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Immunology clues
PASS IMMUNOLOGY
| Question | Answer |
|---|---|
| What is a moiety? | An antigen that usually elicits and immune response. In actuality it can be anything:hair, peanut, corn kernel, popcorn, even a virus can be one and definitely a bacteria |
| What is considered to be so small that the body's immune system cannot recognize it? | Anything < 6000D. |
| What measure is considered to be large enough for the body's immune system to recognize it? | Anything > 6000D. |
| Is a virus large enough to be recognized by our immune system? | No |
| Which virus that exists in humans is not recognizable by the I.S.? | CMV-#1 90% of pop has it and #2 is EBV 70% of pop has it. |
| What is needed to be recognized by the I.S. when dealing with this virus? | It needs to be attached to an immunogen |
| Who makes Ig's? | B-Cells make Ig's these Ig's are immunogens |
| What does Peyer's Patches produce and where are these patches located? | They produce IgA and they are in the terminal Ileum. This where vitamins DEAK and B12 are absorbed. If there is obstruction to an area before these patches, you would have malabsorpt syndr |
| What are the immune cells of the Brain, Lungs, liver, spleen, LN, kidney, bone, Terminal Ileum, skin, macrophages, CT called? | Microglia, alveol macroph, kuppfer c., RES (reticular endothel syst)cells,Dendritic, Osteoclast, M cells of peyrs patch, langerhans, monocytes, epithelioid/giant cell/histiocytes. |
| What are the 2 arms of the I.S.? | Humoral and Cell mediated |
| Which of these I.S. arms deals with bacterial infections? | Humoral |
| which of these I.S. arms would be specific for the blood? | Humoral |
| What are the I.S. cells produced to handle blood infections of bacterial origin? | Neutrophils and B-cells |
| Which of these I.S. cells are most numerous in an I.S. response?` | Neutrophils |
| Which of these I.S. cells take over when the most numerous cells cannot control a raging bacterial infection? | B-cells |
| The other arm of the I.S. will guard against which organisms? | Viruses, fungal, mycobacterium, protozoas, parasites, neoplasms (CA). |
| What is the name of this other arm of the I.S.? | Cell mediated |
| This other I.S. you would find which type of cells and where would you find them? | T-cells and macrophages and they would be in tissue |
| How could one diagnose affections to each arm of the I.S.? | for humoral a blood draw for cell mediated a tissue biopsy |
| What is IL-1? | Interleukin I produces fever |
| Who makes IL-I? | Macrophage that has engulfed an atigen processed it and presented it on MHC II cplx |
| If you have a fever, is that enough to Dx infection? | No |
| What is needed to diagnose infection? | Fever plus Leukocytosis |
| What is WBC demargination? | This is the phenomenom where WBC "hang out" in the blood vessel walls waiting to demarginate(un-stick) to ellicit an Immune response. |
| What can trigger WBC demargination? | A slap to a body part and labs may show leukocytosis |
| What would a fever do to heart rate? | Raise it 10 bpm per degree of elevation |
| Why is fever not a good time to vaccinate anyone? | Heat denatures prot. and vaccines are prot. that are latched on to immunogens with the goal to ellicit an Immune response hence protection. The expected to trigger for a response will be anealed and pt is not covered. The individual parts are < 6000D. |
| A pt arrives to your clinic and has a high fever 101 F and heart rate is normal (80bpm) what is your suspicion and next step? | suspect heart block and get ECG. |
| What inections are commonly implicated on heart block? | Legionella, Lyme dis (ioxodes), Chagas eats ganglia from neural crest, diptheria, typhoid pt c/o burning fire like pain to abd. |
| Where does one get Babesiosis from (vector)? | Ioxodes tick |
| When you are asked about sterilization, what is important to make sure is included in the process to kill spores? | 121 C with vaporized heat. must have vaporized heat. |
| Which bacteria is considered the most immunogenic bacteria ever known? | Shigella only requires 8-10 microbes for full infecton |
| When talking about inflammation pattern, what occurs in the first 24 hrs? | Cellular swelling |
| What happens after 24hrs? | Neutrophills show up the most numerous |
| Who peaks at around day 3? | the most numerous-Neutrophils |
| On day 4 who joins the inflammation party? | T-cells and Macrophages |
| Who peaks on day 7? | T-cells and macrophages-clean up areas make holes in "mesh" this is the time in an post MI that most pt die of rupture...holes. At day 3 post MI they die of Arrhythmias. |
| And on day 7 to 1month, who arrives and for what reason? | fibroblast...patch up the holes. |
| For the next 3-6 months what happens? | fibroblast repair tissue up i.e. scar formation. |
| Status post MI when is a non-stress test performed? | Usually within 6 weeks post MI this is because the fibroblast should have arrived and laid down the patch work, this decreases risk of rupture |
| DiGeorge syndrome is a T cell immune deficiency, what is missing? | 3rd and 4th pharyngeal pouch |
| Which of the affected structures is the one causing the most problems? | 3rd pharyngeal pouch: Third, Thymic aplasia, Trouble with Third, T-cells absent, Tetany |
| Which gland is affected that can have deleterious effects? | Inferior parathyroid pt will have hypocalcemia and can have tetany |
| What infections would the DiGeorge pt suffer most from? | Recurrent viral and fungal infections |
| What Interleukin (IL) is supressed by steroids? | IL-2 this one calls everyone |
| Steroids anti-inflammatory actions do what to immune cells? | kill T cells and eosinos. Inhibit macrophage migration, Stabilize mast c. mebrane and endothelium, and inhibit phospholipase A |
| Cyclosporin has been used for transplants and did revolutionize transplant medicine and Tacrolimus has now become more pop d/t less SE what do these meds inhibit? | Calcineurin this prod is important to prod IL's. |
| Tartrate Resistant Acid Phosphotase, you should be thinking of? | Hairy cell Leuk. it is a B cell leuk but more frequently a T cell leuk it loves METS to the mediastinum |
| What is the cutaneous T Cell lymphoma? | mycosis fungiodes |
| What is the T cell lymphoma that was cutaneous but now in the blood? | Sezary syndrome may say that T cells are dented |
| Boards may describe in vignette that pt has been treated for recurrent fungal infections or such infect won't go away | Mycosis fungiodes |
| Severe Combined Immunodeficiency is abbreviated SCID, what is the problem with this disease? | there is an Adenosine deaminase deficiency |
| In SCID, DNA synthesis is disrupted, why? | Adenosine is required for energy and it's missing |
| SCID affects rapidly dividing cells, which immune cells are disrupted? | T's and B's |
| What is the most common presenting complaint in SCID? | recurrent bacterial and fungal infection, or bact and all else, but must have bact in answer |
| Wiscott Aldrige syndrome what is affected? | IgM is low (flip the W upside down makes an M and they are low) |
| What 3 things are of importance with Wiscott Aldrige Syndrome? | Pt has Eczema, Thrombocytopenia, Recurrent infections. IgA and IgE are normal. High incidence of lymphomas |
| Bruton's agammagolbulinemia affects what that causes the disease? | B cell count is normal but they don't function. the problem is mature B cells are pushed out too ealrly to work |
| This affect seen in Bruton's is caused by? | Class switching, IL-4, CD 40 ligand or Tyrosine Kinase (TK) problem |
| CVID is usually seen after 1 yo and is considered a lat onset Bruton's what is the problem here? | B cell count is normal but they don't function. Class switching, IL-4, CD 40 ligand or Tyrosine Kinase (TK) problem. |
| How can one differentiate Bruton's to late onset Bruton's? | Bruton's is at birth d/t x linked recessive while the latter is seen 1 yr after birth |
| Multiple Myeloma (MM) is a plasma cell CA what kind of lesion is seen in this? | Multiple osteolytic lesions. present with hyperCa d/t mult osteolyt lesions, M spike is d/t IgG, roleaux formation, kappa Bence Jones proteins. |
| Pt with many mucosal infections, anaphylaxis during transfusions is what | Selective IgA deficiency usually runs with another Ig deficiency |
| Clues is that this deficiency of Ig is the main opsonin for encapsulated organisms and is lacking or low therefore this pt may have recurrent infections by the capuslated organisms? | Selective IgG2 deficiency encapusalted organisms:G neg- Salmonella, Klebsiella, Haemophilus i. B, Pseudomonas, Neisseria, Citrobacter (Some Killers Have Pretty Nice Capsules). G pos- Strept pneumo |
| Myeloperoxidase deficiency would be seen in which Immune cell? | Macrophage |
| If you have a myeloperoxidase deficiency what would you not be able to make? | peroxide leading to prod of POCl(bleach). |
| What would you not be able to make if you had a deficiency in the NADPH oxidase path of the macrophage? | No respiratory burst or the superoxide (O2.) therefor unable to make peroxide. Problem with CGD. |
| Which immune cells when stimulated to attack are most numerous? | Neutrophils |
| A drop in the most numerous Imm. cells increases risk to which infections? | S. aureus and pseudomonas other at risk of this proble are burn pt's, CF, diabetics |
| If you have a fever, is that a diagnostic sign of fever? | No, must have leukocytosis with it and vice versa. |
| A staph infection must be covered with how many antibiotics? | One...Nafcillin |
| A pseudomonas infection must be covered with how many antibiotics? | 2- they are: |
| Chediak Higashi is a macrophage defect, what is the defect exactly? | Lazy Lysosomes. Lysosomes are slow to react to engulfed antigens by the Macrophage |
| Nasal polyps in kids is what? | CF in adults think ASA insensitivity |
| Albinism is d/t what? | failure of neural crest to migrate..POMC does not find the melanocytes to stimulate |
| In HIV it is determined that there are 2 populations of highest risk to infection by HIV, they are elderly and Black females heterosexual on both groups who is at lowest risk and why? | Prepubertal females-they have no lactobacilus in their vaginal flora so no acid produced therefore alkaline, the virus hates alkaline envir and thrives in acid. It also loves mucosa (mouth to anus) and any body part having CD4 receptors. |
| Where are CD 4 receptors mostly found? | Female cervix, Blood vessels (vasculitis), macrophages, T-helpers, CNS (microglia-dementia in AIDS), Testes. |
| What is unique about HIV and it's mode of reproduction? | It is the only virus that doesn't penetrate the cells; it injects RNA into cells. The irony is that to get it the pt is penetrated..back joke!!! |
| Important HIV markers that are surface markers are? | GP 120 and P 41 |
Created by:
sxirsrick
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