1601-1800 Flashcards
What types) of immune response is the body capable of making when presented with a killed vaccine?
Humoral only
Who are the “typical” women who present with endometrial carcinoma?
Older, non-sexually active women (whereas young, sexually active women present with cervical carcinoma)
What type of vaccine is the MMR vaccine?
Live, attenuated vaccine
With what virus is postauricular lymphadenopathy associated?
Measles (rubella) virus
In what trimester is the fetus most vulnerable to congenital rubella syndrome?
The first trimester
What is the order of the antibodies, from first to last, in an infected patient with hepatitis?
Hepatitis Be, e, s
What is the first antigen seen in an individual with hepatitis?
Hepatitis Bs antigen (incubation period)
What antibody is an indication of low transmissibility for hepatitis?
Hepatitis Be antibody
What antibody is an indication of recurrent disease for hepatitis?
Hepatitis Be antibody
Antibodies to what hepatitis B antigen provide immunity?
Antibodies to hepatitis Bs antigen
What are the three C’s of measles?
- Cough 2. Coryza 3. Conjunctivitis
What vector is associated with malaria?
Anopheles mosquito
What is the vector for yellow fever?
Aedes mosquito
What are the only two picornaviruses that do NOT lead to aseptic meningitis?
- Rhinovirus 2. Hepatitis A virus
Are antibiotics helpful in treating a disease caused by a prion?
No. Prions are infectious proteins; thus, antibiotics are useless.
What is the only part of the virus that is “detectable” during the eclipse period of the viral growth cycle?
The viral nucleic acid .
What is the only virus to carry its own ribosomes?
Arenavirus
What is the term for the period from the onset of an infection to the appearance of the virus extracellularly?
Latent period
What is the leading cause of diarrhea in the USA?
Campylobacter jejuni
What organism would cause a patient to present with constant diarrhea after drinking mountain stream water on a camping trip?
Giardia lamblia
What parasite can cause vitamin B12 deficiencies?
Diphyllobothrium latum
What viral infection is associated with black vomit?
Yellow Fever (flavivirus)
What are the two nonspecific chemical defenses of the body?
Acidic pH and lysozymes
What are the two nonspecific physical defenses of the body?
Skin and mucus
What immunoglobulin is the first antibody in an immune response?
IgM
What is the major antibody of external secretions?
IgA
What is the major antibody of internal secretions (blood, CSF, lymph)?
IgG
What is the valence of an immunoglobulin molecule equal to?
The number of antigens that the antibody can bind
What immunoglobulin is a marker for mature B cells and is the antigen receptor for B cells?
IgD
What is the only IgG that cannot bind to Staphylococcus protein A?
IgG3
By which process do antibodies make microorganisms more easily ingested via phagocytosis?
Opsonization
Which immunoglobulin is found as a pentamer and activates complement?
IgM
What is synthesized by epithelial cells, protects IgA from degradation, and transports IgA across epithelial barriers?
Secretory component of IgA
Which IgG cannot activate complement?
IgG4
What cell surface marker is used to distinguish different stages in the maturation of T cells?
CD3
What form of graft involves tissue or organ transplantation between genetically identical twins?
Isograft (isogenic graft, syngraft)
True or false: antigen. antibody binding is irreversible?
False; it is reversible because the antigens and antibodies are not linked covalently.
What is the term for a single isolated antigenic determinant?
Hapten (not immunogenic)
Which chromosome is associated with major histocompatibility complex (MHC) genes?
Chromosome 6
Which region of the variable domain comprises the antigen-binding site of the antibody?
Hypervariable region (three per light chain; three per heavy chain)
What form of transplantation crosses the species barrier?
Xenograft
What subdivision of MHC is found on all nucleated cells?
MHC class I (three subtypes: -A,-B,-C)
What protein is used to differentiate MHC class I from MHC class II, and on what chromosome is it found?
Ã2-Microglobulin, on chromosome 15
What cell type recognizes MHC class I?
Cytotoxic T cell (CD8)
What is the predominant antibody of a secondary immune response in the mucosal route?
IgA
What substance is secreted by activated helper T cells to induce T and B cell division?
IL-2
What type of antigen do B cells recognize?
Free, unprocessed antigen
What type of antigen do T cells recognize?
Processed antigenic peptides bound in the groove of the MHC molecule
Which protein prevents internal binding of self proteins within an MHC class II cell?
Invariant chain
In a binding of helper T cells and an antigen-presenting cell (APC), which is the first cell to secrete activating signals?
Helper T cells (cytokines to activate the APCs)
Which type of cell is responsible for immunologic memory?
Memory B cell
What region of the immunoglobulin does not change with class switching?
Hypervariable region
What type of cell does an antigen-stimulated B cell turn into if there is a continuous supply of antigen?
Plasma cell
What three cells are essential for T cell differentiation in the thymus?
- Dendritic cells 2. Macrophages 3. Thymic epithelial cells
What type of T cell leaves the bone marrow?
Pre-T cell (unable to recognize antigen)
What cytokine stimulates stem cell differentiation?
IL-3
What form of T cell binds to mature B cells?
Activated helper T cell
What co-stimulatory molecules are necessary for effective T cell and B cell signaling?
B7 and CD28 (stimulatory signal for the T cell)
At which site of the lymph node are B cells found?
The germinal centers (follicles)
What are the two primary lymphoid organs?
- Bone marrow 2. Thymus
What cytokine, produced by stromal cells of the bone marrow, is important in myeloid development?
IL-3 A “ 3” on its side looks like an m for myeloid
What immunoglobulins are found in an infant at birth?
Maternal IgG and fetal IgM
What cell surface marker is found on blood B cells?
CD19
What cell surface marker do all T cells have?
CD3
What is the major antigen-trapping site in the immune system?
The lymph node
What cells are the first to come into contact with soluble antigen in the lymph node?
Macrophages or dendritic cells
In which region of the lymph node do plasma cells spend their lives secreting antibodies?
Medulla
What cell surface marker is found on activated helper T cells?
CD40
In which region of the lymph node are T cells found?
Paracortex
Myeloperoxidase uses H202 and what to generate additional oxidants?
Halide cofactor (Cl-, I-)
What is the main cell type of chronic inflammation?
Macrophages
What aspect of the complement system is deficient if there are repeated gonococcal infections and recurrent episodes of meningococcal meningitis?
C5, 6 ,7, or 8
A deficiency in C1 esterase (C1-INH) results in what disease?
Hereditary angioedema
What form of immunity kills the host cell in order to recover from intracellular infections?
Cell-mediated immunity
With what area of the spleen are the T cells associated?
Periarteriolar Lymphatic Sheath (PALS)
What are the three secondary lymphoid tissues?
- Lymph nodes 2. Spleen 3. Mucosal-Associated Lymphoid Tissue (MALT)
What type of cell can never leave the lymph node?
Plasma cell
What is the B cell-dependent area of the spleen?
The marginal zone
Which major cell type is found in the red pulp of the spleen?
RBCs-that is why it is called red pulp.
At what stage of the immune response do you see an increase in serum specific antibody levels?
Log phase
What cytokines do APCs secrete to activate helper T cells?
IL-1, IL-6, TNF-a
What immunoglobulin is responsible for antibody- dependent cell-mediated cytotoxicity (ADCC) of parasites, has a high-affinity Fc receptor on mast cells and basophils, and is responsible for the allergic response?
IgE
What immunoglobulin is responsible for activation of complement, opsonization, and ADCC, and is actively transported across the placenta?
IgG
What immunoglobulin activates the alternate pathway, neutralizes bacterial endotoxins and viruses, and prevents bacterial adherence?
IgA
What are defined by antigen-binding specificity?
Idiotypes
What are the genetic variants of a molecule within members of the same species?
Allotypes
What are different classes and subclasses of the same gene products known as?
Isotypes
What are the four phases of immune system defense?
- Recognition 2. Amplification 3. Regulation 4. Elimination-Rare
What is the term for a molecule that will trigger an immune response?
Immunogen (It must be foreign and have at least two antigenic determinants.)
What MHC class does not participate in immune cell communication by direct contact?
MHC class III
What types of T cell receptors (TCRs) comprise 95% of all TCRs?
Alpha and beta chains
Which TCRs are found on the skin and mucosal surfaces?
Gamma and delta TCRs
What type of graft transplants from one individual to another with a different genetic makeup (within the same species)?
Allograft
What type of graft transplants from one site to another on the same person?
Autograft
What is the term for the strength of association between multiple antibody-binding sites and multiple antigenic determinants?
Avidity (greater than one binding site)
How is IgA found in secretions?
As a dimer; it is a monomer in the blood.
What is the limited portion of a large antigen that will actually be recognized and bound to an antibody and contains approximately five to six amino acids or four to five hexose units?
Antigenic determinant (epitope) (Idiotypes bind to epitopes.)
What would be the result if an antibody were cleaved with papain?
There would be two Fab and Fc regions.
What would be the result if an antibody were cleaved with pepsin?
There would be a Fab’ region; thus, it would still be able to participate in precipitation and agglutination.
What type of binding is involved when there is binding of one Fab or one idiotype of IgG?
Affinity
What cytokines are secreted by helper T cells to activate the APC?
INF-y and IL-4
What acts as a target for elimination of abnormal host cells?
MHC class I
At what stage of an immune response do we see stable levels of antibody in the serum?
Plateau phase
At what stage of an immune response do we see catabolism without synthesis of antibody, causing a decline in the levels?
Antigen processing
What stage of the immune response is involved from the time when we are first presented with an antigen to the first time that there are detectable levels of antibody in the serum?
Lag phase
What response involves elevated levels of antibody and a short lag phase, and requires low levels of antigen to precipitate?
Secondary response
Whose function is it to present exogenous peptides to helper T cells?
MHC class II
What process is involved when an antigen is in the endocytic vacuole and there is fusion with lysosomes, which contain proteases that cleave the protein antigens into peptide fragments?
Antigen processing
Which four helper T cell cytokines are involved in differentiation?
I. IL-4 2. IL-5 3. IL-6 4. IL-10
Which co-stimulatory molecules are necessary for B cell differentiation (class switching)?
CD40 and CD40L (gp39)
Which cytokine is chemotactic for neutrophils?
IL-8
Which nondividing cells synthesize immunoglobulins in great amounts?
Plasma cells
Which process is involved in rearranging the DNA that encodes for the constant region of the heavy chain?
Class switching
What are the two functions of the thymus in T cell differentiation?
- Hormone secretion for T cell differentiation 2. T cell education to recognize self from nonself
Which process is involved in rearranging one heavy chain gene to produce a functional gene product, while it shuts off the rearrangement and expression of the other alleles to ensure that one antibody type is made?
Allelic exclusion
What are the three rules of clonal selection?
- One cell type 2. One antibody type 3. Random selection of hypervariable regions, and only cells with bound antigen undergo clonal expansion
When is the last time that maternal IgG is seen in circulation?
Between 9 and 15 months
What cytokine, produced by stromal cells of the bone marrow, is important in lymphoid development?
IL-7 A “7” upside down looks like an “L” (L for Lymphoid).
Which region of the thymus contains the mature T cells?
The medulla (They mature in the cortex.)
What are the cell surface markers of helper T cells?
CD28 and CD4
What are the cell surface markers of cytotoxic T cells?
CD28 and CD8
Which complement fragments cause lysis of cells?
C5b-9
Which complement fragment is deficient if a patient presents with repeated infections, fever, rash, and arthralgia?
C3
What three factors cause opsonization?
IgG, C3b, and mannose binding protein
Which cell surface marker binds to C3d fragments?
CD21
What disease is associated with an inherited deficiency in NADPH oxidase, in which the individual is likely to develop infections with catalase-positive organisms?
Chronic granulomatous disease
What cells are antigen-specific and have MHC restricted killing?
Cytotoxic T cells
What large granular lymphocytes have CD16 and CD56 as cell surface markers, do not secrete immunoglobulins, and are not antigen specific?
NK cells
What three complement fragments are also anaphylatoxins?
- C3a 2. C4a 3. C5a
What pathology is associated with low levels of immunoglobulin that persist in children for up to 2 years?
Transient hypogammaglobulinemia of childhood
What cell surface marker is found on pre-T cells?
Tdt
What cell surface marker is required for class switching?
CD40
What large granular lymphocytes are stimulated by IL-2 and INF-y and are activated by natural killer (NK) cells?
Lymphokine-activated killer (LAK) cells
Which cells recognize the Fc region of IgG and carry out ADCC?
Killer cells
What are the four chemotactic agents?
- C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides
What are the five main oxidizing reactions that are used to kill ingested organisms?
- H202 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid
True or false-it is perfectly normal to have low levels of IgG from 3 to 12 months of age?
True; it is called physiologic hypogammaglobulinemia of infancy.
What valve of the heart is most commonly affected in IV drug abusers?
Tricuspid valve
What is the first sign of reversible cellular damage?
Ballooning or hydropic changes secondary to mitochondrial injury
What is another name for isolated right-sided heartfailure?
Cor pulmonale
What region of the aorta is affected in syphilitic (luetic) aneurysms?
Ascending arch or the root
What organism is associated with hyaline membrane formation and cold agglutinins?
Mycoplasma
What cell type is commonly elevated in asthma?
Eosinophils
What enzyme level is commonly elevated in sarcoidosis?
Angiotensin converting enzyme (ACE)
What form of lung cancer is commonly associated with asbestosis?
Malignant mesothelioma
With what protein-losing enteropathy do you see hypertrophied gastric rugal folds?
Menetrier’s syndrome
What region of the GI tract does Giardia lamblia most commonly affect?
Duodenum
What organism is associated with “flask-shaped” ulcers?
Entamoeba histolytica
What hepatic pathology is associated with ingestion of oral contraceptives?
Liver adenoma
True or false alpha-1-antitrypsin deficiency can lead to cirrhosis of the liver?
True; it is most commonly associated with panacinar emphysema of the lower lobes.
What organism is associated with cholangiocarcinoma?
Clonorchis sinensis
True or false-polycythemia is associated with renal cell carcinoma?
True, because there is an increase in erythropoietin
What cancer of the male genitourinary system is associated with osteoblastic bony metastasis?
Prostatic carcinoma
What organism is commonly associated with IUD infections?
Actinomyces
What female genitourinary pathology is associated with elevated levels of human chorionic gonadotropin (hCG) and has a “snowstorm” appearance on an ultrasound?
Hydatidiform mole
What subset of leukemia involves gingival hypertrophy?
Acute myelocytic leukemia (AML)-M5, also called acute myelogenous leukemia
What chemical pathogen is associated with squamous cell carcinoma of the skin?
Arsenic
With what form of cancer is diethylstilbestrol (DES) associated?
Vaginal clear cell adenoma
What form of cancer is most commonly associated with nitrosamines?
Gastric cancer
What cellular process defines irreversible cellular injury?
Vacuolation of the mitochondria
Antinuclear antibodies (ANA), anti-dSDNA, and smooth muscle antigen (Sm ag) are all used to diagnose what disease?
Systemic lupus erythematosus (SLE)
SS-A(Ro), SS-B(La), and R-ANA are diagnostic markers of what disease?
Sjogren’s disease
What disease is characterized by decreased bone resorption due to defective osteoclast function?
Osteopetrosis (Albers- Schonberg disease)
What metaplastic cellular change (from what cell type to what cell type) occurs in Barren’s esophagus?
Squamous to columnar cell (adenocarcinoma)
Antinuclear antibodies (ANAs) and anti-SCL-70 antibodies are diagnostic of what disease?
Scleroderma
What T cell defect is found in Graves’ disease?
Defect in antigen-specific suppressor T cells
A gastric mucosal erosion caused by extensive burns to the body surface is known as what?
Curling’s ulcer (Burns
A superficial gastric mucosal erosion causing an excessive secretion of pepsin, due to an increase in intracranial pressure from trauma or surgical injury to the CNS, is known as what?
Cushing’s ulcer
What two antibodies are used to diagnose Hashimoto’s thyroiditis?
Antithyroglobulin and antimicrosomal antibodies
What is the term for the copper corneal deposits found in Wilson’s disease?
Kayser-Fleischer rings
What is the triad of Meig’s syndrome?
- Right-sided hydrothorax 2. Ascites 3. Ovarian fibroma
What is the triad of Plummer-Vinson syndrome?
- Atrophic glossitis 2. Esophageal webs 3. Iron-deficiency anemia
In multiple myeloma, what are the immunoglobulin protein droplets within plasma cells called?
Russell bodies
Obstetric hemorrhage or shock to the anterior pituitary leads to what syndrome?
Sheehan’s syndrome (approximately 90% destruction of the pituitary)
What is the term for a twisting of a loop of bowel leading to an obstruction?
Volvulus
In what condition is a strawberry gallbladder seen?
Cholesterolosis
What is the term for a palpable left supraclavicular lymph node?
Virchow’s node (due to metastatic gastric carcinoma)
What pathology is associated with Budd-Chiari syndrome?
Hepatic venous thrombus
Cell fragments of hemolysis are known as what?
Helmet cells (schistocytes)
What is the name given to the red blood cell that contains a peripheral rim of hemoglobin along with a dark central area containing hemoglobin?
Target cell
What are the three causes of a microvesicular fatty change in the liver?
- Tetracycline toxicity 2. Reye’s syndrome 3. Fatty liver of pregnancy
Abnormal, unstable RNA within a developing RBC is known as what?
Basophilic stippling
What is the term for an RBC with inorganic iron-containing granules?
Siderocyte
A patient presenting with dark urine, pale stools, and itchy skin has what form of jaundice?
Obstructive (direct) jaundice
…
With what form of hepatitis do you see elevated levels of AST (SGOT) and GGT liver enzymes?
In both alcoholic 2nd viral hepatitis, AST and ALT are elevated. SGOT > SGPT in alcoholic hepatitis, and SGPT > SGOT in viral hepatitis.
What region of the liver is affected during shock?
Pericentral (necrotic) region
What drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
Heroin
What type of metal poisoning causes basophilic stippling?
Lead
What drug causes a six- fold increase in schizophrenia, can impair motor activity, and can cause lung problems?
Marijuana
…
With what disease do you see dust-containing macrophages within a reticulin mesh?
Coal workers’ pneumoconiosis
With what two pathologies is a honeycomb lung associated?
- Asbestosis 2. Silicosis
What is Caplan’s syndrome?
Rheumatoid arthritis with silicosis
What chemical can be potentially dangerous if you work in the aerospace industry or in nuclear plants?
Beryllium
What are the three causes of angiosarcoma of the liver?
- Vinyl chloride 2. Thorium dioxide 3. Arsenic
What causes acellular fibrosis in the upper zone of the lung?
Silicosis
What dye is a major cause of transitional cell carcinoma of the urinary bladder?
Naphthalene
Interstitial fibrosis of the lower lobe is pathognomonic of what?
Asbestosis
With what is cherry red intoxication associated?
Acute carbon monoxide poisoning
With what disease do you see Brushfield’s spots?
Down syndrome
