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Path Mega Deck > Immunology > Flashcards

Immunology Flashcards

1
Q

Kupffer Cell

A

Liver macrophage

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2
Q

Mesangial Cell

A

Kidney macrophage

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3
Q

Microglia

A

Neural macrophage

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4
Q

Langerhans Cell

A

Skin macrophage

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5
Q

Isotype Switching and Somatic Hypermutation happen where?

A

Germinal Centre

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6
Q

Memory response caused by which type of immunoglobulin?

A

IgG

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7
Q

Congenital neutropaenia

A

Kostmann Syndrome

HAX1 mutation

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8
Q

Neutropaenia every 6 weeks

A

Cyclic neutropaenia

Neutrophil Elastase mutation

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9
Q

Very high neutrophils in blood, none in tissue

A

Leukocyte Adhesion Deficiency: lack CD18 –> neutrophils can’t exit blood

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10
Q

Recurrent chickenpox

A

NK Deficiency

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11
Q

SLE caused by deficiency of which complement pathway?

A

Classical Pathway Deficiency

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12
Q

Which renal disease causes complement deficiency?

A

Membranous Glomerulonephritis = nephritic factors attack C3

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13
Q

High forehead, low-set ears, hypocalcaemia

A

DiGeorge Syndrome

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14
Q

DiGeorge Syndrome is due to deletion of what?

A

Chromosome 22q11.2

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15
Q

Do not respond to immunisations

A

Common Variable Immune Deficiency (very low IgG)

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16
Q

Gene locus in Coeliac

A

HLA-DQ2

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17
Q

Confirmation of Coeliac diagnosis

A

Upper GI endoscopy + distal duodenal biopsy

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18
Q

Periodic fevers, amyloid A amyloidosis and red rash

A

Familial Mediterranean Fever

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19
Q

Hypoparathyroidism and Addison’s

A

APS1 and APECED = defect in autoimmune regulator (AIRE) = transcription factor for T cell tolerance in thymus

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20
Q

Crohn’s caused by this mutations

A

NOD2 mutation in chromosome 16

NOD2 stimulates NFkB

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21
Q

Inflammation of entheses (insertion of ligament/tendon) and sacro-iliitis

A

Ankylosing Spondylitis

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22
Q

Anti-GAD65 and anti-IA2 antibodies

A

Type I Diabetes

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23
Q

Drooping eyelids and weakness after repetitive activity

A

Myasthenia Gravis

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24
Q

Autoimmune condition featuring crescentic nephritis on biopsy

A

Goodpasture’s Disease

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25
Q

Tensilon Test

A

Myasthenia Gravis

= edrophonium (anti-cholinesterase) prolongs life of ACh…

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26
Q

Rheumatoid Arthritis associated with these alleles

A

HLA DR1 and DR4

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27
Q

Porphyromonas gingivalis gum infection causes which autoimmune disease?

A

Rheumatoid Arthritis

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28
Q

Rheumatoid Arthritis associated with these polymorphisms

A

PAD2 and PAD4

PTPN22

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29
Q

Anti-Ro and anti-La

A

Sjogren’s

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30
Q

Heliotrope rash

A

Dermatomyositis

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31
Q

Severe side effect of cyclophosphamide

A

Haemorrhagic cystitis = toxic metabolite acrolein excreted in urine

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32
Q

People susceptible to bone marrow suppression with azathioprine

A

Thiopurine Methyltransferase (TPMT) polymorphism = can’t metabolise azathioprine…

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33
Q

Severe side effects of mycophenolate

A

Progressive Multifocal Leukoencephalopathy (JC virus which destroys oligodendrocytes)

Herpes reactivation

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34
Q

Side effect of ciclosporin

A

Dysmorphia

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35
Q

Side effect of rituximab

A

Progressive Multifocal Leukoencephalopathy

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36
Q

Side effects of anti-TNFa

A

Lupus-like condition
Demyelination
Melanoma

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37
Q

Side effect of denosumab

A

Avascular necrosis of jaw

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38
Q

Which malignancies are increased in transplant patients?

A

Virus-associated

  • Kaposi Sarcoma (HHV8)
  • Lymphoproliferative Disease (EBV)
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39
Q

Definition of AIDS

A

CD4 < 200

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40
Q

Definition of positive skin-prick test

A

> 3mm greater than negative control

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41
Q

Biomarker of anaphylaxis

A

Serial mast cell tryptase

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42
Q

Gold-standard test for allergy

A

Challenge Testing

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43
Q

Antibodies deposited along GBM in “smooth linear pattern”

A

Goodpasture’s

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44
Q

Low T cells with cleft palate

A 
DiGeorge Syndrome = CATCH:
Cardiac 
Atresia (oesophagus)
Thymus absent
Cleft Palate
Hypocalcaemia
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45
Q

Mutation of MHC III causes this disease

A

Common Variable Immunodeficiency (recurrent chest infections)

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46
Q

Negative NBT Test (i.e. stays colourless)

A

Chronic Granulomatous Disease = deficiency of NADPH oxidase
(NADPH oxidase turns NBT blue)
–>have NORMAL neutrophil count as their numbers are fine, just their mechanism of killing

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47
Q

Deficiency in either MHC I or MHC II

A

Bare Lymphocyte Syndrome

-causes jaundice

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48
Q

Recurrent resp and GI infections

Anaphylaxis after 2nd blood transfusion from same donor

A

Selective IgA Deficiency Disease

  • IgA = mucosal immunity, so have recurrent resp and GI infections
  • Anaphylaxis after blood transfusions due to donor IgA (2nd transfusion only as need to make antibodies against donor IgA in 1st transfusion)
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49
Q

Low IgM

Raised IgA and IgG

A

Wiskott-Aldrich Syndrome

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50
Q

Deficiency in this enzyme causes SCID

A

Adenosine deaminase

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51
Q

BCG vaccine contains this live attenuated organism

A

Mycobacterium bovis

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52
Q

Vaccine made of detoxified exotoxin product of the microbe

A

Tetanus

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53
Q

Vaccine made using recombinant DNA

A

Hep B

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54
Q

Vaccine given to sero-negative women only

A

Rubella

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55
Q

Vaccine available in live attenuated (oral) and inactivated –> excreted in stools

A

Poliomyelitis

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56
Q

Conjugate vaccine given to neonates

A

HiB

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57
Q

Adjuvant that promotes antibody response via IL-4 (which primes naive B cells)

A

Alum

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58
Q

Which immunity is induced by vaccines: active or passive?

A

Active

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59
Q

Immunosuppressant causing gum hyperplasia

A

Cyclosporine A

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60
Q
  1. Steroid used to prevent rejection

2. Steroid used to treat rejection

A
  1. Prednisolone

2. Methylprednisolone

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61
Q

Anti-Jo1

A

Dermatomyositis

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62
Q

Anti-topoisomerase

A

Diffuse systemic scleroderma

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63
Q

Dry mouth and eyes

Joint pain

A

Sjogren’s Syndrome (exocrine glands destroyed)

–> diagnose dry eyes using Schirmer’s Test

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64
Q

Antibodies in Sjogren’s

A

Anti-Ro and Anti-La … also Rheumatoid Factor

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65
Q

Saddle-shaped nose, with haemoptysis and haematuria

A

Wegener’s Granulamatosis

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66
Q

Target of IgG in Goodpasture’s

A

Type IV collagen (found in GBM and lung basement membrane!)

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67
Q

Polyarteritis nodosa with these infections

A

Hepatitis B and C – look out for “IVDU” in the question!

68
Q

22 year old female who has recently undergone surgery presents with difficulties breathing and swelling of the face, hands and feet. She also complains of severe abdominal pains. She has experienced similar problems in the past.

A

C1 inhibitor deficiency = Hereditary Angioedema

69
Q

HLA associated with psoriatic arthritis

A

HLA-B27

70
Q

HLA associated with dermatitis herpetiformis

A

HLA-DR3

71
Q

Which cells mediate:

  1. Hyperacute organ rejection
  2. Acute and chronic organ rejection
A
  1. B cells

2. T cells

72
Q

Complements that can activate mast cells to cause allergic symptoms

A

C3a and C5a

73
Q

What type of hypersensitivity in:

  • SLE
  • Rheumatoid arthritis
  • Serum sickness
  • Post-strep glomerulonephritis
A

Type III = antibody-antigen complexes depsoit

  • SLE = dsDNA
  • Rheumatoid arthritis = Fc region of IgG
  • Post-strep = strep wall antigens
74
Q

What type of hypersensitivity in:

  • T1 DM
  • MS
  • Contact dermatitis
  • Hashimoto’s
A

Type IV = T cells

  • T1 DM = beta cells
  • MS = myelin protein
  • Contact dermatitis = environmental chemicals
  • Hashimoto’s = thyroglobulin
75
Q

What type of hypersensitivity in:

  • Autoimmune Haemolytic Anaemia
  • ITP
  • Goodpasture’s
  • Pernicious anaemia
A

Type II = antibodies bind to cell-based antigen

  • Autoimmune Haemolytic Anaemia = RBCs
  • ITP = platelets
  • Goodpasture’s = GBM
  • Pernicious anaemia = parietal cells
76
Q

What type of hypersensitivity in:

  • Graves
  • Myasthenia Gravis
A

Type V = antibodies bind to cell surface receptor

  • Graves = TSH receptor
  • Myasthenia Gravis = ACh receptor
77
Q

Immunoglobulin which passes through:

  1. Placenta
  2. Breast milk
A
  1. IgG

2. IgA

78
Q

First immunoglobulin secreted in response to infection

A

IgM

79
Q

Cell surface marker associated with Reed-Sternberg cells

A

CD15

80
Q

Complement deficiency predispose to which type of infection?

A

Encapsulated bacterial (meningococcus, pneumococcus…)

81
Q

Which kidney disease causes secondary complement deficiency?

A

Membranous Glomerulonephritis = nephritic factors attack C3

82
Q

Enzyme deficiency causing SCID

A

Adenosine Deaminase (ADA) Deficiency

83
Q

Condition where you lack MHC II

A

Bare Lymphocyte Syndrome

  • -> lack CD4 (have normal CD8 and B cells)
  • ->low IgG and IgA as lack help from CD4!
84
Q

Condition where you lack mature B cells

A

Bruton’s X-Linked Agammaglobulinaemia
= abnormal B cell tyrosine kinase
-only in boys as X-linked!

85
Q

Condition where you have lots of IgM, but no other immunoglobulin

A

Hyper IgM Syndrome
=mutation in CD40 ligand (expressed on T cells)
–>IgM B cells can’t enter germinal centre
–>no isotype switching

86
Q

Hyper IgM predisposes you to this infection

A

Pneumocystis jiroveci

87
Q

B cell deficiency associated with Coeliac

A

Selective IgA Deficiency

88
Q

Monogenic auto-inflammatory disorder

A

Familial Mediterranean Fever

89
Q

Immunoglobulin that is a dimer

A

IgG = most abundant immunoglobulin

90
Q

Immunoglobulin that is a pentamer

A

IgM

91
Q

HLA DR3

A

Graves
SLE
Myasthenia Gravis

92
Q

HLA DR4

A

T1DM

Rheumatoid Arthritis

93
Q

SLE deficient in which complement pathway?

A

Classical (C1, 2, 4) = clears immune complexes and apoptotic cells

94
Q

Autograft
Isograft
Allograft
Xenograft

A 
Autograft = own
Isograft = twin
Allograft = same species
Xenograft = different species
95
Q

Azathioprine converted to this metabolite, which prevents DNA synthesis

A

6-mercaptopurine

96
Q

Corticosteroids inhibit….

A

Phospholipase A2

97
Q

How does HIV enter CD4?

A

gp120 binds to CXCR4 on surface of CD4

CCR5 is on surface of macrophages!

98
Q

Important side effects of anti-TNF

A

Lupus-like condition
Demyelination
Cancer

99
Q

Denosumab inhibits…

A

RANK ligand (inhibiting osteoclast)

100
Q

Specific test for dry eyes in Sjogren’s

A

Schirmer’s Test

101
Q

Anti-CCP target what in rheumatoid?

A

Filaggrin

102
Q

Anti-centromere

A

Limited systemic scleroderma (CREST)

103
Q

Anti-thyroid peroxidase and anti-thyroglobulin

A

Hashimoto’s

104
Q

Abnormal FoxP3 –> dysfunctional Tregs

A

IPEX (X-linked)

  • Diabetes
  • Eczema
  • Enteropathy
105
Q

Mutations in AIRE (important for central tolerance)

A

APECED Syndrome Type 1

–>hyothyroid, alopecia and vitiligo

106
Q

Anti-CD25 (part of IL-2R), prevents allograft rejection

A

Basiliximab

107
Q

CTLA4 fusion protein, for rheumatoid arthritis

A

Abatacept

108
Q

Monoclonal used in highly-active MS and last-resort for Crohn’s

A

Natalizumab = anti-α4 integrin

109
Q

Denosumab inhibits

A

RANK ligand

110
Q

Anti-IL-12 and anti-IL-23 used in psoriasis and Crohn’s

A

Ustekinumab

Side effect = TB

111
Q

Most severe form of influenza

A

Influenza A

112
Q

Bird flu is this strain if influenza

A

H5N1

113
Q

What is anti-SCL-70?

A

Anti-topoisomerase in systemic sclerosis!

114
Q

Biologic used in psoriasis

A

Ustekinumab = anti-IL-12 and anti-IL-23

115
Q

Mechanism of cyclophosphamide

A

Alkylating agent –> alkylates guanine base of DNA –> damages DNA

116
Q

Mechanism of mycophenolate

A

Anti-metabolite = Stops synthesis of new guanine –> prevents DNA replication

117
Q

Immunosuppressant used in multi-system vasculitis (like Wegener’s)

A

Cyclophosphamide

118
Q

Which type of antihistamine used in allergy: H1, 2, 3 or 4?

A 
H1 antagonist
(H2 = gastric mucosa)
119
Q

Neutralising antibodies are formed against this HIV molecule

A

gp120

120
Q

Non-neutralising antibodies are formed against this HIV molecule

A

p24

121
Q

Co-receptors required for HIV entry into cells

A

CCR5 and CXCR4

122
Q

What is CD40L deficiency?

A

Hyper IgM Syndrome!

123
Q

Who can have falsely negative anti-TTG?

A

IgA Deficient (as anti-TTG is IgA)

124
Q

Single gene mutation involving FOXP3 –> abnormal T regulatory cells

A

IPEX

125
Q

Mutated pyrin-marenostrin

A

Familial Mediterranean Fever

126
Q

Tests for Chronic Granulomatous Disease

A

NBT Test (does not change yellow to blue) and DHR Test (no fluorescence)

127
Q

Recurrent atypical Mycobacterium infections

A

IFN-γ receptor deficiency

128
Q

Initiates Classical Complement

Deficiency associated with SLE

A

C1q

129
Q

Test used to diagnose Di George

A

FISH = detects microdeletions (22q11)

130
Q

Recurrent meningococcal infections

A

Complement Deficiency

131
Q

Recurrent resp and CNS infections (in a boy)

A

Bruton’s X-Linked Agammaglobulinaemia

132
Q

Defect in Bruton’s X-Linked Agammaglobulinaemia

A

Abnormal B cell tyrosine kinase –> pre-B cells do not mature

133
Q

Most specific test in Sjogren’s

A

Anti-La

134
Q

Components of Classical Complement Pathway

A

C1, 2, 4 – C1 binds to antibody-antigen complexes, activating cascade

135
Q

Components of Alternative Complement Pathway

A

C3 and Factors B, I, P – C3 binds to bacterial cell wall parts (like LPS)

136
Q

Components of MBL Pathway

A

C2 and C4 – MBL binds to microbial cell surface carbs, stimulating Classical Pathway

137
Q

Complement Pathway dependent of adaptive immune system

A

Classical (C1 binds to antibody-antigen complexes)

138
Q

What complement gets activated in the major amplification step of the cascade?

A

C3

139
Q

Membrane Attack Complex via which complements?

A

C5-9

140
Q

Membrane Attack Complex formation defect (C5-9 deficiency) results in…

A

Meningococcal infections

141
Q

Deficiency in Classical Complement Pathway associated with…

A

Immune-complex diseases (SLE)

142
Q

Most common mode of inheritance in Di George

A

90% sporadic!

143
Q

Low IgM, eczema and low platelets

A

Wiskott-Aldrich Syndrome

144
Q

Recurrent PCP infections in a child

A

SCID (low T cells)

145
Q

Recurrent Aspergillus infection

A

Chronic Granulomatous Disease (neutrophils can’t kill)

146
Q

Hereditary Angioedema = deficiency in what?

A

C1 inhibitor protein –> have low C4 during attacks

147
Q

Dose used in anaphylaxis

A

0.5mg of 1:1000

148
Q

Antibody which correlates with disease severity in SLE

A

Anti-dsDNA

149
Q

Positive hydrogen breath test, increased stool osmolality

A

Lactose Intolerance

150
Q

Cause of commonest SCID

A

X-linked recessive mutation of common gamma chain on chr X (cytokine receptor)

151
Q

Cause of SCID in girls

A

Adenosine Deaminase (ADA) Deficiency

152
Q

DiGeorge is due to developmental defects in what during pregnancy?

A

3rd and 4th pharyngeal pouches = source of thymus and parathyroids

153
Q

Deficiency in this complement increases risk of encapsulated organisms

A

C3

154
Q

HLA in Reactive Arthritis

A

HLA-B27

155
Q

HLA in Dermatitis Herpetiformis

A

HLA-DR3

156
Q

HLA in Rheumatoid Arthritis

A

HLA-DR4

157
Q

First immunoglobulin in response to infection

A

IgM = IgNow!

158
Q

Immunoglobulin deficiency predisposing towards encapsulated organisms

A

IgG Deficiency

159
Q

Biologic against alpa-4-integrin

A

Natalizumub

160
Q

Calcineurin Inhibitors inhibit secretion of this cytokine

A

IL-2 (promotes T cell proliferation)

161
Q

Diagnosis of coeliac in IgA deficient

A

Go straight to duodenal biopsy

162
Q

Coeliac antibody that remains for 12 months after gluten-free diet

A

Anti-gliadin

163
Q

Cytokine in central memory

A

IL-2

164
Q

Vaccine made using recombinant DNA technology

A

Hep B

165
Q

Antigen assembled in a multimeric form and saponin that provokes a strong serum antibody response.

A

Immunostimulatory complexes (ISCOMS)

166
Q

Type of collagen targeted in Goodpasture’s

A

Type IV collagen

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