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1MB Respiratory > Immunology > Flashcards

Immunology Flashcards

1
Q

What are SPUR infections? What do they indicate?

A

Serious, Persistent, Unusual, Recurrent
Indicate immune deficiency

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2
Q

What is the main hallmark of immune deficiency?

A

Recurrent infections

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3
Q

Primary immune deficiencies are common. True/False?

A

False
Rare! Secondary immune deficiencies are common

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4
Q

Risk of infection ______ as neutrophil count increases

A

Decreases

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5
Q

How can failure to produce neutrophils arise?

A

Failure of stem cell differentiation
Failure of neutrophil maturation

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6
Q

What is Kostmann syndrome?

A

Rare autosomal recessive disorder; congenital neutropenia
Clinically presents as (recurrent) infections 2 weeks after birth

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7
Q

What is leukocyte adhesion deficiency?

A

Rare primary immune deficiency where neutrophils fail to bind to endothelial markers - cannot find where infection is!
Genetic defect in CD18

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8
Q

What is chronic granulomatous disease?

A

Failure of oxidative killing due to inability to generate oxygen free radicals

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9
Q

Name an important related side effect of anti-TNF therapy

A

Reactivation of latent TB

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10
Q

In congenital neutropenia, neutrophil count is normal. True/False?

A

False
Low or absent

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11
Q

Is there pus formation in congenital neutropenia?

A

No

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12
Q

In leukocyte adhesion deficiency, neutrophil count is low during infection. True/False?

A

False
It is high

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13
Q

Is there pus formation in leukocyte adhesion deficiency?

A

No

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14
Q

In chronic granulomatous disease, neutrophil count is normal. True/False?

A

True
Would be raised in the acute stage but not once granuloma has formed

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15
Q

Is there pus formation in chronic granulomatous disease?

A

Yes

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16
Q

Give examples of definitive management of phagocyte deficiencies

A

Bone marrow transplant, gene therapy

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17
Q

What cells do T cells arise from?

A

Haemopoetic stem cells in bone marrow

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18
Q

Defects in stem cell differentiation in haemopoetic cells causes which fatal condition?

A

Reticular dysgenesis

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19
Q

What is Severe Combined Immunodeficiency (SCID)?

A

Failure of production of lymphocytes

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20
Q

What are some key clinical phenotypes of SCID?

A

Unwell by 3 months
Diarrhoea
Failure to thrive
Early death

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21
Q

Why does SCID present only after 3 months of age?

A

Maternal IgG protects the infant up to this point

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22
Q

In X-linked SCID, which receptor is mutated?

A

IL2 receptor

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23
Q

What is DiGeorge syndrome?

A

Failed development of the thymus
“Funny looking kid”

24
Q

Which chromosome is deleted in DiG syndrome?

A

22q11

25
Q

In DiG syndrome, the thymus fails to develop. What is the consequence of this?

A

Low/no T cells can mature (thus low T cell numbers)

26
Q

What is common variable immunodeficiency?

A

Low IgG, IgA and IgE
Leads to recurrent infections, often autoimmune

27
Q

Which type of hypersensitivity reaction do allergic diseases come under?

A

Type 1

28
Q

Define what is meant by allergy

A

IgE-mediated response to an external antigen

29
Q

Describe the hygiene hypothesis

A

Decrease in infectious exposure in early life predisposes to increased sensitivity/predisposition to allergic stimuli

30
Q

Allergic reactions typically take a few hours to develop. True/False?

A

False
Can be from within minutes to a couple hours

31
Q

What is the clinical effect of histamine and other inflammatory mediators in the lung?

A

Bronchoconstriction
Vasodilation
Increased vascular permeability
Mucosal oedema, mucus secretion
Yellow sputum

32
Q

What is urticaria? How long does it last?

A

Hives/rash
Lasts typically 6 hrs

33
Q

Name some elective investigations for identifying allergic disease

A

Skin prick test
Challenge testing

34
Q

What would be measured in an acute anaphylactic episode?

A

Serum tryptase

35
Q

Which drug class should be discontinued prior to skin prick testing?

A

Antihistamines for 48hrs

36
Q

Corticosteroids should be stopped before skin prick testing. True/False?

A

False

37
Q

Why is measuring total IgE not useful in diagnosing allergic disease?

A

IgE can be raised by lots of things - allergy can also occur in the absence of IgE

38
Q

Which drug supposedly blocks mast cell degranulation?

A

Sodium chromoglycate

39
Q

What disease type is an example of Type I hypersensitivity?

A

Allergy

40
Q

Type II hypersensitivity involves direct cell killing through which main mechanism/process?

A

Complement pathway

41
Q

What mediates Type III hypersensitivity?

A

Immune complexes

42
Q

Which cell type mediates Type IV hypersensitivity?

A

T cells

43
Q

What term is given to a collection of activated macrophages and lymphocytes?

A

Granuloma

44
Q

What is the main danger of live attenuated vaccines?

A

Can cause disease particularly in immunosuppressed individuals

45
Q

Give examples of live attenuated vaccines

A

Measles and mumps
Chickenpox
Rubella
Smallpox

46
Q

Which Ig is contained in colostrum?

A

IgA

47
Q

HLA Class II presents to which T cell?

A

CD4

48
Q

HLA Class I presents to which T cell?

A

CD8

49
Q

What are the 2 situations where HLA matching is used to allocate donors?

A

Stem cell transplants
Kidney transplants

50
Q

When is HLA matching not used to allocate donors?

A

Lung, heart and liver transplants

51
Q

Which type of hypersensitivity reaction is acute cellular rejection?

A

Type IV

52
Q

What is the time-frame over which acute cellular rejection of a transplant takes place?

A

5-30 days

53
Q

Transplantation of donor tissue between blood groups will always result in hyperacute rejection. True/False?

A

True

54
Q

Over what time-frame does acute vascular rejection of a transplant occur?

A

5-30 days

55
Q

Which type of hypersensitivity reaction is acute vascular rejection of a transplant?

A

Type II

56
Q

What is the most major cause of graft loss?

A

Chronic allograft failure

57
Q

Over what time-frame does chronic allograft failure occur?

A

Greater than 30 days

1MB Respiratory (13 decks)

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