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40 Qs on the lectures 5 Qs from the Quizzes 5 Qs from the practical

40 Qs on the lectures 5 Qs from the Quizzes 5 Qs from the practical. Done by & مجهــــــــــــــــــــول Prof. A. Thanks to Nour AlMozain. Immunology Quiz no.1.

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40 Qs on the lectures 5 Qs from the Quizzes 5 Qs from the practical

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  1. 40 Qs on the lectures5 Qs from the Quizzes5 Qs from the practical Done by & مجهــــــــــــــــــــول Prof. A Thanks to Nour AlMozain

  2. Immunology Quiz no.1. 1.A25-years old man presented with nasal symptoms in the form of nasal itching , sneezing , runny nose and sometimes itching in the eyes. He was using anti-histamine medications regularly for the last 2-months to control his symptoms. . 1.What is the possible underlying immunologic Problem ? 1\ type 1 hypersensitivity 2.What is the most relevant test that can help to diagnose this case ? 2\ skin prick test, measurement of IgE .

  3. 3.How can you explain the symptoms with underlying immunopathology ? 3/ Allergin deposits on the nasopharynx and bronchial mucosa which leads to B cell sensitization and subsequent transformation into plasma cells releasing 1ry and 2ndary mediators which causes recruitment of inflammatory cells releasing other mediators such as Histamine ( which causes vasodilatation so runny nose and congestion ) ANF kinine ( which causes itching ) IN OTHER WORDS, upon exposure of th atopic person to specific antigen leads to sensitization of B cells to become plasma cells producing IgE which binds to high affinity receptors on mast cells & basophils causing sensitization. Then subsequent exposure leads to degranulation & release of allergic sub. Such as histamine.

  4. Immunology Quiz no.2.(immunodeficiency ). A 9-month old boy presented with history of recurrent episodes of serious bacterial infections. These included bacterial pneumonia, otitis media , Sinusitis & septicemia. Repeated bacteriological cultures revealed Streptococcus pneumonae, H. influenzae & Staphylococci. 1.List the relevant immunologic investigation in this case . 1/ X-linked Agammaglubinemia and Transient hypogammaglubinemia. 2.What immunologic processes are likely to be involved . 2/ Ab production and B-cell deficiency.

  5. What is the probable diagnosis ? 3/ X-linked Agammaglubinemia 4.What are the appropriate lines of management ? 4/ IgG Intravenously injected. .5.Why was the child normal up to 9-month of age and then started to develop infections? 5/ because maternal antibodies survive in the baby’s circulation until approximately 6 to 8 months of birth & then they fade. 6.Can this disease affect female children ? 6/ NO, they can be only carriers because the disease X-linked.

  6. Immunology Quiz no.3.(infectious diseases ). A 5-years old child , who did not receive the recommended immunizations had a cut wound in the foot which became contaminated with soil. 1. What will you advice for treatment ? • 1/ Anti-Tettinus shot then passive vaccination of already-made Ab that are chosen on the basis of the infection. • Later, we give the patient the active vaccines. 2. What are the different types of vaccines available ? 2/ Live (attenuated) organismsInactivated organisms( killed)Purified microbial macromoleculesClonal microbial antigensToxoid ( inactivated toxins ) 3. What is the recommended vaccination 3/ schedule for children in Saudi Arabia ? See next page.

  7. VACCINE TABle– it is already found in the females booklet.

  8. Vaccine TABLE – it is already found in the females booklet.

  9. Immunology Quiz no.4.( autoimmunity). 1.What is the association between infection, autoimmunity and hypersensitivity ? 1/ Microbes ( in hypersensitivity ) predispose to Auto-immunity because these microbes may mimic the Host antigen leading to Ab production against them. ( molecular mimicry ) Also, the pathology of autoimmunity is mediated by type 2,3,4 hypersensitivity reactions. 2.Mention 2 infections which may lead to development of autoimmunity and the underlying hypersensitivity causing the pathological tissue damage ? 2/ Streptococcus infection causing Raumatoid Fever. Post Rabies encephalitis. CoxsackieVirus leading to Type 1 Diabetes Millitus. 3.Mention 2 autoimmune diseases in which tissue damage is caused by more than one hypersensitivity reaction ? 3/ Raumatic Arthritis and Systemic Lupus Erythematosus.

  10. 4. What is the explanation for the fact that certain autoimmune diseases get better during pregnancy, while others get worse ? 4/ During pregnancy, the female immune response undergoes modification by increasing H2 & decreasing H1 which creates anti-inflammatory environment so diseases with antibody mediated component such SLE which enhanced by H2 like response are exacerbated during preg. While diseases involving inflammatory responses such as RA or MS sometimes ameliorated in preg.

  11. Immunology Quiz no.5.( transplantation ). 1.What does HLA stand for ? 1/ HLA = human leuckocyte antigen . 2.M.A. is a 40 years old man who require a kidney graft due to end-stage renal disease. His HLA genotype was as follows: HLA-A3/A6.B27/B44,CI/C8,DR1/DR4. He brought 5 donors .and tissue typing was performed. Which one of them is the best choice ? Donor no.1 HLA type: HLA-A3/A8, B7/B28, C4/C8, DRI/DR4. Donor no.2 HLA “ : HLA-A6/A6, B27/B24, C12/C1, DR1/7. Donor no.3.HLA “ “ : HLA-A27/A44, B1/B8, C3/C6, DR3/DR14. Donor no.4 HLA “ ‘ : HLA-A3/A6, B24/B7,C2/C9, DR4/DR7. Donor no.5 HLA “ “ : HLA-A3/A3, B27/B44, C1/C8, DR4/DR4. 2\ choice # 5 , only 2 alleles r different.Also, there is no big difference between 5 and the host in MHC11 ( they both have DR4 ) 3. What type of cells are used to detect HLA antigens ? 3/ T-cell , B-cell (notice that PCR used for ant type of cells )

  12. 4.A 5-months old boy who was diagnosed with severe combined immunodeficiency (SCID ) received a bone marrow transplantation from an HLA-matched donor. He was doing well until 2 weeks after transplantation when he developed a skin rash. Subsequently he developed diarrhea, an enlarged liver & spleen and jaundice. What immunological process might be involved in his problem ? 4/ GVHR (Graft Versus Host Reaction ) 5.Which one is more important for graft survival MHC-class1 or MHC-class11 matching ? 5/ MHC11 is more important. In fact, The more compatibility between MHC11 of host and donor, the more is the rate of graft survival rate.

  13. Practicals:ImmunodiffusionCH50ELISAFLOW CYTOMETRYSKIN PRICK TESTPATCH TEST

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