Immunology

Question 1

IL associated with pyrexia

Answer 1

IL-1
IL-6

Question 2

IL associated with neutrophil chemotaxis

Answer 2

IL-8

Question 3

IL associated with B cell differentiation

Answer 3

IL-6

Question 4

Site of action of IL-1
Action

Answer 4

Macrophages
Fever

Question 5

Site of action of IL- 8
Action

Answer 5

Macrophages
Neutrophil chemotaxis

Question 6

Site of action of IL-6
Action

Answer 6

Macrophages
Fever
B-cell differentiation

Question 7

Mastocytosis
- What is it?
- What are the symptoms?

Answer 7

= proliferation of mast cells, neoplasm
Symptoms of carcinoid + urticaria

Question 8

Marker in hereditary angioedema
Deficiency

Answer 8

C4 (because we have been there BEFORE)
Deficient = C1
C1 = vascular permeability > leaky vessels

Question 9

CD4 T cells
- Express
- Also known as

Answer 9

MHC Class II
T helper cells

Question 10

CD8 T cells
- Express
- Also known as

Answer 10

MHC Class I
Cytotoxic T cells

Question 11

Further subdivision of CD4 cells
- How can they be told apart?

Answer 11

Th1 and Th2 cells
Classification depends on cytokines released
Th2 = humoral immunity (cytokines focus on Ab release)
Th1 = cell mediated immunity (cytokines focus on killing T cells)

Question 12

How does IL-1 mediate the sepsis response?

Answer 12

Activates platelet activating factor, prostaglandin and nitric oxide
= potent vasodilators

Question 13

Action of IL-5

Answer 13

Production and activation of eosinophilsA

Question 14

Action of G-CSF

Answer 14

Allows development and activation of neutrophils

Question 15

Action of TNF-alpha

Answer 15

Fever
Macrophage activation

Question 16

Action of INF-gamma

Answer 16

Activation of macrophages

Question 17

Cytokines which result in fever (3)

Answer 17

IL-1
IL-6
TNF-alpha

Question 18

Action of INF-alpha

Answer 18

Activates macrophages

Question 19

What activates the classical complement pathway?

Answer 19

IgM antibodies
IgG antibodies

Question 20

What activates the alternative complement pathyway?

Answer 20

IgA
Endotoxin - LPS released from lysis of bacterial cell wall

Question 21

Complement deficiency associated with immune complex disease
- Examples (3)

Answer 21

C2 and C4
- SLE, HSP, glomerulonephritis

Question 22

Complement deficiency in recurrent infections

Answer 22

C5-C9

Question 23

Alternative pathway

Answer 23

C3

Question 24

Classical pathway

Answer 24

C1 > C4 > C2 > C3 > C5-9

Question 25

Which antibody is the most abundant?

Answer 25

IgG

Question 26

Can IgG cross the placenta?

Answer 26

Yes - hence issue with anti-D IgG antibodies in future pregnancy

Question 27

Monomer antibodies (2)

Answer 27

IgG IgD

Question 28

Pentamer antibody

Answer 28

IgM

Question 29

Which antibody activates the alternative complement pathway?

Answer 29

IgA

Question 30

Autoimmune haemolytic anaemia - Cold - Warm

Answer 30

Cold = IgM because cold is Miserable: intravascular Warm = IgG

Question 31

Cryoglobulinaemia Type 1 Type 2 Type 3

Answer 31

Type 1 = monoclonal Type 2 = mixed monoclonal, polyclonal Type 3 = polyclonal

Question 32

Association with Type 1 cryoglobulinaemia (2)

Answer 32

Myeloma, Waldenstroms - one clonal cell proliferating

Question 33

Association with Type 2 cryoglobulinaemia (2)

Answer 33

Hepatitis C, Lymphoma

Question 34

Type II hypersensitivity - problem - example (5)

Answer 34

Cell bound = antibody binds to cell surface e.g. autoimmune haemolytic anaemia, transfusion reaction, post-streptococcal glomerulonephritis, goodpastures, ITP

Question 35

What type of hypersensitivity is Grave's disease?

Answer 35

Type II - TSH antibody binds to receptor, causing thyroid effects

Question 36

Type III hypersensitivity - problem - example (4)

Answer 36

Immune complex = antibodies, free antigen and complement bind together to form complexes e.g. drug induced haemolytic anaemia, hypersensitivity pneumonia, malaria, SLE

Question 37

Direct Coomb's Test - aim of test - example

Answer 37

Aim = looking for antibodies bound to red blood cells - AIHA - will be positive

Question 38

Indirect Coomb's Test - aim of test - application

Answer 38

Looking for free antibodies in serum e.g. prior to transfusion, pregnancy for anti-D/other sensitising antibodies

Question 38

What mediates hyperacute organ rejection?

Answer 38

B cell mediated - antibodies attack and destroy graft - Present due to previous sensitisation event

Question 39

What mediates acute organ refection?

Answer 39

T cell mediated - T cells migrate out of graft, processed then invade

Question 40

Pathogenesis of graft vs host disease

Answer 40

Donor lymphocytes attack antigen of recipient

Question 41

B cell only disorders (4)

Answer 41

IgA deficiency Common variable immunodeficiency Bruton's Hypogammaglobulinaemia

Question 42

Infection pattern in B cell disorders

Answer 42

Pyogenic bacteria Yeasts Giardia

Question 43

Bruton's immunodeficiency - genetics - presentation age - problem

Answer 43

X-linked inheritance Under 6 months at presentation No B cells present

Question 44

Combined B cell and T cell deficiencies (3)

Answer 44

Severe combined immunodeficiency Ataxic Telangiectasia Wiskott-Aldrich

Question 45

Ataxic Telangiectasia - genetics - presentation (4)

Answer 45

Autosomal recessive Cerebellar ataxia, occular telangiectasia ENT, chest infections

Question 46

Wiskott-Aldrich Syndrome - genetics - infection

Answer 46

X-linked recessive Pyogenic infections

Question 47

Infection pattern in T cell disorders

Answer 47

Opportunistic infections

Question 48

T cell disorder (1)

Answer 48

DiGeorge Syndrome

Question 49

DiGeorge syndrome - genetic mutation - pathogenesis - presentation (3)

Answer 49

22q11 deletion - part of long arm Ch 22 is missing - Absence of a thymus due to issue with 3rd/4th pharyngeal pouch Hypoparathyroidism, CV problems, opportunistic infections

Question 50

Infection pattern in neutrophil disorders

Answer 50

Gram -VE bacteria Staph aureus Viral infections Aspergillus

Question 51

Chronic Granulomatous Disease - genetics - pathogenesis - when presents?

Answer 51

X-linked Defect in NADPH oxidase axis Presents in first 2 years of life

Question 52

What kind of hypersensitivity reaction is ITP?

Answer 52

Type II - antibodies bind to platelets

Question 53

Function of IgD antibodies

Answer 53

Activate B cells

Question 54

Hyperacute transplant rejection mediated by which antibody?

Answer 54

IgG