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Immunology and Haematology > Basics of Immunology > Flashcards

Basics of Immunology Flashcards

1
Q

Where do specialised cells of the immune system originate?

A

The bone marrow via the common progenitor cell (haematopoetic stem cell)

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2
Q

What does the common progenitor divide into?

A

Common myeloid progenitor

Common lymphoid progenitor

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3
Q

What does the common lymphoid progenitor?

A

NK Cells

Small lymphocyte

  • T Lymphocyte
  • B lymphocyte
    • plasma cell
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4
Q

What does the common myeloid progenitor specialise into?

A

Megakaryocyte
Erythrocyte
Mast Cell
Myeloblast

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5
Q

What do megakaryocytes specialise into?

A

Platelets

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6
Q

What do myeloblasts specialise into?

A

Basophils
Neutrophils
Eosinophils
Monocyte

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7
Q

What do monocytes specialise into?

A

Macrophage

Dendritic Cells

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8
Q

What is the innate immune system?

A

A fast but non-specific immune response

Shows no immunological memory

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9
Q

What is the adaptive immune system?

A

A slow but specific immune response that establishes an immunological memory

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10
Q

Where are MHC I’s found on human cells?

A

On the surface of all nucleated cells

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11
Q

What do HLA genes code for?

A

Cell surface proteins that present antigens to T Cells

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12
Q

What does class I of HLA present to?

A

the APC for presentation of antigen to Tc

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13
Q

What does class II of HLA present to?

A

the APC for presentation of antiben to TH cells

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14
Q

What kind of APC’s present with both MHC class I and class II ?

A

Dendritic cells and macrophages

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15
Q

What do naive CD8+ Tcells need to become Tc Cells?

A

professional APC such as dendritic cells and macrophages

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16
Q

What are examples of innate immunity?

A

Barriers

Cells (phagocytes, eosinophils, basophils, mast cells, NK cells)

Actions of the complement system

Soluble mediators (acite phase reactants, cytokines, chemokines, matrix metallo-proteinases, defensins)

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17
Q

What does TH1 do?

A

Secrete interferon Y, IL-2, TNF, fights against intracellular pathogens, has a disease role in autoimmunity and chronic inflammation

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18
Q

What does TH2 do?

A

Secrete IL4, IL5, IL13. Defends against helminths and plays a disease role in allergy

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19
Q

What does TH17 do?

A

Secrete IL-17, IL-22 important in host defence against extracellular bacteria and fungi. Plays a diseaserole in autoimmunity and inflammation

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20
Q

What is the role of T Reg cells ?

A

Exert a controlling and regulatory influence on immune responses

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21
Q

What do Tc Cells do?

A

Secrete IFNY, kill cells infected by intracellular microbes

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22
Q

What is the role of B Cells?

A

They detect antigens via antibodies

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23
Q

What are the subclasses of antibodies?

A

IgG, IgA, IgM, IgD, IgE

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24
Q

What is the structure of antibodies?

A

2 heavy and 2 light chains

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25
Q

What are the functions of antibodies?

A

To bind and neutralise toxins, to form the immune complex, opsonisation, complement activation, cellular cytotoxicity

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26
Q

Give examples of primary lymphoid tissues?

A

Thymus and bone marrow

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27
Q

What occurs and the thymus?

A

T cells mature

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28
Q

What occurs at the bone marrow?

A

B cells mature

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29
Q

What are secondary lymphocytes?

A

Places where lymphocyte responses to foreign antigens are initiated

  • lymph nodes, spleen, tonsils, adenoids, intestines
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30
Q

What is the naive state of an antigen?

A

immunoglobulin

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31
Q

What happens to immature B cells that recognise self antigen in the bone marrow?

A

They are negatively selected and die through apoptosis

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32
Q

When are developing T cells in the thymus not selected?

A

If they do not recognise self MHC

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33
Q

When are developing T Cells negatively selected?

A

When they recognise self-peptide plus self-MHC with high affinity
= apoptosis

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34
Q

What are the most important mechanisms of peripheral tolerance?

A

Anergy and T regulatory cells

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35
Q

What is the principle of Anergy?

A

where the T cell regognises the antigen presented on an MHC molecule but does not respond as there is no costimulation. Cell becomes anergic

36
Q

What is the function of T-regulatory cells ?

A

Inhibit neighbouring T-Cells

37
Q

What is hypersensitivity?

A

An exaggerated or inappropriate fashion to environmental antigens which do not normally cause tissue damage

38
Q

What is bystander damage?

A

The tissue damage is done by the exaggerated response rather than the antigen itself

39
Q

What are hypersensitivities Types I, II and III mediated by?

A

Antibodies

40
Q

What mediates hypersensitivity type IV reactions?

A

Inappropriate actions of TH1 and TH17 cells

41
Q

What is involved in a type I hypersensitivity reaction?

A

Allergen, IgE, mast cell, TH2 cells, eosinophils and genes

42
Q

Give examples of an airbourne allergen?

A

pollens, house dust mite, animal products

43
Q

Give examples of an ingested allergen?

A

Milk, eggs, fish/shellfish, cereals, nuts

44
Q

Give an examples of occupational allergens?

A

Latex, drugs (hospital)

Industrial

45
Q

What is the definition of an atopic reaction?

A

Where you have a genetic potential to produce allergic reactions but will not suffer from any kind of clinical problem

46
Q

What is atopy?

A

a genetic tendency to produce IgE to normally innocuous environmental allergens

47
Q

What is allergy?

A

A clinical expression of the atopic tendency

48
Q

Give examples of preformed mast cell mediators?

A

Histamine, heparin, tryptase, chymase, ECF, NCF

49
Q

What mast cell mediators are newly synthesised as and when needed?

A

Prostaglandins, leukotrienes

50
Q

What is the pathogenesis of an allergic reaction?

A

Allergen exposure –> ,mast cell + IgE production –> degranulation –> synthesis –> mucosal oedema/ capillary leakage/ secretios/ smooth muscle contractions/ vasodilation

51
Q

What is the early phase response of an allergic reaction?

A

preformed mast cell mediators are released

52
Q

What is the late phase response of an allergic reaction?

A

Newly synthesised mast cell mediators, Th2 cytokines and eosinophil mediators are released

53
Q

What are type II hypersensitivity reactions?

A

Reactions mediated against antigens found on the surface of cells or fixed within certain tissues

54
Q

How does antigen damage occur in a type II hypersensitivity reaction/.

A

Complement activation
Fc binding and stimulation of phagocytes
ADCC
Inhibition of function of target cell function or stimulation of target cell function

55
Q

Name some clinical type II hypersensitivity disorders?

A

Haemolytic reactions
Haemolytic disease of the newborn
Hyperacute graft rejection

Graves disease, myaesthenia gravis, goodpasture’s syndrome, pemphigus

56
Q

What is a type III hypersensitivity reactions?

A

occurs when there is accumulation of immune complexes that have not been adequately cleared by innate immune cells, giving rise to an inflammatory response and attraction of leukocytes

57
Q

Give examples of clinical presentations of type III hypersensitivity disorders?

A

Farmers lung, post-strep glomerulonephritis, tumours, SLE

58
Q

What is an autoimmune disease?

A

Response to self-antigen, loss of tolerance

59
Q

What are the functions of complement cells?

A

Chemotaxis of phagocytes to sites of inflammation
Opsonisation
Lysis of micro-organisms
Maintenance of solubility of Ag/Ab

60
Q

What do C1,4,2,3 deficiencies lead to?

A

Immune complex disease

Infection

61
Q

What is MBP function?

A

Activates a classical complement pathway

An opsonin in that it can bind to the cell surface of micro-organisms whose cell walls contain mannan

62
Q

What do deficiencies of MBP result in?

A

A susceptibility to recurrent bacterial infections

63
Q

What is SCID?

A

Severe Combined Immune Deficiency

  • Heterogeneous group of conditions with variable underlying genetic defects but generally produce severe dysfunction in T and B cell development
64
Q

Why does SCID occur?

A

defects in pluripotent stem cells, lymphoid stem cells or T & B celsl

65
Q

How does SCID present?

A

Infant usually well for the first 3 months then:

  • persistent superficial candida
  • diarrhoea and failure to thrive
  • chronic bronchiolitis
  • interstitial pneumonitis
  • overwhelming bacterial sepsis
66
Q

What treatment is available for SCID?

A

Intensive supportive therapy, nutritional support, prophylactic and therapeutic antibiotics, anti-fungals, anti-virals, Ig replacement therapy, bone marrow transplant

67
Q

What is an autograft?

A

Transfer of tissue between different sites within the same organism e.g skin graft

68
Q

What is an isograft?

A

Transfer between genetically identical individuals

69
Q

What is an allograft?

A

Transfer between genetically non-identical members of the same species

70
Q

What is a Xenograft?

A

Transfer between species

71
Q

What major antigens must donor and recipient share?

A

ABO blood group antigens

HLA-A, HLA-B and HLA-HR

72
Q

When is blood or tissue match not required?

A

In tissue where little blood or lymphatic supply is present

73
Q

What are the complications of transplantation?

A 
Graft rejection
Graft vs Host disease
infection
neoplasia
drug side effects
recurrence of original disease
Ethical, surfical problems
74
Q

What causes graft rejection?

A

HLA mismatch

75
Q

What causes hyperacute rejection?

A

Pre-formed antibodies

76
Q

What causes accelerated rejection?

A

TCell presence

77
Q

What causes acute rejection?

A

Newly sensitised TCells

78
Q

What causes chronic rejection?

A

Multifactorial

79
Q

How can graft rejection be prevented?

A

ABO matching and detection of pre-sensitisation to donor organs

Close tissue matching

Prophylactic immunosuppressive therapy

80
Q

How do corticosteroids work?

A

Affect T and B cell function which affects cytokine networks, inflammation, TCell and monocyte function and transit or immunologically active cells

81
Q

How does azathioprine work?

A

Purine analogue which inhibits DNA synthesis. Inhibits T and NK cell function

82
Q

How does cyclophosphamide work?

A

Alkylating agent which interferes with DNA synthesis which suppresses B cells and Ab production

83
Q

What does cyclosporin and tacrolimus do?

A

Suppresses T cells and NK cells

84
Q

What does sirolimus cell do?

A

Decreases IL-2 production by TH cellsq

85
Q

What does mycophenolic acid do?

A

Inhibits purine and prevents T cell proliferation, antibody production and leukocyte migration

Immunology and Haematology (10 decks)

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