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STEP 1 > 05a: Immunology > Flashcards

05a: Immunology Flashcards

1
Q

(Primary/secondary) lymph nodes follicles have pale central germinal centers and are (active/dormant).

A

Secondary; active

Primary follicles are dense and dormant

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2
Q

Viral infection: which part(s) of lymph node would you expect to enlarge?

A

Paracortex (T-cell zone), between follicles and medulla

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3
Q

Trachea and esophagus drain to (X) lymph nodes.

A

X = mediastinal

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4
Q

Which structure(s) drain to axillary lymph nodes?

A

Limbs, breast, skin above umbilicus

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5
Q

Celiac nodes drain up to (X) part of GI tract. SMA drain up to (Y) part. IMA drain up to (Z) part.

A 
X = upper duodenum
Y = splenic fixture (colon)
Z = upper rectum
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6
Q

Lower rectum to anal canal (above pectinate line) drains to (X) lymph nodes. And anal canal below pectinate line to (Y) nodes.

A 
X = Internal iliac
Y = superficial inguinal
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7
Q

Vagina and cervix drain to (X) lymph nodes. Uterus drains to (Y) lymph nodes. Ovaries drain to (Z) lymph nodes.

A 
X = internal iliac
Y = Z = para-aortic
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8
Q

Kidneys drain to (X) lymph nodes. Bladder to (Y) lymph nodes.

A 
X = para-aortic
Y = internal iliac
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9
Q

Nearly all skin below umbilicus drains into (X) lymph nodes. The exception is (Y) part of leg.

A 
X = superficial inguinal
Y = posterior calf and dorsolateral foot (drain into popliteal nodes)
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10
Q

Prostate drains into (X) lymph nodes.

A

X = internal iliac

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11
Q

T/F: R lymphatic duct only drains R side of body above diaphragm.

A

True - thoracic duct (L) drains everything else

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12
Q

Why are (lymphopenia/lymphocytosis) and (thrombopenia/thrombocytosis) consequences of splenectomy?

A

Lymphocytosis and thrombocytosis - due to loss of sequestration/removal by spleen

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13
Q

Periarteriolar lymphoid sheath (PAL) is found in which structure?

A

Spleen - the T cell zone

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14
Q

Which structure in spleen is the site for APC capture of blood-borne antigens for lymphocyte recognition?

A

Marginal (outermost) zone of follicle

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15
Q

Thymomas are associated with which two diseases?

A
  1. Myasthenia Gravis

2. SVC syndrome

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16
Q

In which genetic syndromes is the thymus hypoplastic?

A
  1. DiGeorge

2. SCID

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17
Q

MHC I protein structure: (X) number of (short/long) chains.

A

X = 2

ONE short, ONE long (for MHC ONE)

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18
Q

MHC II protein structure: (X) number of (short/long) chains.

A

X = 2

TWO long/equal-length chains for MHC TWO

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19
Q

MHC (I/II) is more exclusive, only present on (X) cells.

A

II
X = APCs

(MHC I on all nucleated cells)

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20
Q

MHC I: (exogenous/endogenous) Ags are presented to (X) cells.

A

Endogenous (viral, cytosolic proteins)

X = CD8 T cells

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21
Q

MHC II: (exogenous/endogenous) Ags are presented to (X) cells.

A

Exogenous (bacterial proteins)

X = CD4 T cells

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22
Q

MHC I: antigens loaded onto receptor in (X).

A

X = RER (after delivery through transporter, TAP)

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23
Q

MHC II: antigens loaded onto receptor in (X).

A

X = endosome (after acid environment releases CLIP protein that blocks MHC II binding site)

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24
Q

Beta2 microglobulin is associated with MHC (I/II). And invariant chain with MCH (I/II).

A

I;

II (blocks MHC II binding site via CLIP until proper Ag present)

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25
Which diseases associated with HLA B27?
``` Seronegative arthropathis ("PAIR") Psoriasis, Ankylosing spondylitis, IBD-associated arthritis, Reactive arthritis ```
26
Which diseases associated with HLA DQ2/DQ8?
Celiac disease "I 8 2 much gluten at DQ (Dairy Queen)"
27
Multiple sclerosis associated with which HLA subtype?
DR2
28
SLE associated with which HLA subtype?
DR2/DR3 ("2-3 for SLE")
29
DM I associated with which HLA subtype?
DR3/DR4 Note: so is Addison's disease
30
Hashimoto's associated with which HLA subtype?
DR2/DR4
31
Pernicious anemia associated with which HLA subtype?
DR5
32
Rheumatoid arthritis associated with which HLA subtype?
DR4 | "4 walls in a rheum"
33
Candida superficial infection (ex: oral/esophageal, cutaneous, vulvovaginitis) is prevented by which members of immune system?
T lymphocytes (hence HIV or other low T count conditions cause superficial candidiasis)
34
Candidemia or other forms of disseminated candidiasis is prevented by which members of immune system?
Neutrophils! (hence more likely in chemo/neutropenic patients)
35
Which cytokines enhance NK cell activity?
IL2, IL12, IFNa, IFNb
36
Target cell with (present/absent) MHC (I/II) will be killed by NK cell.
Absent | MHC I
37
CD(X) on NK cell can activate it when binding to (Y) region of Ig.
``` X = 16 Y = Fc ```
38
T/F: T cells responsible for both acute and chronic cell organ rejection.
True
39
Helper T cell can become TH1 differentiated with help of (X) cytokines.
X = IL-12, IFN-gamma
40
Helper T cell can become TH2 differentiated with help of (X) cytokines.
X = IL-2, IL-4
41
Helper T cell can become TH17 differentiated with help of (X) cytokines.
X = IL-6, TGF-beta
42
Helper T cell can become Treg differentiated with help of (X) cytokines.
X = TGF-beta
43
Thymus: self-antigens found in tissues are expressed during negative selection by the action of (X). Deficiency of (X) leads to which syndrome?
X = AIRE (autoimmune regulator) Autoimmune polyendocrine syndrome 1
44
TH1 cell inhibits TH2 differentiation by secreting (X). And TH2 inhibits TH1 differentiation by secreting (Y).
``` X = IFN-gamma Y = IL-4, IL-10 ```
45
Main action of TH1-differentiated T cells
Activate macrophages and cytotoxic T cells
46
Main action of TH2-differentiated T cells
Recruit eosinophils (parasite defense) and IgE production by B cells
47
T/F: NK cells and cytotoxic lymphocytes kill via same mechanism.
True - perforin and granzyme release causes cell apoptosis
48
T-regulatory cells produce (X) cytokines and are identified by expression of which receptors?
X = anti-inflammatory (IL-10, TGF-beta) CD3, CD4, CD25, FOXP3
49
Which costimulatory signal is required for T cell activation? And for B cell activation/class switching?
T cell: CD28 (on helper/cytotoxic T cell) with B7 (on APC) B cell: CD40 (on B cell) with CD40L (on helper T Cell)
50
Three steps/components of generating antibody diversity (independent of antigen)
1. VDJ (heavy chain) and VJ (light chain) gene recombination 2. Random NT addition to DNA by TdT during recombination 3. Random heavy and light chain combinations
51
Two steps/components of generating antibody specificity (dependent on antigen)
1. Somatic hypermutation and affinity maturation (in variable region of Ab) 2. Isotype switching (of Ab constant region)
52
T/F: IgG is the isotype that is most abundant in serum and produced the most overall.
False - most abundant in serum, but IgA is the isotype produced most (despite low serum conc)
53
If you could test for antibodies in your tears, which isotype would you expect to find?
IgA (released into secretions like saliva, tears, mucus, breast milk)
54
The antibody receptor on B cells that recognizes antigen is which isotype?
IgM (monomer form)
55
Vaccination: antigens (containing/lacking) (X) component often require boosters/adjuvants. Why?
Lacking; X = peptide (ex: LPS on G- bac) No protein component means can't be presented on MHC (thymus-independent; weakly immunogenic)
56
T/F: NK cells kill by cell lysis.
False - perforins make holes in target cell, granzymes enter and induce APOPTOSIS
57
Major component of adaptive immunity against Giardia is:
IgA (deficiency predisposes to chronic giardiasis)
58
Acute phase reactants are produced by (X) and notably induced by (Y) cytokine.
``` X = liver Y = IL-6 ```
59
Iron (absorption/release/sequestering) is increased in state of inflammation due to action of which acute-phase reactant(s)?
Absorption and release are decreased (via hepcidin); sequestering into cells is increased (via ferritin)
60
Hepatic synthesis of which two key proteins is down-regulated in response to inflammation?
1. Albumin (to conserve AA for acute-phase reactants) | 2. Transferrin (to keep iron sequestered in macrophages)
61
List the 3 complement pathways and the activators of each
1. Classic: IgG, IgM ("GM makes classic cars"); Ag-Ab complexes 2. Alternative: microbe surface molecules 3. Lectin: mannose/sugars on microbe surface
62
The three complement pathways find common ground/converge on (X).
X = C3 (cleavage into C3a, C3b)
63
Complement: C4b2b is also known as (X) and is formed from which complement pathway(s)?
X = C3 convertase Lectin (C4b) plus Classic (C2b) pathways
64
Complement: C3bBb is also known as (X) and is formed from which complement pathway(s)?
X = C3 convertase Alternative (C3b) pathway (plus B cleavage product into Bb)
65
Complement: C4b2b3b is also known as (X).
X = C5 convertase (can also arise from C3bBb3b product)
66
MAC complex is composed of which complement factors?
C5b-C9
67
Which complement factors are responsible for anaphylaxis?
C3a, C4a, C5a ("a" for "anaphylaxis")
68
Which factor deficiency is associated with severe, recurrent pyogenic sinus/resp infections as well as high susceptibility to type III HS rxns?
C3 deficiency (immune complexes can't be cleared)
69
Low C1 esterase inhibitor is diagnostic for (X). The pathogenesis of this disease is centered around (activation/inhibition) of (Y).
X = hereditary angioedema (AD inheritance) | Unregulated activation of kallikrein (high bradykinin)
70
IL-1 function(s)
1. Fever, inflammation 2. Endothelial activation to express adhesion molecules 3. Chemokine secretion "Hot (IL-1) T-bone stEAK"
71
IL-2 function(s)
Stimulates growth of T cells (as well as NK cells) "Hot T (IL-2)-bone stEAK"
72
IL-3 function(s)
Stimulates bone marrow (growth/differentiation of stem cells; similar to GM-CSF) "Hot T-bone (IL-3) stEAK"
73
IL-4 function(s)
Induces TH2 differentiation and B cell growth; IgE (and IgG) class switch "Hot T-bone stE(IL-4)AK"
74
IL-5 function(s)
Growth/differentiation of B cells and IgA class switch; eosinophil growth/differentiation "Hot T-bone stEA(IL-5)K"
75
IL-6 function(s)
aKute phase reactants "Hot T-bone stEAK(IL-6)"
76
PMN phagolysosome: first key step is converting (X) to (Y) with which enzyme?
``` X = O2 Y = O2- (free radical) ``` NADPH oxidase (deficient in chronic granulomatous disease)
77
PMN phagolysosome: second key step is converting (X) to (Y) with which enzyme?
``` X = O2- (free radical) Y = H2O2 ``` superoxide dismutase
78
PMN phagolysosome: Bleach can be formed via which reaction/enzyme?
H2O2 combined with Cl (enzyme: myeloperoxidase)
79
Green sputum: what gives it the color?
Myeloperoxidase
80
(X) enzyme in neutrophil converts H2O2 to H2O by (oxidizing/reducing) glutathione. What does it require for proper function?
X = Glutathione peroxidase Oxidizing Selenium
81
Glutathione reductase work by simultaneously (oxidizing/reducing) (NADP/NADPH). The reaction requires (X) for proper function.
Oxidizing; NADPH X = riboflavin
82
IFN-alpha and beta are secreted by (X) cells and act on (Y).
``` X = virus-infected cells ("INTERFERe with viruses") Y = local uninfected cells ("prime them" by inducing them to decrease protein synthesis and upregulate MHC expression) ```
83
Macrophages express CD(X) receptor for PAMPs like bacterial LPS.
X = 14
84
T and B cells become anergic when:
Exposed to antigen without co-stimulatory signal
85
Superantigens, such as those produced by (X) bacteria, cause massive release of cytokines by which mechanism?
X = S. aureus, S. pyogenes Cross-link beta region of TCR to MHC II on APCs (can activate any CD4 T cell)
86
T/F: Shock caused by N. meningitides is mediated by T-helper cells.
False - endotoxins/LPS directly stimulate macrophages by binding TLR (CD14); no T cells involved

STEP 1 (21 decks)

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