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Pathology > Ch6 > Flashcards

Ch6 Flashcards

1
Q

NF-Kb TF does what when turned on?

A

Causes production of cytokines leading to destruction of microbe by phagocytosis

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2
Q

T cell receptor has what structure?

A

Alpha and beta chain with disulfide bonds

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3
Q

Each T cell receptor is linked to what? 2

A

CD3 complex

2 zeta chains

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4
Q

CD3 complex has what in it?

A

gamma
delta
epsilon

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5
Q

First signal to T cell?

A

Antigen/MHC presentation

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6
Q

Second signal to T cell?

A

CD28 and B7/CD80/CD86

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7
Q

Polyclonal T cell proliferation is described how?

A

Non-neoplastic

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8
Q

Monoclonal T cell proliferation is described how?

A

Neoplastic

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9
Q

CD means what?

A

Clusters of differentiation

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10
Q

CD3 and CD5 define what type of cells?

A

T cell

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11
Q

CD19 and CD20 define what cells?

A

B cell

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12
Q

T lymphocytes are what percentage of lymphocytes?

A

60-70

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13
Q

B lymphocytes are what percentage of circulating peripheral lymphocytes?

A

10 to 20

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14
Q

B cells form what when stimulated?

A

Plasma cells that secrete Ig’s

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15
Q

What 3 main receptors do B cells have?

A

Complement receptor
FC receptor
CD40

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16
Q

What is the complement receptor for Epstein-Barr?

A

Type 2 complement receptor (CR2, CD21)

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17
Q

What are the two signals to a B cell when interacting with external free antigen-complement?

A
  1. Igalpha and Igbeta coreceptor signaling

2. Complement binding to CR2/CD21

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18
Q

Two types of dendritic cells?

A

Interdigitating Dendritic cells

Follicular dendritic cells

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19
Q

Interdigitating dendritic cells have what important title?

A

Most important APC for initiating T cell response again protein antigens

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20
Q

Immature dendritic cells in epidermis are called what?

A

Langerhans cells

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21
Q

Nucleus of dendritic cell is described how?

A

Reniform

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22
Q

What receptors do follicular dendritic cells have?

A

Fc receptors for IgG and C3b

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23
Q

What do follicular dendritic cells do?

A

Present antigens to B cells

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24
Q

How are macrophages involved in CMI?

A

T cells activate them to let them kill microbes

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25
Q

How are macrophages involved in HI?

A

Phagocytose and destroy microbes that are opsonized by IgG or C3b

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26
Q

What makes NK cells different?

A

Can kill infected cells without prior exposure to a microbe or antigen

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27
Q

NK cells are positive for what CD’s?

A

CD16 and Cd59

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28
Q

CD16/FCgammaRIII is the receptor for what?

A

NK IgG receptor

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29
Q

What main cytokine do NK cells release?

A

IFN-gamma to activate macrophages

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30
Q

What stimulates proliferation of NK cells?

A

IL-2 and IL-15

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31
Q

What stimulates NK cells to kill and secrete IFN-gamma?

A

IL-12

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32
Q

More than half of the body’s lymphocytes are where?

A

Mucosal tissues

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33
Q

B cells are concentrated where in lymph node?

A

Follicle cortex of lymph nodes possibly with germinal center

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34
Q

T cells are where in lymph nodes?

A

Paracortex

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35
Q

Follicular dendritic cells are where in lymph node? 2

A

Follicles (present to B) and paracortex (present to T)

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36
Q

Where are T cells in the spleen?

A

PALS

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37
Q

Where are B cells in spleen?

A

Follicles

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38
Q

Where do plasma cells go to respond to an antigen?

A

Stay in lymph node

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39
Q

Where are the genes for HLA encoding?

A

Chromosome 6

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40
Q

what type of antigen do MHC-1 molecules present?

A

Intracellular, usually viruses

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41
Q

Class I MHC have what genes?

A

HLA-A, HLA-B, HLA-C

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42
Q

Class II MHC have what genes?

A

DP, DQ, DR

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43
Q

What removes the CLIP from MHC II?

A

HLA-DM

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44
Q

How is the expression of HLA described?

A

Codominant: one allele from mom, one from dad

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45
Q

Ankylosing spondylitis and postinfectious anthropathies are associated with people that have what antigen?

A

HLA-B27

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46
Q

Rheumatoid arthritis involves what HLA allele?

A

DR4

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47
Q

Type 1 diabetes involves what HLA allele? (3)

A

DR3
DR4
DR3/DR4 (the worst risk)

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48
Q

21-hydroxylase deficiency is involves with what antigen?

A

HLA-Bw47

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49
Q

Hereditary hemochromatosis is associated with what antigen?

A

HLA-A

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50
Q

What mainly makes the cytokines for innate immunity? (3)

A
  1. macrophage
  2. dendritic
  3. NK cells
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51
Q

What are the 6 cytokines of innate immunity?

A
  1. TNF-alpha
  2. IL-1
  3. IL-2
  4. Type 1 IFN’s (alpha and beta)
  5. IFN-gamma
  6. chemokines
52
Q

What are the cytokines of adaptive immunity?

A
  1. IL-2
  2. IL-4
  3. IL-5
  4. IL-17
  5. IFN gamma
53
Q

What makes most of the adaptive cytokines?

A

CD4+ lymphocytes

54
Q

Early response of CD4 t cells to antigen is what? (2)

A

Secrete IL2

Express receptor for IL-2

55
Q

What mediates functions of helper T’s?

A

CD40

Cytokines

56
Q

memory cells respond when?

A

When re-exposed to an antigen

57
Q

What is the main basis of HS disorders?

A

Imbalance in effector mechanisms of immune responses and control mechanisms that limit these responses

58
Q

What cells play a role in initiation and propagation of Type I hypersensitivity?

A

TH2 cells –> promote IgE production

59
Q

What triggers mast cells to activate? (2)

A
  1. Cross linking IgE Fc receptors

2. C5a and C3a

60
Q

What happens in immediate reaction of Type I?

A

Vasodilation, leaky vessels due to prostaglandin and leukotrienes

61
Q

Histamine has what effect? 3

A
  1. Vasoconstriction
  2. Leaky vessels
  3. increase mucus
62
Q

Leukotrienes C4 and D4 do what?

A

Vasoactive and spasmogenic

63
Q

Leukotriene B4 does what?

A

Chemotaxis for leukocytes

64
Q

Prostaglandin D2 does what? 2

A

Bronchospasm

Increased mucus secretion

65
Q

What cells cause late response of HS Type I?

A

Eosinophils

66
Q

What is it called if you are more likely to have Type I immediate eractions? (2)

A
  1. Higher serum IgE

2. More IL-4 producing Th2 cells

67
Q

Different Type II reactions? 4

A
  1. transfusion rxn
  2. Autoimmune hemolytic anemia
  3. agranulocytosis
  4. thrombocytopenia
68
Q

Type II is due to what pathways?

A

Complement

Fc-receptors

69
Q

Results of Type II HS?

A

Glomerulonephritis

Vascular rejection

70
Q

5 examples of Type II?

A 
Myasthenia gravis
Graves disease
acute rhematic fever
Goodpasture
Autoimmune hemolytic anemia
71
Q

Examples of Type III? 4

A

Systematic lupus erythematosus
Poststreptococcal glomeruonephritis
Serum sickness
Arthus reaction

72
Q

What is arthus reaction?

A

Localized tissue necrosis from acute immune complex vasculitis

73
Q

Type IV HS is mediated by who?

A

CD4 and CD8 t cells

74
Q

Examples of type IV?

A 
Type 1 diabetes
multiple sclerosis
rhematoid arthritis
crohn disease
contact dermatitis
75
Q

What is granulomatous formation?

A

DTH due to persistent antigens in which CD4 cells are replaced by macrophages that form giant cells

76
Q

CTL is important for what? 2

A
  1. Virus infections

2. tumor rejection

77
Q

What enzymes do cytotoxic T cells have?

What special killing receptor

A

Perforins and granzymes

Fas

78
Q

3 requirements for autoimmunity?

A
  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
Q

Autoimmune diseases encompass what HS diseases?

A

II, III, IV

80
Q

What is self-tolerance?

A

Lack of response to one’s own antigens

81
Q

What causes anergy in B cells?

T cells?

A

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
Q

Regulatory T cells have what protein?

Mutation in this causes what?

A

FoxP3

IPEX

83
Q

What regulatory T cell gene has polymorphisms in MS?

A

CD25

84
Q

What does PTPN-22 cause? 2

A

RA

Type 1 DM

85
Q

NOD-2 causes what?

A

Crohn

86
Q

IL-2 and IL-7 receptor alpha chain defect causes what?

A

MS

87
Q

What characterizes SLE?

A

Anti-nuclear Autoantibodies against all parts of body

88
Q

What is the lupus pneumonic?

A 
Malar Rash
Discoid Rash
Serositis
Oral Ulcers
Arthritis
Photosensitivity
Blood abnormalities
Renal
ANA antibodies
Immune abnormalities
Neurologic
89
Q

Antinuclear antibodies are directed against what? 4

A

DNA
Histones
Proteins on RNA
Nucleolar antigens

90
Q

Test for ANA’s?

A

Indirect immunofluorescence or EIA

91
Q

Homogeneous ANA’s find what?

A

Chromatin and histones

92
Q

Rim ANA’s find what?

A

dsDNA

93
Q

Speckled pattern ANA’s find what?

A

Histones and RNP’s

94
Q

Which is most common ANA pattern?

A

Speckled

95
Q

Nucleolar ANA pattern means what?

A

RNA

96
Q

antiphospholipid antibodies are found in what percentage of SLE patients?

A

40-50

97
Q

This anti-phospholipid of SLE is used in detecting what disease?

A

Syphilis

98
Q

What happens to people with anti-phospholipid SLE?

A

Recurrent spontaneous miscarriages

Focal cerebral or ocular ischemia

99
Q

What is the genetic link of SLE?

A

HLA-DQ

100
Q

When does SLE show up in patient?

A

20 or 30’s

101
Q

Who gets SLE more, females or males?

A

Females 9 to 1

102
Q

Lupus nephritis as a result of SLE means what?

A

Immune complex deposition in glomeruli

103
Q

Five patterns of lupus nephritis?

A 
-  Minimal mesangial (Class I)
– Mesangial proliferative (Class II)
– Focal proliferative (Class III)
– Diffuse proliferative (Class IV)
– Membranous (Class V)
104
Q

Classes I and II of lupus nephritis see an increase in what?

A

Mesangial matrix and cells due to proliferation and complex deposition

105
Q

Class III of lupus nephritis have glomeruli that show what?

A
  1. crescent formation
  2. fibrinoid necrosis
  3. Proliferation of endothelial and mesangial cells
106
Q

Which is most severe class of lupus nephritis?

A

Class IV

107
Q 
In class IV lupus nephritis how many glomeruli are involved?
Is this class symptomatic?
A

over 50%

Yes: HTN and renal insufficiency

108
Q

Class V lupus nephritis sees what?

A

Diffuse thickening of capillary wall causing very severe proteinuria or nephrotic syndrome

109
Q

Deposits in SLE can be identified with what?

A

Immunofluorescence

110
Q

Membranous lupus nephritis deposits where?

A

Subepithelial

111
Q

Focal and diffuse proliferative deposit where?

A

Subendothelial

112
Q

What lesion results from class III and IV?

A

Wire loop

113
Q

Main characteristic of SLE on skin?

What makes it worse?

A

Facial butterfly

Sunlight

114
Q

What happens to heart in SLE?

A

Valvular endocarditis (Libman sacks)

115
Q

What is seen in nearly every case of SLE?

A

Hematologic derangement: Anemia or thrombocytopenia

116
Q

Chronic discoid lupus drythematosus is similar to SLE how?

A

Skin manifestations are the same

117
Q

In Chronic DLE, what is the main sign?

A

Skin plaques surrounded by an elevated erythematous border of face and scalp

118
Q

Subacute cutaneous lupus erythematosus is similar to SLE how?

A

Mild systemic symptoms similar

119
Q

What is the mutation in subacute cutaneous lupus erythematosus?

A

Antibodies to SS-A antigen and HLA-DR3 genoptype

120
Q

Sjogren syndrome has what two main symptoms?

A

Dry eyes

Dry mouth

121
Q

What are the two forms of sjogren syndrome?

A 
Primary = sicca syndrome
Secondary = sjogren + another autoimmune disease
122
Q

What happens in Sjogren syndrome?

A

Lymphocytic infiltration and fibrosis of lacrimal and salivary glands with ANA’s against SS-A and SS-B

123
Q

What is Mikulicz syndrome?

A

Anything that can cause a lacrimal and salivary gland enlargement

124
Q

What needs to be done to diagnose sjogren syndrome?

A

Biopsy of lip

125
Q

Systemic sclerosis/Scleroderma means what?

A

Fibrosis throughout the body and mainly skin

126
Q

Two cattegories of sclerosis?

A

Diffuse

Limited

Pathology (36 decks)

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