Immunology Flashcards

(48 cards)

1
Q

causes of secondary immune deficiency?

A
infection
old age
drugs
malignancy
nutritional disorder
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2
Q

what is a granuloma?

A

an organised collection of activated macrophages and lymphocytes

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3
Q

why do granulomas sometimes form?

A

inflammatory response triggered by a stimulus
failure of removal of the stimulus results in persistent cytokine production
immune cells cluster in a circle

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4
Q

DDx lung granuloma

A
TB
sarcoidosis
chronic hypersensitivity pneumonitis
dust diseases eg silicosis
foreign body
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5
Q

people with antibody deficiencies tend to get bacterial/viral infections

A

bacterial

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6
Q

how does antibody deficiency present

A

recurrent bacterial infections

antibody mediated autoimmune disease

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7
Q

selective IgA deficiency patients to tend to get infections in what system?

A

respiratory BUT most are asymptomatic

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8
Q

what is hypogammaglobulinaemia

A

decrease in gammaglobulins INCLUDING immunoglobulins

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9
Q

if you arent antibody deficient but you have hypogammaglobulinaemia what could be the cause?

A

protein loss or failure of protein synthesis eg by leukaemia

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10
Q

NK cells kill cells that lack what?

A

MHC

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11
Q

toll-like receptors respond to what?

A

PAMPS

pathogen associated molecular patterns

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12
Q

TLRs are expressed on..

A

phagocytes

dendrites

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13
Q

by activating TLRs, you will trigger the release of…

A

pro-inflam cytokines

type 1 interferon secretion

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14
Q

TNF inhibitors block…

A

pro-inflam cytokines

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15
Q

give an example of a TLR activating drug

A

imiquimod

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16
Q

why are biologic drugs not hepato or nephrotoxic?

A

are normal proteins so their metabolism doesnt depend on liver/renal function

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17
Q

what are biologic drugs made of?

A

artificial antibodies

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18
Q

name the fastest kind of transplant rejection; how long does it take to present?

A

hyperacute

minutes-hrs

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19
Q

acute cellular rejection is an example of type _ hypersensitivity

A

4

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20
Q

cells involved in acute cellular rejection?

A

CD4 and CD8 T cells

21
Q

acute vascular rejection is an example of type _ hypersensitivity

22
Q

name the types of transplant rejection that occur 5-30 days after transplant

A

acute cellular rejection

acute vascular rejection

23
Q

what transplant rejection can present with vasculitis?

A

acute vascular rejection

24
Q

what transplant rejections are treated? with what?

A

hyperacute - nil
acute cellular/vascular - immunosuppression
chronic allograft failure - treat symptoms

25
pathophysiology of chronic allograft failure
fibrosis | scarring
26
which transplant rejection occurs >30 days after transplant?
chronic allograft fracture
27
2 types of active immunisation
live attenuated | inactive
28
what kind of T cells become memory T cells
effector T cells
29
how does the antibody response to infection change if there is memory?
IgG is produced at the same time as IgM instead of after
30
why do inactivated vaccines require multiple injections?
dont stimulate clonal expansion of B and T cells
31
give an example of a whole cell inactivated vaccine
polio rabies cholera (think travel vaccines)
32
give an example of a fractional inactivated vaccine
``` hep B flu HPV diphtheria tetanus HiB ```
33
give an example of a live attenuated vaccine
``` MMR chicken pox yellow fever polio BCG for TB ```
34
test for ANA?
ELISA
35
autoantibody Ix for SLE?
1. ANA | 2. dsDNA and ENA if the staining pattern of ANA matches that of SLE
36
rheumatoid factor is an autoantibody directed to....
the Fc region of IgG
37
what do c-ANCA and p-ANCA mean?
``` c-ANCA = diffuse staining into Cytoplasm p-ANCA = Peripheral staining around nuclei ```
38
NK cells are part of the innate/adaptive immune system
innate
39
what cells are part of adaptive immunity
T and B lymphocytes
40
the formation of what accounts for the rapid production of IgG at re-exposure to a microbe after vaccination
memory B cells
41
why is it good to have multiple vaccines at once?
produces memory
42
how are biological drugs metabolised?
broken down into amino acids (dont need liver/renal function)
43
biological therapy is a form of passive/active immunity
passive
44
methotrexate is an example of an immunosuppressant T or F
F, its an anti inflammatory
45
what receptor does methotrexate act on?
adenosine A2 receptor
46
liver contraindications to methotrexate?
any chronic liver disease | alcoholism
47
you should stop a biologic if you have low eGFR T or F
F, biologics dont affect the kidneys or liver
48
if you take away TNF what are you at risk of?
reactivation of TB as the granuloma will break up