Sophia Shared "CMS Immunology Exam 2" - 22 Picmonics

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CMS Immunology Exam 2

Hypersensitivity Type I
Previous Antigen Exposure
Immediate Reaction
IgE Cross-linking
Presensitized Mast Cells
Histamine Release
Vasodilation
Anaphylaxis
Allergies
Treatment
Epinephrine
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1 min
Hypersensitivity Type II
Cytotoxic
IgM or IgG antibody-mediated
Membrane Attack Complex (MAC)
Mechanism
Opsonization
Complement Activation
NK Cells
Testing
Direct Coombs test
Indirect Coombs Test
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1 min
Hypersensitivity Type III
Immune Complex
Antigen-antibody (IgG) complex activates complement
Neutrophils release lysozomal enzymes
Examples
Arthus Reaction
Serum Sickness
Systemic Lupus Erythematosus (SLE)
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1 min
Hypersensitivity Type IV
Delayed-Type Hypersensitivity
T Cell Mediated
Antibody Independant
Macrophages Activated
Examples
Transplant Rejection
PPD Skin Test
Contact Dermatitis
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1 min
Penicillin
Gram Positive
Spirochetes
Bind PBPs
Block Transpeptidase Cross-linking of Cell Wall
Activate Autolytic Enzymes
Bactericidal
Hypersensitivity Reactions
Hemolytic Anemia
Beta-lactamase Sensitive
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2 mins
Anaphylaxis Intervention
Intervention
Assess Airway and Oxygen Needs
Reassure Patient with Anxiety
Supine Position
Methylprednisolone (Solu-medrol)
Epinephrine
Diphenhydramine (Benadryl)
Medical Alert Bracelet
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2 mins
Inflammatory Response
Pathogens Infect Tissue
Mast Cells Release Histamine
Histamine Dilates and Increases Capillary Permeability
Macrophages Engulf Pathogens
Macrophage Signals Cells With Cytokines
Responding Neutrophils Cross Capillary Wall
B And T Lymphocytes Arrive At Injury Site
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2 mins
Heparin Mechanisms
Mechanism of Action
Short Half-life
Antithrombin Activation Cofactor
Decrease Thrombin, Factor Xa
Side Effects
Bleeding
Heparin Induced Thrombocytopenia (HIT)
Antidote
Protamine Sulfate
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2 mins
TNF-Alpha Inhibitors Overview
Mechanism
Downregulates pro-inflammatory cytokines
Decreased lymphocyte activation and migration
Granuloma breakdown
Treats
Crohn's Disease
Rheumatoid Arthritis
Juvenile Rheumatoid Arthritis
Psoriasis
Ankylosing spondylitis
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1 min
TNF-Alpha Inhibitor Drugs and Complications
Etanercept
Decoy TNF- Alpha receptor
Anti-TNF- Alpha antibody
Adalimumab
Infliximab
Complications
Increased risk of infection
Predispose to Tuberculosis (TB) reactivation
Order Baseline PPD- skin test
Quantiferon Gold In-Tube
Order Chest X-Ray
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2 mins
Tuberculosis Skin Mantoux Test (PPD)
Delayed Hypersensitivity (Cell Mediated Response)
Intradermal Injection
Read 48-72 hours
Positive Results
≥ 5 mm Induration
Immunosuppressed
≥ 10 mm Induration
High Risk Patients
≥ 15 mm Induration
Considerations
Chest X-Ray
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3 mins
Systemic Lupus Erythematosus (SLE) Diagnosis and Clinical Features
IM DAMN SHARP acronym
Immunoglobulins
Malar rash
Discoid rash
Antinuclear antibody
Mucositis
Neurologic disorders
Serositis
Hematologic disorders
Arthritis
Renal disorders
Photosensitivity
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2 mins
Leukocyte Adhesion Deficiency
Pathophysiology
Autosomal Recessive
Integrin CD18 Protein
Defect in LFA-1
Attached to ICAM
Signs and Symptoms
Neutrophilia
Bacterial Infections
Non-Pyogenic
Delayed Separation of Umbilical Cord
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2 mins
Bruton's Agammaglobulinemia
Pathophysiology
X-linked Recessive
Defective Bruton Tyrosine Kinase
Blocks B Cell Maturation
Signs & Symptoms
Decreased Immunoglobulins of All Classes
Bacterial Infections After Six Months
Maternal IgG Protects Before Six Months
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2 mins
Thymic Aplasia (DiGeorge Syndrome)
Pathophysiology
DiGeorge Syndrome
22q11 Deletion
Failure to Develop Third and Fourth Pharyngeal Pouches
Signs and Symptoms
Undeveloped Thymus
T Cell Deficiency
Recurrent Viral and Fungal Infections
Undeveloped Parathyroids
Hypocalcemia
Tetany
Aortic Defects
Congenital Heart Defects
Diagnosis
Absent Thymic Shadow on CXR
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2 mins
Hyper IgM Syndrome
Pathophysiology
Deficient CD40 Ligand on Helper T-cells
Defective CD40 Receptor on B-cells
Inability to Class Switch
Signs and Symptoms
Pyogenic Abscess
Decreased IgG, IgA, IgE
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4 mins
Hyper IgE Syndrome
Pathophysiology
Job's Syndrome
Abnormal Chemotaxis
Decreased IFN Gamma
Signs and Symptoms
Leonine Facies
Cold Non-Inflamed Staph Aureus Abscesses
Retained Primary Teeth
Eczema
Red Hair
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1 min
Common Variable Immunodeficiency
Pathophysiology
Defect in B Cell Maturation
Decreased Plasma Cells
Decreased Immunoglobulins
Signs & Symptoms
Sinopulmonary Infections
Increased Risk of Autoimmune Disease
Lymphoma
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1 min
Chronic Granulomatous Disease
Pathophysiology
Most Commonly X-linked Recessive
Defective NADPH Oxidase (Enzyme Complex)
Decreased Hydrogen Peroxide
Impaired Intracellular Killing in Phagocytes
Signs and Symptoms
Recurrent Purulent Skin and Lung Infections
Catalase Positive Organisms
Diagnosis
Negative Nitroblue Tetrazolium Test
DHR (Dihydrorhodamine) Flow Cytometry
Treatment
Antimicrobial Prophylaxis
TMP-SMX
Itraconazole
Interferon-Gamma
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3 mins
Ataxia Telangiectasia
Pathophysiology
Autosomal Recessive
ATM Gene
Defect in DNA repair
Signs & Symptoms
Cerebellar defects
Spider Angiomas
Sensitive to Radiation
Defective Tumor Suppressor Gene
Increased risk of Cancer, Leukemias, and Lymphomas
Increased AFP levels
IgA deficiency
Repeated sinopulmonary infections
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2 mins

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