IMMUNOLOGY
MULTIPLE MYELOMA
Cardiac
ANAEMIA
ANATOMY
100
What is the basic mechanism behind type I hypersensitivity?
Production of IgE and degranulation of mast cells
100
What does CRAB stand for?
Calcium elevation, Renal insufficiency, Anaemia, Bone lesions
100

Life-threatening consequence of pericarditis

Cardiac Tamponade

100
What are some signs/symptoms of iron deficiency anaemia?
General symptoms of anaemia (fatigue, shortness of breath, palpitations, pallor, tachycardia) + glossitis, angular stomatitis, koilonychias, dysphagia, pica.
100

list the two superficial cervical nodes


Submental 

Submandibular

200

True or False: Type 1 hypersensitivity can occur the first time an antigen is encountered without prolonged exposure


False

200
What are Bence-Jones proteins?
A monoclonal globulin protein or immunoglobulin light chain found in the urine – suggestive of MM
200

How do you calculate MAP with a BP of 120/87?

MAP = DBP + 1/3 (SBP - DBP)

MAP = 87 + 1/3(120 – 87) = 1/3(33) + 87 = 11 + 87 = 98 mm Hg.

200

Why does B12 and/or folate deficiency lead to megaloblastic anaemia

They are required for DNA synthesis in reticulocytes (RBC precursors) in order for them to survive/mature. Deficiency leads to large immature RBCs (they get smaller as they mature)

200

Which branch of the trigeminal nerve supplies all four muscles of mastication?

(extra 100 points for the 4 muscles)


Mandibular 

- temporalis

- masseter

- medial pterygoid

- lateral pterygoid

300

What mediates type IV hypersensitivity and how long after contact does the reaction occur?

Mediated by T cells and macrophages (antibody independent), and occurs hours to days after contact with antigen.

300
What is an ‘M-spike’?
On serum protein electrophoresis you get a large spike in the gamma region. It represents a high concentration of monoclonal immunoglobulin.
300

The primary reason for administering morphine to a client with an MI


To decrease oxygen demand on the heart due to decreased sympathetic action

300

List 4 common diagnostic tests for anaemia

Hemoglobin and hematocrit, Reticulocyte count, RBC indices, Iron studies, Vitamin B12, Folate, Haptoglobin, erythropoietin levels, blood smear

300

which nodes drain the cheek, upper lip. anterior hard palate, body of the tongue, and all teeth except the 3rd molars and mand incisors?


Submandibular

400
How does adrenaline help in anaphylactic shock?
Tightens junctions between endothelial cells, relaxes bronchial smooth muscle and stimulates the heart.
400
What causes renal failure in MM patients?
Renal impairment is caused by the accumulation and precipitation of light chains – obstruction of tubules and toxic to proximal tubules
400

If you are experiencing an extended repolarization which can predispose the ventricles to dysrhythmia, name the syndrome?


Prolonged QT Syndrome 
400
What is the pathophysiology of anaemia of chronic disease?
Increased cytokine release (IL-6) → increased hepcidin →decreased serum iron → decreased RBC production. [Could also be kidney disease, bone marrow infiltration or increased erythrophagocytosis]
400

What nerve(s) innervate the vocal cords?

The recurrent laryngeal nerve innervates the majority of the intrinsic laryngeal musculature, responsible for vocal production. These muscles include the major abductor of the vocal cords, the posterior cricoarytenoid muscle.

500

What are the two mechanisms of T cell mediated tissue injury in type IV hypersensitivity?


Cytokine-mediated inflammation by T helpers cells

T cell-mediated killing of host cells by T cytotoxic cells

500
What is the mechanism behind bone destruction in MM?
Plasma cells increase production of RANK-L; TNF-B, IL-6 → up-regulation of osteoclasts and these produce factors that promote plasma cell development.
500

What are Inotropic Agents? (Digoxin, Dopamine, Dobutamine)

The class of medications that maximizes cardiac performance in clients with heart failure by increasing ventricular contractility?

500
What are 2 causes of non-megaloblastic anaemia?
Alcoholism, liver disease, congenital bone marrow failure, reticulocytosis, MDS
500

which branch of the mandibular nerve supplies all mandibular teeth pulp and buccal gingiva of the md?

Inferior alveolar

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