Podcast
Questions and Answers
Which of the following best describes the primary action of steroids as immunosuppressants?
Which of the following best describes the primary action of steroids as immunosuppressants?
- Specifically targeting and neutralizing TNF-alpha.
- Non-specifically inhibiting multiple steps in immune activation, such as IL-1, IL-2, and TNF. (correct)
- Selectively depleting B cells expressing CD20.
- Inhibiting a single, precise step in the immune activation cascade.
A patient presents with gingival hyperplasia after recently starting immunosuppressant medication post-transplant. Which medication is most likely causing the hyperplasia?
A patient presents with gingival hyperplasia after recently starting immunosuppressant medication post-transplant. Which medication is most likely causing the hyperplasia?
- Sirolimus
- Mycophenolate
- Azathioprine
- Cyclosporin (correct)
What is the primary distinction between innate and adaptive immunity?
What is the primary distinction between innate and adaptive immunity?
- Innate immunity targets specific pathogens, while adaptive immunity provides broad protection against all pathogens.
- Innate immunity involves antibody production, while adaptive immunity relies on phagocytosis.
- Innate immunity is immediate and non-specific, while adaptive immunity is targeted and develops memory. (correct)
- Innate immunity requires antigen presentation, while adaptive immunity does not.
A patient undergoing immunosuppressive therapy develops an oral infection. Which of the following opportunistic infections is most likely to occur?
A patient undergoing immunosuppressive therapy develops an oral infection. Which of the following opportunistic infections is most likely to occur?
Which of the following is the most accurate definition of 'immunocompromised'?
Which of the following is the most accurate definition of 'immunocompromised'?
What is the primary mechanism by which monoclonal antibodies induce immunosuppression?
What is the primary mechanism by which monoclonal antibodies induce immunosuppression?
A patient presents with delayed healing after a routine dental extraction and is known to be on immunosuppressants. Which factor is LEAST likely to contribute to this delayed healing?
A patient presents with delayed healing after a routine dental extraction and is known to be on immunosuppressants. Which factor is LEAST likely to contribute to this delayed healing?
Which of the following best describes 'immunosuppression'?
Which of the following best describes 'immunosuppression'?
Which of the following oral conditions has the highest potential to develop into malignancy in immunosuppressed patients?
Which of the following oral conditions has the highest potential to develop into malignancy in immunosuppressed patients?
What is the underlying mechanism by which chemotherapy agents induce immunosuppression?
What is the underlying mechanism by which chemotherapy agents induce immunosuppression?
What is a key distinction between the mechanisms of action of monoclonal antibodies and steroids in immunosuppression?
What is a key distinction between the mechanisms of action of monoclonal antibodies and steroids in immunosuppression?
Which of the following is NOT a typical feature of innate immunity?
Which of the following is NOT a typical feature of innate immunity?
A patient receiving immunosuppressive therapy complains of multiple oral ulcers. Viral infections are suspected. Which virus is most commonly associated with oral ulcers in immunocompromised patients?
A patient receiving immunosuppressive therapy complains of multiple oral ulcers. Viral infections are suspected. Which virus is most commonly associated with oral ulcers in immunocompromised patients?
Which of the following immunosuppressive drugs is a biologic?
Which of the following immunosuppressive drugs is a biologic?
What is the primary function of antigen presentation in the adaptive immune response?
What is the primary function of antigen presentation in the adaptive immune response?
Why are patients with sickle cell disease considered to have a form of acquired immunodeficiency?
Why are patients with sickle cell disease considered to have a form of acquired immunodeficiency?
Which of the following is the most immediate step in the innate immune response following the entry of a pathogen into the body?
Which of the following is the most immediate step in the innate immune response following the entry of a pathogen into the body?
Which of the following best describes the potential consequences of iatrogenic immunosuppression?
Which of the following best describes the potential consequences of iatrogenic immunosuppression?
A patient with rheumatoid arthritis is being treated with Infliximab. By what mechanism does Infliximab exert its immunosuppressive effect?
A patient with rheumatoid arthritis is being treated with Infliximab. By what mechanism does Infliximab exert its immunosuppressive effect?
What is the role of Cytokines in innate immunity?
What is the role of Cytokines in innate immunity?
Flashcards
Immunodeficiency Definition
Immunodeficiency Definition
Any state in which the immune system operates below its optimal level of function.
Immunosuppression Definition
Immunosuppression Definition
The artificial suppression of the immune system's activity, often induced by medications or other interventions.
Immunocompromised Definition
Immunocompromised Definition
Individuals who are at increased risk of infection or other complications due to reduced immune function.
Two Steps of Innate Immunity
Two Steps of Innate Immunity
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Features of Innate Immunity
Features of Innate Immunity
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Two Steps of Adaptive Immunity
Two Steps of Adaptive Immunity
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Common Acquired Immunodeficiencies
Common Acquired Immunodeficiencies
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Drugs Causing Immunosuppression
Drugs Causing Immunosuppression
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Features of Steroids as Immunosuppressors
Features of Steroids as Immunosuppressors
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Oral Side Effects of Immunosuppression
Oral Side Effects of Immunosuppression
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Gingival Hyperplasia Mechanism
Gingival Hyperplasia Mechanism
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Study Notes
- Immunodeficiency is any state where the immune system is below its optimal level.
- Immunosuppression is the act of artificially depressing the immune system.
- Immunocompromised individuals are those at risk due to reduced immune function.
Innate Immunity
- The two steps are recognition of pathogens, and cytokines, complement, and phagocytosis.
- An acute inflammatory response contains infection.
- Innate immunity features are immediate, non-specific, and without memory.
Adaptive Immunity
- The two steps are antigen presentation and activation of T helper cells.
- A targeted response involves antibody, cytotoxic T cells, and memory cells.
Rare Congenital Immunodeficiencies
- Selective IgA deficiency
- Ectodermal dysplasia
- Severe combined immunodeficiency
- Bruton's disease
- Di George Syndrome
- Ataxia Telangiectasia
- Wiskott Aldrich Syndrome
- Aggamaglobulinemia
- Hyper IgM Syndrome
- Chediak Higashi Syndrome
- Cyclic Neutropenia
Common Acquired Immunodeficiencies
- Infectious diseases such as HIV
- Malignancies such as Hodgkin’s disease and leukemia
- Autoimmune diseases such as Rheumatoid arthritis and SLE
- Nutritional deficiencies such as iron/vitamin deficiencies
- Other conditions like Sickle cell disease
- Iatrogenic suppression such as anti-rejection drug therapy
Immunosuppressive Drugs
- Steroids (e.g., prednisolone, dexamethasone, hydrocortisone)
- Monoclonal antibodies (e.g., infliximab, rituximab)
- Chemotherapy agents (e.g., azathioprine, mycophenolate, cyclosporin, sirolimus, everolimus)
- Biologics (e.g., adalimumab, etanercept, infliximab, anakinara)
Steroids as Immunosuppressors
- Non-specific
- Inhibit multiple steps in immune activation (IL1, IL2, IL6, TNF, prostaglandins, chemokines, MHCII)
- Have multiple side effects
Oral Side Effects of Immunosuppression
- Gingival hyperplasia due to increased collagen synthesis and decreased breakdown: consider taking them off cyclosporin, increase OH.
- Delayed healing
- Infection
- Candida
- Herpes simplex
- Leukoplakia
- Malignancy, e.g., SCC
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