AAW - Immunology Flashcards
In lymph tissue, where is the site of B-cell localization and proliferation?
Follicle of cortex of lymph node.
What types of cells are in the Medullary sinuses of lymph nodes?
Reticular cells and macrophages
Lymph drainage:
What lymph node cluster drains the:
Lower rectum to anal canal (above pectinate line), bladder, vagina (middle third), prostate
Internal iliac
Lymph drainage:
What lymph node cluster drains the:
Testes, ovaries, kidneys, uterus
Para-aortic
Lymph drainage:
What lymph node cluster drains the:
Anal canal (below pectinate line), skin below umbilicus (except popliteal territory)
Superficial inguinal
What drains everything besides the right side of the body above the diaphragm, and where does it drain to?
The thoracic duct - drains into junction of left subclavian and internal jugular veins
Histological hallmark of the sinusoids of the spleen
Long, vascular channels in red pulp (made of RBCs) with fenestrated “barrel hoop” basement membrane.
What type of cells are found in the periarterial lymphatic sheath of the white pulp of the spleen
T cells
What type of cells are found in the follicles within the white pulp of the spleen
B cells
What types of cells are found in the marginal zone of the spleen
Antigen presenting cells (APC) - macrophages and specialized B cells that capture blood borne antigens
If you have a splenic dysfunction, what infectious organisms are you more susceptible to?
Encapsulated organisms:
SHiNE SKiS
What types of cells are in the following areas of the Thymus:
cortex
medulla
Hassal corpuscles
Cortex - immature T cells
Medulla - mature T cells
Hassall corpuscles - epithelial reticular cells.
calcineurin inhibitors
name 2
mech
particularly high yield toxicity
cyclosporine, tacrolimus
cycloSPORKin TACKrolimus
2 things that stab you
Blocks IL-2 transcription, inhibiting T cells
Nephrotoxic, because when you shank someone you go for the kindeys
also tacroLIMEus and siroLIMEus both bind FKBP (when you get stabbed and put a LIME on it, it hurts and you say FucK)
what is the first test you do to screen for HIV
enzyme linked immunosorbent assay to test for antibodies against HIV proteins
the patient could have a false negative until 3-7 weeks after getting HIV
confirm with western blot (AKA checking the viral load)
adult male with random and sudden hemoptysis, elevated creatine and BUN, hematuria
goodpastures, autoantibodies against type IV collagen (in pulmonary alveoli and renal glomeruli)
young person has recurrent bacterial and fungal infections with staph, e.coli. and aspergillus
what disease
what cytokine can you give them
CGD (chronic granulomatous disease)
lack of NADPH oxidase activity, phagocytes use NADPH oxidase to convert molecular oxygen to ROS
susceptible to catalase positive organisms
give the recombinant cytokine INF-gamma
nitroblue tetrazolium test
determines phagocyte NADPH oxidase activity, which is reduced in patients with CGD
phagocytes use NADPH oxidase to convert molecular oxygen to ROS
severe pyogenic infections early in life; opportunistic infection with pneumocystis, cryptosporidium, cmv
increased serum IgM
what is the mech
hyper-IgM syndrome:
Most commonly due to
defective CD40L on Th
cells = class switching defect (you can only make IgM);
X-linked recessive.
chronic granulomatous disease - what orgs are you susceptable to?
what is the molecular defect
susceptibility to catalase \+ organisms (PLACESS): Pseudomonas, Listeria, Aspergillus, Candida, E. coli, S. aureus, Serratia.
Defect of NADPH oxidase decrease in reactive oxygen species (e.g., superoxide) and absent respiratory burst in neutrophils; X-linked recessive.
HLA-A3
hemochromatosis
HLA-B27
PAIR
Psoriatic arthritis, Ankylosing spondylitis, arthritis of Inflammatory bowel disease, Reactive arthritis
AKA the seronegative arthropathies
HLA-DQ2/DQ8
celiac disease
started going to Dairy queen when I was 2 but had to stop when I was * because they found out i have celiac
HLA-DR2
multiple sclerosis, hay fever, (2,3,SLE) SLE, Goodpasture syndrome
an MS2 student in a HAY PASTURE with BUTTERFLIES (SLE)
HLA-DR3
diabetes mellitus type 1, (2,3,SLE) SLE, Graves disease, hashimoto, addison
Addison got recently added to DR3 and 4
hashimoto recently got added to DR3
HLA-DR4
Rheumatoid arthritis (4 walls in a RHEUM), diabetes mellitus type 1, addison disease
addison got recently added to DR3 and DR4
HLA-DR5
pernicious anemia –> vit b12 deficiency, Hashimoto thyroiditis (i got five on that hash - and hash is pernicious)
anti-ach receptor antibody
myasthenia gravis
anti-basement membrane antibody
goodpasture syndrome (type 4 collagen)
anticardiolipin antibody
SLE
anticentromere antibody
limited scleroderma (CREST):
calcinosis and centromere, Raynaud’s, esophageal dysmotility, sclerodactyly, telangiectasia.
anti-desmoglein antibody
pemphigus vulgaris
anti-glutamic acid decarboxylase antibody
AKA GAD-65
type 1 diabetes mellitus
antihemidesmosome antibody
bullous pemphigoid
anti-histone antibodies
drug-induced lupus
anti-Jo, anti-SRP, anti-Mi2
polymyositis, dermatomyositis
antimicrosomal antibodies
hashimotos with antithyroglobulin
antimitochondrial antibodies
primary biliary cirrhosis
antinuclear antibodies
SLE, but not specific (used just for screening)
antiparietal cell antibodies
pernicious anemia
antiphospholipase A2 receptor
primary membranous nephropathy - granular immune complex deposition, nephrotic syndrome, spike and dome appearance with subepithelial deposits
(glucocorticoids inhibit phospholipase A2, which converts phospholipids to arachidonic acid)
anti-dna topoisomerase I antibodies
diffuse scleroderma (antibody is also known as anti-scl-70)
anti-smooth muscle antibodies
autoimmune hepatitis type 1
anti-SSA, anti-SSB (anti-Ro, anti-La) antibodies
sjogren syndrome
anti-U1 RNP antibodies
mixed connective tissue disease - features of SLE, systemic sclerosis, and polymyositis
antibodies are related to the anti spliceosomal snRNP antibodies (aka anti smith) seen in SLE
voltage-gated calcium channel antibodies
lambert-eaton syndrome
IgA anti-endomysial, IgA anti-tissue transglutaminase
celiac disease
MPO-ANCA/p-ANCA antibodies
microscopic oplyangiitis, eosinophilic granulomatosis with polyangitis (churg-strauss)
PR3-ANCA, c-ANCA
granulomatosis with polyangitis (wegeners)
autoantibody in Rheumatoid arthritis
IgM antibody that targets IgG Fc region (Rheumatoid factor)
also anti-CCP (more specific)
snRNP antibody
AKA anti-smith antibody
SLE
3 things that are s-100 positive
langerhans histiocytosis
melanoma
schwannoma
where are T cells found in a lymphnode?
b cells?
t - paracortex
b - follicles
catch-22
Cleft palate Abnormal facies Thymic aplasia Cardiac defects Hypocalcemia secondary to parathyroid aplasia
22q11 microdelesion leads to digeorge syndrome (thymic, parathyroid, and cardiac defects)
and velocardiofacial syndrome (palate, facial, and cardiac defects)
