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Medications
Immunology
37
Immunology
Professional
12/06/2019

Additional Immunology Flashcards

 


 

Cards

Term
Rituximab is a monoclonal antibody against which antigen?
Definition
CD20 (autoimmune disease, B lymphocyte lymphoma)
Term
Omalizumab is a humanized monoclonal antibody against which antigen?
Is total IgE and free IgE increased or decreased?
What is the range of total IgE when Omalizumab can be used?
Definition
FcepsilonRI ( cepsilon3 constant region) (asthma)
IgG1 molecule with 95% human and 5% murine sequence
Increased total IgE, decreased free IgE
30-700
Term
What medications block calcineurin?
Definition
Cyclosporin and FK-506(tacrolimus)
Term
Imiquimod is an agonist to which TLR?
Resiquimod?
Definition
TLR 7
TLR 7 and 8
Term
Imatinib targets which receptor?
Definition
Kit (receptor for stem cell factor which is growth factor of mast cells)
Term
What is used for treatment of anaphylaxis for patients on beta-adrenergic blockade?
Definition
Atropine (for bradycardia), glucagon (for inotropic and chronotropic effects)
Term
OKT3 is a monoclonal antibody against which antigen?
Definition
CD3 (renal transplants)
Term
Binding of what receptor is the proposed mechanism of IVIG?
Definition
FcgammaRIIb
Term
What nomenclature is used for monoclonal antibodies of mouse, chimera, humanized and human type?
Definition
-omab, -ximab (murine variable, human constant), -zumab (murine hypervariable, human IgG molecule), -umab (human variable cloned into bacteriophage)
Term
Adalimumab is a monoclonal antibody against which antigen?
Definition
TNF-alpha (RA)
Term
Efalizumab is a monoclonal antibody against which antigen?
Definition
CD11a (psoriasis)
Term
Palivizumab is a monoclonal antibody against which antigen?
Definition
RSV F-protein (BPD)
Term
Keliximab is a monoclonal antibody against which antigen?
Daclizumab?
Natalizumab?
Abciximab?
Definition
CD4 (MS)
Renal allograft rejection
MS
Cardiac ischemic complications
Term
When is theophyline used?
What is the mechanism of action?
Definition
Alternative for <5 yo not well controlled with low-dose inhaled corticosteroid, COPD
Inhibits phosphodiesterase resulting in elevated cAMP
Term
What is the mechanism of action of antihistamines?
Definition
inverse agonists (stabilize the receptor in the inactive form)
Term
Describe desensitization of beta2-receptors?
Tachyphylaxis?
Definition
Decrease in duration of bronchodilation, occurs over days to weeks
ephedrine displaces norepinephrin, rapid
Term
What B-blockers are nonselective?
What B-blockers are cardioselective (B1>B2)?
What is contraindicated with b-blockers?
Definition
Propranolol, timolol, pindolol, nadolol, labetalol
metoprolol, atenolol
IT
Term
What receptor does montelukast, pranlukast and zafirlukast block?
What receptors do zileuton block?
Definition
cys-LT1 receptor (LTC4, LTD4, LTE4)
Both LTB4 and cys-LTs
Term
What should be monitored when using zileuton?
Definition
LFT's every 3 months
Term
What bronchial challenges are prevented by mast cell stabilizers (cromolyn)?
What challenges are not prevented?
Definition
exercise, air, adenosine, saline, mannitol
methacholine, histamine
Term
What subset of patients is benefited by ipratropium?
Definition
COPD (bronchodilation equal to b-agonists)
Term
What is the order of relative binding affinity for inhaled corticosteroids?
relative potency?
Definition
Mometasone>fluticasone>budesonide>triamcinolone
Mometasone=fluticasone>budesonide=beclomethasone>triamcinolone
Term
What is receptor is over expressed in steroid resistance?
Definition
glucocorticoid receptor beta
Term
What is the molecular target of alemtuzumab? Indications?
Cetuximab?
Eculizumab?
Efalizumab?
Palivizumab?
Abatacept?
Alefacept?
Definition
CD25 (chronic B-lymphocyte leukemia)
EGF (epidermal growth factor) (Colorectal CA, Head/neck CA)
C5 (paroxysmal nocturnal hemoglobinuria)
CD11a (subunit of LFA-1) (Plaque psoriasis)
RSV fusion protein (prevention of RSV)
B7 (RA, JRA)
CD2 (plaque psoriasis)
Term
What is the mechanism of action of methotrexate?
Azathioprine?
Mycophenolate mofetil?
Cyclosporine A?
Tacrolimus/Pimecrolimus?
Definition
inhibits cell replication
inhibits purine nucleotide synthesis and metabolism
affects purine nucleotide synthesis and metabolism
inhibits helper T cell function
calcineurin inhibitors (inhibit NFAT which decreases IL-2)
Term
What is the standard dose of IVIG?
IVIG for Kawasaki and various neurologic diseases?
subcutaneous Ig?
Definition
400-600 mg/kg every 3-4 weeks
2 g/kg every 3-4 weeks
100 mg/kg every week
Term
What are the immunomodulatory effects of Ig replacement?
Definition
Fc receptor blockade (ADCC inhibited by FcgammaRIII on NK cells, antibody production inhibited by FcgammaRIIb on B cells), neutralizes superantigen/toxins/autoantibodies, inhibits cytokines, inhibits complement, inhibits fas-mediated apotheosis on keratinocytes (in TEN)
Term
What precautions should be taken with IVIG?
Definition
Avoid live vaccines for several months, use low IgA products in patient with low IgA levels
Term
What are the indications of IFN-alpha?
IFN-beta?
IFN-gamma?
IL-2?
IL-11?
GM-CSF?
Epoetin/Darbepoetin?
Definition
IFN-a - Hep B/C, hairy cell leukemia, CML, HPV
IFN-b - Relapsing MS
IFN-g - CGD, malignant osteopetrosis
IL-2 - renal cell carcinoma, melanoma
IL-11 - chemo-induced thrombocytopenia
GM-CSF - AML, bone marrow/stem cell transplant, neutropenia
Epoetin/Darbepoetin - anemia from chronic renal failure, HIV, chemo, primary bone marrow disorders
Term
What are the indications for TNF-alpha?
What are examples and what do they bind?
What precautions should be made?
Definition
RA, psoriatic arthritis, ankylosing spondylitis
Infliximab (TNF-alpha), Etanercept (TNF-alpha and TNF-beta), Adalimumab (TNF-alpha), Cerolizumab, Golimumab
Risk of reactivation of TB, development of autoantibiodies, increased LFTs, live vaccines not recommended
Term
Name the mechanisms of these drugs
Anakinra
Rilonacept
Basiliximab
Daclizumab
Toclizumab
Definition
Recombinant IL-1Ra
IL-1 Trap
Chimeric IL-2Ra
Humanized IL-2Ra
Humanized IL-6Ra
Term
What do these nomenclatures for monoclonal antibodies mean?
omab
ximab
zumab
umab
cept
Definition
murine
chimeric human/mouse
humanized
fully human
fusion of a receptor to the Fc part of human IgG1
Term
What medication inhibits COX-2 expression?
What medications are tolerated by aspirin hypersensitivity pt?
What prostaglandin is mast cell derived in response to IgE mediated reactions?
Definition
Glucocorticoids
Acetaminophen and COX-2 inhibitors
PGD2
Term
What percent of asthmatics have AERD?
Definition
5-10%
Term
In aspirin sensitivity which direction do these mediators change?
cyt-LT1
LTD4
urine LTE4
PGE2
Definition
Increased
Increased
Increased
Decreased
Term
What are the side effects of tar skin preparations?
Definition
photosensitivity, pustular folliculitis
Term
What is a complication of gene therapy in X-linked SCID?
Definition
ALL from transgene insertion into LMO2 gene
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