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[h] Immunology Flashcards

[i] Master this session in just 5 minutes.

[q] Which type of immune system?

Nonspecific immune response that provides the body’s early line of defense against microbial invaders, with limited diversity, no memory cells, immune cells involved are Neutrophils, macrophages, monocytes, dendritic cells, natural killer (NK) cells?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElubmF0ZSBpbW11bml0eS4=[Qq]

[q] Which type of immune system?

very specific immune response response antigens of microbial and nonmicrobial agents, high diversity, with development of memory cells, immune cells involved are Lymphocytes (other than NK cells)?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFkYXB0aXZlIGltbXVuaXR5Lg==[Qq]

[q] Which type of immune cell?

– Location: Bloodstream.

– Identification: Kidney bean shaped nucleus, CD14 positive.

– Function: Phagocytic, differentiate into tissue macrophages.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1vbm9jeXRlcy4=[Qq]

[q] Which type of immune cell?

– Location: Tissues.

– Identification: Ruffled membrane, cytoplasm with vacuoles and vesicles, CD14 positive.

– Function: Phagocytosis, secretion of cytokines.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1hY3JvcGhhZ2VzLg==[Qq]

[q] Which type of immune cell?

– Location: Epithelia, tissues.

– Identification: Long cytoplasmic arms.

– Function: Antigen capture, transport, and presentation.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERlbmRyaXRpYyBjZWxscy4=[Qq]

[q] Which type of immune cell?

– Location: Bloodstream.

– Identification: Multilobed nucleus (3-5 lobes); small pink granules.

– Function: Phagocytosis and activation of bactericidal mechanisms.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE5ldXRyb3BoaWxzLg==[Qq]

[q] Which type of immune cell?

– Location: Bloodstream.

– Identification: Bilobed nucleus, large pink granules.

– Function: Defense against parasitic infections by antibody-dependent cellular cytotoxicity (ADCC), a method of killing that depends on the ability of the immune cell to recognize specific antibody bound to a cell and trigger the death of that cell without the use of complement.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEVvc2lub3BoaWxzLg==

Cg==

Cg==[Qq]

[q] Which type of immune cell?

– Location: Bloodstream.

– Identification: Bilobed nucleus, large blue granules.

– Function: Nonphagocytic, release pharmacologically active substances (histamine) during allergic responses.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEJhc29waGlscy4=[Qq]

[q] Which type of immune cell?

– Location: tissues, mucosa, and epithelia.

– Identification: Small nucleus, cytoplasm packed with large blue granules.

– Function: Release of granules containing histamine during allergic responses.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1hc3QgY2VsbHMu[Qq]

[q] Which type of immune cell?

– Location: Bloodstream, lymph nodes, spleen.

– Identification: Large, dark nucleus, small rim of cytoplasm.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEx5bXBob2N5dGVzLg==[Qq]

[q] Which type of immune cell?

– Location: Bloodstream.

– Identification: Lymphocytes with large cytoplasmic granules CD16 CD56 positive.

– Function: Kill tumor/virus cell targets or antibody-coated target cells (ADCC).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE5hdHVyYWwga2lsbGVyIChOSykgbHltcGhvY3l0ZXMu[Qq]

[q] Which type of immune cell?

– Location: Lymph nodes, spleen, mucosal associated lymphoid tissues, and bone marrow.

– Identification: Small dark nucleus, intensely staining Golgi apparatus.

– Function: End cell of B-cell differentiation, produce antibody.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBsYXNtYSBjZWxscy4=[Qq]

[q] The B lymphocyte, in its mature ready-to-respond form, wears molecules of two types of antibody or immunoglobulin called ………. embedded in its membrane. The naive T cell wears a single type of genetically related molecule, called …….., on its surface.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElnTSBhbmQgSWdELCB0aGUgVC1jZWxsIHJlY2VwdG9yIChUQ1IpLg==

Cg==

Cg==[Qq]

[q] The constant domains of immunoglobulin determines …………., but the variable domain determines ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElzb3R5cGUsIElkaW90eXBlLg==

Cg==

Cg==[Qq]

[q] In the B cell, this signal transduction complex is composed of two single-chain immunoglobulin relatives known as ………… In the T cell, the signal transduction complex is a multichain structure called ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGxnLc6xIGFuZCBsZy3OsiBhbmQgdHdvIG90aGVyIG1vbGVjdWxlcyBkZXNpZ25hdGVkIENEIChjbHVzdGVyIG9mIGRpZmZlcmVudGlhdGlvbikgMTkgYW5kIDIxLCBDRDMu

Cg==

Cg==[Qq]

[q] deoxyribonucleotidyl transferase (Tdt) randomly inserts bases without a template on the complementary strand in variable domain of (Heavy or light chain) only?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEhlYXZ5IGNoYWluIG9ubHku

Cg==

Cg==[Qq]

[q] Primary lymphoid organs are sites of lymphoid-cell development (lymphopoiesis) and include ………. and ……..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEJvbmUgbWFycm93IChCIGx5bXBob2N5dGVzKSwgVGh5bXVzIChUIGx5bXBob2N5dGVzKS4=[Qq]

[q] Secondary lymphoid organs are sites of antigen exposure and include ………. and ……..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNwbGVlbiwgTHltcGggbm9kZXMsIE11Y29zYWwtYXNzb2NpYXRlZCBseW1waG9pZCB0aXNzdWVzLg==[Qq]

[q] B lymphocytes whose idiotype has too great affinity for normal cellular molecules in the bone marrow undergoes ……. or in the periphery undergoes …….?.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGNsb25hbCBkZWxldGlvbiwgY2xvbmFsIGFuZXJneS4=[Qq]

[q] ……… is expressed on all nucleated cells in the body. Consist of an α heavy chain with three extracellular domains and an intracytoplasmic carboxy-terminus and a second light chain, β2-microglobulin.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1IQyBDbGFzcyBJIG1vbGVjdWxlLg==

Cg==

Cg==[Qq]

[q] ……. is expressed (also codominantly) on the antigen-presenting cells of the body (macrophages, B lymphocytes, dendritic cells, and Langerhans cells). The molecules are two chain structures of similar length, called α and β, and each possesses two extracellular domains and one intracytoplasmic domain.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1IQyBDbGFzcyBJSSBtb2xlY3VsZS4=

Cg==

Cg==[Qq]

[q] Immature T-lymphocytes express both the CD4 and CD8 cell surface antigens (Double positive) in addition to a complete TCR or a pro-TCR. These lymphocytes exist in the …….. where they undergo ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoeW1pYyBjb3J0ZXgsIHBvc2l0aXZlIHNlbGVjdGlvbi4=[Qq]

[q] Those that have TCRs capable of binding with low affinity will receive a ……… signal to divide and establish clones that will eventually mature in the medulla.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHBvc2l0aXZlIHNlbGVjdGlvbi4=[Qq]

[q] Those that bind too strongly to self MHC molecules will be induced to undergo ………. because these cells would have the potential to cause autoimmune disease.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGFwb3B0b3NpcyAobmVnYXRpdmUgc2VsZWN0aW9uKS4=[Qq]

[q] The cells are directed to express only CD8 if their TCR binds ……. and only CD4 if their TCR binds ……..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1IQyBjbGFzcyBJLSBQZXB0aWRlIGNvbXBsZXggbW9sZWN1bGVzLCBNSEMgY2xhc3MgSUktIFBlcHRpZGUgY29tcGxleCBtb2xlY3VsZXMu[Qq]

[q] Site of B-cell localization and proliferation in lymph nodes is ……….., and in spleen is ……..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENvcnRpY2FsIGZvbGxpY2xlcywgRm9sbGljbGVzIG9mIHdoaXRlIHB1bHAu

Cg==

Cg==

[Qq]

[q] Site of T-cell localization and proliferation in lymph nodes is ……….., and in spleen is ……..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBhcmFjb3J0ZXggcmVnaW9uIG9mIGx5bXBoIG5vZGVzLCBwZXJpYXJ0ZXJpb2xhciBseW1waGF0aWMgc2hlYXRoIChQQUxTKS4=

Cg==

Cg==

[Qq]

[q] ……. of the lymph nodes is not well developed in patients with DiGeorge syndrome.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBhcmFjb3J0ZXgu[Qq]

[q] …….. are capable of recognizing molecules of almost any chemical composition.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEIgbHltcGhvY3l0ZXMu[Qq]

[q] …….. recognize peptides only when presented to them in the groove of an MHC molecule on the surface of an antigen-presenting cell.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFQgbHltcGhvY3l0ZXMu[Qq]

[q] …….. is a low molecular weight substance which is incapable of inducing immune response alone but when coupled with a carrier molecule (protein) it can act as an antigen.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEhhcHRlbi4=

Cg==

Cg==[Qq]

[q] ……… on the endothelium bind to mucin-like adhesion molecules on the phagocyte membrane and bind the cell briefly, but the force of blood flow into the area causes the cell to detach and reattach repeatedly, rolling along the endothelial surface until stronger binding forces can be elicited.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEUtc2VsZWN0aW4gbW9sZWN1bGVzLg==

Cg==

Cg==[Qq]

[q] Interaction between ……….. and Ig-superfamily cellular adhesion molecules (Ig CAMs) mediates the tight binding of the phagocyte to the endothelial cell during acute inflammatory response.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGludGVncmlucy4=

Cg==

Cg==[Qq]

[q] …….. is a rare autosomal recessive disease in which there is an absence of CD18, which is the common β2 chain of a number of integrin molecules. These patients suffer from recurrent, chronic bacterial infections, delayed wound healing, abnormally high numbers of granulocytes in their circulation, and absent pus formation.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExldWtvY3l0ZSBhZGhlc2lvbiBkZWZpY2llbmN5Lg==[Qq]

[q] Both macrophages and neutrophils have membrane receptors for ……., If an antigen is coated with either of these materials, adherence and phagocytosis is enhanced.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElnRyBhbnRpYm9keSBhbmQgQzNiLg==

Cg==

Cg==[Qq]

[q] ……… is an inherited deficiency in the production of neutrophils NADPH oxidase. These patients suffer from chronic, recurrent infections with catalase-positive organisms. Incubation of nitroblue tetrazolium to a sample of patient neutrophils failed to change its color.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENocm9uaWMgZ3JhbnVsb21hdG91cyBkaXNlYXNlIChDR0QpLg==[Qq]

[q]  …….. is synthesized in the endoplasmic reticulum of the cell and proteins are loaded there by an endogenous pathway.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1IQyBjbGFzcyBJIG1vbGVjdWxlLg==

Cg==

Cg==[Qq]

[q] Proteins synthesized in the cell cytosol are routinely degraded in proteasomes, and the peptides from these proteins are transported through a peptide transporter, known as the ……., into the endoplasmic reticulum, where they have the opportunity to bind to freshly synthesized MHC class I proteins.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRBUCBjb21wbGV4Lg==

Cg==

Cg==[Qq]

[q] ……. is used to present antigens that antigen presenting cells (dendritic cells, macrophages and B-lymphocytes) have encountered in the body and have taken up by phagocytosis or endocytosis.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1IQyBDbGFzcyBJSSBtb2xlY3VsZS4=

Cg==

Cg==[Qq]

[q] Without lysosomal acidification, antigen processing in association with …….. would not occur, and therefore, unable to bind the TCR.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1IQyBDbGFzcyBJSSBtb2xlY3VsZS4=

Cg==

Cg==[Qq]

[q] ……… are dendritic cells found in the skin that act as professional antigen presenting cells. These cells are derived from the myeloid cell line and they possess characteristic racquet-shaped intracytoplasmic granules known as Birbeck granules.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExhbmdlcmhhbnMgY2VsbHMu[Qq]

[q] Several surface molecules are involved in the activation of mature, naive T lymphocytes:
A. First (primary) signal is ………….?
B. Second (costimulatory) signal is …………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]

Cg==

QS4gRmlyc3QgKHByaW1hcnkpIHNpZ25hbDogcmVjb2duaXRpb24gb2YgdGhlIE1IQy1wZXB0aWRlIGNvbXBsZXggYnkgdGhlIFQgY2VsbCByZWNlcHRvciBhbmQgY29yZWNlcHRvcnMgKENENCBhbmQgQ0Q4KS4=
CkIuIFNlY29uZCAoY29zdGltdWxhdG9yeSkgc2lnbmFsOiByZWNvZ25pdGlvbiBvZiBCNyBieSBDRDI4Lg==[Qq]

[q] Later in the immune response, B7 will preferentially bind to ……….., effectively turning off the T-cell response.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENUTEEtNCBvciBQRC0xLg==

Cg==

Cg==[Qq]

[q] …….. are bacterial proteins that cross-link the variable β domain of a T-cell receptor to an α chain of a class II MHC molecule. This, in turn, activates macrophages, resulting in overexpression of proinflammatory cytokines (IL-1, IL-6 and TNF-α). Excess amounts of these cytokines induce systemic toxicity.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFN1cGVyYW50aWdlbnMu

Cg==

Cg==[Qq]

[q] Differentiation of a Th0 cell into a Th1 cell is stimulated by intracellular pathogens (viruses and intracellular bacteria). These pathogens induce a strong innate immune response with the resultant production of ……. by macrophages and …… by NK cells.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElMLTEyLCBJRk4tzrMu[Qq]

[q] Th1 cells secrete high levels of the inflammatory cytokine ……. which amplifies the Th1 response and inhibits the Th2 response.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElGTi3Osy4=[Qq]

[q] Differentiation of a Th0 cell into a ……. cell seems to be encouraged in response to large extracellular parasites such as helminths or allergens. Several cytokines are produced including IL-4, IL-5, IL-10, and IL-13.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoMi4=[Qq]

[q]  produced by Th1 cells promotes further Th1 development and inhibits the proliferation of Th2 cells, while …….. produced by Th2 cells promote Th2 differentiation and inhibit the activation of THI cells.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElGTi15LCBJTC00IGFuZCBJTC0xMC4=

Cg==

Cg==[Qq]

[q] Differentiation of a Th0 cell into a …… cell occurs in the presence of extracellular bacterial and fungal infections. The activated cells will secrete the cytokines IL-17, IL 21 and IL-22.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoMTcu

Cg==

Cg==[Qq]

[q] …….. help maintain specific immune tolerance by suppressing CD4 and CD8 T-cell effector functions. Have been shown to be critical for the prevention of autoimmunity. Activated cells produce anti-inflammatory cytokines (IL-10, TGF-β).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFQgcmVndWxhdG9yeSBjZWxsIChUIFJlZyBjZWxsKS4=[Qq]

[q] What is the most likely diagnosis?

2 years old male child presenting with symptoms of DM, severe diarrhea and Eczematous rash + intestinal biobsy shows villous atrophy of small intestine?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElQRVggKEltbXVuZSBkeXNyZWd1bGF0aW9uLCBQb2x5ZW5kb2NyaW5vcGF0aHksIEVudGVyb3BhdGh5LCBYLWxpbmtlZCkgc3luZHJvbWUu

Cg==

Cg==

JiM4MjExOyBHZW5ldGljIGRlZmljaWVuY3kgb2YgRk9YUDMg4oaSIGF1dG9pbW11bml0eS4=[Qq]

[q] …….. requires interaction of the CD40 receptor on activated B-cells with the CD40 ligand expressed by activated T-cells.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElzb3R5cGUgc3dpdGNoaW5nLg==[Qq]

[q] Th2 helper cells release IL-13 which, together with IL-4, preferentially promotes …….. production.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGxnRS4=

Cg==

Cg==[Qq]

[q] …….. results from an inability of B-lymphocytes to undergo isotype switching from lgM to other immunoglobulin isotypes such as lgD, lgG, lgE and lgA due to genetic deficiencies in the CD-40 T-lymphocyte ligand that is essential in inducing B-cells to switch classes.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEh5cGVyLWxnTSBzeW5kcm9tZS4=[Qq]

[q] During the intense proliferative response of the B cell, random mutations in the coding of the variable domain region may occur. This is called …….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHNvbWF0aWMgaHlwZXJtdXRhdGlvbi4=

Cg==

Cg==

JiM4MjExOyBPY2N1cnMgaW4gQsKgIGNlbGxzIG9ubHku[Qq]

[q] Which type of proteolytic enzymes (Papain or pepsin) that can preserve the agglutination function of the antibody?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHBlcHNpbi4gVGhlIGJyaWRnaW5nIG9mIGFudGlnZW5zIGJ5IGFudGlib2R5IG1vbGVjdWxlcyBpcyByZXF1aXJlZCBmb3IgYWdnbHV0aW5hdGlvbiBvZiBwYXJ0aWN1bGF0ZSBhbnRpZ2VucyBvciB0aGUgcHJlY2lwaXRhdGlvbiBvZiBzb2x1YmxlIGFudGlnZW5zLg==

Cg==

Cg==[Qq]

[q] The first isotype of immunoglobulin that can be produced by a B cell with or without T-cell help is ……..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElnTS4=[Qq]

[q] The IgM molecule on the surface of the B cell is a ………, but the secreted form of this molecule is a ………, held together in an extremely compact form by a J chain synthesized by the cell.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG1vbm9tZXIsIHBlbnRhbWVyLg==

Cg==

Cg==[Qq]

[q] ……. activates complement, acts as an opsonin, and mediates ADCC. It is also actively transported across the placenta by receptor-mediated transport and thus plays a crucial role in protection of the fetus during gestation.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElnRy4=

Cg==

Cg==[Qq]

[q] ……. is particularly important as a component of the colostrum, or the first breast milk fed to an infant after birth, where it functions to provide the infant with passive mucosal immunity.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElnQS4=[Qq]

[q] ……. serves an important function in IgA transepithelial transport, and once in the lumen of the tract, has a function in protecting the molecule from proteolytic cleavage.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoZSBzZWNyZXRvcnkgY29tcG9uZW50Lg==[Qq]

[q] ……… is a complement product that enhance phagocytosis and also helps clear immune complexes.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEMzYi4=

Cg==

Cg==[Qq]

[q] ………….. are complement products that mediate anaphylaxis.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEMzYSwgQzRhLCBDNWEu

Cg==

Cg==[Qq]

[q] …….. is a complement product that act as a chemoattractant.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEM1YS4=

Cg==

Cg==[Qq]

[q] (Early or terminal) complement deficiencies increases risk of severe, recurrent pyogenic sinus and respiratory tract infections; susceptibility to type III hypersensitivity reactions.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEVhcmx5IGNvbXBsZW1lbnQgZGVmaWNpZW5jaWVzIChDMS1DNCku[Qq]

[q] (Early or terminal) complement deficiencies increases susceptibility to recurrent Neisseria bacteremia.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRlcm1pbmFsIGNvbXBsZW1lbnQgZGVmaWNpZW5jaWVzIChDNS1DOSku[Qq]

[q] …………. causes complement-mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERBRiAoR1BJLWFuY2hvcmVkIGVuenltZSkgZGVmaWNpZW5jeS4=

Cg==

Cg==[Qq]

[q] ……… causes hereditary angioedema due to unregulated activation of kallikrein → ↑ bradykinin. Characterized by ↓ C4 levels. ACE inhibitors are contraindicated (also ↑ bradykinin). Symptoms include facial swelling (without urticaria), life-threatening laryngeal edema, and gastrointestinal manifestations (nausea/vomiting, colicky pain, diarrhea).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEMxIGVzdGVyYXNlIGluaGliaXRvciBkZWZpY2llbmN5Lg==

Cg==

Cg==

[Qq]

[q] ……….. on both lgG and lgM is located in the Fc portion closer to the hinge region.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoZSBjb21wbGVtZW50IGJpbmRpbmcgc2l0ZS4=

Cg==

Cg==[Qq]

[q] Autosomal recessive deficiencies of the IFN-gamma receptor (or other elements of this pathway) result in ……….. in infancy or early childhood.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGRpc3NlbWluYXRlZCBteWNvYmFjdGVyaWFsIGRpc2Vhc2Uu

Cg==

Cg==[Qq]

[q] Patients with IL-12 receptor deficiency suffer from severe mycobacterial infections due to the inability to mount a strong cell mediated granulomatous immune response. They are treated with ………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElGTi15Lg==[Qq]

[q] The 2 mechanisms of killing by cytotoxic T lymphocytes induce the activation of ………. which activate the “death domain”.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGNhc3Bhc2VzLg==

Cg==

Cg==[Qq]

[q] Atypical lymphocytes observed in the peripheral blood smears of patients with infectious mononucleosis represent ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGFjdGl2YXRlZCBDRDgrIGN5dG90b3hpYyBULWx5bXBob2N5dGVzLg==

Cg==

Cg==[Qq]

[q] ……… work on Neighboring cells of the viral infected cells making them in antiviral state by downregulating protein synthesis to resist potential viral replication and by upregulating MHC I expression to facilitate recognition of infected cells and enhance the activity of T cytotoxic and natural killer cells. Also play a major role in activating antitumor immunity.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEludGVyZmVyb25zLg==

Cg==

Cg==[Qq]

[q] ………. is secreted By macrophages. Also called osteoclast-activating factor. Causes fever, acute inflammation.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElMLTEu[Qq]

[q] ………. is secreted By macrophages. Causes fever and stimulates production of acute phase proteins.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElMLTYu[Qq]

[q] ……. is secreted By macrophages and Major chemotactic factor for neutrophils.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElMLTgu[Qq]

[q] ………. is secreted By macrophages. It induces differentiation of T cells into Th1 cells and activates NK cells.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElMLTEyLg==[Qq]

[q] ……… is secreted By macrophages. It mediates septic shock, Causes cachexia in malignancy and maintains granulomas in TB.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRORi3OsS4=[Qq]

[q] ………. is secreted by All T cells. It stimulates growth of helper, cytotoxic, and regulatory T cells, and NK cells.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElMLTIu[Qq]

[q] ………. is secreted by All T cells. Supports growth and differentiation of bone marrow stem cells. Functions like GM-CSF.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElMLTMu[Qq]

[q] ………. is secreted by Th1 and NK cells in response to IL-12 from macrophages and stimulates macrophages to kill phagocytosed pathogens.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEludGVyZmVyb24tzrMu[Qq]

[q] ………. is secreted by Th2 cells. Induces differentiation into Th2 cells and enhances class switching to IgE and IgG.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElMLTQu[Qq]

[q] ………. is secreted by Th2 cells. It enhances class switching to IgA and stimulates growth and differentiation of eosinophils.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElMLTUu[Qq]

[q]……… is secreted by Th2 cells and regulatory T cells. It down-regulate local cytokine production and inflammatory reactions

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElMLTEwLg==[Qq]

[q] …….. is Cytokines available in recombinant form and ↑ Lymphocyte differentiation and ↑ NKs. Used in renal cell cancer and metastatic melanoma.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFsZGVzbGV1a2luIChJTC0yKS4=[Qq]

[q] ……. is Cytokines available in recombinant form. ↑ Granulocytes and macrophages –> used for marrow recovery.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNhcmdyYW1vc3RpbSAoR00tQ1NGKS4=[Qq]

[q] Which type of vaccine?

– Induces cellular and humoral responses.

– Pro: induces strong, often lifelong immunity.

– Cons: may revert to virulent form.

– Often contraindicated in pregnancy and immunodeficiency

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExpdmUgYXR0ZW51YXRlZCBWYWNjaW5lLg==

Cg==

Cg==

[Qq]Adenovirus (nonattenuated, given to military recruits), Typhoid (Ty21a, oral), Polio (Sabin), Varicella (chickenpox), Smallpox, BCG, Yellow fever, Influenza (intranasal), MMR, Rotavirus

“Attention Teachers! Please Vaccinate Small, Beautiful Young Infants with MMR Regularly!”

[q] Which type of vaccine?

– Pathogen is inactivated by heat or chemicals.

– Mainly induces a humoral response.

– Pro: safer than live vaccines.

– Cons: weaker immune response; booster shots usually required.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEluYWN0aXZhdGVkIG9yIGtpbGxlZCBWYWNjaW5lLg==

Cg==

Cg==

[Qq]Rabies, Influenza (injection), Polio (Salk), hepatitis A

(“R.I.P. Always”).

[q] Which type of vaccine?

– Includes only the antigens that best stimulate the immune system.

– Pros: lower chance of adverse reactions.

– Cons: expensive, weaker immune response.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFN1YnVuaXQgdmFjY2luZS4=

Cg==

SEJWIChhbnRpZ2VuID0gSEJzQWcpLCBIUFYgKHR5cGVzIDYsIDExLCAxNiwgYW5kIDE4KSwgYWNlbGx1bGFyIHBlcnR1c3NpcyAoYVApLCBOZWlzc2VyaWEgbWVuaW5naXRpZGlzICh2YXJpb3VzIHN0cmFpbnMpLCBTdHJlcHRvY29jY3VzIHBuZXVtb25pYWUsIEhhZW1vcGhpbHVzIGluZmx1ZW56YWUgdHlwZSBiLg==[Qq]

[q] Which type of vaccine?

– Denatured bacterial toxin with an intact receptor binding site.

– Stimulates the immune system to make antibodies without potential for causing disease.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRveG9pZCB2YWNjaW5lLg==

Cg==

LUNsb3N0cmlkaXVtIHRldGFuaSwgYW5kIENvcnluZWJhY3Rlcml1bSBkaXBodGhlcmlhZS4=[Qq]

[q] ……… is the only type of hypersensitivity mediated by IgE antibodies.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFR5cGUgSSAoaW1tZWRpYXRlKSBoeXBlcnNlbnNpdGl2aXR5Lg==[Qq]

[q] ………. is a marker of mast cell activation after Type I (immediate) hypersensitivity.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRyeXB0YXNlLg==[Qq]

[q] The main inflammatory mediator of Type I (immediate) hypersensitivity is ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGhpc3RhbWluZS4=[Qq]

[q] What is the most likely diagnosis?

43 years old patient presenting with respiratory compromise, hypotension, tachycardia and facial edema and swelling after eating shrimp in sea food restaurant?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFuYXBoeWxhY3RpYyByZWFjdGlvbiBkdWUgdG8gVHlwZSBJIChpbW1lZGlhdGUpIGh5cGVyc2Vuc2l0aXZpdHk=[Qq]

[q] Hemolytic disease of the newborn (erythroblastosis fetalis) and acute hemolytic transfusion reaction are examples of  ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGFudGlib2R5LW1lZGlhdGVkIChUeXBlIElJKSBoeXBlcnNlbnNpdGl2aXR5IHJlYWN0aW9uIChDZWxsdWxhciBkZXN0cnVjdGlvbiku[Qq]

[q] Goodpasture syndrome and Rheumatic fever are examples of  ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGFudGlib2R5LW1lZGlhdGVkIChUeXBlIElJKSBoeXBlcnNlbnNpdGl2aXR5IHJlYWN0aW9uIChpbmZsYW1tYXRpb24pLg==[Qq]

[q] Myasthenia gravis and Graves disease are examples of  ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGFudGlib2R5LW1lZGlhdGVkIChUeXBlIElJKSBoeXBlcnNlbnNpdGl2aXR5IHJlYWN0aW9uIChDZWxsdWxhciBkeXNmdW5jdGlvbiku[Qq]

[q] What is the most likely diagnosis?

Newborn child presenting with severe anemia, pleural and pericardial effusion, hepatosplenomegaly, jaundice and positive coombs test + blood group of the newborn is A+, his mother A- and his older brother is A+?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEhlbW9seXRpYyBkaXNlYXNlIG9mIHRoZSBuZXdib3JuIChlcnl0aHJvYmxhc3Rvc2lzIGZldGFsaXMpLg==

Cg==

SGVtb2x5dGljIGRpc2Vhc2Ugb2YgdGhlIG5ld2Jvcm4gY2FuIGJlIHByZXZlbnRlZCBieSB0cmVhdGluZyB0aGUgUmgtIG1vdGhlciB3aXRoIFJob0dBTeKEoiwgYSBwcmVwYXJhdGlvbiBvZiBodW1hbiBhbnRpLVJoRCBJZ0cgYW50aWJvZHksIGF0IDI4IHdlZWtzIG9mIGdlc3RhdGlvbiBhbmQgYWdhaW4gd2l0aGluIDcyIGhvdXJzIGFmdGVyIGJpcnRoLg==

Cg==

[Qq]

[q] The type of  RhoGAM™ is ……..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJoRCBJZ0cgYW50aWJvZHku[Qq]

[q] With maternal blood types A and B, erythroblastosis fetalis and hemolytic disease of the newborn do not occur, as the naturally occurring antibodies (anti-A and B) are of the …….. type and cannot cross the placenta. In contrast, in type O mothers, the antibodies are predominantly ….. and can cross the placenta to cause fetal hemolysis.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGxnTSwgbGdHLg==

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

40 years old patient brought to hospital after exposure to automobile accident presenting with  fever, hypotension, disseminated intravascular coagulation (DIC), renal failure and hemoglobinuria (dark urine) after transfusion with 2 packed RBC’s?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFjdXRlIGhlbW9seXRpYyB0cmFuc2Z1c2lvbiByZWFjdGlvbiAoQUJPIGJsb29kIGdyb3VwIGluY29tcGF0aWJpbGl0eSku[Qq]

[q] ………. involves autoantibodies against basement membrane collagen of glomerular and alveolar epithelia (Type II hypersensitivity).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdvb2RwYXN0dXJlIHN5bmRyb21lLg==[Qq]

[q] SLE, Poststreptococcal glomerulonephritis, Serum sickness, and Arthus reaction are examples of ………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFR5cGUgSUlJIChpbW11bmUgY29tcGxleGVzKSBIeXBlcnNlbnNpdGl2aXR5Lg==[Qq]

[q] What is the most likely diagnosis?

30 years old patient presenting with fever, urticaria, arthralgias, glomerulonephritis, lymphadenopathy, and a low serum C3 level 5-10 days after intravascular exposure to infliximab for crohn’s disease?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNlcnVtIHNpY2tuZXNzLg==[Qq]

[q] Tuberculin and lepromin skin tests are examples of …….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFR5cGUgSVYgKFQtY2VsbCBtZWRpYXRlZCkgSHlwZXJzZW5zaXRpdml0eS4=[Qq]

[q] Rheumatoid arthritis is considered ……….. because not all patients have rheumatoid factor, but all of them have T lymphocytes and macrophages infiltration in their cartilage.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHR5cGUgSVYgaHlwZXJzZW5zaXRpdml0eS4=[Qq]

[q] Atopic dermatitis is example of ……….., but contact dermatitis is example of …….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHR5cGUgSSBoeXBlcnNlbnNpdGl2aXR5IHJlYWN0aW9uLCB0eXBlIElWIGh5cGVyc2Vuc2l0aXZpdHkgcmVhY3Rpb24u[Qq]

[q] …………. is Type I hypersensitivity reaction against plasma proteins in transfused blood. Presenting within minutes to 2-3 hours with Urticaria, pruritus, fever, wheezing, hypotension, respiratory arrest, shock.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFsbGVyZ2ljL0FuYXBoeWxhY3RpYyByZWFjdGlvbi4=[Qq]

[q] ……… is associated with type II hypersensitivity reaction with recipient antibodies directed against donor HLA and WBCs. Presenting within 1-6 hours with Fever, headaches, chills, flushing. This Reaction prevented by leukoreduction of blood products.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEZlYnJpbGUgbm9uaGVtb2x5dGljIHRyYW5zZnVzaW9uIHJlYWN0aW9uLg==[Qq]

[q] ………… is due to Donor anti-leukocyte antibodies against recipient neutrophils and pulmonary endothelial cells. Presenting with Respiratory distress and noncardiogenic pulmonary edema within 6 hours.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRyYW5zZnVzaW9uLXJlbGF0ZWQgYWN1dGUgbHVuZyBpbmp1cnku[Qq]

[q] What is the most likely diagnosis?

6th months old male child presenting with recurrent lower respiratory tract infections and Giardia lamblia infection + Absent B cells in peripheral blood with ↓ Ig of all classes + absent germinal centers in the lymph nodes?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFgtbGlua2VkIChCcnV0b24pIGFnYW1tYWdsb2J1bGluZW1pYS4=

Cg==

Cg==

JiM4MjExOyBEZWZlY3QgaW4gQlRLLCBhIHR5cm9zaW5lIGtpbmFzZSBnZW5lICYjODIxMjsmZ3Q7IG5vIEItY2VsbCBtYXR1cmF0aW9uLg==[Qq]

[q] What is the most likely diagnosis?

10 years old patient presenting with Recurrent otitis media, sinusitis, bronchitis, pneumonias and chronic malabsorption symptoms due to giardiasis + serum findings shows ↓ IgA with normal IgG, IgM levels?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNlbGVjdGl2ZSBJZ0EgZGVmaWNpZW5jeS4=

Cg==

Cg==

JiM4MjExOyBXaGVuIHRyYW5zZnVzZWQgd2l0aCBibG9vZCBvciBibG9vZCBwcm9kdWN0cyBjb250YWluaW5nIHNtYWxsIGFtb3VudHMgb2YgbGdBIHRoZXNlIHBhdGllbnRzIG1heSBkZXZlbG9wIHBvdGVudGlhbGx5IGZhdGFsIGFuYXBoeWxhY3RpYyByZWFjdGlvbnMuIEdhbW1hLWdsb2J1bGluIHByZXBhcmF0aW9ucyBzaG91bGQgbm90IGJlIHVzZWQgZm9yIHRyZWF0bWVudCBvZiB0aGVzZSBwYXRpZW50cyBhcyBpdCBtYXkgaW5jcmVhc2UgdGhlIHN5bnRoZXNpcyBvZiBhbnRpLWxnQSBhbnRpYm9kaWVzIGJlY2F1c2UgdGhlIHBhdGllbnQmIzgyMTc7cyBib2R5IHJlY29nbml6ZXMgaXQgYXMgYSBmb3JlaWduLg==[Qq]

[q] What is the most likely diagnosis?

25 years old female patient presenting with recurrent lower respiratory tract infections and Giardia lamblia infection + normal B cells in peripheral blood with ↓ Ig of all classes?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENvbW1vbiB2YXJpYWJsZSBpbW11bm9kZWZpY2llbmN5Lg==[Qq]

[q] What is the most likely diagnosis?

18 years old patient presenting with recurrent infections by viral, fungal, protozoan and intracellular bacterial pathogens + truncus arteriosus + cleft palate + serum findings shows: ↓ T cells, ↓PTH, ↓ Ca + CXR shows absent thymic shadow + poorly developed paracortex region in lymph nodes?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoeW1pYyBhcGxhc2lhIChEaUdlb3JnZSBzeW5kcm9tZSku

Cg==

Cg==

JiM4MjExOyAyMnExMSBtaWNyb2RlbGV0aW9uOyBtYWxkZXZlbG9wbWVudCBvZiB0aGUgdGhpcmQgYW5kIGZvdXJ0aCBwaGFyeW5nZWFsIHBvdWNoIGRlcml2YXRpdmVzIO+DoCBhYnNlbnQgdGh5bXVzIGFuZCBwYXJhdGh5cm9pZCBnbGFuZC4=[Qq]

[q] What is the most likely diagnosis?

22 years old patient presenting with Cold (noninflamed) staphylococcal Abscesses, retained Baby teeth, Coarse facies, eczema, and  bone Fractures from minor trauma + serum findings shows: ↑IgE, eosinophils?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEF1dG9zb21hbCBkb21pbmFudCBoeXBlci1JZ0Ugc3luZHJvbWUgKEpvYiBzeW5kcm9tZSku

Cg==

Cg==

JiM4MjExOyBEZWZpY2llbmN5IG9mIFRoMTcgY2VsbHMgZHVlIHRvIFNUQVQzIG11dGF0aW9uIOKGkiBpbXBhaXJlZCByZWNydWl0bWVudCBvZiBuZXV0cm9waGlscyB0byBzaXRlcyBvZiBpbmZlY3Rpb24u[Qq]

[q] Localized candidiasis is common in HIV-positive patients, while …….. are more likely to have systemic disease.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG5ldXRyb3BlbmljIGluZGl2aWR1YWxzLg==[Qq]

[q] What is the most likely diagnosis?

2 years old child presenting with recurrent infections caused by bacteria, viruses, fungi, and opportunistic pathogens as well as failure to thrive, thrush and chronic diarrhea + Absence of thymic shadow (CXR) and germinal centers in lymph node biopsy and ↓ T-cell receptor excision circles (TRECs)?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNldmVyZSBjb21iaW5lZCBpbW11bm9kZWZpY2llbmN5IChTQ0lEKS4=

Cg==

Cg==

JiM4MjExOyBTZXZlcmFsIHR5cGVzIGluY2x1ZGluZyBkZWZlY3RpdmUgSUwtMlIgZ2FtbWEgY2hhaW4gKG1vc3QgY29tbW9uLCBYLWxpbmtlZCku

[Qq]

– Adenosine deaminase deficiency is the second most cause of SCID. Retroviral gene therapy for this illness is promising. Retroviral vectors are used to “infect” patient hematopoietic stem cells with the genetic code for adenosine deaminase thereby resulting in production of this enzyme by all daughter cells of that stem cell.

[q] What is the most likely diagnosis?

6 years old child presenting with increased risk of sinopulmonary infections,  Cerebellar ataxia, and oculocutaneous telangiectasias + imaging of the brain shows cerebellar atrophy?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEF0YXhpYS10ZWxhbmdpZWN0YXNpYS4=

Cg==

Cg==

JiM4MjExOyBJdCBpcyBhbiBhdXRvc29tYWwgcmVjZXNzaXZlIGNvbmRpdGlvbiB0aGF0IG9jY3VycyBkdWUgdG8gbXV0YXRpb24gb2YgQVRNIGdlbmUuIEFUTSAoQXRheGlhIFRlbGFuZ2llY3Rhc2lhIE11dGF0ZWQpIGdlbmUgaXMgcmVzcG9uc2libGUgZm9yIEROQSBicmVhayByZXBhaXIu[Qq]

[q] What is the most likely diagnosis?

12 years old patient presenting with Severe pyogenic infections early in life; opportunistic infection with Pneumocystis, Cryptosporidium, CMV + serum findings shows ↑ IgM with ↓↓ IgG, IgA, IgE?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEh5cGVyLUlnTSBzeW5kcm9tZS4=

Cg==

Cg==

JiM4MjExOyBHZW5ldGljIGRlZmljaWVuY3kgaW4gdGhlIENELTQwIFQtbHltcGhvY3l0ZSBsaWdhbmQgdGhhdCBpcyBlc3NlbnRpYWwgaW4gaW5kdWNpbmcgQi1jZWxscyB0byBzd2l0Y2ggY2xhc3Nlcy4=[Qq]

[q] What is the most likely diagnosis?

2 years old male child presenting with recurrent (pyogenic) infections, eczema, thrombocytopenia + peripheral blood smear shows smaller than normal platelets?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFdpc2tvdHQtQWxkcmljaCBzeW5kcm9tZS4=

Cg==

Cg==

JiM4MjExOyBNdXRhdGlvbiBpbiBXQVMgZ2VuZSAoWC1saW5rZWQgcmVjZXNzaXZlKTsgbGV1a29jeXRlcyBhbmQgcGxhdGVsZXRzIHVuYWJsZSB0byByZW9yZ2FuaXplIGFjdGluIGN5dG9za2VsZXRvbiDihpIgZGVmZWN0aXZlIGFudGlnZW4gcHJlc2VudGF0aW9uLg==[Qq]

[q] What is the most likely diagnosis?

13 years old patient presenting with recurrent bacterial skin and mucosal infections, absent pus formation, impaired wound healing, CBC shows abnormally high numbers of neutrophils?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExldWtvY3l0ZSBhZGhlc2lvbiBkZWZpY2llbmN5ICh0eXBlIDEpLg==[Qq]

[q] What is the most likely diagnosis?

20 years old patient presenting with recurrent pyogenic infections by staphylococci and streptococci, partial albinism, peripheral neuropathy, progressive neurodegeneration, infiltrative lymphohistiocytosis + peripheral blood smear shows Giant granules in granulocytes and platelets?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENow6lkaWFrLUhpZ2FzaGkgc3luZHJvbWUu

Cg==

Cg==

JiM4MjExOyBEZWZlY3QgaW4gbHlzb3NvbWFsIHRyYWZmaWNraW5nIHJlZ3VsYXRvciBnZW5lIChMWVNUKS4=

[Qq]

– Microtubule dysfunction in phagosome-lysosome fusion; autosomal recessive.

[q] What is the most likely diagnosis?

20 years old mal patient presenting with recurrent infection with catalase ⊕ organisms + Abnormal dihydrorhodamine test with ↓ green fluorescence + Nitroblue tetrazolium dye reduction test is ⊝ and patient’s neutrophils fail to turn blue upon nitroblue tetrazolium?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENocm9uaWMgZ3JhbnVsb21hdG91cyBkaXNlYXNlLg==[Qq]

[q] Which type of graft rejection?

Onset: Within minutes.

Pathogenesis:
– It is an antibody-mediated reaction that is caused by preformed antibodies (type II hypersensitivity reaction) within the recipient that are directed against donor antigens and activate complement.

– Classically, this form of transplant rejection is diagnosed by the surgeon in the operating room because upon anastomosis of the donor and recipient blood vessels and initial perfusion of the organ, the organ immediately becomes cyanotic and mottled.

– Blood flow through the new organ ceases immediately due to fibrinoid necrosis of the small vessels of the organ in addition to the rapid formation of extensive thrombosis within the transplanted organ.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEh5cGVyYWN1dGUgcmVqZWN0aW9uLg==[Qq]

[q] Which type of graft rejection?

Occurs one to four weeks following transplant and the histopathology showing a dense infiltrate of mononuclear cells.

Occurs in approximately 2 of every 5 hearts transplanted and in the large majority of cases occurs by the cell-mediated pathway. In rare cases due to anti-donor host antibodies.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFjdXRlIHJlamVjdGlvbi4=[Qq]

[q] Which type of graft rejection?

Onset: Months to years.

Pathogenesis:
– CD4+ T cells respond to recipient APCs presenting donor peptides, including allogeneic MHC.

– Recipient T cells react and secrete cytokines that induces proliferation of vascular smooth muscle and parenchymal fibrosis and causes an obliterative intimal smooth muscle hypertrophy and fibrosis of cortical arteries (obliterative vascular fibrosis).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENocm9uaWMgcmVqZWN0aW9uLg==[Qq]

[q] Which type of graft rejection?

Onset: Varies.

Pathogenesis:
– Occurs after allogeneic bone marrow transplantation, transplantation of organs rich in lymphocytes (such as liver), or transfusion of non-irradiated blood.

– Recipient present with  maculopapular rash, jaundice, diarrhea, hepatosplenomegaly.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdyYWZ0LXZlcnN1cy1ob3N0IGRpc2Vhc2UgKEdWSEQpLg==[Qq]

[q] ………. binds cyclophilin and acts as Calcineurin inhibitor. Clinical uses include Psoriasis and rheumatoid arthritis. Cause Nephrotoxicity, hypertension, hyperlipidemia, neurotoxicity, gingival hyperplasia, and hirsutism.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEN5Y2xvc3BvcmluZS4=

Cg==

Cg==[Qq]

[q] ……… binds FK506 binding protein (FKBP) and acts as Calcineurin inhibitor. Clinical uses include Transplant rejection prophylaxis. Cause nephrotoxicity but no gingival hyperplasia or hirsutism.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRhY3JvbGltdXMgKEZLNTA2KS4=

Cg==

Cg==[Qq]

[q] ……. binds FKBP and acts as mTOR inhibitor. Clinical uses include Kidney transplant rejection prophylaxis and Also used in drug-eluting stents. Cause pancytopenia, insulin resistance, and hyperlipidemia as side effects.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNpcm9saW11cyAoUmFwYW15Y2luKS4=

Cg==

Cg==[Qq]

[q] …….. is a monoclonal antibodies that block IL-2R. Clinical uses include Kidney transplant rejection prophylaxis. Cause Edema, hypertension, tremor as side effects.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERhY2xpenVtYWIsIGJhc2lsaXhpbWFiLg==

Cg==

Cg==[Qq]

[q] …….. is Antimetabolite that inhibits lymphocyte proliferation by blocking nucleotide Synthesis. Cause Pancytopenia as a side effect. Toxicity ↑ by allopurinol.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEF6YXRoaW9wcmluZS4=

Cg==

Cg==[Qq]

[q] ………. reversibly inhibits IMP dehydrogenase, preventing purine synthesis of B and T cells. Clinical uses include Lupus nephritis. Cause Pancytopenia as a side effect.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE15Y29waGVub2xhdGUsIE1vZmV0aWwu

Cg==

Cg==[Qq]

[q] ……… inhibit NF-κB and Suppress both B- and T-cell function by ↓ transcription of many cytokines. Can cause iatrogenic Cushing syndrome.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdsdWNvY29ydGljb2lkcy4=

Cg==

Cg==[Qq]

[q] ………. is IL-2 that is currently used as immunotherapy for metastatic melanoma and renal cell carcinoma.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFsZGVzbGV1a2luLg==[Qq]

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