Exam questions

Clinical Immunology, Academic year 2017/2018, winter term

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A. Basic immunology

  1. Mechanisms of innate and adaptive immunity  main characteristics and differences.
  2. Antigen, hapten, superantigen, thymus-dependent and thymus-independent antigens.
  3. Biochemical structure of immunoglobulins. Biological roles of immunoglobulin classes and subclasses.
  4. B- and T-lymphocytes, their subsets and functions.
  5. K, NK,NKT andMAIT cells and their functions.
  6. Classical, alternative and lectin pathways of complement activation.
  7. Phagocytosis and mechanisms of intracellular killing of ingested microorganisms.
  8. Pattern-recognition receptors, pathogen-associated molecular patterns (PAMPs) and damage(danger)-associated molecular patterns (DAMPs).
  9. HLA-complex, its structure and biological and medical significance.
  10. Antigen presentation, phenomenon of immunological restriction. Development of the immune response, cooperation between cells.
  11. Cytokinesgeneral properties. Haemapoietic growth factors. Interferons class I, II, and III)
  12. Proinflammatory cytokines (IL-1, TNF, IL-6, IL-12, IL-17)
  13. Antiinflammatory cytokines (IL-10, TGF-beta, IL-35) and cytokines of adaptive immunity(IL-2, IL-4, IL-5, Il-13).

B. Immunopathogenic mechanisms and clinical immunology

1.Type I hypersensitivity reactions. Atopy, anaphylaxis  differences. Allergens. Mechanisms of allergy development, early and late phase of allergic reactions (IgE, IgR, cells, primary and secondary mediators, cytokines), genetic factors in allergy.

2.Clinical symptomatology of atopy. Prevention and therapy of atopic diseases, allergen hyposensibilisation.

3.Laboratory and clinical diagnostics of type I. hypersensitivity reactions.

4.Anaphylaxis – mechanisms of development. Anaphylactic and anaphylactoid shock, clinicalsymptoms and therapy.

5.Histamine intolerance (HIT), laboratory diagnostics and therapy. Atopytherapy, allergenvaccination.

6.Type II hypersensitivity reactions - mechanisms of development and clinical manifestation.Drug-induced reactions, ABO-incompatibility, Bombay phenomenon. Isoimmunisation inRhesus system and its prevention.

7.Type III hypersensitivity reactions and their clinical manifestation – local and systemic.

8.Serum sickness and serum shock –aetiopathogenesis, therapy.

9.Type IV and V hypersensitivity reactions – mechanisms of development and clinical manifestation.

10. Inflammation, sepsis, septic shock, microcirculatory failure /Systemic inflammatory syndrome (SIRS), compensatory inflammatory response syndrome (CARS), andmixed antagonistic response syndrome (MARS), and multiorgan dysfunction syndrome /MODS/). Laboratory diagnostics of SIRS/sepsis.

11. Autoimmunity mechanisms of induction and maintenance of tolerance to self-antigens (central and peripheral tolerance), and its breakdown.

12. Autoimmunityrole of (auto)antigens.Changes/misbalance in the cytokine network, Th1, Th2 andTh17-mediated autoimmune diseases. Role of regulatory T cells.

13. Genetic basis of autoimmunity. Nutrition, hormones and autoimmunity.

14. Immunopathogenesisand immunotherapy ofrheumatoid arthritis.

15. Immunopathogenesis and immunotherapy of multiple sclerosis.

16. Immunopathogenesis and immunotherapy of psoriasis vulgaris.

17. Immunopathogenesis and immunotherapy ofcoeliac disease.

18. Immunopathogenesis and immunotherapy of type 1 diabetes mellitus.

19. Immunopathogenesis and immunotherapy ofCrohn's disease.

20. Immunopathogenesis and immunotherapy of Graves' disease andmyasthenia gravis.

21. Immunopathogenesis and immunotherapy ofsystemic lupus erythematosus.

22. Immunodeficiencies general features, clinical symptomatology, division.

23. Congenital defects of innate (non-specific) immunity.

24. Congenital defects of adaptive (specific) cellular andhumoral immunity.

25. Congenital combined immunodeficiencies.

26. AIDS HIV structure and interaction with the cells of the human immune system. HIV transmission. Immunodiagnostics andtherapeutic possibilities in HIV infection.

27. AIDS the impact of HIV infection on the immune system. Clinicalsymptomatology in individual stages of HIV infection. Paediatric AIDS.

28. Transplantation nomenclature. Mechanisms of rejection of transplanted tissues and organs. Exemptions from rejection.

29. Transplantation of kidneys.

30. Bone marrow transplantation.

31. Mechanisms of tumour development (physical, chemical, and biological factors, oncogenes). Immunology of the metastatic process.

32. Effector mechanisms of anti-tumour immunity. Mechanisms that enable malignant cells to escape from the immunologic surveillance. Immunodiagnostics and immunotherapy of tumours.

33. Anti-infectious immunity –overview of mechanisms of protective immunity to extracellular and intracellular bacteria, viruses, parasites and fungi.

34. Immunostimulation – overview of the most important immunostimulatory agents and mechanisms of their action.

35. Immunosuppression – overview of the most important immunosuppressive agents and mechanisms of their action.

36. Cytokines in the therapy of diseases.

37. Monoclonal antibodies in the therapy of diseases.

38. Active andpassive immunisation (vaccination andvaccines).

39. Foeto-maternal relationships and the immune system of the foetus and thenew-borns.

Assoc. Prof. MUDr. Mária Bucová, CSc.

Head of the department

29.10.2017