D2)

230

What is the ligand for CR3?

iC3b and ICAM1

231

What is the ligand for CR4?

iC3b

232

What is the ligand for CD46?

C4b and capsid

233

What is the ligand for CD55?

C5b-8 and monomeric C9

234

How is properdin deficiency inherited?

X linked (all other complement def are typically AR)

235

What is the most common complement d/o seen in SLE?

C1q deficiency.

236

What is the most common AR agammaglobulinemia?

mu heavy chain

237

What is a common codominantly inherited blood disorder?

Blood typing (ABO)

238

ADA SCID T/B/NK?

ADA SCID = (T-/B-/NK-)

239

Reticular dysgenesis T/B/NK?

Reticular dysgenesis AKA AK2 (T-/B-/NK-)

240

RAG1/2 T/B/NK?

RAG1/2 T-/B-/NK+

241

Artemis T/B/NK?

Artemis T-/B-/NK+

242

Cernunnos and ligase IV: T/B/NK?

Cernunnos and ligase IV: T-/B-/NK+

243

Common gamma chain T/B/NK?

Common gamma chain: T-/B+/NK-

244

IL7Ra: T/B/NK?

IL7Ra: T-/B+/NK+

245

CD3 subunit def: T/B/NK?

CD3 subunit def: IL7Ra: T-/B+/NK+

246

Coronin 1-A def: T/B/NK?

Coronin 1-A def: T-/B+/NK+
- no thymus regress

247

CD45 tyrosine phosphatase def: T/B/NK?

CD45 tyrosine phosphatase def: T-/B+/NK+

248

What is the abn in reticular dysgenesis?

defect in mitochondrial adenylate kinase2

249

What are the Es of OmEnn syndrome?

Es: Erythroderma, Eosinophilia, Elevated IgE

250

Wiscott-Aldrich gene mutation?

WASP gene mutation - X-linked

251

At what age does alpha fetoprotein increase in Ataxia Telangiectasia?

Increased alpha fetoprotein after 6-12 months

252

CD40L deficiency inheritance?

X-linked - CD40L

253

CD40 deficiency inheritance?

Autosomal Recessive

254

NEMO deficiency inheritance?

X-linked

255

Which def one presents with neutropenia: CD40L, CD40, NEMO

CD40L

256

What are the two enzymes in B cells needed for class switching?

AID and UNG

257

XLP1 mutation?

X linked SH2D1A/SAP gene

258

XLP2 mutation?

X linked defect in XIAP gene

259

MAGT def?

XMEN: X linked immunodeficiency with mag defect

260

What is RALD and what mutation is seen?

RALD: RAS Associated Leukoproliferative Disorder: NRAS/KRAS mutation; nil DNTs

261

What is the mutation in APECED including which gene?

AIRE mutation, AR ; 21q22

262

IPEX mutation

X linked FOXP3 mutation

263

How is BTK mutation inherited?

BTK = X linked

264

How is mu heavy chain inherited?

AR - the most common of AR agammaglobulinemia

265

What are AD forms of agammaglobulinemia?

E47, AKA, E2A, TCF3

266

What is the function of BTK?

BTK phosphorylates PLCg2 - also present in monocytes and platelets and that is how you can screen for Btk bc these patients have no B cells.

267

CD27+ is on which type of cells

CD27+ are memory B cells

268

CD 27 are part of which cytokines family?

CD27 part of the TNF family of cytokines

269

CD21 aka and what is it's function?

CD21 aka CR2 which is the C3d receptor ; C3b opsonizes Ag --> C3b degraded to C3d --> C3d ligand for CD21, which is part of the BCR complex (CD21-CD19-CD81)

270

What are the ligands for TACI?

Ligands for TACI receptor on B cells are BAFF and APRIL

271

What is the function of AID?

AID - deaminated cytosine to uracil (C->U); receptor editing function

272

What is the function of UNG?

Removes Us; function in receptor editing

273

How are CD21, CD19, CD81 defects inherited?

AR

274

What class of meds can cause IgA deficiency?

IgA def: anticonvulsants: phenytoin, carbamazepine, valproic acid

275

Which IgG subclass def is assoc with IgA def?

IgG2 subclass def

276

When is the IgG nadir in children?

IgG nadir is about 3-6 months (400mg/dL)

277

What results from a Lyst mutation?

Lyst mutation: primary and secondary granules fuse - giant granules (which is Chediak Higashi)

278

Which mutations cause lack of phagocyte secondary granules and lack of defensins?

C/EBPe mutation

279

What is the Rx for CGD?

- antifungals: AZOLEs - decreased mortality
- abx: BACTRIM ppx
- INFg
- steroids

280

What is the difference in neutrophil function (rolling, tethering, etc) in LAD1 vs LAD2?

LAD1: defect in adhesion, sticking vs LAD2: defect in rolling

281

What is the cytokine that induces mast cells?

SCF

282

What are the transcription factors for basophils?

C-EBPa and GATA-2

283

What are the contents of a basophil?

histamine, IL4, IL13, TSLP

284

How are mast cells and basophils different in how they mature?

Mast cells can mature in the periphery; Basophils leave the Bone marrow mature (BB = mature)

285

Can mast cells regranulate?

Yes - mast cells can regranulate

286

Which mast cell type is deeper in the tissue versus more superficial?

Deeper: MCtc; more superficial: MCt

287

Which mast cell responds to C5a?

MCtc (Basophils also respond to C5a)

288

Which mast cell responds to PAF?

MCt

289

Which mast cell responds to opiates?

MCtc

290

Which mast cell responds to substance P?

MCtc and MCt
- early phase mediator

291

Which mast cell responds to antigen?

MCtc

292

MCtc vs MCt: respond to which triggers?

- MCtc: responds to more triggers (substance P, Ag, opiates, C5a)
- MCt: responds to PAF

293

What cell responds to f-met-leu-phe?

basophils

294

What are the two cytokines tested in basophil activating test?

CD63 and CD203c

295

What is CD63?

CD63 on basophils - protein coated on the inside of secretory granules ; histamine degranulation

296

What is CD203c?

CD203c on basophils - ectoenzyme, cleaves nucleotides outside the cell; piecemeal degranulation

297

What is CD name for IL3R? (to help ID basophils on basophil activating test)

IL3R = CD123

298

What chemical do basophils not make?

Prostaglandins

299

Does omalizumab bind free or bound IgE?

omalizumab binds free IgE

300

On which cell does omalizumab reduce IgE receptors on: mast cells of basophils?

Basophils, mast cells, DC, monocytes

301

What type of tryptase is released with anaphylaxis? *****

B tryptase is released with anaphylaxis

302

What are the dx criteria for cutaneous mastocytosis?

1 major + 1 minor; MAJOR: typical skin lesions assoc w Darier's sign. MINOR: bx shows increased mast cells OR activating KIT mutation in bx

303

True or false: Scabies can cause eosinophilia

True, scabies can cause hypereos

304

What is the CD marker for selectin?

CD62 P, E, L

305

Common gamma chain inheritance?

X linked

306

What is the side effect of mepolizumab?

Herpes zoster - consider immunizing beforehand

307

Which biologic has adverse side effect of candidiasis?

Secukinumab (used for psoriasis, IL17A is the target) - blocks the IL17 pathway leading to candidiasis

308

Which biologic has a side effect of niesserial infections?

Eculizumab (C5 inhibitor, used for PNH, aHUS), blocks C5 and terminal complement pathway

309

Which biologic has alpha gal picture?

Cetuximab (EGFR blocker), makes IgE Ab to galactose-a-1, 3-galactose, sensitization to the lone star tick

310

Zinc deficiency clinical phenotype?

periorificial and aural (limbs) dermatitis, alopecia (loss of hair) and diarrhea

311

What is acrodermatitis enteropathica, inheritance, and what mineral is deficient?

AR metabolic condition affecting Zinc def: patients have zinc def phenotype: periorificial and aural (limbs) dermatitis, alopecia (loss of hair) and diarrhea

312

What is the MAO of Rapamycin?

mTOR/AKT blockage

313

Which medications are calcineurin inhibitors?

Tacrolimus, Sirolimus, and Pimecrolimus

314

Felty syndrome

RA, Neutropenia, and Splenomegaly (FELTY RANS)

315

How does location of eczema differ from infants/small children to adults?

Infants/small children: face, scalp, extensor (side opposite the joint) surfaces ; Adults: flexural surface

316

What is the genetic defect in Comel-Netherton Syndrome?

SPINK5 - which encodes LEKT1

317

LL-37

cathelicidin, antimicrobial peptide that is decreased in eczema; important in antiviral (think eczema herpeticum and vaccinatum)

318

Which coxsackie strain is related to eczema coxsackium

coxsackievirus A6

319

What is eczema vaccinatum?

disseminated live vaccinia virus from smallpox vaccination (no one gets smallpox anymore in US because it's been eradicated)

320

Which antimicrobial peptides are abnormally regulated in AD?

LL-37 (cathelicidin) and HBD2-3 (human B-defensins)

321

Which two cold urticarias have a low CH50?

low CH50: cyroglobulinemia and leukocytoclastic vasculitis

322

Systemic atypical acquired cold urticaria

Localized or generalized urticaria with cold exposure; negative ice cube test

323

Cold dependent dermatographism

Dermographic whealing after stroking pre-cooled skin

324

Cold-induced cholinergic urticaria

Exercise in cold environments leads to generalized urticaria

325

Delayed cold urticaria

Urticaria develops 12-48 hours after application of cold provocation

326

Localized cold reflex urticaria

Positive immediate urticarial response at a site distant to cold provocation

327

FCAS: Fam cold auto-inflamm syndrome: Symptoms, inheritance, and mutation

Pseudourticaria, fever, arthralgia, conjunctivitis occurring 1-2 hours after cold exposure; AD mutation in NLRP3/CIAS

328

PLAID: Phospholipase Cg2 associated def and immune dysregulation: symptoms and test?

Cold urticaria in childhood, Ab def, autoimmunity. Positive Evaporative cooling test

329

How to physically test for PLAID?

Positive evaporative cooling test; neg. ice cube test

330

What is the mutation in PLAID?

mutation in PLCG2 - AD

331

Which type of solar urticaria is assoc with erythropoietic protoporphyria ?

Type 6 VI

332

Which type of urticarias can be passively transferred by serum?

Acquired Cold (IgE, IgM, IgG, cryoglobulins), Solar (Type 1 and 4) and Dermatographism (IgE) (ADS)

333

Factor I def.

AR, urticaria, decrease Factor I (C3b inactivator), dec C3 levels

334

What is SERPING1?

SERPING1 = C1-INH gene in hereditary angioedema

335

Treatment in Giant cell arteritis?

STEROIDS!! Need to decrease risk for visual loss

336

What is the treatment for Kawasaki disease?

IVIG x 1 and aspirin: decrease the risk of aneurysms

337

What diseases can polyarteritis nodosa be associated with?

Hep B or Hep C

338

Which HLA is associating with Abacavir Sn?

Abacavir Sn in white = HLA-B*5701

339

Which HLA is associating with Carbemazepine Sn in Han Chinese?

Carbepazepine in Han Chinese = HLA-B*1502

340

Which HLA is associating with Carbemazepine Sn in Europeans?

Carbemazepine Sn in Europeans = HLA-B*3101

341

Which HLA is associating with allopurinol reactions in Asians?

allopurinol reactions in Asians = HLA-B*5801

342

Which HLA is associating with insulin, gold, and penicillamine reactions?

HLADR3

343

Which cytokine is produced by the T-cells in AGEP?

IL8 / CXCL8

344

Major determinant for PCN allergy

Major: BenzylpeniciLOYL (PrePen)

345

Minor determinant for PCN allergy

Minor: Penicilloate, penilloate, benzylpenicillin (Pen G)

346

Which cytokine is related to mucus gland hypertrophy?

IL9 --> mucous gland hypertrophy

347

Which sinuses drain into the middle meatus?

Anterior ethmoid, frontal, maxillary

348

Where is the OME complex located?

OME complex is located under the middle meatus, and that is why the Anterior ethmoid, frontal, maxillary all drain into the OME/middle meatus area

349

Where do the posterior ethmoids drain?

Sphnoethmoid recess

350

Do anti-leukotriene agents block the early or late phase?

anti-leukotriene block the early and the late phase

351

Do antihistamines block the early or late phase reaction?

Early phase reaction

352

What CT finding is seen in empty nose syndrome?

turbinates are very small

353

Where is a haller cell located?

Haller cell = medial floor of the orbit (basically next to the nose and under the eye.

354

What is the cell type in Western nasal polyps?

Eosinophilic

355

What is the cell type in Asain nasal polyps?

Neutrophilic (elevated IL8)

356

What is the first line treatment for acute rhinosinusitus?

Augmentin; then doxy or a resp flouroquinolone (moxi)

357

How long does it take after pet removal for allergen to go back to normal levels?

about 4 months (16-20 weeks)

358

Which nasal spray is ok to use in pregnancy?

Budesonide; B=baby (cromolyn is also safe in pregnancy)

359

Which immunosuppressed group can receive the varicella vaccine?

Isolated B cell deficiency

360

What is the rule for antibody containing antibody product and vaccines?

If a patient has recently received Antibody containing blood product, they must wait 3 months before receiving MMR and varicella (except zoster) containing vaccines. If patient got vaccine first, wait 2 weeks to give Ab product.

361

What is the CI for getting Rotavirus vaccine?

CI are: immunodeficiency and h/o intussusception

362

What is the vaccine rule for nonfunctional spleen?

Functional or anatomic asplenia: patient should have PCV13 and Menactra 4 weeks apart (cannot get them on the same day like other patients)

363

What is the timing rule for live vaccines?

Either get the live vaccines on the same day, OR get them 4 weeks apart.

364

Which vaccine is the exception to the live vaccine rule (which vaccine may be given)?

Rule is: get same day or 4 weeks apart; but can get Yellow Fever <30 days from MMRV containing vaccines

365

What if a live vaccine is given < 4 weeks/28 days from last live vaccine?

Will need to repeat dose of 2nd vaccine given bc the response probably was not robust enough

366

Which vaccines contain yeast?

Hep B (any Hep B containing vaccine)

367

Which vaccine is contraindicated in egg allergy?

Yellow fever (MMR and influenza are not)

368

Which vaccines contain Gelatin?

Too Much Running for this Very Yellow Zebra:
Typhoid
MMR
Rabies
Varicella Zoster
Yellow Fever
Zoster - herpes

369

What mutation confers HIV resistance?

CCR5 deletion of bp32 confers resistance to HIV: dbl mutation = resistance, single mutation = slower progression
- CXCR4 and CCL3L1 mutations can also have affect on HIV burden

370

What is lipocalin also known as?

lipocalin aka calycin

371

What is a direct bronchoprovocation test?

Methacholine challenge

372

What is an indirect bronchoprovocation test?

Exercise, cold air, mannitol, adenosine monophosphate

373

What is considered a positive methacholine challenge test?

< 8 +; 4-16 is borderline

374

Which cells make IL-12?

IL12 is made by myeloid cells, but not T cells or innate cells

375

Conventional dendritic cells CD markers

CD1, CD11b/c, CD13, CD14

376

Plasmacytoid dendritic cells CD markers

CD123

377

Langerhans cells CD markers

CD11c, CD207

378

Interstitial dendritic cells CD markers

CD11c, CD2, CD9, CD68

379

Which lipid mediator is lower in AERD after COX inhibition, leading to bronchospasm?

PGE2 production goes down after COX1 inhibition, and there is no block of 5LO, leading to uncontrolled production of cysLT

380

What is higher in the urine of AERD patients?

LTE4 (because of uncontrolled production of cysLT)

381

Which CD markers does basophils have?

CD123, CD203c, CD63, CD69

382

Which cells produce PGD2?

Only mast cells produce PDG2

383

Platelet Activating Factor: preformed, lipid, or cytokine?

lipid

384

heparin: preformed, lipid, or cytokine?

preformed

385

chondroitin sulfate E: preformed, lipid, or cytokine?

preformed

386

chymotryptase: preformed, lipid, or cytokine?

preformed

387

carboxypeptidase: preformed, lipid, or cytokine?

preformed

388

What is the gene mutation in Familial Cold AutoInflammatory Syndrome?

CIAS1, AD: Cold Induced Auto-Inflammatory Syndrome 1 gene

389

What is the gene mutation in Muckle Wells Syndrome?

CIAS1, AD: Cold Induced Auto-Inflammatory Syndrome 1 gene

390

Which cat allergen is related to Pork-Cat syndrome

Fel d 2: albumin

391

Where does superantigen bind on the TCR (and CD name)?

Vb chain of the TCR (CDR4)

392

Do superantigen bind to MHCI or MHCII?

Superantigen bind to MHCII (extracellular bacteria)

393

What are the Staph superantigens?

SEA, SEB, (staph enterotoxins); TSST (toxic shock syndrome toxin)

394

What are the strep super antigens?

SPE-A (Strep Pyogenes exotoxins)

395

Where do Tregs develop?

Tregs develop in the thymic medulla

396

Which TLR binds to mycoplasma and what is its ligand?

TLR6 - ligand is diacyl lipopeptides

397

Which TLR binds to synthetic sources?

TLR 7/8 - imidazoquinoloones, synthetic, virus

398

Which TLR binds to unmethylated CpG motifs of bacteria and viruses?

TLR 9

399

Serum Sickness is which type of HSN d/o?

Serum sickness if type 3

400

Which medications do you have to be careful of fluticasone causing Cushing's?

Protease Inhibitors - namely Ritonavir

401

Which PID is associated with fractures?

Hyper-IgE/Jobs/STAT3 deficiency - AD

402

What is the major mouse allergen and which part of the mouse does it come from?

Mus m 1: Lipocalin: Urine of the male mouse

403

In which eye disease can you see keratoconus?

AKC

404

In which eye disease can you see anterior cataracts?

AKC

405

Biopsy in dematographism

dermal edema with a few perivascular mononuclear cells., dilated blood vessels w perivascular cells, normal epidermis, no spongiosis of hyperplasia

406

How to test HIV infected infant

PCR: at birth, 14-21 days, 1-2 months, and 4-6 months
ELISA: 12 and 18 months (baby still has maternal Ab until 18 mo)

407

What is the prophylaxis HIV + infants are on from when until when?

PJP prophylaxis from 4-6 weeks to at least 1 year of age

408

Which of the complement factors ONLY regulates the alternative pathway?

Factor H - is this right?

409

What is the ligand for MADCAM?

a4b7 for gut homing

410

What binds VCAM1?

VCAM1 = VLA4 (a4b1)

411

What is the other name for VLA4?

a4b1

412

What does NCAM bind?

NCAM = VLA4

413

What is the CD marker for dendritic cells?

CD11b/c they all share EXCEPT pDC which have CD123

414

Which TLR does RSV bind to?

TLR4

415

What is the ligand for TLR6?

diacyl lipopeptides

416

Which TLR had ssRNA as it's ligand?

TLR8

417

Pollutant involved in worse asthma?

Ozone / O3

418

Pollutant skewing to Th2 ?

Diesel exhaust

419

Pollutant that is by product of photochemical smog?

Nitrogen dioxide

420

What complement tests are low in early complement deficiency (C1q, C1s, C2, C4)?

decreased CH50

421

Which complement tests are low in C3 deficiency?

Decrease CH50, decreased AH50, decreased C3; + C3 Nephritic factor, IgG anti-C3 AutoAb

422

Which complement tests are low in C5-C9 deficiency?

decreased CH50, decreased specific complement, decreased AH50

423

Which complement tests are low in Factor B, D, properdin deficiency?

decreased AH50

424

What is the genetic mutation in MBL deficiency?

MASP2 mutation

425

Which OA agent is associated with welder, chemical/metal workers?

Platinum salts/potassium chromate (think welder holding fancy metal glass with banana juice)

426

Which OA agent is associated with hairdressers?

Persulfate salts (ammonia persulfate) - think of a hairdresser holding a purse

427

Which OA agent is associated with adhesives, epoxy resin, paint and plastics?

Phlthalic anhydride

428

Which OA agent is associated with plastics/paint?

Trimellitic anhydride

429

Which OA agent is associated with shellac, lacquer, plastics, cleaners?

Amines

430

Which OA agent is associated with hospitals and labs?

Formaldehyde, Psyllium

431

What phenotype are all the radiosensitive SCID, and name them all?

T-B-NK+ : ARTEMIS, CERNUNNOS, ligase IV, Nijmegen Breakage Syndrome
- Ataxia Telangiectasia is also radiosensitive

432

HyperIgM1: mutation, inheritance, and germinal centers?

HyperIgM1: CD40L deficiency; X linked; absent germinal centers

433

HyperIg3: mutation, inheritance, and germinal centers?

HyperIgM3: CD40 deficiency; AR; absent germinal centers

434

HyperIgM2: mutation, inheritance, and germinal centers?

HyperIgM2: AID; AR; giant germinal centers and lymphoid hyperplasia

435

HyperIgM4: mutation, inheritance, and germinal centers?

HyperIgM4: UNG; AR; giant germinal centers and lymphoid hyperplasia

436

Which is the only HyperIgM syndrome that does not have AR inheritance?

HyperIgM1: CD40L, X linked

437

Ataxia telangiectasia: inheritance and gene mutation?

ATM mutation; AR

438

Chronic mucocutaneous candidiasis: inheritance and gene mutation?

AIRE mutation; AR

439

APS-1: inheritance and gene mutation?

AIRE; AR

440

APECED: inheritance and gene mutation?

AIRE; AR

441

What is TNFS5?

TNFS5 = CD40L

442

What is the gene defect in DiGeorge Syndrome?

22q11.2 (think CATCH 22, 90%) OR 10p13-14 (renal/GU defect)

443

What is the autoimmune Ab that may be seen in DiGeorge Syndrome?

TUPLE1 (FISH)

444

How is CTLA4 inherited?

CTLA4 is a haploinsufficiency

445

Which disease would have low/absent CD15?

LAD2 would have abs/low CD15/Sialyl-Lewis X

446

Which disease would have low/absent CD18, CD11b?

LAD1

447

What gene is abnormal in LAD1?

ITGB2 gene: B2 integrin CD18 - beta chain - , CD11b abnormal
- ITGB2 - "IT Got Bad"

448

What gene is abnormal in LAD2?

FUCT1, GDP-fucose transporter; CD15/Sialyl Lewis X

449

What gene is abnormal in LAD3?

FERMT3; Kindlin3 (intracellular beta intern activator)

450

What is CD79a?

Ig alpha chain on B cells, part of B cell receptor

451

What is CD79b?

Ig beta chain on B cells, part of B cell receptor

452

What is CD179?

B cell light chain

453

Colophony - which industry?

Electronics industry (think of PHONE - electronic)

454

Which mutation in AAT gives you increased risk of emphysema?

ZZ mutation

455

Major Ag in honeybee venom?

Phospholipase A2 (Api m 1)

456

What is vespula venom standardized by?

Vespula venom is standardized by the amount of hyaluronidase

457

What does yellow jacket cross reaction with?

White faced hornet, yellow Hornet "Horney yellow jacket"

458

What drugs decrease the clearance of theophylline?

(CIMZiA)
- cimetidine
- zileuton
- allopurinol
- also: macrolide Abx and cipro
- decrease clearance = increased level

459

What does Der p 23 bind to?

Chitin - chitin recognized by TLR2

460

Which are the ice cube test NEGATIVE urticarias?

- cold induced cholinergic urticaria
- systemic cold urticaria
- cold dependent dermatographism
- FCAS: Familial Cold AutoInfl. Syndrome
- PLAID
(the syndromes, systemic and cholinergic)

461

What disease can HUVs be associated with?

COPD

462

Which DM and cockroach allergens are tropomyosin?

- Der p 10
- Per a 7
Tropical Derm Purse 107

463

Major allergen for vespids?

Antigen 5

464

Which antigen can stimulate BOTH T and B cell proliferation?

Pokeweed Antigen

465

What is the allergen for celery?

Api g 1 (A pig ate 1)

466

Which milk allergen is a lipocalin?

Bos d 5: lactoglobulin

467

What is the allergen Met e 1?

Met e 1 is a shrimp tropomyosin

468

Which type of allergen involves the peel of the fruit?

lipid transfer protein

469

Which class of allergen involves the pulp of the fruit

PR-10, Bet v 1

470

What kind of urticaria is seen in PLAID?

Cold Urticaria

471

What pairs with cashew?

Pistachio

472

What pairs with walnut

Pecan

473

In AD, does IFNg increase or decrease in the skin?

Decrease

474

Which type of mutation is present in AD of filaggrin?

Loss of function mutation: filaggrin

475

What is the treatment for disseminated eczema herpeticum?

Systemic acyclovir

476

Patients on dapsone should be monitored for which side effects?

- anemia
- neuropathy
- methemoglobinemia

477

What Ab are present in Goodpasture's disease?

Anti-Glomerular Basement Membrane (anti-GBM) Ab

478

What is the most common side effect of nasal steroids?

local nasal irritation

479

What is the time duration for chronic rhino-sinusitis?

Greater or equal to 12 weeks (EPOS 2012)

480

Where do double positive T cells develop?

Thymus cortex

481

Where do double negative T cell develop?

Thymus cortex

482

Where do single positive T cells develop?

Thymus medulla

483

Where do B cells develop before and after birth?

- Before: Fetal Liver
- After: Bone marrow

484

What is the CD marker for the common gamma chain?

CD132

485

How is the function of IL4, IL5, and IL13 different?

IL4 and IL13 --> class switch to IgE
IL5 --> Eos

486

Are CD8 T cells involved in acute or chronic graft rejection?

CD8+ CD45RO + cells involved in acute graft rejection

487

Which cytokine is produced by CD4 cells to help augment CD8 cells?

IL21

488

Encapsulated Bacteria Mnemonic

Some Nasty Killers Have Serious CaBsule ProtEction
- Strep Pneumo / Group B
- Neisseria
- Klebsiella
- H flu
- Salmonella Typhi
- Cryptococcus Neoformans
- Bordatella Pertusis/ Bacilus Anthracis
- Pseudomonas/E coli (some)

489

Dry/sunny/windy mold Mnemonic

AC2E and BO PITyed SMUT because of his DRESs
- Alternaria
- Curvalria
- Cladosporium
- Epicoccum
- Botrytis
- Pitospora
- Smut spores
- Dreschlera

490

Rainy day mold mnemonic

AscosBosF:
- ascosporidium
- basidiospores
- fusarium (F looks like R)

491

Humid Night mold

- ascosporidium
- basidiospores

492

What does CTLA4 bind to?

CTLA binds to B7-1(CD80)/B7-2 (CD86)

493

How is TGFb involved in Igs?

TGFb promotes IgA production by inducing B cells to switch to this phenotype

494

Are B1 cells T cell independent or dependent? What other cells are they analogous to?

B1 cells = T cell 1ndependent , help with polysaccharide vaccines; analogous to delta T cells

495

Are B2 cells T cell independent or dependent?

B2 cells = T cell dependent , help with protein vaccines

496

Which chromosome is B2 microglobulin encoded on ?

Chromosome 15

497

HLA-E function

NK cell recognition; NEK (neck)

498

HLA-F function

Localized to ER and Golgi apparatus (EFG)

499

HLA-H function

Iron metabolism (H-->I)

500

MHC1 vs MHC2 deficiency: which disease has absent germinal centers

MHC2 deficiency has absent germinal centers
- both have AR inheritance

501

What is the end result of receptor editing, and is it central or peripheral tolerance?

In B cells, CENTRAL tolerance ONLY in the bone marrow; if too reactive in the bone marrow --> rearrangement and production of new light chain

502

FasL aka?

FasL aka CD98 --> Fas=FasL --> caspase activation

503

What receptor is downregulated in peripheral B cell tolerance?

CXCR5 is down regulated in B cell peripheral tolerance, inhibiting homing and interaction w B cells

504

Which are the purine nuceolotides?

A, G

505

Which are the pyrimidine nuceolotides?

T, C

506

What is the earliest B cell to produce Ig?

pre-B lymphocyte earliest to produce Ig

507

Which of the IgG subclasses is the latest to reach adult levels?

IgG2 is the latest to reach adult levels

508

Somatic Hypermutation involves which region of Ig?

V region

509

Class switch recombination involves which region of Ig?

C region; C for class switch

510

Lck is in which family and binds to what?

Lck in the Src family and binds to CD4 and CD8

511

Fyn is in which family and binds to what?

Fyn is in the Src family and binds to CD3

512

What SCID phenotype is Zap70 deficiency?

T-/B+/NK+

513

Which cytokine especially responds to gram negative rods?

TNF especially responds to gram negative rods

514

Which cytokine does IL-10 inhibit production of?

IL-10 inhibits production of IL-12 (IL-12 promotes TH1 cells)

515

Which cytokine promotes B lymphocytes into Ab producers?

IL-6

516

Which cytokine is required for NK cell differentiation and activation?

IL-15

517

Which cytokine induces adhesion molecule ICAM1?

IL-18 induced ICAM1 and other adhesion molecules, leading to enhanced recruitment of leukocytes

518

Which cytokine is important for resistance of Klebsiella pneumoniae?

IL-23 ; Kleb 23 (Klerb23)

519

Which cytokine promotes differentiation and maintenance of T cells that produce IL-17?

IL-23

520

Which cytokine receptors share common B chain?

IL3, IL5, GM-CSF

521

Mutation in which gene confers malaria resistance?

GATA in DARC gene confers malaria resistance in African Americans

522

Which selectins are affected in LAD2 deficiency?

P and E selectin

523

What is the chemokine abn in Heparin Induced Thrombocytopenia?

CXCL4

524

What are SIGLECS?

Sialic Acid binding Ig lectin: have ITIM, work to dampen the immune system response (Siglec-8 on Eos)

525

What are the two types of gravitational samplers?

Durham and Settle (Gravity Settled in Durham NC after the storm)

526

Which pollen sampler allows you to sample over an entire weekend?

Allergenco Air Sampler: Grab type sampler allows for sampling over an entire weekend

527

Which pollen sampler orients to the wind?

Burkard sampler, which is a type of gravitational sampler

528

In Factor H or Factor I deficiency, which complement tests would be low?

low CH50 and low AH50

529

Which lymph organs is the production of IgE the highest?

tonsils and adenoids

530

What body secretions is IgA secreted in?

BiMiSaSw:
- bile
- milk
- saliva
- sweat

531

Where are the marginal zone B cells found?

marginal zone of the spleen

532

Der p 1 size and homology?

Der p 1 : 24 kD and cysteine protease

533

CXCR5: which cells bind and what is it's ligand?

CXCR5 - expressed on mature naive B cells
CXCR5 binds CXCL13

534

Function of DNA PK?

DNA-PK = DNA-dependent protein kinase complex: opens up hairpins at coding ends (like Artemis)

535

Function of ku?

ku: binds broken DNA ends of coding segment and recruits DNA-PK

536

Endonuclease function?

Endonuclease: removes nucleotides for junctional diversity

537

DNA ligase function and other name?

DNA ligase aka XRCC4: ligate both coding and RSS ends

538

Sphingosine - 1 - phosphate receptor (S1PR1)?

CD69: decreases surface expression of S1PR1

539

Where is CD1 encoded?

CD1 encoded on chromosome 15 (like B2 micro globulin of MHC1)

540

What is the CRTH2 receptor?

CRTH2 receptor is PGD2 receptor

541

What are the transcription factors for mast cells vs basophils vs eosinophils?

mast cells: GATA2
basophils: GATA2
eosinophils GATA1

542

Where do eosinophils mature (BM vs Tissue)?

Eosinophils mature in the bone marrow, just like basophils. Mast cells mature in the tissues

543

Which cells is the trimeric form of FceRI on?

DC, monocytes, and eosinophils

544

Which allergen cleaves FceRII (CD23)?

Der p 1 cleaves FceRII

545

Does omalizumab block the early or late phase reaction?

Omalizumab blocks early and late reactions

546

Where does IgE bind to FceRI?

IgE binds to FceRI by the alpha chain

547

CD marker for C5a?

C5a = CD88

548

Basophils are present in early or late allergic disease response?

Basophils = late response

549

CD 69 and basophil release?

CD69 is NOT associated with degranulation; rather with TLR stimulation (NON-allergen stimulation)

550

Primary granules of Eosinophil and what is their other name?

Charcot Leyden crystal aka Galectin-10

551

What are the two main chemokines for neutrophils?

- CXCL8 (IL8)
- LTB4 (B looks like 8; 4x2=8)

552

Mnemonic for Epithelial cell layers

Before Signing, Get Legal Counsel
- Basale (bottom)
- Spinosum
- Granulosum
- Lucidum
- Corneum

553

Which cytokines do keratinocytes/epithelial cells secrete?

TSLP, GM-CSF, IL25, IL33 (IL33 part of the IL1 family)

554

Where are hassall's corpuscles located (be as specific as possible)

Hassall's corpuscles are located in the thymus medullary

555

What are the immune privileged sites of the body?

BAT: Brain, Anterior Chamber of eye, Testis

556

Where are the largest number of lymphocytes found?

#1: spleen
#2: bone marrow:
#3: GI tract
#4: skin

557

Which vessels carries lymphocytes into the spleen?

Splenic artery

558

How much mucus is produced in an adult nose per day?

1 quart

559

Where does the nasolacrimal duct drain?

Inferior meatus

560

CCL27: aka and receptor?

CCL27 aka CTACK; receptor = CCR10

561

Bullous Pemphigus or pemphigoid has prominent pruritus?

Bullous pemphigoid has prominent pruritus

562

When does herpes gestationis/pemphigoid gestationis occur and symptoms?

- occurs in 2nd trimester; pruritus and tense bullae

563

What molecule are defensins abundant in?

Cysteine rich peptides, abundant in neutrophils

564

Which phase of a clinical trial is submitted for FDA approval?

- after phase 3

565

In which phase of clinical trial is long term safety tested in?

Phase 4: "post marketing", may find adverse reactions outside the clinical trials

566

What are the phases of clinical trials and what are the checking for?

1: Safety
2: Efficacy
3: Confirm finding in large patient population --> FDA approval
4: Long term safety in a diverse population; "post marketing"

567

Type I and Type II error difference?

- Type I: no true difference: null hypothesis falsely rejected
- Type II error: true difference: null hypothesis falsely accepted

568

What % of eosinophils on a nasal smear in NARES?

>20% eosinophils

569

What are the bacteria that are involved in Atrophic Rhinits?

- Klebsiella Ozaenae
- S Aureus
- Proteus Mirabalis
- Coccobacillus faoetidus ozaenae
- Pseudomonas Aeriginosa
- E Coli
"KOSA the CFO of PM wanted PeACE"

570

When should AIT be started in AFRS?

AIT for fungal and non fungal allergens should be started 5-6 weeks post surgery

571

Which eye pathologies are Horner-Tranta's dots seen in?

VKC and AKC

572

Order of eye diseases that Eos seen in conjunctiva (greatest to least)?

#1 GPC
#2 VKC
#3 AKC
#4 SAC/PAC
"Giant Vernal AtopieS

573

Cytokines in Acute and Chronic AD

- Acute: IL4, IL13: "4 suits with 13 cards in each deck, including ACes"
- Chronic IL5, IL12, IFNg: " Education is chronic starting at 5 through Grade 12"

574

What Vitamin deficiencies can be related to rash similar to Eczema?

Vitamin B6, niacin, Biotin (vitamin B7)

575

Anti-CCP Ab indicate which disease and high/low severity?

Anti-CCP indicate more aggressive disease in RA (so does RF)

576

What gene in asthma/atopy has cluster of IL4 that may affect severity?

Chromosome 5q

577

What % of asthmatics can have their asthma triggered by NSAIDs?

10%

578

What % of asthmatics also have GERD?

45-65%

579

Obstruction parameters for asthma

Moderate 50-69%
Severe 35-49%
Very severe <35

Vs GOLD criteria for COPD :
- Gold 0: symptoms only
- Gold 1: FEV1 >/= to 80; mild
- Gold 2: 50-79; moderate
- Gold 3: 30-49; severe
- Gold 4: <30 or < 50 with chronic respiratory failure present; very severe

580

What factors increase FeNO levels ?

Increase FeNO levels:
- Viral URI
- Atopy/AR
- Nitrite Rich foods: hot dog, salami, bacon, baloney
- Spinach, green bean, carrot, beet: (2 green, 1 orange, 1 beet: Think of Barney (purple w green middle) eating carrots, spinach

581

Foods with sulfites

- think beer/wine/processed foods:
- processed potato
- dried fruit
- sauerkraut
- shrimp
- lemon/lime
- pickled peppers
- maraschino cherries
- pickled veggies
"Beer, Wine, Lemon/lime"

582

Linear epitope for allergens characteristics

Allergen is stable and persistent; more prolonged allergy

583

Confirmational epitope for allergens characteristics

Allergen is unstable; mild transient allergy

584

What are the two foods that there are 95% NPV cut off for?

Egg and milk

585

What are the cut off for EGG for 95% NPV?

2y/o: 2/7
- <2 y/o: IgE > 2
- >2 y/o: IgE> 7

586

What are the cut off for MILK for 95% NPV?

1y/o: 5/15
- <1 y/o: IgE > 5
- >1 y/o: IgE> 15

587

Which peanut component goes along with oral allergy syndrome?

Ara h 8

588

% of children who outgrow Peanut allergy and ages likely to outgrow

20% by age 6; unlikely to outgrow after age 10

589

% of children who outgrow tree nut allergy and rule about outgrowing

9%; unlikely to outgrow if allergic to more than 1 TN

590

LEAP study inclusions and cut offs

- Egg allergy or severe eczema or both
- Serum IgE: <0.35 --> home challenge; >0.35 --> SPT
- SPT:
-- 0-2mm wheal : home intro
-- 3-7 mm wheal: supervised challenge
-- >/= 8mm wheal: allergic

591

What % of anaphylaxis does biphasic response occur?

- 20% of anaphylactic episodes have biphasic reaction

592

How to differentiate exercise anaphylaxis and cholinergic urticaria?

Cholinergic urticaria can occur with Passive Warming

593

How long will serum vs urinary histamine be elevated for?

- serum: 5-60 minutes
- urinary: 24 hours

594

How long it tryptase elevated for?

- up to 5 hours

595

What is the mechanism and reaction of oversulfated chondroitin sulfate?

- contaminant in heparin
- activation of contact system by C5a
- rxn: hypotension, AE, no urticaria or pruritus

596

Latex allergens specific for health care workers?

Hev b 5, 6, 7: "5-6-7 Health!"

597

What is the key allergen for Dolichovespula arenaria / maculata (hornet)?

Dol m 5 - Antigen 5 (hornet)

598

What is the key allergen for Vespula?

Antigen 5 - Ves v 5

599

% of + venom ST with negative serum IgE
% of + venom serum IgE with negative ST

- % of + venom ST with negative serum IgE: 20%
- % of + venom serum IgE with negative ST: 10%

600

What is the official name for Bed Bugs?

Cimicids, Cimex lectularius
- bite In a row: "breakfast, lunch and dinner, all in a row"

601

PUPPP: Pruritus Urticarial Papules and Plaques or Pregnancy - what areas does it spare? What is the Rx?

- PUPPP: is erythematous papule within abdominal striae
- SPARES: spares umbilicus, face, palms, soles
- Rx: loratadine, cetirizine

602

What percentage of new asthma diagnoses in the US are occupational ?

9-15% of new asthma diagnoses in the US are occupational

603

Which test, if done at work and negative, excludes OA?

Methacholine challenge: should be done when a patient is symptomatic and at work

604

Organic Dust Toxic Syndrome (ODTS)?
Is ODTS or farmer's lung more common?

- from dust exposure that contains toxin-producing fungi (grain, hay, textiles)
- lack of ST to common fungi
- ODTS is 50X more common than farmers lung

605

Toxic fume bronchiolitis: what exposure?

Nitrogen dioxide and sulfur dioxide

606

Silo unloader's disease: what exposure?

- acute exposure of NO2 leading to asphyxia

607

Byssinosis: what exposure?

- dust inhalation of cotton, flax, hemp

608

What is Myroxylon pereirae?

Balsam of Peru

609

What is the spot test for nickel called?

Dimethylglyoxime test
- pink = positive

610

What flavorings does Balsam of Peru cross react with?
What plant does Balsam of Peru cross react with?

- Cinnamon and vanillin
- pine tree
- may cross react with Colophony (also made from pine trees)

611

Most common preservative in the US, and is it formaldehyde releaser or not?

Quaternium 15: formadehyde releaser

612

What is colophony made from?

`Colophony made from pine trees

613

What are the four classes of steroids?

HyTriBetah17
A: hydrocortisone
B: triamcinolone
C: betamethasone
D: hydrocortisone-17-butyrate

614

Antifibrinolytic Side Effects

- thrombosis
- postural hypoTN
- myalgia, myositis
- n/v/d
- muscle cramps
- fatigue

615

What SCID phenotype is PNP deficiency?

T-/B+/ NK+or-

616

Which PID has skeletal abn and rachitic rosary?

ADA SCID : T-/B-/NK-

617

What is PNP deficiency from?

defective purine nucleotide metabolism:
T-/B+/NK-+

618

Which radiosensitive SCID has an absence of Hassall's corpuscles on biopsy?

Nijmejen breakage syndrome

619

What kind of blood products can SCID babies get?

CMV negative, irradiated

620

RIDDLE Syndrome

- RNF168 mutation
- increased IgM and low IgG: "How funny it is like HyperIgM"
- E Coli and HSV infection

621

Job's Syndrome/Stat3 deficiency inheritance

AD-STAT3

622

DOCK8 inheritance

AR-DOCK8

623

What is Tyk2 syndrome and how is it inherited?

AR-Tyk2
- similar to DOCK8 with disseminated BCG lymphadenitis and salmonellosis

624

How is Wiskott-Aldrich inherited?

X-linked Wiskott-Aldrich
Think WIXcott

625

What do the germinal centers in XLA look like

XLA germinal centers: small/absent lymphoid tissue, no germinal center

626

PASLI disease

P-delta Activating mutation with Senescent T cells, LAD and Immunodeficiency
- Recurrent infections starting in childhood, chronic EBV, increase in EBV lymphoma
- MTOR is excessively activated

627

Most familial CVID are inherited in which way?

Familial CVID = AD

628

What class of drugs can cause IgG subclass deficiency?

Anti-epileptics

629

Mutations in CGD

- gp91 - CYBB, X-linked, 65%
- gp47 - NCF1, AR, 25%
- gp22 - CYBA, AR, 5%
- gp67 - NCF2, AR, 5%
- gp40, NCF4, AR, <1%

630

What are the subunits of IL-12?

IL-12: p35, p40

631

What are th subunits of IL-23?

IL-23: p19, p40

632

Which cells are CCR5 on ?

Monocytes/macrophages

633

Which cells are CXCR4 on?

T cells

634

What can gp120 bind?

gp-120 can bind DC-SIGN

635

Which chemokine is implicated in EOE?

Eotaxin-3; induced by IL-13

636

How long should a patient be on PPI before checking biopsy for EoE?

8 weeks/2 months

637

IgE value for 95% PPV for Peanut?

>/= to 14

638

IgE value for 95% PPV for Fish?

>/= to 20

639

Which layer of the GI tract can eosinophils be found normally?

Found in the lamina propria normally, not the surface epi
- Eos NOT normal in the esophagus

640

Meeting how many of the criteria is needed for diagnosis of mastocytosis?

1 major and 1 minor
OR
3 minor

641

Which TLRs are involved in killing mycobacterium?

TLR2 and TLR4

642

What is the presentation of children with croup?

- barking cough

643

Which cytokines induce Th17?

IL1B, IL6, IL21, IL23, TGFB --> Th17

644

Which immunomodulator requires a yearly eye exam?

Hydroxychloroquine

645

What is the Ig involved in immunohematologic disease?

IgG
(IgM usually involved in auto-immune disease)

646

How to prevent nonhemolytic febrile reactions?

Removed leukocytes before storage; helps decrease cytokines release of TNFa and IL1b which play a role

647

How to prevent urticarial transfusion reactions?

Washing future blood products; IgE mediated

648

How to prevent anaphylactic transfusion reactions?

Twice washing RBCs or use product from IgA deficient donor

649

How to prevent GVHD transfusion reactions?

Gamma irradiation of cellular blood product

650

Which receptor for NK cell and ADCC?

FcGRIIIA; binds ONLY to clustered IgG, not monomeric

651

Which autoantibody is seen in Primary Adrenal failure?

Anti-CYP21A1 (enzyme necessary to make cortisol)

652

Most common cause of nephrotic syndrome in adults?

Membranous nephropathy

653

Most common cause of nephrotic syndrome in children?

Minimal change disease

654

Most common glomerulonephritis in the world?

IgA nephropathy

655

What is the treatment for scleritis?

NSAIDs, steroids, immunosuppression

656

What does the pupil look like in Anterior Uveitis?

Miotic Pupil

657

What is the main side effect of colchicine?

GI distress: pain, bleeding; rare: BM suppression

658

What is the fever syndrome with the longest lasting fevers?

TRAPS (TNF receptor disorder) has fevers for up to several weeks

659

Lofgren's syndrome

sarcoid + rash (erythema nodosum) + joints

660

Does C-ANCA correlate with disease severity in Granulomatosis with Polyangiitis?

No

661

Is EGPA related to C-ANCA or P-ANCA?

EGpA = P-ANCA = myeloPeroxidase

662

Which organ transplants do not require immunosuppression?

cornea, bone, joint tissue

663

How long after a HSCT can one receive live vaccines?

2 years after HSCT can a patient receive live vaccines

664

Which SCID does the best after HSCT?

T-/B+/NK- SCID - no conditioning (not including X-linked who have B cells present and non-functional)

665

Which SCID does the worst after HSCT?

T-/B-/NK-

666

Acute vs Chronic GVHD timeline?

- Acute = first 100 days - CD8
- Chronic > 100 days - CD4

667

Types of rejection and timing?

- Hyperacute: on the table, minutes to hours; thrombosis
- Accelerated: 2-5 days; thrombosis
- Acute: 7 days - 3 months; CD8
- Chronic: months to years; CD4

668

Which of the stem cells take the longest to engraft?

Umbilical cord cells take the longest of the stem cells to engraft

669

Which foods should CF patients avoid?

CF patients should avoid soy because of glutathione dysfunctions

670

Which HLA , cytokines, and complement regulatory proteins are placental specific?

- HLA-E, F, G
- PGE2, IL-10, Il-4 - regulatory cytokines
- CD46, DAF - prevent complement activation

671

What time of day is pollen count the highest?

Early morning from 5-10AM

672

Northern Grass Mnemonic

I grew up in the NORTH, where I got TO Relish Fresh Sweet Blueberries
- Timothy
- Orchard
- Rye
- Fescue
- Sweet vernal
- Bluegrass (Kentucky)

673

Southern Grass Mnemonic

Then I moved to the SOUTH for LOVE, where by Boo Bought me Johnsons and a Prarie
- lovegrass
- bermuda
- bahia
- Johnson
- prairie

674

Which two allergen types cannot be mixed with pollens?

Mold and cockroach

675

Which allergen extracts may be able to be placed with high protease activity extracts?

ragweed and cat in 50% glycerin

676

Effective doses for standardized pollens?

RaCe to the GDP(B)
- RW: 1000-4000 AU
- Cat: 1000-4000 BAU
- Grass: 1000-4000 BAU
- DM: 500-2000 AU
- Bermuda: 300-1500 BAU
- Venom: 100mcg single; 300 mcg mixed

677

What is the effective dose for dog allergen in AIT?

15 micrograms of Can f 1
"My dog weighs 15 lbs"

678

What is the effective dose for short ragweed allergen in AIT?

6-12 microgram of Amb a 1

679

What is the dose of glucagon you would use in a patient who is on B-Blocker and on AIT?

1-5mg glucagon IV push

680

Dual H1 and mast cell mediators?

AlcAz OKe
- alcaftidine
- azelastine
- olapatidine
- ketotifen
- epinastine

681

Which second gen H1 blockers to use in pregnancy?

- cetirizine, levocetirizine, and loratadine

682

Which second gen H1 blockers to use in liver disease?

fexofenadine (My liver is Fine)

683

Which second gen H1 blockers to use in kidney disease?

loratadine

684

Which antihistamines give you the side effect of prolonged QT?

FIRST generation antihistamines (chlorpheniramine, diphenhydramine, doxepin, hydroxyzine) have this side effect in high doses
- blockage of potassium current --> prolonged QT --> torsade de points

685

What are the cardioselective BB?

Cardioselective:
- metoprolol
- atenolol

686

Which pregnancy category is montelukast?

Category B
(Zileuton is category C)

687

Which anti-leukotriene agent may have liver toxicity?

Zafirlukast

688

Which medications do you need to adjust while on Zileuton? ***

Theos War Prop :
Theophylline
Warfarin
Propranalol
- Zileuton inhibitis CYP1A2 - need to decrease the dose of above medications bc Zileuton increases their serum concentration

689

Muscarinic Receptor functions

M1: eosinophils in COPD; found in ganglia and mast cells
M2: Inhibitory rec on parasympathetic nerves: decreased in viral infections, increased Ach
M2: primary mediator of smooth muscle contraction in human airways - increases intracellular Ca, casting bronchoconstriction
-- H1 blockers can have AntiAch effects via M3 receptor

690

First line bronchodilator in COPD?

SAMA - ipratropium

691

Steroid drug metabolism

INCREASE LEVELS:
Cathy TROLls UP the RITunda looking to Kates Birth Control
- Clarithromycin
- troleandromyecin
- increase steroid levels
- Ritonavir (Protease Inhibitor)
- Ketoconazole
- OCP

692

Does omalizumab increase or decrease total IgE?

Omalizumab increases total IgE but decreases free IgE

693

Where does IgE bind on FceRI?

IgE binds at the alpha chain of FcERI

694

What is the CD marker for CTLA4?

CD152

695

Which disease has Hurthle cells?

Hashimoto's aka Chronic Lymphocytic Thyroiditis

696

What disease is associated with antibodies against P antigen?

Paroxysmal cold hemoglobinuria

697

What cells enter the LN through high endothelial venules ?

Naive B and T cells enter through high endothelial venules

698

Asplenic patient: Prevnar or Menactra first?

Get Prevnar first

699

Thermoactinomyces sacchari vs vulgaris

- Thermoactinomyces Sacchari: Bagassosis, mold sugar cane
- Thermoactinomyces vulgaris: Farmer's lung

700

Are CD4 or CD8 cells seen in the parotid biopsy of Sjogren's disease?

CD4 cells

701

How are prions removed from Ig replacement?

Cold ethanol fractionation (modified Cohn-Oncley cold ethanol fractionation)

702

What are the 3 criteria for aspirin desensitization?

1: FEV1> 70% predicted
2: Montelukast started 1 week prior
3: Patient should continue treatment of ICS +/- LABA Rx

703

What is the concentration of Epi for SQ/IM and IV administration?

- SQ/IM: 0.01mg/kg of 1:1000
- IV: 0.01mg/kg of 1:10,000

704

Which vaccines have neomycin?

Neomycin:
MVP
- MMR
- Varicella and Herpes Zoster
- Polio

705

Japanese Encephalitis Vaccine Reaction

Delayed Urticaria and angiodema

706

MMR Vaccine Reaction

rash, thrombocytopenia, late fever (5-12 days)

707

Tetanus Vaccine Reaction

Brachial neuritis, arthus reaction

708

Pertussis Vaccine Reaction

Febrile seizures, inconsolable crying hypotonic hyporesponsive event
- vaccine contraindicated in patient who had encephalopathy <7 days after pertussis containing vaccine

709

Yellow Fever Vaccine Reaction

Encephalitis

710

Smallpox Vaccine Reaction

Myopericarditis, eczema vaccinatum

711

TB skin test vaccine CI

MMR given same day as TB or 4 weeks apart

712

Steroids and vaccines

<2 weeks on steroids, OK to get
>2 weeks >20 mg/day, wait 1 month

713

Sulfa antibiotic versus antibiotic: what is the difference?

Non-antibiotic does not have the aromatic amine at the N4 position (and why there is little cross reactivity)
- Sulfa antibiotic: SO2NH2 moiety

714

Periostin is produced in response to which cytokine?

IL13

715

Reproducibility of FEV1 and FVC?

3 effort that should be within 150ml of each other

716

What are the SLE Ab?
Which is the most Specific, which is the most Sensitive?

ANA - SNOUT - most sensitive
anti-dsDNA
anti-smith - SPIN - most specific

717

When can you get Tdap vaccine if pregnant?

Tdap during third trimester

718

How much bleach per water ratio for eczema?

1/3 cup 8.25% bleach per one tub

719

Which cell types are CD62L on?

CD62L are on B, T, and NK cells
- on T memory cells, NOT effector cells ***

720

Which specific CD marker B cells are missing in BTK?

CD19+ B cells

721

NBT test : positive vs negative:

Positive: changes from yellow --> BLUE (can reduce NBT to formazan)
- negative: yellow - no change

722

AH50 vs CH50: sheep vs rabbit

- AH50: rAbbit - Alternative
- CH50: sheep jumping over clouds - Classical

723

Which allergen confers honeybee and vespid cross reactivity?

Hyaluronidase

724

Which DNA measuring method is used to quantify TRECS?

quantitative PCR

725

Which viral infection can decrease the number of TRECs?

HIV1 - TREC numbers improve with HAART

726

Radiation of XRAY vs CT?

CT has 60-120 times more radiation

727

Food challenge: what amounts of wet and dry food?

Dry food: 10g
Wet food: 100ml
Double the amount for meat and fish

728

IgE value for 95% PPV for Soybean?

30 kAu/L

729

IgE value for 95% PPV for Wheat?

26 kAu/L

730

IgE value for 95% PPV for TreeNuts?

15 kAu/L

731

What are the NPV for ST for egg and PN?

= to 3mm

732

What are the NPV for Serum IgE for egg, milk and PN?

= to 2 (no reaction history to peanut)
- reaction history to peanut =5)

733

What's the risk of peanut allergy in a child whose sibling is allergic to peanut?

7%

734

Atopic patient with eczema and food allergy, risk of being allergic to PN?

30%

735

Risk of being becoming allergic it cut out peanut?

1%

736

Major grass families

- Northern: Pooiedae
- Southern: Chloridiodae, Panicoideae (Chlorine in the Pain)

737

How is aspirin made?

Aspirin is made from the bark of a willow tree

738

Mnemonic for Indoor molds

Indoor CAMPR
- Cladosporium (outdoor that moves indoor)
- Aspergillus
- Mucor
- Penicillium
- Rhizopsus

739

Which allergen cleaves CD25?

Der p 1 and Der p 2

740

Can DM mix with cockroach or mold?

Yes, DM which has high protease activity, can mix with cockroach or mold (but cockroach and mold cannot be mixed with pollens)

741

IPEX-like disorder mutation

STAT5b deficiency; low CD25 and low Treg;

742

What is the receptor for adenovirus?

CD46/MCP

743

Lifetime prevalence of eczema for school children?

17%

744

What immunodeficiency is seen in Ataxia Telangiectasia?

low IgA, low IgE

745

How do lymphocytes get to GALT?

GALT has no HEV, so lymphocytes get there via afferent lymphatics

746

What organization is responsible for AIT standardization?

CBER: Center for Biologics Eval and Research

747

Is RF an IgM or IgG?

RF is an IgM against IgG
- think about how IgG is for antibody protection and IgM is for active Rheum or infection