USMLE 2 Immunology
Card Set Information
USMLE 2 Immunology
USMLE Step Immunology
Cards for USMLE Step 2 studying
Cells involved in a type I sensitivity reaction
Examples of Type I hypersensitivity reaction
Rubber glove allergy
How does C1 esterase inhibitor deficiency present
Hereditary angioedema (swelling of lips, eyelids, airway or bowel)
C4 is low
Causes of autoimmune hemolytic anemia
Examples of Type II hypersensitivity reaction
Autoimmune hemolytic anemia
Hyperacute transplant rejection
What causes type II hypersensitivity reaction
IgG and IgM react with antigen and cause inflammation
What causes Type III hypersensitivity reaction
Immune-complexes deposit in tissues causing inflammation
Examples of Type III hypersensitivity reactions
What causes Type IV hypersensitivity reactions?
Sensitized T cells release inflammatory mediators
Examples of Type IV hypersensitivity reactions
TB skin test
Chronic transplant rejection
Patient with recurrent respiratory and GI infections
Develops anaphylaxis after Ig exposure
Male patient, Low B-cells, recurrent Strep and Haemophilus infections of lungs and sinuses starting after 6 months of age
Hypocalcemia and tetany in newborn, Absent hypoplastic thymus, heart defects
DiGeorge Syndrome from hypoplasis of third and fourth pharyngeal pouches
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
Male patient with eczema, thrombocytopenia, and recurrent respiratory infections
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)
Patient with oculocutaneous albinism and giant granules in neutrophils
(Defect in microtubule polymerization)
Patient with recurrent Neisseria infections
Patient with recurrent thrush, scalp, skin, and nail infections; anergy to Candida skin test; Often has hypothyroid
Chronic mucocutaneous candidiasis
Fair-skinned, red haired patient with recurrent staph infections, esp skin infections and eczema; High IgA levels
Hyper IgE syndrome (Job-Buckley syn)
At what CD 4 levels should action be taken for HIV pts?
: 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
What should be given to a pregnant woman with HIV?
Zidovudine (AZT) and child for six weeks
Common malignancies seen in HIV pts?
Non-Hodgkin lymphoma (B cell lymphoma of CNS)
Positive India ink stain of CNS on HIV pt
Cryptococcus Neoformans meningitis
Ring enhancing lesion in brain of HIV pt?
Toxoplasmosis or lymphoma
Taenia solium in pts from S america
Rx for CMV retinitis in HIV pt
Acyclovir or gancyclovir
Differential dx in adult with thrush
Young adult with herpes zoster?
What diarrhea infections are almost uniquely seen in HIV patients
PNA symptoms in pt with HIV
S PNA, H Influ, Nocardia
Diarrhea in pt with HIV. DDx?
Isospora, Strongyloides, Cryptosporidium
CNS or Neurologic issues seen in pt with HIV?
Progressive multifocal leukoencephalopathy
CMV (vision loss)
HIV patient presents with Fever, Dyspnea, and diarrhea, or severe mono-like fatigue with no pharyngitis or lymphadenopaty. Causitive agent?
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