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Flashcards in immunology Deck (81):
1

HLA-A3

hemochromatosis

2

HLA-B27

seronegative arthropathies

3

HLA-DQ2/DQ8

celiac dz

4

HLA-DR2

MS, hay fever, SLE, goodpastures

5

HLA-DR3

T1DM, SLE, graves, hashimotos

6

HLA-DR4

RA, T1DM

7

HLA-DR5

pernicious anemia, hashimotos

8

type I HSR

IgE -> mast cell and basophil degranulation -> vasodilation of postcapillary venules -> delayed response from arachidonic acid metabolites (leukotrienes)

9

type II HSR

IgM, IgG bind to Ag on enemy cell -> cytotoxic killing via opsonization, complement + Fc receptor-mediated, and Ab-mediated cellular dysfxn. coombs test. acute transfusion rxns, AIHA, GBS, graves, MG, rheumatic fever, etc.

10

type III HSR

Ag, Ab, and complement get stuck together -> neutrophils release lysosomal enzymes. serum sickness and arthus rxn are specific types. SLE, post-strep glomerulonephritis, etc.

11

type IV HSR

NOT Ab-relatedd. delayed. T cells bind Ag -> cytokines -> macrophage activation. transplant rejection, TB skin test, touching (contact dermatitis). MS.

12

febrile nonhemolytic transfusion rxn

type II HSR. host Abs against donor HLA and WBCs -> fever, h/a, chills, flushing

13

acute hemolytic transfusion rxn

type II HSR. ABO incompatibility -> intravascular hemolysis, host Ab rxn w/foreign Ags -> extravascular hemolysis -> fever, hypotension, tachypnea, tachycardia, flank pain, hemoglobinuria (intravascular), jaundice (extravascular).

14

why does complement deficiency increase risk of SLE?

b/c complement is necessary to remove Ag/Ab complexes

15

anti-basement membrane

goodpastures

16

anticardiolipin, lupus anticoagulant

SLE, antiphospholipid

17

anticentromere

limited scleroderma (CREST)

18

anti-desmosome, anti-desmoglein

pemphigus vulgaris

19

anti-smith

SLE

20

anti-glutamic acid decarboxylase (GAD-65)

T1DM

21

antihemidesmosome

bullous pemphigoid

22

anti-histone

drug-induced lupus

23

anti-Jo-1, anti-SRP, anti-Mi-2

polymyositis, dermatomyositis

24

antimicrosomal, antithyroglobulin

hashimotos

25

antimitochondrial

PBS

26

antinuclear Abs

SLE, nonspecific

27

antiparietal cell

pernicious anemia

28

anti-Scl-70, anti-DNA topoisomerase I

scleroderma (diffuse)

29

anti-SSA, anti-SSB (anti-Ro, anti-La)

sjogrens

30

anti-smooth muscle

autoimmune hepatitis

31

anti-TSH

graves

32

anti-U1 RNP (ribonucleoprotein)

mixed connective tissue dz

33

IgA anti-endomysial, IgA anti-tissue transglutaminase

celiac

34

MPO-ANCA/p-ANCA

microscopic polyangiitis, eosinophilis granulomatosis w/polyangiitis (churg-strauss)

35

PR3-ANCA/c-ANCA

granulomatosis w/polyangiitis (wegener)

36

RF, anti-CCP

RA. RF = IgM against IgG Gc region. anti-CCP = more specific

37

immunodeficiency that -> giardia, bacterial, enteroviral infxns after 6 mos

bruton's agammaglobulinemia. no BTK -> no B cell maturation, so no plasma cells. absent/scanty lymph nodes

38

immunodeficiency that -> recurrent mucosal infxns, esp. viral

selective IgA def. usually asymptomatic.

39

immunodef. that -> bacterial, enterovirus, and giardia infxns acquired later

common variable immunodef. many causes (e.g. B cell or helper T cell defect) -> B cell maturation failure -> dec. plasma cells, immunoglobulins. inc. risk of autoimmune dz, bronchiectasis, lymphoma, sinopumonary infxns.

40

IL-12 def.

dec. Th1 response. AR. -> disseminated mycobacterial and fungal infxns. may present after BCG vaccine. dec. IFN-gamma

41

hyper-IgE syndrome

AD. job syndrome. STAT3 mutation -> Th17 def. -> impaired neutophil recruitment. course facies, cold (non-inflamed) staph abscesses, retained primary teeth, inc. IgE, dermatologic problems (eczema). low IFN-gamma

42

no B cells ->

fungal + viral infxns

43

no T cells ->

bacterial + protozoal infxns

44

no IgA ->

enterovirus

45

no C5-9 ->

neisseria

46

no C1 inhibiter ->

hereditary angioedema (esp. periorbital) + mucosal surfaces

47

3 causes of SCID

cytokine receptor defects
adenosine deaminase deficiency
MHC II def. -> dec. CD4+ -> dec. T + B cells

48

ataxia-telangiectasia

ATM gene defect -> failure to repair dsDNA breaks -> cell cycle arrest -> cerebellar defects, spider angiomas, IgA def. + inc. AFP, low IgA, IgG, IgE. lymphopenia.

49

wiskott-aldrich

WAS mutation, XR -> T cells can't reorganize actin cytoskeleton -> TTP, eczema, recurrent humoral + cellular infxns, inc risk of autoimmunity. low/nl IgG, IgM. inc. IgE, IgA. fewer, smaller plts.

50

leukocyte adhesion deficiency type 1

AR. defect in LFA-1 integrin CD18 subunit -> impaired migration + chemotaxis of phagocytes -> delayed cord separation, recurrent bacterial + mucosal infxns w/o pus.

51

chediak-higashi

AR defective lysosomal trafficking regulator gene (LYST). microtubule dysfxn -> lysosome + phagosome can't fuse. -> recurrent pyogenic staph + strep infxns, partial albinism, long nerve neuropathy, infiltrative lymphohistiocytosis. giant granules in granulocytes + plts. pancytopenia (impaired cell division), mild coag defect (primary hemostasis problem)

52

MPO deficiency

defective conversion of H2)2 -> HOCL -> inc. candida. normal NBT test

53

cyclosporine

calcineurin inhibitor, binds cyclophilin. blocks T cell activation by preventing IL-2 transcription!! Tx for PPx transplant rejection, psoriasis, RA. nephrotoxic

54

tacrolimus

= FK506. calcineurin inhibitor, binds FKBP. blocks T-call activation by preventing IL-2 transcription! Tx: PPx transplant rejection. nephrotoxic! inc. DM, neurotox. no gingival hyperplasia or hirsuitism

55

sirolimus

= rapamycin. mTOR inhibitor; bind FKBP. blocks T cell activation/B cell differentiation by preventing response to IL-2! Tx: kidney tranplant recetion PPx. not nephrotoxic. cytopenias, insulin resistance, HL

56

daclizumab, basiliximab

Abs block IL--2R. Tx: kidney tranplant PPx. edema, HTN, tremor

57

azathioprine

antimetabolite precursor of 6-mercaptopurine. inhibits lymphocyte proliferation by blocking nucleotide synthesis. Tx: rejection PPx, autoimmune stuff. cytopenias. 6-MP is degraded by xanthine oxidase so allopurinol -> inc. toxicity.

58

glucocorticoids

inhibit NF-kappaB. suppress B and T cells by dec. cytokine transcription.

59

aldesleukin

= IL-2. use in renal cell CA, metastatic melanoma

60

epoetin alfa

= erythropoietin.

61

filgrastim

= G-CSF. use for bone marrow recovery

62

sargramostim

= GM-CSF. use for bone marrow recovery

63

IFN-alpha

use in chronic hep B + C, kaposi sarcoma, malignant melanoma.

64

IFN-beta

MS

65

IFN-gamma

CGD

66

romiplostim, eltrombopag

thrombocytopenia

67

oprelvekin

= IL-11. use in thrombocytopenia

68

alemtuzumab

targets CD52. use in CLL

69

bevacizumab

targets VEGF. use for colorectal CA, renal cell CA. neovascular macular degeneration.

70

cetuximab

targets EGFR. use in stage IV colorectal CA, head + neck CA

71

rituximab

targets CD20. use in H-cell NH lymphoma, CLL, RA, ITP

72

trastuzumab

targets HER2/neu

73

adalimumab, infliximab

targets soluble TNF-alpha. use in IBD, RA, AK, psoriasis

74

etanercept

decoy TNF-alpha receptor, not monoclonal Ab

75

eculizumab

targets complement protein C5. use in paroxysmal nocturnal hemoglobinuria

76

natalizumab

targets alpha4-integrin (WBC adhesion). use in MS, crohns. -> inc. risk of PML in pts w/JC virus.

77

abciximab

targets plt glycoproteins IIb/IIIa. use to prevent ischemic complications during vascular cath.

78

denosumab

targets RANKL. use in osteoporosis to inhibit osteoclast maturation.

79

digoxin immune Fab

antidote for dig toxicity

80

omalizumap

targets IgE. use for allergic asthma: prevents IgE binding to Fc-epsilon-RI

81

palivizumap

targets RSV F protein. use as RSV PPx in high risk babies