X-linked agammaglobulinemia:The case:Alvin was well during the first 10 months, but then presented with several bouts of otitis media and asevere case of streptococcal infection of skin. During the next two years, Alvin continued to have ahistory of repeated infection of sinuses and ears and had 2 episodes of pneumonia. Tested with verylow IgG, no detectable IgM or IgA. Flow cytometry revealed circulating lymphocytes positive forCD3, CD4, and CD8 but did not detect lymphocytes with CD19. Mitogenic responses to PHA, conca-navalin A, tetanus toxoid, and diphtheria toxoid were normal. No response to anti-IgM(H+L) in pres-ence of IL-4. Also, the boy had no discernible tonsils (remember, tonsils are 80-90% B cells). Alvinwas treated successfully with intravenous gamma globulin (IVIG). The mother had two brothers whodied during infancy from pneumonia at a time before use of antibiotics. The mother has two sisterswho are well.

A 9-month-old boy is brought to the immunology clinic for evaluation. Clinical history notes thatthe patient has a three-month history of recurrent bouts of otitis media, sinusitis,bronchopneumonia, and gastroenteritis. Serum protein electrophoresis reveals depressed levels ofall serum immunoglobulins.1. What is the most likely diagnosis?2. What is the genetic defect? State the molecular and cellular consequences.3. What organisms will likely be found in the patient’s respiratory tract? What organisms willlikely be found in the patient’s gastrointestinal tract?Over the next two years, the boy develops arthritis. Treatment with replacement immunoglobulinsrelieves the symptoms.4. What is the rationale for the intravenous immunoglobulin therapy?235. Refer to the patient’s pedigree. Identify the inheritance pattern.6. The female individuals could be affected by this condition under what circumstance?24NeoplasiaCase 1:A 62-year-old woman had her uterus removed for uterine prolapse and urinary incontinence. Apedunculated mass, 3 cm in diameter, was found inside the uterus, 5 cms from the internal os. Cutsections of the mass revealed solid, whorled, cream tan surface.Refer to slide #Guide Questions:1. Illustrate the tumor. Give your histopathological diagnosis and describe the microscopicfeatures.2. What feature/s in this tumor suggests that it is likely to be a benign neoplasm?253. What feature/s in this kind of tumor would lead a pathologist to think it may be a malignantneoplasm?

n staphylococcal skin infection there is neutrophilic infiltrate causing tissue damage. Thetissue damage is most likely caused due to:Select one:a. Activation of caspasesb. Generation of superoxidec. Release of cytochrome cd. Release of cytosolic calcium

Emphysema Pneumonia Otitis mediaii. Identify a respiratory tract infection from part i that CANNOT be treated throughantibiotics.

In staphylococcal skin infection there is neutrophilic infiltrate causing tissue damage. Thetissue damage is most likely caused due to:Select one:a. Activation of caspasesb. Generation of superoxide c. Release of cytochrome cd. Release of cytosolic calcium

In staphylococcal skin infection there is neutrophilic infiltrate causing tissue damage. Thetissue damage is most likely caused due to:Select one:a. Release of cytosolic calciumb. Release of cytochrome cc. Activation of caspasesd. Generation of superoxideClear my choice