Immunology Flashcards

1
Q

What cells do the common lymphoid progenitor cells give rise to?

A

T cells, B cells and NK cells

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2
Q

What cells do the Common Myeloid Progenitors give rise to?

A

Megakaryocyte/erythrocyte progenitor, dendritic cells and granulocyte/macrophage progenitor cells which differentiate into neutrophils, monocytes, eosinophils and basophils.

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3
Q

2008A Q5

Which of the following vaccines is least likely to induce long term immunologic memory?
A. Bacille Calmette-Guérin (BCG).
B. Diphtheria-tetanus-pertussis.
C. Haemophilus influenzae type B conjugate.
D. Hepatitis B.
E. Pneumococcal polysaccharide.

A

E. Pneumococcal polysaccharide.

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4
Q

What causes Graft Vs Host Disease?

A

Immune cells transplanted from a non-identical donor (the graft) recognize the transplant recipient (the host) as foreign, thereby initiating an immune reaction that causes disease in the transplant recipient.

The pathogenesis of GVHD is a complex, multistep process, but is primarily a T cell mediated process.

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5
Q

What medications are used in preventiion and treatment of GVHD?

A

Non-specific immunosuppressive drugs, such as corticosteroids and methotrexate,

as well as more specific T cell immunosuppressive drugs, such as cyclosporine and tacrolimus

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6
Q

Which virus is most likely to trigger Haemophagocytic Lymphohistiocytosis (HLH) in X-linked lymphoproliferative disease?

A

Epstein-Barr virus

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7
Q

What is mechanism of Staph aureus exacerbating atopic eczema dermatitis?

A

T-cell stimulation

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8
Q

What medications taken by atopic individuals should be ceased prior to skin prick testing?

A

Loratadine and other antihistamines

Steroids are okay to continue.

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9
Q

The gene defect in chronic granulomatous disease affects which protein?

A

NADPH oxidase

CGD is characterised by recurrent life threatening fungal and bacterial infections.

Inability of phagocytes to destroy certain microbes

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10
Q

Once a peanut allergy develops, it often persists lifelong. How many will spontaneously resovle and at what age? At what age does it usually present?

A

20% resolve at adolescence.

Presents at 6-24 months

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11
Q

If there is a FHx of SCID in a newborn, what should you look for in cord blood?

A

Reduction in lymphocytes is diagnostic.

All forms of SCID have deficiency of T lymphocytes.

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12
Q

A baby having episodic attacks of angiodema of hands and feet without pruritis is likely to have what disorder?

It is a deficiency of what?

A

Hereditary Angiodema

C1 Esterase deficiency

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13
Q

In children with immunodeficiency, the purpose of routine irradiation of administered blood products is to decrease the risk of:

A. Alloimmunization.

B. Cytomegalovirus (CMV) infection.

C. Graft-versus-host disease.

D. Transfusion related acute lung injury (TRALI).

E. Variant Creutzfeld-Jakob disease (vCJD).

A

C. Graft-versus-host disease.

Leukoreduced red cells — White blood cells (WBCs) can be removed from blood products by highly efficient filters that reduce the number of WBCs by more than 99.9 percent, generally to <1 x 106 WBCs per red cell unit [6]. The few that remain are capable of replication and can cause transfusion-associated-graft-versus-host disease (TA-GVHD).

Irradiated red cells — Transfusion-associated graft-versus-host disease (TA-GVHD) is caused by viable donor lymphocytes that are transfused into a patient who either does not recognize these cells as foreign or does not have the capacity to destroy them. TA-GVHD usually begins 8 to 10 days following transfusion and is almost inevitably fatal.

At a standard dose, gamma irradiation of the blood product prior to transfusion stops proliferation of foreign lymphocytes, which entirely prevents TA-GVHD. However, the dose of radiation used for cellular blood products is not sufficient to kill viruses. Thus, irradiation does not provide a CMV-safe product, and does not eliminate the need for either leukoreduction or CMV-seronegative blood products if a CMV-safe product is required. Conversely, leukoreduction does not eliminate all viable donor lymphocytes, and a leukoreduced product can cause TA-GVHD disease if it was not irradiated.(Uptodate)

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14
Q
A
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15
Q

How does chronic granulomatous disease tend to present?

A

Presents in first 3 years of life with skin infections, pneumonias, osteomyelitis (esp small bones), abscesses, presistent lymphadenopathy and hepatosplenomegally, and uncommon organisms.

Confirmed by NBT Test (Nitroblue tetrazolium test)

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