USMLE 2 Immunology

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matt.hoffman
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14312
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USMLE 2 Immunology
Updated:
2010-04-20 16:04:15
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USMLE Step Immunology
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Cards for USMLE Step 2 studying
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  1. Cells involved in a type I sensitivity reaction
    • IgE antibodies
    • Mast cells
    • Basophils
  2. Examples of Type I hypersensitivity reaction
    • Anaphylaxis
    • Rubber glove allergy
    • hay fever
    • urticaria
    • allergic rhinitis
    • some asthma
  3. How does C1 esterase inhibitor deficiency present
    • Hereditary angioedema (swelling of lips, eyelids, airway or bowel)
    • C4 is low
    • Autosomal Dominant
  4. Causes of autoimmune hemolytic anemia
    • Methyldopa
    • Penicillin
    • Sulfa drugs
  5. Examples of Type II hypersensitivity reaction
    • Autoimmune hemolytic anemia
    • ITP
    • Transfusion reactions
    • Rh compatibility
    • Goodpastures syndrome
    • Myasthenia Gravis
    • Graves disease
    • Pernicious anemia
    • Hyperacute transplant rejection
  6. What causes type II hypersensitivity reaction
    IgG and IgM react with antigen and cause inflammation
  7. What causes Type III hypersensitivity reaction
    Immune-complexes deposit in tissues causing inflammation
  8. Examples of Type III hypersensitivity reactions
    • Serum sickness
    • Lupus
    • RA
    • Polyarteritis Nodosa
    • Chronic hepatitis
    • Glomerulonephritis
  9. What causes Type IV hypersensitivity reactions?
    Sensitized T cells release inflammatory mediators
  10. Examples of Type IV hypersensitivity reactions
    • TB skin test
    • Contact dermatitis
    • Chronic transplant rejection
    • granulomas
  11. Patient with recurrent respiratory and GI infections
    Develops anaphylaxis after Ig exposure
    IgA deficiency
  12. Male patient, Low B-cells, recurrent Strep and Haemophilus infections of lungs and sinuses starting after 6 months of age
    X-linked agammaglobulinemia
  13. Hypocalcemia and tetany in newborn, Absent hypoplastic thymus, heart defects
    DiGeorge Syndrome from hypoplasis of third and fourth pharyngeal pouches
  14. Severe infections first few months of life, B and T-cell defects, absent or dysplastic thymus and lymph nodes
    • SCID (autosomal recessive or X-linked)
    • Caused by adenosine deaminase deficiency
  15. Male patient with eczema, thrombocytopenia, and recurrent respiratory infections
    Wiskott-Aldrich syn
  16. Male patient with recurrent Staph and Pseudomonas infections
    Deficient nitroblue tetrazolium dye reduction
    Positive superoxide production testing
    • Chronic Granulomatous disease
    • (decreased NADPH activity so no repiratory burst)
  17. Patient with oculocutaneous albinism and giant granules in neutrophils
    • Chediak-Higashi syndrome
    • (Defect in microtubule polymerization)
  18. Patient with recurrent Neisseria infections
    C5-C9 deficiencies
  19. Patient with recurrent thrush, scalp, skin, and nail infections; anergy to Candida skin test; Often has hypothyroid
    Chronic mucocutaneous candidiasis
  20. Fair-skinned, red haired patient with recurrent staph infections, esp skin infections and eczema; High IgA levels
    Hyper IgE syndrome (Job-Buckley syn)
  21. At what CD 4 levels should action be taken for HIV pts?
    • @ diagnosis: MMR, Pneumococcal, hep B, inactive polio, annual influ
    • CD4 count < 350 start Antiretroviral therapy
    • 200 start TMP-SMX or pentamadine for Pneumocystis jiroveci
    • 100 start azithro, clarithro, or rifabutin for Mycobacterium Avium
    • also fluconazole for cryptococcal and candida
  22. What should be given to a pregnant woman with HIV?
    Zidovudine (AZT) and child for six weeks
  23. Common malignancies seen in HIV pts?
    • Kaposis sarcoma
    • Non-Hodgkin lymphoma (B cell lymphoma of CNS)
  24. Positive India ink stain of CNS on HIV pt
    Cryptococcus Neoformans meningitis
  25. Ring enhancing lesion in brain of HIV pt?
    • Toxoplasmosis or lymphoma
    • Taenia solium in pts from S america
  26. Rx for CMV retinitis in HIV pt
    Acyclovir or gancyclovir
  27. Differential dx in adult with thrush
    • HIV
    • Diabetes
    • Leukemia
  28. Young adult with herpes zoster?
    Consider HIV
  29. What diarrhea infections are almost uniquely seen in HIV patients
    • Cryptosporidium
    • Isospora
  30. PNA symptoms in pt with HIV
    • Coccidioidomycosis
    • S PNA, H Influ, Nocardia
    • Pneumocystis Carinii
    • TB
  31. Diarrhea in pt with HIV. DDx?
    • Isospora, Strongyloides, Cryptosporidium
    • Wasting syndrome
    • Histoplasmosis
    • CMV
    • Mycobacterium Avium
  32. CNS or Neurologic issues seen in pt with HIV?
    • Dementia
    • Toxoplasmosis
    • Lymphoma
    • Progressive multifocal leukoencephalopathy
    • Cryptococcal meningitis
    • CMV (vision loss)
  33. HIV patient presents with Fever, Dyspnea, and diarrhea, or severe mono-like fatigue with no pharyngitis or lymphadenopaty. Causitive agent?
    CMV
  34. What are the common life threatening reactions to HIV medications?
    • 1. Didanosine - Pancreatitis
    • 2. Abacavir - Hypersensitivity reaction
    • 3. NRTI - Lactic Acidosis
    • 4. NNRTI - Steven-Johnson Syn
    • 5. Nevirapine - Liver failure

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