#1 immunology Flashcards
delayed separation of the umbilical cord
leukocyte adhesion deficiency
– along w/ poor wound healing, recurrent skin infections w/o pus, and gingivitis / periodonitis.
autosomal recessive, deficiency of CD18, needed for INTEGRIN formation
steps for leukocyte exiting blood stream
- margination: increased vascular leakage –> hemoconcentration, decreased wall shear stress, improved contact of neutrophils w/ endothelial lining
- rolling - loose binding of sialylated carbohydrate groups (sialyl lewis X or PSGL-1 to L-selectin on neutrophils or E-selectin/P-selectin on endothelial cells
- activation - sense chemokine, will be able to bind
- tight adhesion and crawling - CD18 beta 2 integrins (Mac-1 and LFA-1) to intercellular adhesion molecule-1 (ICAM-1) on endothelial cells
- transmigration - PECAM-1, peripheral intercellular junctions of endothelial cells
myeloperoxidase deficiency
similar to chronic granulomatous disease (NADPH deficiency), but since MPO is missing, can’t kill catalase + or catase - microbes (while NADPH def, can kill catalse - )
alpha-2 globulins (name 3)
haptoglobin, ceruloplasmin, alpha-2 macroglobulins.
- haptoglobin – scavenger molecule for hemoglobin released from RBC in hemolysis
- ceruloplasmin – serum carrier protein for Copper ions, decreased in Wilson’s disease
anterior mediastinal mass in graves patient
thymus abnormalities, (eg thymoma, thymic hyperplasia)
polymyositis clinical presentation & implicated pathophys
autoimmune disease w/ symmetric proximal muscle weakness (CD8+ lymphocyte mediated damage)
eosinophilic infiltration of skeletal muscle
eosinophilic myositis, rare disorder associated w/ parasitic infxn. present w/ myalgia
IL-2 (aldesleukin) mechanism of action against tumor cells and therapeutic use
IL-2 anti-tumor effect by increasing T cell and NK activity.
immunotherapy for metastatic melanoma and renal cell carcinoma
alemtuzumab
anti CD-52, used for treatment of chronic lymphocytic leukemia. initiates direct cytotoxic effect
what agent increases MHC I and II presentation?
IFN gamma
describe serum sickness
most serum sickness is now caused by drugs acting as haptens
type III hypersensitivity rxn
– fever, urticaria (hives), arthralgia, glomerulonephritis, lymphadenopathy 5-10 days after exposure to antigen. can have fibrinoid necrosis and neutrophil infiltration of arteries
decrease C3 (immune complex + complement)
sulfonamides can cause this
graft vs. host disease commonly occurs after [3]
- allogeneic bone marrow transplantation
- transplantation of organs rich in lymphocytes (like liver)
- transfusion of non-irradiated blood
skin, liver, and GI tract commonly affected
acute gvhd – 1 wk post transplant
distinguish (1) sarcoidosis (2) hypersensitivity pneumonitis (3) lymphocytic interstitial pneumonitis (AIDS)
(1) sarcoidosis high CD4:CD8 T cell ratio (5:1 to 20:1) (2) hypersensitivity pneumonitis decreased CD4:CD8 ratio (3) lymphocytic interstitial pneumonitis (AIDS) decreased CD4:CD8 ratio
look in bronchoalveolar lavage
CD8+ T cell predominance in bronchoalveolar lavage fluid
lung transplant patient w/ bronchiolitis obliterans due to chronic rejection
CD22+
immunological marker for ALL
CD14+
monocyte macrophage lineage
CD7+
multi-chain complex T cell marker
Henoch-Schonlein purpura (HSP)
palpable skin lesion
abdominal pain
arthralgia
renal involvement
antigen exposure (bacterial / viral infxn) preceedig
deposition of IgA immune complexes
delayed hypersensitivity occurs against which organisms
intracellular: m. tuberculosis and fungi. mediated by activated macrophages that form granulomata
most common vasculitis in 3-10 y/o
recurrent mycobacterial or salmonella infxn? rx?
IL-12 receptor deficiency; ultimately have decrease IFN-gamma
macrophages infected w/ mycobacteria make IL12 –> stimulates T cells and NK cells to make IFN-gamma.
rx: lifelong treatment w/ antimycobacterial antibiotics.
X-linked agammaglobulinemia
X-linked recessive; Brutons
defect in BTK tyrosine kinase, no B cell maturation
recurrent bacterial and enteroviral infxn after 6 months
small lymph nodes / tonsils
susceptible to lower respiratory infxn and giardia
C3 deficiency
- recurrent pyogenic sinus and respiratory tract infections
- increased type III hypersensitivity (b/c C3 helps clear immune complexes)
symptoms of staphylococcal scalded skin syndrome (exfoliatin exotoxin)
- Nikolsky sign (skin slipping off w/ gentle pressure)
- epidermal necrolysis
- fever
- pain w/ skin rash
protease cleaves desmoglein in desmosomes
langerhans cells
- stellar cells w/ intracytoplasmic “tennis-shaped” Birbeck granules on EM
- ## a form of dendritic cell (t cell interaction)