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Immunology day 2
Question | Answer |
---|---|
Which antibodies can be given passively? | To Be Healed Rapidly: Tetanus, Botulinum, HBV, RabiesI |
Isotype switching is mediated by | CD40 ligan, IL-4, IL-5, Il-6 |
IgA functions | Prevents attachment of bacteria and viruses to mucous membranes, does not fix complement |
Defect in tyrosine kinase gene (BTK). Name disorder, what you would see, lab findings, inheritance? | (decreased production) Bruton's agammaglobinulinemia. Recurrent bacterial infections after 6 month (maternal IgG levels decline). Low B cells, normal pro-B cells. X linked |
Thymus and parathyroids fail to developt owing to failure of development of 3/4 pouch. Name disorder, what you would see, lab findings, inheritance | (Decreased production). CATCH-22 (Cardiac defects, abnromal facies, thymic hypoplasia, cleft palate, hypocalcemia (tetany), microdeletion of 22). Will have recurrent fungal/viral infections. 22q11 deletion |
Name the multiple causes of SCID and labs for each. | Causes: Failure to synthesize MHC II (noraml immature T cells), defective IL-2 receptor (normal Pro-T cells, X-linked), ADA deficiency (only stem cells present) |
No rejection of allografts | SCID |
Patient with SCID will present: | Recurrent viral, bacterial, fungal, protozoal infections. No rejection of allografts, high incidence of malignancy, GVH disease, FTT) |
Decreased activation of T cells is a result of what deficiency? What cells are deficient? | IL-12; causes disseminated mycobacterial infections due to decreased TH1 resposne |
decreased activation of B cells results in what disorder? presentation, lab values | hyper-IgM syndrome; CD40L on CD4 T helper cells --> inability to class switch. Presents with pyogenic infections. High IgM, low IgG, IgE, IgA |
Disorder= high IgM, low IgG, IgE, IgA, Disorder= high IgE, IgA, low IgM, Disorder = High IgE | Hyper-IgM syndrome, Wiskott-Aldrich syndrome, Job's syndrome |
Defect in the ability to mount an IgM response to capsular polysaccharides of bacteria. Disorder, mechanism, presentation, lab, genetics | Wiskott-Aldrich syndrome (decreased activation of B cells), "WIPE" = pyogenic Infections, thrombocytopenic Purpura, Eczema, high IgE, IgA, X-linked |
Neutrophils fail to respond to chemotactic stimuli | Job's syndrome (decreased activity of neutrophils), Failure of IFN-gamma production by helper T cells. (FATED) Coarse facies, cold staphylococcal abcesses, retained primary Teeth, high igE, Dermatologic problems (eczema) |
Defect in LFA-1integrin (CD_) proteins on ___ | CD18, phagocytes; LAD defciency (phagocyte cell deficiency). Early recurrent bacterial infections, absetn pus formation, neutrophila, delayed seperation from umbilical cord |
Defect in microtubular function and lysosomal emptying of phagocytic cells. Presentation, genetics | Chediak-Higashi (phagocytic cell deficiency). Recurrent pyogenic infections, by staph, strep, partial albinism, peripheral neuropathy, autosomal recessive |
Defect in microbiocidal activity of ____. Describe presentation. Describe diagnostic test | NADPH oxidase. Chronic granulomatous disease (deficiency of phagocytes). Presents with marked susceptibility to S. aureus, E. coli, Aspergilllus. Negative nitroblue tetrazolium dye reduction test |
Chronic mucotaneous candidiasis is a dysfunction in what cell type? | T cell dysfunction against candida. Presents with skin and mucous membrane candida infections |
Deficiency in a class of immunoglobulins | Selective immunoglobulin deficiency. Selective IgA deficiency is the most common; Presents with sinus, lung infections, milk allergies, diarrhea. |
milk allergies, diarrhea due to - | IgA deficiency |
Anaphylaxis to bloo products | IgA deficiency |
Defect in DNA reapir enzymes. Its associated with what deficiency? presents with what problems? | Ataxia telangiectasia; associated with IgA deficiency. cerebellar problems, spider angiomas (due to ATM gene) = autosomal recessive, tumor suppressor |
decreased plasma cells but normal B cells | Common variable immunodeficiency; present in 20s-30s; increased risk of autoimmune disease, lymphoma. |
Bugs that have antigenic variation include | salmonella (flagellar), borrelia, Neisseria (pilus), Virus (shift=rearrangment, drift=random mutation), trypanosomes (african sleeping sickeness)- programmed rearrangement |
Anergy: | self-reactive molecules become non-reactive with costimulatory molecule |
Types that have granulomatous disease | Tuberculosis, Fungal (histo), syphillis, leprosy, Cat scratch, sarcoid, crohn's, berylliosis (non-caseating) (aerospace/nuclear industry) |
Define granuloma | Nodular collection of specialized macrophages (epitheliod cells) surrounded by a rim of lymphocytes) |
Desribe progression of granuloma | APC eats antigen; presents on MHC II--> matched with CD4; TH1 stimulates IFN gamma--> monocyte --> macrophage--> epitheliod cell --> giant cell |
Components of granuloma | epitheliod cell, giant cell, fibroblasts, lymphocytes. |
Difference between Langhans cells and foreign body | Langhans= multiple nuclei in horseshoe conformation; Foreign body = scattered nuclei |
Radioimmunosorbent test | Type I (detects specific igE antibodies in serum agasint specific allergies) |
Coomb's: Direct/Indirect; hypersensitivity __ | Direct: detects IgG/C3b attached to RBC; Indirect: detects antibodies in serum (Rh anti-D); II |
Immunofluoresecnt staining | III |
Alternative pathway is part of ___ immune system. Eg: | LPS, gram -; innate |
Classical pathway is part of ___ immune system; it involves | C1-C4 = viral neutralization; adaptive |
Mannose binding lectin pathway | Used for binding to sugars on surface |
C3b =, c3a = c5a = | C3b = opsonization, c5a, c3a = anaphylotoxins, c5a = neutrophil chemotaxis |
Deficiency of c1 esterase leads to | hereditary angioedema = problem with classical system; C1 esterase= noramlly controls complement; without it you'll have a decrease in C2-C4, increased cleavage products --> anaphylaxis (swelling of face/oropharynx) |
C2 deficiency | Association with septicemia (S. pneumoniae), lupus like syndrome in cildren |
C6-C9/C5-8 deficiency | Increased susceptibility to Neisseria/mengitidis |
DAF function | (decay accelerating factor): prevents complemetn activation of self cells |
DAF deficiency | due to a defect in the the anchoring of the particle; leads to complement mediated lysis for RBCs and paroxysmal nocturnal hemoglboinuria (platelets, neutrophils, hemoglobinuria) |
Function of interferons: | induce production of ribonuclease that inhibits viral protein synthesis by degrading viral mRNA. Also activates NK cells to kill virus-infected cells |
Alpha/beta interferons ___-, while gammma does ___ | alpha/beta = inhibit viral protein synthesis, gamma= increases MHC I/II expression and antigen presentation on cells |