Immunology

Front 1

Baby has recurrent fungal ,viral and bacterial infxns. A low IgGm and a thymic shadow. Whats he got?

Back 1

NOT DIGEORGE! Severe combined immunodeficiency. Both T and B cell immunity is fucked. Digeorge has normal humoral immunity

Front 2

What is the most common form of childhood systemic Vasculitis?

Back 2

HenochSchonlein purpura- IgA complexes

Front 3

Whats the triad for Henoch Scholein purpura?

Back 3

Skin, Joints, GI

Front 4

A kid comes in with colicy abdominal pain, joint pain, and palpable purpura. What renal problem is this disease associated with?

Back 4

IgA nephropathy- This disease is Henoch-Schonlein purpura ( due to IgA complexes)

Front 5

What disease affects the skin, joints, and Gi and has Iga complexes?

Back 5

HenochSchonlein purpura- Type III hypersensitivity

Front 6

True/False. Henoch schonlein Purpura have multiple lesions of different ages.

Back 6

False, they are all of the same age

Front 7

What is the first cell to show up during a Type IV hypersensitivity to poison Ivy?

Back 7

Apprently not macrophages, but rather T LYMPHOCYTEs

Front 8

True/False. The Polio vaccine (attenuated) is intramuscular while the killed Salk vaccine is given orally.

Back 8

False, the attenuated version is give orally, and stimulates IgA synthesis so the polio virus is stopped at its site of entry- mucosa (the heat killed one is give intra-muscularly)

Front 9

A patient has diplopia and difficulty chewing that improves on edrophonium infusion. What type of hypersensitvity?

Back 9

Type II

Front 10

Someone has a renal transplant. A biopsy shows vascular fibrinoid necrosis and neutrophils. How long after transplant is this?

Back 10

Immediate- Hyperacute sensitivity (preformed antibodies fix complement)

Front 11

2 yrs after a renal transplant someone shows up with renal failure. Biopsy shows dense lymphocyte infiltration. What happened?

Back 11

They probably stopped their immunosupressants (acute rejection can occur if meds are stopped

Front 12

What bacterial infection does silicosis sometimes predispose to?

Back 12

TB by impairing Macrophage phagolysosome disruption

Front 13

A patient working in a foundry and mine, is found to have tuberculosis, and restrictive lung disease. What is the state of his hilar lymph nodes on CT?

Back 13

This is silicosis- predisposes to Tb (disrupts phagolysosomes). The hilar lymph node would have egg-shell calcification

Front 14

A 4 yr old boy has difficulty walking, and has reccurent respiratory infections. What other enzymes are messed up if he also has IgA deficiency?

Back 14

Ataxia- Telengiectase- DnA Repair enzymes - He will also have spider angiomas

Front 15

What are the three polysach vaccines given to kids that are conjugated with protein?

Back 15

Strep, H. Flu, and Neiseria meningitidis (conj to protein to improve T cell response)

Front 16

What is the role of Nef protein from HIV on immune cells?

Back 16

To reduce MHC-1 on the surface of infected cells

Front 17

True/False. Secretory IgA acts as an opsonin.

Back 17

False, it binds to pilli and other membrane proteins that mediate bacterial adherence. IgA protease lets N.meningitidis, gonnorhea, strep pneumo, h. flu

Front 18

True/False. Although N.meningtidis makes Iga protease, n. gonorrhea does not.

Back 18

False, they both make iga protease

Front 19

Which T helper subset secretes IL-13?

Back 19

Th2 - this is thought to be a mediator in asthma (it is thought that together with Il-4, you get wayyy too much B cell IGE production)

Front 20

True/false. Even though IgGs cross the placenta, RhoGam is an IgG.

Back 20

yes

Front 21

Whats the order fo the immunoglobin heavy chains on the gene?

Back 21

MD GEA

Front 22

If some has really high IgM and low all the other abs, whats the likely defect?

Back 22

Lack of Cd40 Ligand on helper T cells- inability to class switch==HYPER IGM syndrome

Front 23

A patient has recurrent pusforming infxns and lymph hyperplasia. If he has very low IgG and A, what is the likely syndrome?

Back 23

CD40 ligand is missing on T cells so B cells cant class switch= Hyper IGM

Front 24

What cytokines released during tissue injury are anti-inflammtory?

Back 24

il-10 and Tgf beta

Front 25

What two syndromes manifest as IgA deifciencies?

Back 25

Selective Ig Deficiency (isotype switching) and Ataxia-telengectesia (Dna repair enzymes)

Front 26

How many proteins does a Secretory IgA have?

Back 26

ten- 4 Ig heavy, 4 Ig light, J protein , and secretory peptide

Front 27

A very pale child has recurrent skin infxns and respiratory infxns. He has giant cytoplasmic granules in nuetrophils and macrophages. What finding on neuro exam is also likely?

Back 27

Horizontal nystagmus- Chidiak higash (failure of phagolysosomal fusion=albino, peripheral neuropathy, and recurrent infxns)

Front 28

What b and T cell immunodeficiency is X linked?

Back 28

wiXcott Aldrich syndrome= Wiskot aldrich wears a TIE= Thrombocyto, Immunodef, and Exzema = Increased Ige and A, lower IGM

Front 29

What is the lab profile like in wiXcot aldrich syndrome?

Back 29

Increased IgE and A, low IgM

Front 30

What immunodeficiency presents with Eczema?

Back 30

wiXcott Aldrich syndrome= Wiskot aldrich wears a TIE= Thrombocyto, Immunodef, and Exzema = Increased Ige and A, lower IGM

Front 31

Where on IgG does comlpement bind?

Back 31

Near the hinge region (Ch2)

Front 32

Skin infections and gingivitis in a baby. The god Damn umbillical cord just wont fall off. Whats he got?

Back 32

Leukocyte adhesion deficiency- LFA1 intregrin has a defect (CD18) on phagocytes

Front 33

A baby keeps getting skin infections, but there is no pus. Labs show neutrophilia. What is absent?

Back 33

CD18 for LFA-1 integrin marker = the problem is Leukocyte Adhesion Deficiency Type 1 - umbillical cord doesn’t fall off either

Front 34

For a woman with non-caseating granulomas in the lung, and bilateral lymphadenopathy, what is the broncoalveolar lavage likely to show?

Back 34

Increased CD4/CD8 T cells ==More cd4s

Front 35

What immunodeficiency deals with a lack of a tyrosine kinase ad has reccurent bacterial infxns after 6mos?

Back 35

Brutons X linked Agammaglobulinemia

Front 36

What immunodeficiency has normal pro-B cells , but less maturation, # of b cells, and immunoglobiun?

Back 36

Brutons X linked Agammaglobulinemia

Front 37

A boy comes in with recurrent respiratory infxns, low immunoglobulin of all kinds, and has a maternal uncle with the defect. Whats his lymph node look like?

Back 37

lack of germinal centers