Ch6 Flashcards
1
Q
NF-Kb TF does what when turned on?
A
Causes production of cytokines leading to destruction of microbe by phagocytosis
2
Q
T cell receptor has what structure?
A
Alpha and beta chain with disulfide bonds
3
Q
Each T cell receptor is linked to what? 2
A
CD3 complex
2 zeta chains
4
Q
CD3 complex has what in it?
A
gamma
delta
epsilon
5
Q
First signal to T cell?
A
Antigen/MHC presentation
6
Q
Second signal to T cell?
A
CD28 and B7/CD80/CD86
7
Q
Polyclonal T cell proliferation is described how?
A
Non-neoplastic
8
Q
Monoclonal T cell proliferation is described how?
A
Neoplastic
9
Q
CD means what?
A
Clusters of differentiation
10
Q
CD3 and CD5 define what type of cells?
A
T cell
11
Q
CD19 and CD20 define what cells?
A
B cell
12
Q
T lymphocytes are what percentage of lymphocytes?
A
60-70
13
Q
B lymphocytes are what percentage of circulating peripheral lymphocytes?
A
10 to 20
14
Q
B cells form what when stimulated?
A
Plasma cells that secrete Ig’s
15
Q
What 3 main receptors do B cells have?
A
Complement receptor
FC receptor
CD40
16
Q
What is the complement receptor for Epstein-Barr?
A
Type 2 complement receptor (CR2, CD21)
17
Q
What are the two signals to a B cell when interacting with external free antigen-complement?
A
- Igalpha and Igbeta coreceptor signaling
2. Complement binding to CR2/CD21
18
Q
Two types of dendritic cells?
A
Interdigitating Dendritic cells
Follicular dendritic cells
19
Q
Interdigitating dendritic cells have what important title?
A
Most important APC for initiating T cell response again protein antigens
20
Q
Immature dendritic cells in epidermis are called what?
A
Langerhans cells
21
Q
Nucleus of dendritic cell is described how?
A
Reniform
22
Q
What receptors do follicular dendritic cells have?
A
Fc receptors for IgG and C3b
23
Q
What do follicular dendritic cells do?
A
Present antigens to B cells
24
Q
How are macrophages involved in CMI?
A
T cells activate them to let them kill microbes
25
How are macrophages involved in HI?
Phagocytose and destroy microbes that are opsonized by IgG or C3b
26
What makes NK cells different?
Can kill infected cells without prior exposure to a microbe or antigen
27
NK cells are positive for what CD's?
CD16 and Cd59
28
CD16/FCgammaRIII is the receptor for what?
NK IgG receptor
29
What main cytokine do NK cells release?
IFN-gamma to activate macrophages
30
What stimulates proliferation of NK cells?
IL-2 and IL-15
31
What stimulates NK cells to kill and secrete IFN-gamma?
IL-12
32
More than half of the body's lymphocytes are where?
Mucosal tissues
33
B cells are concentrated where in lymph node?
Follicle cortex of lymph nodes possibly with germinal center
34
T cells are where in lymph nodes?
Paracortex
35
Follicular dendritic cells are where in lymph node? 2
Follicles (present to B) and paracortex (present to T)
36
Where are T cells in the spleen?
PALS
37
Where are B cells in spleen?
Follicles
38
Where do plasma cells go to respond to an antigen?
Stay in lymph node
39
Where are the genes for HLA encoding?
Chromosome 6
40
what type of antigen do MHC-1 molecules present?
Intracellular, usually viruses
41
Class I MHC have what genes?
HLA-A, HLA-B, HLA-C
42
Class II MHC have what genes?
DP, DQ, DR
43
What removes the CLIP from MHC II?
HLA-DM
44
How is the expression of HLA described?
Codominant: one allele from mom, one from dad
45
Ankylosing spondylitis and postinfectious anthropathies are associated with people that have what antigen?
HLA-B27
46
Rheumatoid arthritis involves what HLA allele?
DR4
47
Type 1 diabetes involves what HLA allele? (3)
DR3
DR4
DR3/DR4 (the worst risk)
48
21-hydroxylase deficiency is involves with what antigen?
HLA-Bw47
49
Hereditary hemochromatosis is associated with what antigen?
HLA-A
50
What mainly makes the cytokines for innate immunity? (3)
1. macrophage
2. dendritic
3. NK cells
51
What are the 6 cytokines of innate immunity?
1. TNF-alpha
2. IL-1
3. IL-2
4. Type 1 IFN's (alpha and beta)
5. IFN-gamma
6. chemokines
52
What are the cytokines of adaptive immunity?
1. IL-2
2. IL-4
3. IL-5
4. IL-17
5. IFN gamma
53
What makes most of the adaptive cytokines?
CD4+ lymphocytes
54
Early response of CD4 t cells to antigen is what? (2)
Secrete IL2
| Express receptor for IL-2
55
What mediates functions of helper T's?
CD40
| Cytokines
56
memory cells respond when?
When re-exposed to an antigen
57
What is the main basis of HS disorders?
Imbalance in effector mechanisms of immune responses and control mechanisms that limit these responses
58
What cells play a role in initiation and propagation of Type I hypersensitivity?
TH2 cells --> promote IgE production
59
What triggers mast cells to activate? (2)
1. Cross linking IgE Fc receptors
| 2. C5a and C3a
60
What happens in immediate reaction of Type I?
Vasodilation, leaky vessels due to prostaglandin and leukotrienes
61
Histamine has what effect? 3
1. Vasoconstriction
2. Leaky vessels
3. increase mucus
62
Leukotrienes C4 and D4 do what?
Vasoactive and spasmogenic
63
Leukotriene B4 does what?
Chemotaxis for leukocytes
64
Prostaglandin D2 does what? 2
Bronchospasm
| Increased mucus secretion
65
What cells cause late response of HS Type I?
Eosinophils
66
What is it called if you are more likely to have Type I immediate eractions? (2)
1. Higher serum IgE
| 2. More IL-4 producing Th2 cells
67
Different Type II reactions? 4
1. transfusion rxn
2. Autoimmune hemolytic anemia
3. agranulocytosis
4. thrombocytopenia
68
Type II is due to what pathways?
Complement
| Fc-receptors
69
Results of Type II HS?
Glomerulonephritis
| Vascular rejection
70
5 examples of Type II?
```
Myasthenia gravis
Graves disease
acute rhematic fever
Goodpasture
Autoimmune hemolytic anemia
```
71
Examples of Type III? 4
Systematic lupus erythematosus
Poststreptococcal glomeruonephritis
Serum sickness
Arthus reaction
72
What is arthus reaction?
Localized tissue necrosis from acute immune complex vasculitis
73
Type IV HS is mediated by who?
CD4 and CD8 t cells
74
Examples of type IV?
```
Type 1 diabetes
multiple sclerosis
rhematoid arthritis
crohn disease
contact dermatitis
```
75
What is granulomatous formation?
DTH due to persistent antigens in which CD4 cells are replaced by macrophages that form giant cells
76
CTL is important for what? 2
1. Virus infections
| 2. tumor rejection
77
What enzymes do cytotoxic T cells have?
| What special killing receptor
Perforins and granzymes
| Fas
78
3 requirements for autoimmunity?
1. Presence of an immune reaction specific for self antigen
2. Reaction is of primary pathogenic significance
3. Absence of another well-defined cause
79
Autoimmune diseases encompass what HS diseases?
II, III, IV
80
What is self-tolerance?
Lack of response to one's own antigens
81
What causes anergy in B cells?
| T cells?
B: Encounter self antigen but have no T cells, so unable to respond and are excluded from follicle
T: If antigen is presented without costimulator
82
Regulatory T cells have what protein?
| Mutation in this causes what?
FoxP3
| IPEX
83
What regulatory T cell gene has polymorphisms in MS?
CD25
84
What does PTPN-22 cause? 2
RA
| Type 1 DM
85
NOD-2 causes what?
Crohn
86
IL-2 and IL-7 receptor alpha chain defect causes what?
MS
87
What characterizes SLE?
Anti-nuclear Autoantibodies against all parts of body
88
What is the lupus pneumonic?
```
Malar Rash
Discoid Rash
Serositis
Oral Ulcers
Arthritis
Photosensitivity
Blood abnormalities
Renal
ANA antibodies
Immune abnormalities
Neurologic
```
89
Antinuclear antibodies are directed against what? 4
DNA
Histones
Proteins on RNA
Nucleolar antigens
90
Test for ANA's?
Indirect immunofluorescence or EIA
91
Homogeneous ANA's find what?
Chromatin and histones
92
Rim ANA's find what?
dsDNA
93
Speckled pattern ANA's find what?
Histones and RNP's
94
Which is most common ANA pattern?
Speckled
95
Nucleolar ANA pattern means what?
RNA
96
antiphospholipid antibodies are found in what percentage of SLE patients?
40-50
97
This anti-phospholipid of SLE is used in detecting what disease?
Syphilis
98
What happens to people with anti-phospholipid SLE?
Recurrent spontaneous miscarriages
| Focal cerebral or ocular ischemia
99
What is the genetic link of SLE?
HLA-DQ
100
When does SLE show up in patient?
20 or 30's
101
Who gets SLE more, females or males?
Females 9 to 1
102
Lupus nephritis as a result of SLE means what?
Immune complex deposition in glomeruli
103
Five patterns of lupus nephritis?
```
- Minimal mesangial (Class I)
– Mesangial proliferative (Class II)
– Focal proliferative (Class III)
– Diffuse proliferative (Class IV)
– Membranous (Class V)
```
104
Classes I and II of lupus nephritis see an increase in what?
Mesangial matrix and cells due to proliferation and complex deposition
105
Class III of lupus nephritis have glomeruli that show what?
1. crescent formation
2. fibrinoid necrosis
3. Proliferation of endothelial and mesangial cells
106
Which is most severe class of lupus nephritis?
Class IV
107
```
In class IV lupus nephritis how many glomeruli are involved?
Is this class symptomatic?
```
over 50%
Yes: HTN and renal insufficiency
108
Class V lupus nephritis sees what?
Diffuse thickening of capillary wall causing very severe proteinuria or nephrotic syndrome
109
Deposits in SLE can be identified with what?
Immunofluorescence
110
Membranous lupus nephritis deposits where?
Subepithelial
111
Focal and diffuse proliferative deposit where?
Subendothelial
112
What lesion results from class III and IV?
Wire loop
113
Main characteristic of SLE on skin?
| What makes it worse?
Facial butterfly
Sunlight
114
What happens to heart in SLE?
Valvular endocarditis (Libman sacks)
115
What is seen in nearly every case of SLE?
Hematologic derangement: Anemia or thrombocytopenia
116
Chronic discoid lupus drythematosus is similar to SLE how?
Skin manifestations are the same
117
In Chronic DLE, what is the main sign?
Skin plaques surrounded by an elevated erythematous border of face and scalp
118
Subacute cutaneous lupus erythematosus is similar to SLE how?
Mild systemic symptoms similar
119
What is the mutation in subacute cutaneous lupus erythematosus?
Antibodies to SS-A antigen and HLA-DR3 genoptype
120
Sjogren syndrome has what two main symptoms?
Dry eyes
| Dry mouth
121
What are the two forms of sjogren syndrome?
```
Primary = sicca syndrome
Secondary = sjogren + another autoimmune disease
```
122
What happens in Sjogren syndrome?
Lymphocytic infiltration and fibrosis of lacrimal and salivary glands with ANA's against SS-A and SS-B
123
What is Mikulicz syndrome?
Anything that can cause a lacrimal and salivary gland enlargement
124
What needs to be done to diagnose sjogren syndrome?
Biopsy of lip
125
Systemic sclerosis/Scleroderma means what?
Fibrosis throughout the body and mainly skin
126
Two cattegories of sclerosis?
Diffuse
| Limited
