Immunology

Question 1

top 6 most common AI conditions in order most to least common

Answer 1

Graves > RA > Hashimotos thyroiditis > vitiligo

>T1D > pernicious anaemia

Question 2

IPEX syndrome - mono/polygenic AI?
stands for
age =

Answer 2

monogenic
Immune dysregulation, Polyendocrinopathy, Enteropathy, X linked inheritance
early childhood

Question 3

symptoms of IPEX syndrome

Answer 3

severe infections
intractable diarrhoea
eczema
early onset T1D

Question 4

pathogenesis of IPEX syndrome =
\_\_\_ gene (for regulation of T cell dev) > failure of peripheral \_\_\_ (inactivation of \_\_\_ that escape central \_\_\_ (removal of \_\_\_\_ in primary lymphoid tissues)

Answer 4

FOXP3
tolerance
self-reactive lymphocytes
tolerance
self-reactive lymphocytes

Question 5

treatment of IPEX syndrome

Answer 5

HSCT (haemopoietic stem cell transplant) cures it

IS and TPN

Question 6

broad classes of genes involved in polygenic AI (3)

Answer 6

HLA
sex
immune regulatory

Question 7

HLA ass with ank spond

Answer 7

B27 (90% relative risk)

Question 8

HLA ass with RA

Answer 8

DR4 (10%)

Question 9

HLA ass with SLE

Answer 9

DR3 (5%)

Question 10

HLA ass with MS

Answer 10

DR2 (5%)

Question 11

HLA ass with T1D

Answer 11

DR4/3 (20%)

Question 12

HLA ass with myasthenia gravis

Answer 12

DR3 (10%)

Question 13

in myasthenia gravis HLA DR3 is predisposing for ___ and protective of __ onset

Answer 13

predisp - early onset

protect - late onset

Question 14

molecular mimicry =

Answer 14

in infection eg Strep the pathogens antigens cause cross-reactive Igs to be produced that attack self
eg. Rheumatic fever

Question 15

SLE is a type __ H/S disease

Answer 15

3

Question 16

appearance of glomerulonephritis in SLE (a type 3 H/S)

Answer 16

IgG and C3 deposited = lumpy bumpy pattern

Question 17

glomerulonephritis appearance in Goodpastures (type 2 H/S)

Answer 17

linear IgG deposits along glomerular basement membrane

Question 18

SLE increases risk of ___

Answer 18

CVD

Question 19

features of SLE = SOAP BRAIN MD

stands for

Answer 19

Serositis
Oral ulcers
Arthritis
Photosensitivity
Blood disorder
Renal
ANA
Immunological
Neurological
Malar rash
Discoid rash

Question 20

ANA is useful in diagnosis of these 6 conditions

Answer 20

SLE
systemic sclerosis
Sjogrens
dermato+polymyositis
MCTD
AI hepatitis

Question 21

RA is a type __ H/S reaction

Answer 21

4

Question 22

in RA ___ => synovitis then __+___ are stimulated

Answer 22

CD4+

B cells and auto Igs

Question 23

__+__ are involved in RA - with high synovial concns = potent stimulators of fibroblasts, osteoclasts, condrocytes, stimulate__ release and mediate ___

Answer 23

TNFα + IL1
MMP
joint destruction

Question 24

___ is involved in inflammation of joint and systemic effects of RA

Answer 24

IL6

Question 25

RF is 100% specific for RA with __+__

Answer 25

nodules and extra articular features

Question 26

RF is only __% specific for RA

Answer 26

90%