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Step 1 DIT > 8. Immuno > Flashcards

8. Immuno Flashcards

1
Q

To which lymph nodes do the sigmoid colon and the rectum drain?

A

sigmoid colon: inf mesenteric

upper rectum: inf mesenteric

lower (to pectinate line): int iliac

lower (below pec line): sup inguinal

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2
Q

In what parts of the lymph nodes would B cells and T cells be located?

A

B cells: follicles (of the cortex)

T cells: paracortex

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3
Q

Where would you find Peyer’s patches?

A

ileum (in lamina propria + submucosa)

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4
Q

What molecules are expressed on the surface of antigen-presenting dendritic cells?

A
  • MHC class 1, 2
  • B7 protein
  • CD40
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5
Q

What 3 cell types are known for presenting antigens to CD4+ T cells?

A
  • dendritic cells
  • macrophages
  • B cells
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6
Q

What characteristic finding would you see on electron microscopy of a dendritic cell in a pt with Langerhans cell histiocytosis?

A

Birbeck granules (tennis racket)

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7
Q

Which cytokines are produced by Th1 cells? by Th2 cells?

A 
Th1 = IL-2, IFN-gamma 
Th2= IL-4, IL-5, IL-10
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8
Q

Which cytokines inhibit Th1 cells? Which inhibit Th2 cells?

A

Th1 –> IL-10

Th2 –> IFN-gamma

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9
Q

How do cytotoxic T cells kill virus-infected cells and neoplastic cells?

A
  1. granzyme B + perforin

2. Fas-ligand on T-cell binds to Fas-receptor on target cell –> induce apoptosis

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10
Q

Which surface markers are found on B-cells?

A 
CD19, 20, 21 
IgM, IgD 
MHC class I, 2 
B7 protein 
CD40
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11
Q

What immunoglobulin is associated with allergies b/c it is bound by mast cells and basophils and causes them to degranulate and release their histamine?

A

IgE

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12
Q

What immunoglobulin comprises 70-75% of the total immunoglobulin pool?

A

IgG

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13
Q

What immunoglobulin is present in large quantities on the surface of many B cells?

A

IgD, IgM

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14
Q

What immunoglobulin crosses the placenta and additionally confers immunity to neonates in the first few months of life?

A

IgG

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15
Q

What immunoglobulin can occur as a dimer?

A

IgA (secretory)

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16
Q

What immunoglobulin is largely confined to the intravascular pool and is the predominant early antibody frequently seen in the immune response to infectious organisms with complex antigens?

A

IgM

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17
Q

What immunoglobulin is distributed evenly b/w the intravascular and extravascular pools?

A

IgG

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18
Q

What immunoglobulin is the predominant immunoglobulin in mucoserous secretions such as saliva, colostrum, milk, tracheobronchial secretions, and GU secretions?

A

IgA

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19
Q

What immunoglobulin can be a pentamer?

A

IgM

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20
Q

What initiates recombination of V(D)J sequences?

A

RAG-1, RAG-2

–> recombination activating genes

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21
Q

Which viral vaccines are potentially dangerous to pts with an egg allergy? (2)

A
  • influenza

- yellow fever

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22
Q

What autoimmune disease is associated with anti-dsDNA antibodies?

A

SLE

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23
Q

What stain is used to identify amyloid microscopically, and how is its appearance described?

A

congo red stain

- apple green birefringence under polarized light

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24
Q

Which type of hypersensitivity is responsible for post-strep GN?

A

3

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25
Q

Which type of hypersensitivity is responsible for asthma?

A

1

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26
Q

Which type of hypersensitivity is responsible for rheumatic fever?

A

2

27
Q

Which type of hypersensitivity is responsible for tuberculosis skin test (PPD)?

A

4

28
Q

Which type of hypersensitivity is responsible for allergies, anaphylaxis, and hay fever?

A

1

29
Q

Which type of hypersensitivity is responsible for polyarteritis nodosa (PAN)?

A

3

30
Q

Which type of hypersensitivity is responsible for serum sickness?

A

3

31
Q

Which type of hypersensitivity is responsible for ABO blood type incompatibility?

A

2

32
Q

Which type of hypersensitivity is responsible for poison ivy?

A

4

33
Q

Which type of hypersensitivity is responsible for eczema?

A

1

34
Q

Which type of hypersensitivity is responsible for contact dermatitis?

A

4

35
Q

Which type of hypersensitivity is responsible for Goodpasture syndrome?

A

2

36
Q

A patient suffers from recurrent Neisseria infections. What complement proteins are deficient?

A

C5b - 9

37
Q

Which complement is responsible for neutrophil chemotaxis?

A

C5a

38
Q

What cytokines are produced by Th1 cells?

A

IL-2, IL-3, IFN-gamma

39
Q

What cytokines are produced by Th2 cells?

A

IL-2, IL-3, IL-4, IL-5, IL-10

40
Q

What cytokines promotes growth and differentiation of B cells?

A

IL-4, IL-5

41
Q

What cytokines promotes growth and activation of eosinophils?

A

IL-5

42
Q

What cytokines are pyrogens secreted by macrophages?

A

IL-1, IL-6

43
Q

What cytokines enhance synthesis of IgE and IgG

A

IL-4 (remember, BEG 4 it)

44
Q

What cytokines enhance synthesis of IgA

A

IL-5

45
Q

What cytokines mediate inflammation?

A

IL-1, IL-6, TNF-alpha

46
Q

What cytokines are secreted by Th1 cells and activate macrophages?

A

IFN-alpha

47
Q

What cytokines are secreted by Th2 cells and inhibits macrophage activation?

A

IL-10

48
Q

What cytokines inhibits production of Th1 cells?

A

IL-10

49
Q

What cytokines inhibits production of Th2 cells?

A

IFN-gamma

50
Q

What cytokines are released by virus-infected cells?

A

IFN-alpha, IFN-beta

51
Q

What cytokines supports growth and differentiation of bone marrow stem cells?

A

IL-3

52
Q

What cytokines supports T-cell proliferation, differentiation, and activation?

A

IL-2

53
Q

What is the function of macrophages in the spleen? (2)

A
  1. remove encapsulated bacteria

2. remove dysfunctional RBCs

54
Q

Which immunosuppressant is a precursor of 6-mercaptopurine?

A

azathioprine

55
Q

Which immunosuppressant inhibits IMP dehydrogenase?

A

mycophenolate

56
Q

Which immunosuppressant inhibits calcineurin resulting in the loss of IL-2 production and inhibition of T-cell differentiation and activation?

A

cyclosporin

57
Q

Which immunosuppressant binds FK-binding protein (FKBP) leading to loss of IL-2 production?

A

tacrolimus

58
Q

Which immunosuppressant binds FKBP12 leading to inhibition of mTOR and inhibition of T-cell proliferation?

A

sirolimus (rapamycin)

59
Q

Which immunosuppressant is used for lupus nephritis?

A

azathioprine

mycophenolate and cyclosporin used off-label

60
Q

Which immunosuppressant is metabolized by xanthine oxidase, therefore allopurinol increases its toxicity?

A

azathioprine

61
Q

What are the X-linked immunodeficiencies?

A

WACH

  • Wiskott-Aldrich syndrome
  • Agammaglobulinemia (Bruton)
  • Chronic granulomatous disease (CGD)
  • Hyper IgM syndrome
62
Q

What are the clinical features of Wiskott-Aldrich syndrome?

A

WAITER

  • Wiskott
  • Aldrich
  • Immunodeficiency
  • Thrombocytopenia + purpura
  • Eczema
  • Recurrent pyogenic infections
  • low IgM, high IgA
63
Q

What is the cause of chronic granulomatous disease (CGD)? To what infections are these individuals susceptible?

A
  • absence of NADPH oxidase

- susceptible to catalase + pathogens (esp. S. aureus, aspergillus)

64
Q

A young child presents with tetany from hypocalcemia, and candidiasis resulting from immunosuppression. What cell type is deficient in this patient?

A

T-cell (DiGeorge; thymic aplasia)

Step 1 DIT (20 decks)

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