PEARLS before Swine
Overproduction of this protein is the cause of the "M-spike" in the diagnosis of multiple myeloma.
IgG
Malar rash, photosensitivity, and blood in urine.
SLE
A patient who's been using crutches for a while complains of weakness when performing a certain motion in the wrist. Name the exam finding you'd observe and the nerve responsible.
Axillary nerve. Think of Saturday night's palsy entrapping the radial nerve.
These two antibodies are transferred to the fetus during pregnancy. What are they, and through what structures are they transmitted?
IgG (placenta)
IgA (breast milk)
This cell structure on macrophages is responsible for recognition of flagella.
TLR-5
Biopsy of this structure would help in the differential diagnosis of large cell vasculites.
Temporal artery
You should have this on your differential for a patient with pain in the TMJ joint without crepitus, as well as vision changes.
GCA
Muscle weakness in the pelvis as well as erythematous rash on the upper eyelid would warrant ordering labs for... (Name two!)
Creatinine kinase, muscle biopsy, electromyogram, anti-ANA, Jo-1, mi2... Dermatomyositis!
This family of immune cells are commonly implicated in maintaining granulomas.
Macrophages
Th-1
Name three enzymes that are involved in the development of B cells.
TdT, RAG1, RAG2, AID
A patient who squats to relieve cyanosis and with a cleft palate would need this curative treatment for recurrent infections.
Thymic transplant
Pain in a 70-year-old's DIP joint relieved by rest, worsening throughout the day.
Osteoarthritis
A 45-year-old patient presents with progressive muscle weakness after his knee was struck with a baseball bat. He seems to be dragging his feet with his toes dragging on the floor as he walks into the office. What nerve may be damaged leading to this abnormality?
Deep fibular nerve, weakness in dorsiflexion.
Name two cytokines that might help tumor growth.
TGF-beta, IL-10, and more...
A certain cancer cell is downregulating MHC-1 in an attempt to evade the immune system. They would successfully avoid attack by this immune cell, but they would be vulnerable to this other one... name both!
Vulnerable to NK
Protected against CD8
A patient who just began pharmacological treatment for seizures (phenytoin) now presents with elevated BUN and creatinine. What's the cause, and how would you help diagnose it?
SLE and serology (Anti-ANA, etc...)
Sudden hypotension upon receiving a blood transfusion.
Anaphylaxis
A 17-year-old boy presents with severe muscle cramps after exercise, but he says it gets better if he "runs through the pain for a few minutes." What biochemical phenomenon is responsible for this burst of energy?
Fatty acid oxidation replacing glycogen breakdown in muscle. "Second wind"
This cytokine is heavily implicated in the pathogenesis of gout.
IL-1
Name two mechanisms by which peripheral tolerance is maintained.
Tregs
Anergy
These proteins of the innate immune response are helpful in stimulating histamine release, vascular permeability, and neutrophil chemotaxis.
Anaphylotoxins of the complement system: C3a, C5a
One-month progressive shortness of breath with tender, red nodules on both shins.
Sarcoidosis
Erythema nodosum
This etiology of myopathy may also be seen with arrhythmias and a history of weight gain.
Thyrotoxic myopathy
Hyperthyroidism (Graves' disease)
Immune cells positive for CD15 and CD30 are confirmatory for this kind of malignancy.
Name three ways you could assess for B-cell function when working up an infant for a potential immunodeficiency.
Mitogen assay
Presence of antigens towards previous vaccines (Tdap, pneumococcal)
Cell count
Flow cytometry