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Year 5 Pathology > Past Papers Immuno > Flashcards

Past Papers Immuno Flashcards

1
Q

CD4 deficiency, less IgA and IgG made

Unwell by 3 months

A

Bare lymphocyte syndrome type II

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2
Q

CD40L
X-linked
can’t class switch so no IgA and IgG

A

Hyper IgM

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3
Q

low Neut, 6 days every 3 weeks

What is Tx?

A

Cyclic neutropenia

give G-CSF

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4
Q

X linked tyrosine kinase
BTK gene
No mature B cells, no antibodies, symptoms 3-6 months

A

Bruton’s X-linked hypogammaglobulinaemia

Only B cells (which mature in the bone marrow) are deficient. Ear infections are common as these individuals are susceptible to encapsulated bacterial infections) (or if question had said multiple cells lines affected = Anaplastic Anaemia)

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5
Q

congenital neutropenia

A

Kostmann’s syndrome

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6
Q

Rheumatoid arthritis patient with mycobacterial infections

Cause?

A

Iatrogenic - TNFa antagonists

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7
Q

Recurrent pneumococcal disease and meningitis

A

Complement deficiency - C5-C9

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8
Q

Immune deficiency that has improved with age but not mum is concerned about delayed speaking and language

A

Di George

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9
Q

Marker of antibody mediated rejection

A

C4d

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10
Q

Most important to match for rejection

A

HLA: DR>B>A

HLA = cell surface proteins, encoded on Chr6 by MHC. Present Ags to Tc

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11
Q

Preformed Ab activates complement
Thrombosis and necrosis
prevented by cross matching (HLA, ABO)

A

Hyper-acute rejection (mins-hrs)

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12
Q

CD4 T cells, type IV reaction-> cellular infiltrate

Treat with T cell suppressors

A

Acute Cellular rejection

Weeks - months

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13
Q

Antibodies attack vessels
Exposure -> proliferation + maturation of B cells -> effector phase - antibodies bind to graft endothelium (->vasculitis)

A

Acute - Ab mediated

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14
Q

Donor cells attacking host
Days-weeks
Rash, N+V, bloody diarrhoea, abdo pain, jaundice
Prophylaxis: methotrexate/cyclosporine, steroids

A

Graft vs Host disease

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15
Q

scl-70 topoisomerase

A

diffuse systemic scleroderma

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16
Q

anti-cardiolipin

A

anti phospholipid syndrome

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17
Q

c-ANCA

A

Wegener’s granulomatosis (epistaxis and haematuria)

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18
Q

AIRE mutation

A

Autoimmune Polyendocrinopathy Syndrome Type 1

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19
Q

Grave’s which type of hypersensitivity?

A

Type II

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20
Q

Serum sickness which type of hypersensitivity?

A

Type III

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21
Q

Atopic Eczema which type of hypersensitivity?

A

Type I

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22
Q

dry eyes and mouth

A

Sjogrens

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23
Q

weight loss, anti TTG antibodies, anti endomysial antibodies, steatorrhoea

A

Coeliac

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24
Q

CREST

A

Calcinosis, Raynaud’s, Esophageal dysmotility, Sclerodactyly, Telangiectasia

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25
Q

anti ds DNA

A

SLE

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26
Q

anti parietal cell > anti intrinsic factor

A

Pernicious anaemia

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27
Q

Pollen/fruit ross-react

A

Oral Allergy Syndrome

Sx in mouth only

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28
Q

Bluish mucosa
Seasonal - allergen desensitisation

Tx?

A

Allergic rhinitis

Nasal corticosteroid or oral antihistamine

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29
Q

C1 esterase inhibitor is Mx for

A 
Hereditary angioedema
(angioedema, abdo pain, ascites, facial/testinal oedema)
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30
Q

Urticaria Mx

- idiopathic, food, drugs, latex, viral, infection, exercise

A

H1 receptor antagonist

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31
Q

Angioedema, SOB, low BP

A

Anaphylaxis

Mx - O2 and fluids, help, IM 500mcg Adr, inhaled bronchodilator, 100mcg Hydrocortisone IV, Cloramphenamine 10mcg IV

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32
Q

Main cellular source of histamine

A

Mast cells

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33
Q

How do you measure mast cell degranulation

A

Mast cell tryptase

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34
Q

Chemokine responsible for promoting eosinophil growth

A

IL-5

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35
Q

Engulf debris

A

Macrophage

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36
Q

Secrete Igs, cytokines, present antigens

A

B cells

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37
Q

Present antigens; migrate to lymph nodes when activated

A

Dendritic cells

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38
Q

Cytotoxic - MHC I

A

CD8 Tc

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39
Q

HIV Co-receptor

A

CXCR4/CCR5

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40
Q

HIV Receptor on cell wall which facilitates entry

A

gp120

41
Q

HIV Antigen for non-neutralising antibodies

A

p24

42
Q

HIV drug that inhibits an enzyme that breaks down proteins

A

Protease inhibitors

43
Q

Can be used for RA

A

Rituximab

44
Q

For ank spond (with methotrexate), antiTNFalpha receptor

A

Etarnercept

45
Q

Pooled Ig given for

A

CVID

46
Q

Prophylaxis of allograft rejection

A

Basiliximab (Anti CD25, stops Tc prolif)

Anti-thymocyte globulin (affects Tc)

47
Q

RA Mx
(also for Castleman’s)

Antibody to IL6 receptor
reduces macrophage/T cell/B cell/neutrophil activation

A

Tocilizumab

+ anti TNFa e.g. Etanercept

48
Q

Mx Psoriasis

Antibody to p40 subunit of IL12 and IL23

A

Ustekinumab

49
Q

Osteoporosis Mx

Ab to RANK ligand (stops osteoclast differentiation)

A

Denosumab

+ bisposphonate

50
Q

Mx Wegener’s

Antiproliferative agent - B>T cells affected

A

Cyclophosphamide

51
Q

Chronic granulomatous disease Mx

A

IFN-g

52
Q

Temporal arteritis with high ESR Mx

A

Prednisolone

53
Q

Anti TNFalpha

Used for loads - psoriasis, crohn’s rheumatoid

A

Infliximab

54
Q

Routine but not given to immunocompromised children

A

MMR

55
Q

Travel vaccine not given to someone with ank spond on TNFalpha inhibitor

A

Yellow Fever

56
Q

12-13 year old girls vaccine

A

HPV

57
Q

Vaccine every 5 years given to splenectomy patient

A

Pneumococcal

58
Q

Targets neuraminidase/haemogglutinin

A

Amantadine - influenza A only, targets M2 channel

Oseltamivir, zanamivir, sialic acid - NA inhibitors

59
Q

Vaccine given as post exposure prophylaxis

A

rabies

60
Q

Structure varies yearly

A

Influenza

61
Q

Vaccine that eradicated small pox

A

Vaccinia

62
Q

Hep B type vaccine

A

conjugate vaccine

63
Q

Transplant complications

A 
Lymphoproliferative disease (EBV)
Kaposi's sarcoma
64
Q

Cause progressive multifocal leukoencephalopathy

A

JC virus

65
Q

Boy whose father got TB after BCG now currently has mycobacterium infection after BCG

A

IFN gamma receptor deficiency

66
Q

A teenage girl who when she goes cross country running gets an erythematous rash on her legs. It is well controlled by antihistamines

A

cold urticaria

67
Q

Man can eat apple pie. But if he eats fresh apples and pears, he gets inflamed lips

A

OAS

68
Q

Man has an allergic reaction during surgery and who’s lips becomes swollen/oedematous when blowing up balloons as his daughter’s birthday party

A

Type 1 hypersensitivity

69
Q

Bloated after drinking milk but not IgE mediated

A

lactose intolerance (enzyme deficiency rather than IgE mediated)

70
Q

A girl with a sore throat is given penicillin and develops a rash. She is found to have EBV.

A

Drug reaction (serum sickness)

71
Q

Teenager + sore throat
3 causes

cause if rapid antigen testing is negative and monospot/heterophile antibody test positive

cause if monospot/heterophile antibody test negative (therefore not EBV) + Rapid antigen test negative

A

Strep throat
EBV
CMV

RAT -ve/ monospot +ve = EBV

CMV

72
Q

Paviluzimab use

A

monoclonal Ab for RSV

73
Q

HIV immune response:
neutralising AB
Non-neutralising Ab

A

neutralising Ab - anti-gp120

non-neutralising - anti- p24

74
Q

What cell is inhibited by the presence of MHC1 on cells

A

NK cells

75
Q

What cell is increased in cases of a parasitic infection

A

eosinophils

76
Q

Woman presents with aches all over, (diffuse swelling), and joint stiffness?

A

Rheumatoid arthritis

77
Q

A patient with well controlled HIV, who is currently on HAART. What would you measure?

A

CD4 via FACS (flow cytometry) viral load

78
Q

A women with known SLE presents with an exacerbation of her SLE/worsening symptoms. What do you measure?

A

C3 and C4

79
Q

Rhesus D negative woman is having a Haematopoietic stem cell transplant (HSCT) and is CMV IgG negative. What is the most important thing to ensure in the transplant?

a. HLA of donor and recipient identical
b. Related to recipient and HLA identical
c. HLA haploidentical
d. CMV IgG negative
e. Donor not Rhesus match

A

CMV IgG negative

80
Q

HIV RNA forms HIV, via which error prone enzyme?

A

Reverse transcriptase

81
Q

Which of these vaccines must not be given to a pregnant woman:

a. MMR
b. Hep B
c. DTP

A

MMR (live vaccine) as is BCG, typhoid

82
Q

5 special drug treatments. Which drug can be used to treat some malignancies and affects T cell activity?

a. Infliximab
b. Pembrolizumab
c. Rituximab

A

Rituximab

83
Q

Gout man on allupurinol

Which meds would need to be altered to prescribed allopurinol?

A

Azathioprine

84
Q

Man has intermittent + tongue swelling for the past 2 years
unresponsive to anti-histamines
is on aspirin and ACE inhibitor
likely cause?

A

Drug induced reaction - angioedema is commonly associated with ACE-inhibitors and NSAIDs.

85
Q

Cell sits immature in periphery

matures + presents to T cells

A

Dendritic cells

86
Q

cell inhibited by MHC1 on cells

A

NK cells

87
Q

Heterophile antibody

A

Infectious mononucleosis

88
Q

Anti-Jo-1

A

Dermatomycositis

89
Q

Anti-Thyroperoxidase/throglobulin AB

A

Hashimoto’s thyroiditis

90
Q

Anti-U1RNP Ab (speckled pattern)

A

Mixed CTD

91
Q

p-ANCA

A

Microscopic polyangiitis

Churg-Strauss

92
Q

congenital heart block in infant of mum with SLE

A

Anti-Ro Ab

93
Q

AIRE Mutation

A

– Autoimmune polyendochrinopathy syndrome 1

endocrinopathies: T1DM, addison’s, hypothyroidism

94
Q

cancer

Bruton Tyrosine kinase inhibitor ibrutinib be used in

A

CLL

95
Q

Rhesus D negative woman
having a Haematopoietic stem cell transplant is CMV IgG negative
must ensure that…

A

transplant is CMV IgG negative

96
Q

vomiting, white cell casts in urine

A

pyelonephritis

97
Q

pain, haematuria

A

renal calculus

98
Q

most specific marker for Rheumatoid arthritis

A

Anti-Cyclic Citrullinated Peptide

Year 5 Pathology (13 decks)

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