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Immunology II

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
show receive preformed Ab like IgA in breat milk, antitoxin or just Ig. rapid onset but short half life  
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How is active immunity acquired, what is its onset and duration?   show
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show tetanus toxin, botulinum toxin, HepB, Rabies  
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What is a Live attenuated vaccine? What type of response does it ellicit?   show
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show Pro: strong, often life long immunity Con: may revert to a virulent form  
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show live attenuated vaccine  
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show pathogen is inactivated by heat of chemicals, maintaing surface epitope structure. Induces humoral immunity  
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What are some pros and cons for using an inactivated or killed vaccine?   show
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What type of vaccines are cholera, influenza, hepA, polio (Salk), and rabies?   show
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What is Type I hypersensitivity? What cells mediate it and how fast is the onset?   show
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Which types of hypersensitivity are Ab mediated?   show
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What is the test for Type I hypersensitivity?   show
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What are the general characteristics of Type II hypersensitivity?   show
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show 1. Ab opsonizes cells or activates complement 2. Ab recruit neutrophils and macrophages causing tissue damage 3. ab bind to normal receptors and interfere with their fx  
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What test is used for Type II hypersensitivity?   show
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What is immune complex type III hypersensitivity?   show
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What is serum sickness type III hypersensitivity?   show
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show drugs. see fever uticaria, preoteinuria, lymphadenopathy 5-10 d after ag exposure  
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show local subacute Ab reaction. intradermal injection of Ag induces Ab which from complexes in skin. See edema, necrosis and complement activation  
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What causes the Arthus reaction?   show
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What is the test for Type III hypersensitivity?   show
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What is type IV hypersensitivity?   show
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show no because it doesnt involve Ab  
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show 4Ts: Tcells, Transplant rejection, Tb skin tests, touching (contact dermatitis)  
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show patch test (PPD)  
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What is a useful pneumonic for the 4 types of hypersensitivity?   show
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show Type I hypersensitivity  
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show immediate, anaphylactic, atopic  
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What type of hypersensitivity are hay fever, allergies, eczema, hives and asthma?   show
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show tends to be specific to tissue or site where the Ag is found  
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show Type II hypersensitivity  
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What type of hypersensitivity might be associated with a vasculitis or systemic manifestations?   show
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What type of hypersensitivity mediates SLE, theumatoid arthritis, polyarteritis nodosum, Post strep GN, serum sickness, farmers lung?   show
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show Type III hypersensitivity, this is the Arthus reaction  
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show Type IV hypersensitivity  
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show Type I hypersensitivity against plasma proteins. see uticaria, prutitis, wheezing fever  
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How do you treat an allergic reaction to blood transfusions?   show
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What is the mech of a anaphylactic rejection of blood transfusion? When might it be seen and what are the Sx   show
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show Type II hypersensitivity. Host ab against donor HLA ag and leukocytes  
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show fever, HA, chills, flushing  
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What is an acute hemolytic transfusion reaction? What 2 types of hemolysis could happen?   show
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show fever, hypotensioon, tachypnea, tachycardia, flank pain. hemoglobinemia (if intravascular), jaundice ( if extravascular)(  
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What disorder has anti nuclear Ab (ANA)?   show
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What disorder has anti-dsDNA, anti-Smith ab?   show
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What disorder has antihistone Ab?   show
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show Rheumatoid arthritis  
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show Scleroderma (CREST)  
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What disorder has Anti-Scl-70 (anti DNA topoisomerase I)?   show
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What disorder has antimitochondrial Ab?   show
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show Celiac disease  
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show Goodpasture's syndrome  
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What disorder has anti-desmoglein Ab?   show
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What disorder has antimicrosomial, antithyroglobulin Ab?   show
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show polymyositis, dermatomyositis  
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What disorder has Anti-SS-A (anti-Ro) Ab?   show
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show Sjogren's syndrome  
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show Mixed connective tissue disease  
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show Autoimmune hepatitis  
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show Type I DM  
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What disorder has cANCA?   show
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show other vasculitides, prominently microscopic polyangitis  
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What do bacteria cause if a person lacks T cells?   show
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show encapsulated: Strepto, staphylo, haemophilus, Moraxella  
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show staphy, pseudomonas  
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What types of bacteria are people without complement vulnerable to?   show
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What types of viruses are people without T cells vulnerable to?   show
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What types of viruses are people without B cells vulnerable to?   show
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show Candida, PCP  
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What types of fungi/parasites are people without B cells vulnerable to?   show
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What types of fungi/parasites are people without granulocytes vulnerable to?   show
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Overall that is the tendency of T cell vs B cell deficiencies in infections?   show
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show 1. Burton's agammaglobulinemia 2. Hyper IgM syndrome 3. Selective IgG deficiency 4. Common variable immunodeficiency  
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What is the defect and inheritance in Burton's agammaglobulinemia?   show
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show recurrent bacterial infections after 6 months (decr maternal IgG) due to opsonization defect. absence of thymic shadow  
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What labs are seen in Burton's agammaglobulinemia?   show
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show defective CD40L on TH= can't class switch  
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show severe pyogenic infections early in life  
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show incr IgM, very Decr IgG, A, E  
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What is the defect in selective Ig deficiency?   show
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What is the presentation of selective Ig deficiency? What reaction is especially worrisome?   show
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show IgA deficiency is most common. failure to mature into plasma cells. decr secretory IgA  
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show defect in B cell maturation. many causes  
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What is the presentation of common variable immune deficiency?   show
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What labs are seen in common variable immune deficiency?   show
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show q. Thymic aplasia (DigGeorge) 2. Il-12 receptor deficiency 3. Hyper IgE syndrome (Job's syndrome) 4. chronic mucocutaneous candidiasis  
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show 22q11 delection; failure to develop 3rd and 4th pharyngeal pouches  
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show tetany(hypocalcemia), reccure viral/fungal infections, CHD, great vessel defects  
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show thymus and parathyroid fail to develop. decr T cells, decr PTH, decr ca2+. absent thymic shadow on CXR  
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show decr Th1 response  
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What is the presentation of IL-12 receptor deficiency?   show
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What labs are seen in IL-12 receptor deficiency?   show
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What is the defect in Hyper-IgE syndrome (Job's syndrome)?   show
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show FATED: coarse Facies,cold, staphylococcal Absesses, retained primary Teeth, incr IgE, dermatologic problems (eczema)  
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What labs are seen in Hyper-IgE syndrome (Job's syndrome)?   show
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show T-cell dysfunction  
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What is the presentation of chronic muccocutaneous cadidiasis?   show
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What are 3 major B and T cell combined immune deficiencies?   show
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show several types: defective IL-2 rector (most common and X linked), adenosine deaminase deficiency, failure to synthesize MHC II Ag  
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show recurrent viral, bacterial, fungal and protozoal infections. no thymic shadow, no germinal centrers in LN bipsy, no B cells on PBS  
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What is the Tx for severe combined immunodeficiency (SCID)?   show
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What labs are seen in severe combined immunodeficiency (SCID)?   show
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show defects in ATM gene which codes for DNA repair enzymes  
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What is the presentation of ataxia-telangiectasia?   show
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show decr IgA  
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show X linked recessive defect. progressive deletion of T and B cells  
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show Triad TIE: thrombocytopenia purpura, infections, eczema  
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What labs are seen in Wiskott-Aldrich syndrome?   show
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show 1. Leukocyte adhesion deficiency (type 1) 2. Chediak-Higashi syndrome 3. Chronic granulomatous disease  
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What is the defect in leukocyte adhesion deficiency (type 1)?   show
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What is the presentation of leukocyte adhesion deficiency (type 1)?   show
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show neutrophilia  
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show AutoRec. defect in lysosomal trafficking gene (LYST). causes microtubule dysfunction and phagosome/lysosome fusion  
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What is the presentation of Chediak-Higashi syndrome?   show
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What is the defect in chronic granulomatous disease?   show
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What is the presentation of chronic granulomatous disease?   show
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show negative nitroblue tetrazolium dye reduction test  
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show from self  
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What is a syngeneic graft?   show
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show from nonidentical twin  
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show from a different species  
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show within minutes onset. Type II hypersensitivity (Ab mediated) due to presence of preformed anti donor Ab in transplant recipient  
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What are the major features of hyperacute transplant rejection?   show
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What is the onset and pathogenesis of acute transplant rejection?   show
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What are the features of acute transplant rejection?   show
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What is the onset and pathogenesis of chronic transplant rejection?   show
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What are the features of chronic transplant rejection?   show
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What is the onset and pathogenesis of Graft-versus-host transplant rejection?   show
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show maculopapular rash, jaundice, hepatosplenomegaly, diarrhea. usually seen in BM and liver transplant (these organs are rich in lymphocytes). potentially beneficial in BM transplant  
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What is the mech of cyclosporine?   show
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show surpresses organ rejection. also in select AIDs  
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show predisposes to viral infection and lymphoma. nephrotixic (prevented with mannitol diuresis), gout  
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What is the mech of tacrolimus (FK506)?   show
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What is the clinical use of tacrolimus?   show
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What is the SE of tacrolimus (FK506)?   show
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show inhibits mTOR. inhibits T-cell proliferation in response to IL-2  
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What is the clinical use of sirolimus (rapamycin)?   show
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show hyperlipidemia, thrombocytopenia, leukopenia  
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show MAB with high affinity for IL-2 receptor on activated T cells  
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What is the mech of azathioprine?   show
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show kidney transplants, AIDs (including GN and hemolytic anemia)  
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show bone marrow surpression, active metabolite mercaptopurine is metabolized by xanthine oxidase so toxicites might be incr by allopurinol  
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What is the mech of muromonab-CD3 (OKT3)?   show
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What is the clinical use of muromonab (OKT3)?   show
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show cytokine release syndrome, hypersensitivity reaction  
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What is aldesleukin used for (IL-2)?   show
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What is Eryhtropoetin used for?   show
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show recovery of bone marrow  
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show recovery of bone marrow  
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What is alpha interferon used for?   show
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show multiple sclerosis  
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What is gamm interferon used for?   show
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What is Oprelvekin (IL-2) used for?   show
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What is thrombopoetin used for?   show
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What is the target and use of muromonab-CD3 (OKT3)?   show
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What is the target and use of daclizumab?   show
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show target: digoxin use: antidote for digoxin intox  
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What is the target and use of infliximab?   show
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show target: TNF-alpha use: Crohn's, RA, psoriatic artritis  
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What is the target and use of abciximab?   show
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show target: erb-B2 use: HEr-2 overexpressing breast cancers  
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show target: CD20 use: B-cell non-Hodgkin's lymphoma  
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What is the target and use of omalizumab?   show
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