The place of diseases of the immune system in general morbidity Ukraine and in the world. Reasons for the growing number of allergic diseases in the world and their predicted prevalence in the future. 7 - 3 - preparation of the summary (number of points depends on the quality of training and the ability to respond to additional questions) - you can prepare for essay topics of cycle 1, working independently (extracurricular) in coordination with the teacher .
ADDITIONAL MATERIALS
34;CLINICAL IMMUNOLOGY AND ALLERGOLOGY"
METHODS OF INVESTIGATION OF IMMUNE SYSTEM ORGANS
Occipital lymph nodes are located on the knobs (bumps) of the occipital bone and collect lymph from the scalp and posterior neck. Retroauricular (mastoid) lymph nodes are located behind the ears in the region of the mastoid process. Genial lymph nodes receive lymph from the lower lip and the mucosa of the gums.
THE MAIN RULES OF IMMUNOGRAM INTERPRETATION
If changes in the immunogram indices do not correspond to the clinical picture of the diseases, this is a sign of a serious, unfavorable development of the process. However, in the development of the pathological process, immunogram changes may be more or less expressed than they should be according to the clinical picture. It is evidence that the immune system's response to a foreign agent is weaker or stronger than it is enough to neutralize it.
Complete blood count
In the blood of healthy people, the absolute number of the total number of leukocytes, as well as of cells from separate populations, varies much more than different ratios between these cells, including the relative number of cells from different populations (blood cell formula). Therefore, mismatch between immunogram changes and clinical signs of the process is a bad symptom, indicating that the immune system is not working properly, causing the worsening of the pathological process. Identification of the first signs of such a mismatch in time is one of the main tasks of immunogram interpretation.
INTERPRETATION OF IMMUNOGRAM READINGS
- RLBT
This decrease is one of the reasons for the preservation and accumulation of autoreactive and transformed tumor cells in the patient's organism. X-ray readings: in the upper lobe of the right lung there is a large shadow with unclear outline. Immunotherapy is most commonly used in the treatment of cancers along with chemotherapy (drugs) and radiotherapy (radiation).
If a child has more than one of the symptoms mentioned, the risk of immune deficiency is high. A 3-month-old boy was admitted to the pediatric ward with an abscess in the right armpit, pustular rash on the skin of the face and groin area. On examination: hyperemia and edema of the skin of the face, there are grouped vesicular eruptions, pronounced local edema.
When and where attacks of the disease or worsening of the condition develop most often (at home, at work, outdoors, in the forest, in the field, during the day, at night). Influence of inhalation of tobacco smoke, cold air, strong odors on the course of the disease 14. This will reduce the need for pharmacotherapy considerably and in many cases prevent the progression of the disease.
Evaluation of skin application test Result of reaction Local skin reaction. Evaluation of scarification test Result of reaction Local skin reaction. Skin prick test evaluation Reaction result Local skin reaction.
Intracutaneous test
Slightly positive papule (blister) up to 2-3 mm + hyperemia Positive papule (blister) up to 5 mm + hyperemia. Strongly positive Papule (bubble) up to 5-10 mm + hyperemia + pseudopodia Very strongly positive Papule (bubble) more than 10 mm + hyperemia + pseudopodia. Doubtful Delayed resolution of blister Slight hyperemia without infiltration Slight positive Papule (blister) 4-8 cm + area.
Repeated examination of the patient should be done under conditions of natural contact with the allergen.
Provocative tests
For food allergies, use natural products diluted 1:10; in case of drug allergy, take 1/8-1/4 of the single dose of the dissolved substance. The test is considered positive if there is hyperaemia, oedema, itching, skin eruption in the sublingual area.
Immune-laboratory methods of diagnosis of allergic diseases
Using EIA, a count of allergen-specific IgE in the patient's blood is performed. In the first phase of the study, the tested allergen is covalently linked to the solid phase (paper disk, activated polymer). When adding the patient's serum, coupling of the allergen fixed on the solid phase with the antibody takes place, if antibodies corresponding to this allergen are present in the serum.
The complex of the allergen on the solid phase + specific IgE + antibodies anti-IgE is formed. Using RAST, a count of allergen-specific IgE in the patient's blood is performed. The allergen covalently binds to the paper disc and reacts with specific IgE in the patient's blood.
In the positive reaction, there is deformation of the cells, formation of pseudopodia, more intensive movement of the granules and rarely granules leave the cell with its rupture. The direct basophil test (Shelley test) is based on the study of morphological changes in basophils in the peripheral blood of the patient with an allergic disease in interaction with a specific allergen. The response of histamine release from basophils of the peripheral blood is based on the calculation of the percentage release of histamine after processing basophils with specific allergens.
Reaction of lymphocyte blast transformation (RLBT) is a test of estimation of functional activity of pool T lymphocytes.
SITUATIONAL TASKS
Asthma is a tendency to chronic inflammation of the lungs in which the airways (bronchi) are reversibly narrowed. Because of the spectrum of severity within asthma, some people with asthma experience symptoms only infrequently, usually in response to triggers, while other more severe cases may have noticeable airflow obstruction at all times. Peak flowmetry is a method of peak (maximal) expiratory flow (PEF) measurement, a convenient portable way of monitoring for 24 hours with recording of the findings on a special form.
That is, on the one hand, the disease can be managed, on the other hand, the development of obstruction can be prevented in the stages when clinically there is no obvious deterioration of the patient's condition. PEF monitoring enables the patient who visits the doctor in time to correct the treatment or, after receiving the relevant knowledge in the asthma school, to make a proper decision on his own, without waiting for the subjective deterioration of the condition. After learning according to a special program, which provides the patient with an adequate idea of the character of the disease, the patient can monitor the PEF findings himself.
These tasks are partially solved on the basis of monitoring the findings of peak flowmetry - PEF early in the morning in mild BA and in the morning, in the afternoon and in the evening in persistent moderate and severe course of the disease, which records all the data in the protocol schedule. Monitoring of PEF allows to predict exacerbation of the disease, since on the eve of it, suppression of the parameters develops before the subjective signs of obstruction. The received data from the experimental PEF is compared with the normal data from table, and the percentage of deviation from the normal is counted.
The green area reflects the relative well-being of the patient: it corresponds to PEF>80% and daily variability <15%.
- Spirography
- TECHNIQUE OF INHALATION THROUGH NEBULIZER
- Immunological disorders in autoimmune diseases
- Scoring system of diagnosis of autoimmune hepatitis
Restriction of the functions of external breathing is due to various pathological processes in the respiratory tract. Obstacles to the movement of air can be observed in both the upper and lower airways. In order for most of the drug to enter the respiratory tract and have a medical effect, it is necessary to study the technique of inhalations.
To firmly grasp the mouth of the container with the lip, not closing the hole with the tongue. Breathe in as deeply as possible, to press the bottom of the inhaler at the same time (to feel that the preparation passes into the lungs). If the separator has a mask, press the mask against the child's face.
To press the bottom of the container, that is, to make an injection of the drug in the spacer. For effective dispersion of the medicine when using the powder inhaler, inspiration must be strong, which is not always possible in children. But do not close the special hole for the air on the side of the nozzle.
Antinuclear factor (ANF) is a specific immunological activity of immunoglobulins-autoantibodies on the entire somatic cell nucleus.
MATERIALS
- The test questions control;
- The solution of non-typical tasks
- Decreased appetite B. Fever
- Increased collagen synthesis by fibroblasts D. Opsonization to facilitate phagocytosis
- LTC4 and LTD4 D. PGI2 and PGD2
- Thromboxane and platelet activating factor
- Which of the following enzymes does the neutrophil use to initiate the production of toxic oxygen compounds that kill bacteria?
- Hydrogen peroxide B. Myeloperoxidase
- C3 is cleaved to form C3a and C3b by C3 convertase. C3b is involved in all of the following EXCEPT
- promoting phagocytosis
- altering vascular permeability
- forming alternative-pathway C3 convertase
- forming C5 convertase
- Infectionous mononucleosis B. Chroniosepsis
- HIV-infection
- Lymphogranulomatosis E. Tuberculosis
- Interferon prescription
- Monitoring of the specific IgG IgM with the ELISA D. Cyclovin prescription
- Immunoglobulin injection
- Anti-receptor antibodies
- Complement-mediated reactions
- Deposition of circulating antigen-antibody complexes
- A 22-year-old female comes to the sexually transmitted disease (STD) clinic for her first visit
- Western blot
- FACS ( Fluorescence activated cell sorting) C. RAST (Radioallergosorbent Test)
- RID (Radial immunodiffusion)
- ELISA (Enzyme-linked immunosorbent assay)
- severe combined immunodeficiency B. chronic granulomatous disease
- Waldenström's macroglobulinemia E. Wiskott-Aldrich syndrome
- Adenosine deaminase B. Class III MHC gene
- Gamma chain of the IL-2 receptor D. Tyrosine kinase
- Purine nucleotide phosphorylase
- Wiskott-Aldrich syndrome B. Ataxia telangiectasia
- Acquired hypogammaglobulinemia
- Chronic granulomatous disease
- SCID (severe combined immunodeficiency disease) E. Wiskott-Aldrich syndrome
- Production of myocytes antibodies B. Production of myosin antibodies
- Production of antibodies to endothelial cells D. Production of antibodies to double-stranded DNA
- Jaundice due to conjugation disorder
- Hepatitis
- A 27 year old woman presents with muscle weakness,ptosis,has been receiving gentamicin injections for the last 7 days for a urinary infection.Thyroid function tests,serum creatine kinase,
- Myasthenia gravis
- Duchenne musclar dystrophy D. Peripheral neuropathy
- None of the above
- N-acetyl cysteine and cromolyn by inhaler B. Parenteral phenobarbital
- Tuberculous meningitis D. Brain tumor
- Subdural hematoma
- A college student sitting in the stands at a football game suddenly begins breathing hard and complains to his friends of tightness in his chest. Minutes later, he is sweating profusely and faints
- Epinephrine B. Blocking antibody
- Acute serum sickness (Type III)
- Delayed type hypersensitivity (Type IV) E. Anti-receptor antibodies (Type II)
- Type IV hypersensitivity B. Local anaphylaxis
- T-cell mediated cytotoxicity D. Type III hypersensitivity
- Antibody-dependent cell-mediated cytotoxicity
- Antibody-mediated phagocytosis B. Neutrophil ingestion of bacteria
- T lymphocyte B. Eosinophil
- Irritant dermatitis B. Type IV reaction
- Start the patient on an inhaled corticosteroid
- Order complete pulmonary function tests (PFTs) with diffusion capacity DLCO C. Reassure the patient that these symptoms are not caused by his asthma
- Order allergy skin testing
- Start the patient on a leukotriene receptor antagonist
- A 32-year-old man comes to see you complaining of nasal obstruction and clear nasal drainage
- Intranasal injected corticosteroid B. Oral antibiotics
- Nasal corticosteroid spray
- Oral antihistamine E. Oral corticosteroids
- A 42-year-old man with a history of asthma has increasing shortness of breath and wheezing
- Bacterial pneumonia B. Goodpasture syndrome
- Wegener granulomatosis
- Topical decongestant B. Oral corticosteroids
- Topical corticosteroid nasal spray E. Oral antihistamines
- Nasal polyps B. Clubbing
- Increased tactile fremitus D. Bronchial breath sounds
- Proximal pallor of the nail beds associated with a distal band of reddish brown
- Beclomethasone B. Hydrocortisone
- Disodium cromoglycate D. Prednisone
- Theophylline
- Killing effect as part of immunobiological supervision. The main types of killer cells
- Situation Task
- The cell of innate protective factors and their interaction in the implementation of the immune response
- The main tasks and problems of modern clinical immunology. Groups diseases within the competence of clinical immunologist
- Macrophages. Role in the development and implementation of an immune response
- Principles of anti-allergic and immunotropic therapy of allergy
- Humoral factors of innate immunity. Natural antibodies, interferons
- Principles and anti-allergic therapy treatments in immunotropic of allergy
- Immunological system mucous membranes. Lymphoid tissue associated with gastro - intestinal tract
- Mechanisms disruption tolerance, their role in the development of autoimmune diseases
- Fundamentals of modern molecular Allergic diagnosis and therapy
- Laboratory criteria for diagnosis of autoimmune diseases
- Acquired immunodeficiency diseases, immune-diagnostics, clinic, therapy Immunotropic
- Rheumatoid arthritis: immunopathogenesis, immunodiagnosis, immunotherapy
- The mechanisms of the immune system interaction "host" and tumors
- Immunopathogenesis, stage of development, classification of HIV / AIDS
- Features of pre and post transplantation immunological monitoring. Types of rejection crisis, their clinical and immunological characteristics and prognosis
- Current methods for evaluating immune status
- Congenital immunodeficiencies of phagocytic parts of the immune system and complement system: mechanisms of development, clinical course, and treatment of immune
Administration of the antibody is expected to interfere with which of the following biological functions. During these early stages of infection, which of the following and the wound appears inflamed. Which of the following immune mechanisms does the body use against the live filarial worms.
This patient's condition is thought to be related to a deficiency of which of the following proteins. Which of the following is the main form of defense by which they are positive for acid-fast bacilli. Which of the following is the main form of defense with which the patient's body fights this infection.
If a biopsy were performed on the area of induration, which of the following types of reactive cells would be found? The best choice for maximizing relief and minimizing side effects with long-term use is which of the following. Which of the following agents should most likely be added to the patient's treatment to alleviate his current symptoms?
The cell of innate protective factors and their interaction in the implementation of the immune response.
Questions for final module test (Clinical Immunology and Allergology)
Contemporary views on immune system structure, function and ontogenesis. Primary and secondary organs of immune system
Principles of functioning of immune system in children and senior
Innate cells factors of defense, their interaction in immune response
Humoral factors of innate immunity
Complement system. Biological consequences of its activation
Stages of T- abd B-lymphocytes maturation and differentiation
Th 1 and Th2. Importance of balance (Th1\Th2)
T-regulatory cells, main function
Apoptosis as special form of cell death. Its role it physiological and pathological processes
T-dependent and T-independent immune responses
Cytokines – mediators of immune system, Interleukins, classification, function and role in immune processes
Growth factors. Tumor necrotic factors, interferons and adhesive molecules
Immune system of mucosa. Gut-associated lymphoid tissue (GALT)
Contemporary views on structure and function of MHC
Structure of HLA antigens. Predisposition to diseases according to HLA phenotype
Quantitative and functional immunological tests. Immunogram, main parameters
Method of quantitative and functional T-lymphocyte characteristic determination: rosette test, tests with monoclonal antibodies, blast-transformation reaction with mitogenes
Method of quantitative and functional B-lymphocyte characteristic determination: rosette test, tests with monoclonal antibodies, blast-transformation reaction with mitogenes, circulating
Method of phagocyte activity estimation
Quantitative method of main classes’ serum immunoglobulins determination
Immunopathogenesis, stages, classification of HIV-infection and AIDS
Clinical and laboratory diagnostic, principles of treatment
Major principles of HIV prophylactic in Ukraine. Medical staff as “risk group” for HIV infection
Primary immunodeficiencies of phagocytosis and complement system, mechanisms of development, course of disease, immune diagnostic and treatment
Classification, general principles of immune diagnostic of autoimmune diseases
Laboratory criteria of immunodiagnostic of autoimmune diseases
Causes of allergy development. Stages of allergic reaction
Allergy and atopy. Classification of allergens
Allergy diagnosis, laboratory tests, skin and provocative tests
Principles of antiallergic therapy. Immune methods of treatment
Drug allergy, immunopathogenesis, clinical manifestation, diagnosis, therapy and prophylactic
Non-atopic diseases: types, immunopathogenesis, immunodiagnostic, clinical manifestation and differential diagnosis
Cell-mediated allergic diseases (serum disease, Arthus phenomenon, allergic alveolitis)
Atopic forms of BA: clinical manifestation, diagnostic, treatment
