Immunology

Question 1

How is anaphylaxis diagnosed?

Answer 1

Skin/mucosa involvement and either hypotension or resp distress
Involves >=2 organ systems after exposure to likely allergen
Hypotension after known allergen

Question 2

Hereditary angioedema - signs

Answer 2

Asymmetric nonpitting edema following minor trauma or injuries
Edema can cause colicky abdominal pain or laryngeal airway obstruction
Low C1 inhibitor protein, low C4 due to cleavage

Question 3

What is the cause of febrile non-hemolytic transfusion reaction?

Answer 3

Cytokines released by donor leukocytes

Question 4

What is the cause of transfusion-related acute lung injury?

Answer 4

Leukocyte antibodies from donor that react with antigens in recipient

Question 5

When can transfusion-associated dyspnea be diagnosed?

Answer 5

Acute respiratory distress within first 24h without transfusion-associated circulatory overload (TACO) or acute lung injury (TRALI)

Question 6

Iron sequestration in macrophages is characteristic of what?

Answer 6

Anemia of chronic disease

Question 7

Polyarteritis nodosa affects which organs most?

Answer 7

Constitutional - fever, weight loss, malaise
GI - mesenteric ischemia/infarction
Renal - HTN, insufficiency
Skin - nodules, ulcers, purpura
MSK - myalgia, arthritis
Nervous - headache, seizures, mononeuritis multiplex

Question 8

Polyarteritis diagnosis

Answer 8

Biopsy (gold standard) - nongranulomatous transmural inflammation
Angiography showing microaneurysms + segmental/distal narrowing
Negative ANCA and ANA

Question 9

Acute (100 days) GvHD symptoms

Answer 9

1. Maculopapular rash (painful, confluent resembling Stevens-Johnson syndrome)
2. Profuse, watery diarrhea (secretory pattern) with pain, nausea, vomiting
3. Liver inflammation - damage to biliary tract epithelium, elevated levels across board