Improving care in ED



29.5.12 Immune and Infectious disease1,Which pairing is incorrect between disease and type of immune responseMyasthenia gravis : Type IIGood pastures: Type IVSLE: Type IIIContact dermatitis : Type IV2, Which is not a peripheral lymphoid organThymusLymph nodesSpleenMucosal lymph tissue3. Natural killer cells Need prior exposure /activation by tumour or infected cells to be able to kill themAre involved in the early line of defence against viral infections and intracellular microbial infectionExpress TCRAre smaller than most lymphocytes4. Regarding cells of the immune systemT cells recognise antigens on the MHC2 antigen presenting cellsDendritic cells are phagocyticNatural kiler cells recognize self class I MHC molecules on healthy cells and hence do not attack themMacrophages function as APC ( antigen presenting cells) in B cell activation5. Which inflammatory disease is not associated with the HLA B27 alleleAnkylosing spondylitisPost gonnococcal arthritisRheumatoid arthritisAcute anterior uveitis6 .Regarding different cytokinesCytokine IFN-Y is a potent IgE producer and plays a role in allergiesCytokine IL4 is involved in macrophage activation and is strongly involved in immune mediated inflammatory diseaseIL17 is involved in the recruitment of neutrophils and monocytes and is the host defense against extracellular bacteria and fungiNone of the above7. Which is trueCell mediated immunity implies B lymphocyte activationHumoral immunity implies B lymphocyte activationIgG and IgM activate the complement system by the classical pathwayIgA is important in crossing the placenta to protect the newborn8. Regarding immediate hypersensitivity reactionsIt is mediated by IgM antibodiesSusceptibilty to immediate hypersensitivity reactions is genetically determinesCytokines play an important role in the early stages of the reactionThe Immediate phase is associated with eosinophil infiltration9. In systemic immune complex diseaseThe introduction of a protein Ag triggers an immune reaction and antibody formation around 2 days later The principle morphological manifestation of this immune complex injury is caseous inflammationThe prototype disease of this is the Arthus reactionThe most pathogenic antigen –antibody complexs are those which are medium sized formed in slight Ag excess10. Complement activation is involved in Type I hypersensitivityType II hypersensitivity Type III hypersensitivityType II and Type III hypersensitivity11. In Systemic lupus erythematousisIt is less common in the black populationThe antinuclear antibodies test is specific for this diseasePaients are hypercoagulable and develop primary antiphospholipid antibody syndromeCan have a false +ve syphilis test12. SclerodermaDevelop microvascular disease late in the disease course20% of patients have Raynauds phenomena20% patients develop rapid malignant hypertensionIs associated with CD8+ cells responding to an unknown antigen13. The hyperacute form of graft rejection is mediated byPreformed antibodiesAntibody dependent cell mediated cytotoxicityNecrotising vasculitisTissue macrophages14. The incidence of HIV in the Western world is growing fastest inHomosexualsHeterosexualsIv drug usersHaemophiliacs15. Regarding the HIV virionIt is surrounded by a viral core which contains the important glycoproteins gp41 and gp120, important for HIV cell infectionIt contains 3 important genes , pol, gag and env, of which gag and pol are important targets for antiviral drug mechanismThe core is what the humoral immune response targetsIs known to have 3 subgroups, of which the O subgroup is most common worldwide16.. In HIV10% of untreated patients will develop a malignancyThe central nervous system is the most common extranodal site for lymphomas Body cavity lymphomas constitute 80% of all aids related lymphomaPrimary CNS lymphomas are 50 times more common in AIDs patients c.f the general population17. Measles Are a single stranded DNA virusCause an antibody mediated immunity which is what protects against reinfectionVirus initially multiplies in lymphoid tissueThe rash is less common in people with cell mediated immunity deficiencies18. Regarding MumpsIn 50%of cases the parotiditis occurs bilaterallyThe sterility is secondary to scarring and atrophy of the testicleAseptic meningitis is a rare extra-salivary complication occurring in 1% of casesIs a DNA virus19. Which is a Gram positive bacterium?DiphtheriaNeisseriaBordetellaPseudomonas20. Which is true?Chlamydia is the most frequent cause of infectious blindnessRickettsia injure epithelial walls causing a rashGram negative bacteria have thick cell walls surrounding the cell membraneGram positive bacteria have a thin cell wall found between 2 phospholipid bilayer membranes21. Regarding exotoxinsClostridium tetani releases super antigens that lead to a mass T proliferation V. cholera releases a neurotoxin that degrades the epidermis Botulism is due to clostridium botulinum releasing a neurotoxin that kills neuronsToxic shock is caused by staph. Aureus22. Which of the following is a virulence factor of Pseudomonas Aeruginosa?Pili and adherence proteinsThe secretion of a mucoid exopolysaccharide that protects it from antibodiesThe secretion of a exotoxin that inhibits protein synthesisAll the above are 23. Which is true about scarlet fever?It usually affects 3-6year oldsIt is caused by a Group B streptococcal infectionThe Rash is predominately only on the face and trunkThe Rash usually spares the mouth24. Regarding diphtheriaIt is caused by a gram negative corynebacterium sp.It is often associated with distant lymph node hyperplasiaIf you are immunised it will prevent you getting colonized with C. diptheriaes It is clinically seen as a white superficial membrane 25.. CandidiasisDoes not result in disseminated intravascular coagulationUsually causes acute granulomatous reactions Virulence is dependent on aspartyl proteinase and adenosineIs a rare cause of fungal endocarditis26. Neisseria infections Requires the bacterial pile to bind to the CD46 human proteinAre more common in people lacking immunoglobulin IgAResult from adherence and invasion of ciliated epithelial cells at the site of entryResult from the adherence of short pili to the surface of the bacterium27. Regarding syphilisIs caused by Treponium pallidum subspecies portenueResults in tertiary syphilis in 33% of untreated patientsGumma formation is commonly seen in the brainThe causative bacterium is a gram positive rod28. Regarding the pathogenesis of gastrointestinal infections, which agents virulence is caused primarily due to an exotoxin?Vibrio. CholeraSalmonella typhiGiardia lambliaEnterogenic E coli29. Scrofula is the term associated with tuberculosis infection in which body part?MeningesCervical nodesVertebraeFallopian tubes30. Shigella infectionA large number of bacteria are required to cause diseaseIs accountable for 25% of diarrhoeal deathsIs associated with haemolytic uraemic syndromeIs a commonly found in farm cattle ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download