Title: Bone Wizardry / Mnemonics / Immunology
Tags: bw-mnemonics immuno
On every note of this deck, unless a note says otherwise:
System: immuno

Acronym: Never Let Mom Eat Beans
Title: WBC Differential
Emoji: 🧫
Path: ? N
. Neutrophils (60%)
? L
. Lymphocytes (30%)
? M
. Monocytes (8%)
? E
. Eosinophils (2%)
? B
. Basophils (1%)
? Note
. Order AND percentages
? Note
. Left shift = increased bands
? Note
. Eosinophils NEVER elevated in bacteria

Acronym: HIPPPE
Title: Drug-Induced Lupus
Emoji: 🦋
Path: ? H
. Hydralazine
? I
. Isoniazid (INH)
? P
. Procainamide
? P
. Phenytoin
? P
. Penicillamine
? E
. Ethosuximide
? Note
. Anti-histone Ab (+)
? Note
. Complement NORMAL (unlike SLE)
? Note
. Reversible when drug stopped

Acronym: STELS
Title: Causes of High Monocytes
Emoji: 🦠
Path: ? S
. Syphilis
? T
. Tuberculosis
? E
. EBV
? L
. Listeria
? S
. Salmonella
? Note
. All intracellular pathogens
? Note
. Monocytosis + fever = think TB
? Note
. CD14+ phagocytes

Acronym: ABVD (current standard) / CHOP (Non-Hodgkin) / MOPP (retired)
Title: Lymphoma Chemo Regimens
Emoji: 💊
Path: ? ABVD
. ⭐ Adriamycin, Bleomycin, Vinblastine, Dacarbazine (Hodgkin standard)
? CHOP
. 💪 Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone (NHL)
? R-CHOP
. 🎯 + Rituximab for CD20+ B-cell lymphomas
? MOPP
. ⚠️ Retired: more leukemogenic and causes sterility
? Note
. Bleomycin toxicity = pulmonary fibrosis
? Note
. Adriamycin = dilated cardiomyopathy (lifetime dose limit)
? Note
. Rituximab = anti-CD20 monoclonal antibody

Acronym: TIE: Thrombocytopenia, Infections, Eczema
Title: Wiskott-Aldrich Syndrome
Emoji: 🎀
Path: ? T
. 🩸 Thrombocytopenia with SMALL platelets (unique)
? I
. 🦠 Recurrent pyogenic infections (combined B+T defect)
? E
. 🔴 Eczema: severe atopic dermatitis from infancy
? Note
. X-linked recessive: boys only
? Note
. Increased lymphoma + autoimmune risk
? Note
. Tx: bone marrow transplant; elevated IgA/IgE, low IgM

Acronym: RIP-A: Killed (Inactivated) Vaccines
Title: Safe in Immunocompromised
Emoji: 💀
Path: ? R
. 🐕 Rabies
? I
. 🤧 Influenza (injected shot)
? P
. 💉 Polio (Salk/IPV)
? A
. 🟡 Hepatitis A
? Note
. Killed = CANNOT cause disease (safe in immunocompromised)
? Note
. Weaker immunity → need boosters
? Note
. Live vaccines (contraindicated if immunosuppressed): MMR, Varicella, Sabin, BCG

Acronym: GAMED: Immunoglobulin Heavy Chain Classes
Title: Antibody Isotypes
Emoji: 🛡️
Path: ? G
. 🔄 Gamma = IgG: most abundant, crosses placenta, secondary response
? A
. 🫁 Alpha = IgA: mucosal immunity, dimer with J chain
? M
. 🌊 Mu = IgM: first responder, pentamer, best complement fixer
? E
. 🤧 Epsilon = IgE: allergies, parasites, mast-cell bound
? D
. ❓ Delta = IgD: B-cell surface receptor
? Note
. IgG = ONLY one crossing placenta
? Note
. IgA deficiency = most common primary immunodeficiency
? Note
. IgM elevated in Waldenstrom (hyperviscosity)

Acronym: ABO Blood Type Sugars: A=Galactosamine, B=Galactose, O=Fucose Only
Title: Blood Type Antigen Determinants
Emoji: 🩸
Path: ? A
. 🔵 N-Acetylgalactosamine on H antigen
? B
. 🟢 Galactose on H antigen
? O
. 🟡 Fucose ONLY: H antigen unmodified
? H antigen
. 🧱 Base on all RBCs (made by adding fucose)
? Note
. Bombay phenotype: no H antigen → false type O
? Note
. O = universal donor; AB = universal recipient
? Note
. ABO incompatibility in newborns usually mild (vs Rh = severe)

Acronym: 4 T's of Anterior Mediastinum: Thymus, Thyroid, T-cell Lymphoma, Teratoma
Title: Mediastinal Mass DDx
Emoji: 🫁
Path: ? T
. 🧬 Thymus: thymoma (associated with myasthenia gravis)
? T
. 🦋 Thyroid: substernal goiter
? T
. 🩸 T-cell lymphoma: lymphoblastic, young males
? T
. 🧫 Teratoma: most common mediastinal germ cell tumor
? Note
. Thymoma + MG: anti-AChR antibodies
? Note
. Anterior = in front of heart
? Note
. Posterior mediastinum = neurogenic tumors

Acronym: 4 Bad Associations of Cardiolipin Antibody
Title: Antiphospholipid effects
Emoji: 🩸
Path: ? Stimulates intrinsic clotting
. 🩸 Thrombosis
? Blocks vWF
. 🩸 Von Willebrand-like disease
? Multiple spontaneous abortions
. 🤰 Recurrent pregnancy loss
? False positive VDRL
. 🧪 Syphilis test interference

Acronym: 7 Diagnostic Criteria for RA
Title: 3 or more is diagnostic
Emoji: 🦴
Path: ? Morning stiffness >1 hour
. ⏰ Prolonged stiffness
? Symmetrical involvement
. 🔄 Both sides
? Rheumatoid nodules
. 🔵 Subcutaneous nodules
? High ESR
. 📈 Inflammation marker
? X-ray erosion
. 🦴 Joint destruction
? Positive CCP and RF
. 🧪 Antibodies
? Swelling of 3+ joints
. 🔴 Polyarthritis

Acronym: 6 Drugs Causing Drug-Induced Lupus
Title: Anti-histone antibodies
Emoji: 💊
Path: ? Hydralazine
. 💊 Antihypertensive
? INH
. 💊 Anti-TB
? Procainamide
. 💊 Antiarrhythmic
? Penicillamine
. 💊 Chelator
? Phenytoin
. 💊 Anticonvulsant
? Ethosuximide
. 💊 Anticonvulsant

Acronym: Transplant Rejection Types
Title: 4 types of rejection by timing and pathology
Emoji: 🫀
Path: ? Hyperacute: preformed antibodies, immediate to 12 hours, swelling, must remove organ
. ⚡ prevented by crossmatch
? Acute: T lymphocytes + macrophages on biopsy, treatable with immunosuppressants
. 🔬 cell-mediated infiltrate
? Chronic: fibrosis on biopsy, irreversible, must remove organ
. 🧱 fibrotic replacement
? Graft vs Host: after bone marrow transplant, painful rash, T-suppressor cells
. 🦴 donor attacks host

Acronym: X-Linked Recessive Enzyme Diseases
Title: 9 enzyme deficiencies that are X-linked recessive
Emoji: 🧬
Path: ? CGD (NADPH oxidase deficiency)
. 🦠 catalase positive infections
? G6PD deficiency
. 🩸 hemolytic anemia with oxidative stress
? Fabry disease
. 🧬 alpha-galactosidase A
? Hunter syndrome
. 🧬 iduronate sulfatase
? Lesch-Nyhan syndrome
. 🧬 HGPRT deficiency
? Adrenoleukodystrophy
. 🧬 VLCFA accumulation
? OTC deficiency
. 🧬 ornithine transcarbamylase
? PRPP synthetase
. 🧬 purine overproduction
? Adenosine deaminase (some forms)
. 🧬 SCID variant

Acronym: 3 Most Important Opsins
Title: Molecules that coat pathogens for phagocytosis
Emoji: 🧤
Path: ? IgG
. 🔵 most abundant antibody
? IgM
. 🔴 pentamer, fixes most complement
? C3b
. 🟡 complement component, coats capsule

Acronym: Macrophage Names by Tissue
Title: Same cell, different name in each tissue
Emoji: 🔬
Path: ? Brain: Microglia
. 🧠 acidic environment specialist
? Lung: Alveolar macrophages
. 🫁 patrol the airways
? Liver: Kupffer cells
. 🟤 filter portal blood
? Spleen: RES cells
. 🟣 reticuloendothelial system
? Bone: Osteoclasts
. 🦴 resorb bone
? Kidney: Mesangial cells
. 🫘 glomerular cleanup
? Skin: Langerhans cells
. 🧴 antigen presenting in skin
? Gut: M cells in Peyer patches
. 🦠 sample intestinal antigens
? Blood: Monocytes (CD4 marker)
. 💉 become CD14 in tissue
? Lymph nodes: Dendritic cells
. 🌳 best antigen presenters
? Connective tissue: Histiocytes, giant cells, epithelioid cells
. 🧱 granuloma builders

Acronym: Mast Cell Release Triad
Title: Three substances released during allergic degranulation
Emoji: 💥
Path: ? Histamine: immediate symptoms, vasodilation, bronchoconstriction
. ⚡ first wave, minutes
? SRS-A (leukotriene): 4-8 hours later, worst bronchoconstrictor
. 🐌 slow reacting substance, kills most allergy deaths
? ECF-A: recruits eosinophils
. 📣 eosinophil chemotactic factor

Acronym: Causes of Eosinophilia (NAACP)
Title: 5 causes of elevated eosinophils
Emoji: 📈
Path: ? Neoplasia (especially lymphomas)
. 🎗️ young person with new hives, work up lymphoma
? Allergies and Asthma
. 🤧 allergic rhinitis, salute sign, allergic shiners
? Addison disease
. 🟫 no cortisol to kill eosinophils
? Collagen vascular diseases
. 🦴 autoimmune connective tissue
? Parasites
. 🪱 classic board association

Acronym: Allergic Rash Escalation Ladder
Title: Type 1 hypersensitivity rashes from mild to fatal
Emoji: 🪜
Path: ? Urticaria (hives): raised red lesions
. 🔴 mildest, most common
? Erythema multiforme: flat red target lesions
. 🎯 looks like bullseye targets
? Stevens-Johnson syndrome: EM + 2 or more mucosal surfaces
. 👄 mucosal involvement = danger
? Toxic epidermal necrolysis: positive Nikolsky sign
. 🔥 worst, skin sloughs off

Acronym: IgM vs IgG Primary Response Timeline
Title: When each antibody arrives, peaks, and disappears
Emoji: ⏱️
Path: ? IgM arrives day 3, peaks 2 weeks, gone 2 months
. 🅼 first responder, pentamer
? IgG arrives 2 weeks, peaks 2 months, gone 1 year
. 🅶 primary response
? Memory IgG arrives 3 days, peaks 5 years, gone 10 years
. 🧠 anamnestic response at 5x concentration

Acronym: Live Vaccines List
Title: Vaccines you cannot give to immunocompromised patients
Emoji: 💉
Path: ? Varicella
. 🐔 chickenpox
? Measles
. 🔴 rubeola
? Mumps
. 🐹 parotitis
? Rubella
. 🌹 German measles
? Rotavirus
. 🔄 first vaccine had intussusception risk
? BCG
. 💉 TB vaccine, not endemic in US, leaves shoulder scar
? Oral Polio (Sabin)
. 👄 OPV, live attenuated
? Yellow Fever
. 🟡 egg-based like MMR and influenza
? Smallpox
. 🦠 variola

Acronym: 4 Immunoprivileged Sites
Title: Organs with no lymphatics and no antigen expression
Emoji: 🛡️
Path: ? Brain: no lymphatic flow, no WBCs in CSF
. 🧠 why brain infections are devastating
? Thymus: can transplant anywhere (e.g. forearm) for DiGeorge
. 🫁 clonal deletion organ
? Cornea: most successful transplant in America, no antigens
. 👁️ zero rejection risk
? Testicle: theoretically transplantable, no volunteers
. 🫢 immunoprivileged but untested

Acronym: T-Cell Immunodeficiencies List
Title: 8 conditions that impair cell-mediated immunity
Emoji: 🛡️
Path: ? DiGeorge syndrome: absent thymus, hypocalcemia, chromosome 22
. 🫁 3rd pharyngeal pouch missing
? Chronic mucocutaneous candidiasis: T cells fight everything except candida
. 🍄 chronic fatigue from hypoglycemia
? Steroids: kill T cells and eosinophils
. 💊 iatrogenic immunosuppression
? Cyclosporine
. 💊 calcineurin inhibitor
? Hairy cell leukemia: TRAP+, 25% T-cell form
. 🦠 more T-cell than other leukemias
? SCID: adenosine deaminase deficiency, absent thymic shadow
. 🧬 autosomal recessive
? Wiskott-Aldrich: X-linked, eczema + thrombocytopenia + infections
. 🩸 TIE triad
? HIV: targets CD4 receptors
. 🦠 progressive T-cell depletion

Acronym: B-Cell Immunodeficiencies List
Title: 12 conditions that impair humoral immunity
Emoji: 🛡️
Path: ? Bruton agammaglobulinemia: X-linked, early onset, B cells present but nonfunctional
. 🧬 nonsense/frameshift mutation
? CVID: late onset Bruton, missense mutation
. 🧬 after first year of life
? Leukemias and Lymphomas
. 🎗️ most commonly B-cell origin
? Multiple Myeloma: IgG M-spike, Bence Jones proteins, rouleaux
. 🦴 osteolytic lesions
? Selective IgA deficiency: anaphylaxis during transfusion
. 🩸 use filter for subsequent transfusions
? Selective IgG2 deficiency: recurrent encapsulated organism infections
. 🦠 IgG is main opsin
? Job syndrome: increased IgE, red-haired female
. 🔴 cell signaling defect

Acronym: Four Hypersensitivity Types with Examples
Title: Type 1-4 reactions with key examples
Emoji: ⚡
Path: ? Type 1 (Immediate): IgE, mast cells, no complement. Ex: anaphylaxis, urticaria, SJS, EM
. 💥 minutes to hours
? Type 2 (Cytotoxic): deliberate attack on self, complement after. Ex: myasthenia gravis, pernicious anemia
. 🎯 anti-self antibodies
? Type 3 (Immune complex): NOT deliberate, complement consumed (low on test). Ex: SLE, RA, serum sickness, PSGN
. 🌊 bystander tissue damage
? Type 4 (Delayed/Cell-mediated): T cells + macrophages. Ex: MS, contact dermatitis, poison ivy, PPD
. 🐌 takes 48-72 hours

Acronym: Complement Component Functions
Title: What each complement piece does
Emoji: 🧩
Path: ? C3b: opsin (coats capsule for phagocytosis)
. 🧤 most important opsin along with IgG and IgM
? C5a: anaphylaxis/angioedema
. 💥 localized anaphylaxis
? C8: aligns the capsule
. 📐 structural orientation
? C9: perforin, leads MAC complex
. 🔨 punches holes in capsule

Acronym: 4 Syndromes Associated with Chromosome 22
Title: Board-favorite chromosome 22 associations
Emoji: 🧬
Path: ? DiGeorge Syndrome
. 🫁 absent thymus and parathyroids
? CML: translocation 9-22
. ⚗️ Philadelphia chromosome
? Neurofibromatosis: translocation 17-22
. 🧠 cafe au lait spots
? Ewing Sarcoma: translocation 11-22
. 🦴 small round blue cells

Acronym: Cancers Common in HIV
Title: 4 malignancies associated with HIV/AIDS
Emoji: 🎗️
Path: ? Cervical cancer
. 🔴 HPV-driven
? Kaposi sarcoma (HHV-8)
. 🟣 vascular tumor
? CNS and testicular lymphomas
. 🧠 immunoprivileged site tumors
? Anal carcinoma (HPV)
. 🔴 HPV-driven

Acronym: Extra RhoGAM Dose Indications
Title: 5 instances requiring additional RhoGAM beyond routine
Emoji: 💉
Path: ? Miscarriage
. 😢 fetal blood may cross
? Abortion
. 📋 planned or spontaneous
? Ectopic pregnancy
. 🔺 tubal rupture risk
? Abruptio placentae
. 🩸 premature separation
? Significant abdominal trauma
. 💥 abruption risk