Immunology Flashcards

(39 cards)

1
Q

Features of Wiskott-Aldrich

A

T cell immune deficiency, Thrombocytopenia, Eczema, X linked

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2
Q

Features of DiGeorge syndrome

A

Heart, palatal and facial defects, absent thymus hypocalcaemia

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3
Q

Cause of DiGeorge syndrome

A

Deletion of section of chromosome 22 causing maldevelopment of 5th branchial arch

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4
Q

Features of Duncan syndrome

A

X-linked lymphoproliferative disease - unable to respond to EBV, either die of the infection or develop secondary lymphoma

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5
Q

Features of ataxia telangiectasia

A

T cell defects, defect in DNA repair, increased risk of lymphoma, cerebellar ataxia, developmental delay

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6
Q

What is the defect in Bruton agammaglobulinaemia

A

X linked; abnormal tyrosine kinase gene, which is needed for B cell maturation

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7
Q

Features of selective IgA deficiency

A

Most common primary immune deficiency; asymptomatic or recurrent ear, sinus, pulmonary infections

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8
Q

What is the defect in chronic granulomatous disease

A

Neutrophil phagocytosis - failure to produce superoxide after ingestion of microorganisms

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9
Q

What are the features of chronic granulomatous disease?

A

Recurrent bacterial infections
Poor wound healing
Invasive fungal disease
Granulomas from chronic inflammation

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10
Q

What is the defect in leukocyte adhesion deficiency?

A

Deficiency of neutrophil surface adhesion molecules, CD18 and CD11b - neutrophils are unable to migrate to sites of infection/inflammation

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11
Q

What are the features of leukocyte adhesion deficiency

A

Delayed separation of umbilical cord
Delayed wound healing
Chronic skin ulcers
Deep seated infections

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12
Q

What are the features of complement defects

A

Recurrent bacterial infections
SLE like illness
Recurrent meningococcal infections

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13
Q

What is the defect in hereditary angioedema?

A

Deficiency of C1 inhibitor leads to spontaneous activation of classic complement pathway and kinin-releasing syndrome

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14
Q

What is the defect in Duncan disease?

A

defect of SLAM associated protein which is involved in T cell stimulation

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15
Q

Which cells have defects in X-linked lymphoproliferative disease?

A

CD8+, NK cell and T cells

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16
Q

What are the clinical features of X-linked lymphoproliferative disease?

A

Fulminant mono
Lymphoma
Dysgammaglobulinaemia
Aplastic anaemia

17
Q

What are the features of IPEX?

A

Onset in infancy
Immunodysregulatory syndrome with a triad of:
○ Enteritis
○ Endocrinopathy
○ Dermatitis
Can also have cytopenia, glomerulonephritis, hepatitis
Susceptible to bacteria, viral and fungal infections
High rate of mortality - most die before 2 years without HSCT

18
Q

What is the defect in Chediak-Higashi?

A

Lysosome-related organelle disorder

19
Q

What are the clinical features of Chediak-Higashi?

A

Immunodeficiency
Neurological: weakness, ataxia, peripheral neuropathy, progressive neurodegeneration
Hypopigmentation: oculocutaneous albinism
Accelerated phase with haemophagocytosis, lymphocyte and monocyte infiltration of tissues, often fatal

20
Q

Who is more likely to get SCID?

A

Males affected more than females because X-linked SCID caused by common gamma chain deficiency is the most common form; the remaining forms are autosomal recessive

21
Q

When does classical SCID present?

22
Q

What are the clinical features of classical SCID?

A
Respiratory infections
Diarrhoea and faltering growth
Oral thrush and perineal candidiasis
BCG complications
Disseminated viral infections
Skin rash
Absent lymphoid tissues
23
Q

What is Omenn syndrome?

A

A kind of SCID - Exaggerated inflammatory response caused by emergence of oligoclonal T cell populations, often autoreactive. Clonally expanded T cells then infiltrate tissues

24
Q

What are the clinical features of Omenn syndrome?

A

Skin - erythroderma, thickened and leathery skin, hair loss
Gut - chronic diarrhoea, protein loss leading to oedema
Reticuloendothelial system - lymphadenopathy, hepatosplenomegaly

25
What is the defect in Omenn syndrome?
Most frequently occurs with RAG1 or RAG2 deficiency, in which B cells are absent
26
What is maternofetal engraftment in SCID?
Patients with SCID don't have functional T cells so can't reject foreign lymphocytes Maternal T lymphocytes that cross the placenta engraft in the infant, mediating a graft vs host process Presents as morbiliform erythroderma or papular dermatitis
27
What is the common defect in Wiskott-Aldrich?
deficiency in WASP protein which leads to global aberration in innate and adaptive immunity
28
What are the features of ataxia telangiectasia?
``` Defect in DNA repair T-cell defects Increased risk of lymphoma Cerebellar ataxia Ocular telangiectasia Developmental delay ```
29
What is CVID?
B-cell deficiency | High risk of autoimmune disorders and malignancy
30
What are the clinical features of CVID?
Later onset than X-linked agammaglobulinaemia Recurrent sinopulmonary infections with reduction in 2 or more Ig isotypes and impaired vaccine responses, usually >2 years Clinically heterogeneous
31
What will be the blood results in CVID?
Reduction in at least two of IgG, IgA and IgM | Impaired functional antibody response to vaccines
32
what is the defect in hyper IgM syndrome?
• CD40L deficiency leads to lack of class switching, then therefore cellular and humoral immunity
33
What is the triad of Hyper IgE syndrome?
High IgE and eosinophilia Eczema Recurrent skin and pulmonary infections
34
What is Job syndrome?
AD form of Hyper IgE caused by STAT3 mutation
35
How does hyper IgE syndrome present?
Pustular rash in newborn period, which can evolve Cutaneous cold abscesses, lacking signs of inflammation Otitis media, sinusitis, pyogenic pneumonia Fungal infections
36
What are the typical facies in Hyper IgE?
``` Prominent forehead and chin Deep set eyes Bulbous nose Coarse facial features Facial asymmetry High palate ```
37
What are some associated features of hyper IgE?
Scoliosis, midline anomalies, craniosynostosis, vascular abnormalities
38
What are the features of Schwachman-Diamond?
Pancreatic exocrine insufficiency Skeletal abnormalities Recurrent infection of lungs, bones and skin Most have neutropenia Up to 25% have pancytopenia Risks of myelodysplasia and leukaemia are increased
39
What are the features of cyclical neutropenia?
Recurrent neutropenia for 3-6 days over a 21 day cycle (some variation) Autosomal dominant May cause stomatitis, oral ulcers or bacterial infections