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HDM Midterm > CIS: Immunizations And Complement > Flashcards

CIS: Immunizations And Complement Flashcards

1
Q

An immunization (vaccination) mimics a natural infection. A normal immune response is invoked to destroy and clear the components of the vaccine.

The primary immune response that results in immunological memory is called __________.

Each subsequent immunization results in increased __________ and __________ of response.

______________ is when repetitive challenge with antigen achieves a heightened state of immunity.

A

Priming

Intensity; magnitude

Hyperimmunization

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2
Q

_________ immunity is acquired when a critical number of individuals in a population are vaccinated which results in the reduction in the transmission of disease which effectively protects unimmunized individuals

A

Herd

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3
Q

Why can’t all individuals in a population be vaccinated?

A

Certain individuals within a population will be immunocompromised or immunosuppressed

Vaccination would be potentially harmful or ineffective in this portion of the population

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4
Q

__________ immunization gives immediate but transient immunity, and uses preformed antibodies

A

Passive

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5
Q

What type of immunization might be used to prevent disease after a known exposure or ameliorate symptoms of an ongoing disease?

A

Passive

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6
Q

What kind of immunization protects immunosuppressd patients and blocks the action of bacterial toxins and prevent diseases they cause?

A

Passive

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7
Q

What are some examples of passive immunization?

A

Snake bite antivenom

Passive transfer of Ig from mother to child

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8
Q

_________ immunizations provide delayed immunity but more permanent, and produce immunological memory

A

Active

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9
Q

What are some examples of active immunization?

A

Natural exposure to pathogens

Vaccines

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10
Q

What type of immunization was designed to give both immediate, transient protection as well as slowly developing durable protection?

A

Combined passive-active immunization

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11
Q

What are some examples of combined passive-active immunization?

A

Tetanus

Rabies

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12
Q

Considerations to make in the development of an immunization schedule include:

Timing of likely __________

Immunological _________ of the child

Passively transferred Abs may interfere with the immune response to a vaccine

Interference

A

Exposure

Maturity

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13
Q

After birth, the mother is no longer capable of supplying the baby with _____, so the remaining maternally derived ____ is broken down.

Eventually, the infant will begin to produce its own antibody.

_______ is produced around birth, _____ and _____ lag 6-12 months, leaving a vulnerable period when a baby is not immunocompetent.

A

IgG; IgG

IgM; IgG, IgA

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14
Q

What are the 2 types of live vaccines?

A

Live viruses from a different species

Live, attenuated viruses

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15
Q

What are the 4 types of inactivated vaccines?

A

Killed
Subunit/component
Toxoid
Conjugate

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16
Q

What are the 2 types of experimental vaccines?

A

DNA

Recombinant vector

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17
Q

What are some potential problems with vaccines?

A

Clinically important epitopes may not be intact in vaccine

Individual genetics may effect efficacy

Some individuals may be genetically predisposed to adverse events

Often work poorly in very young infants or the elderly

Many do not induce CMI; Ab may not be sufficient

Allergies to vaccine components

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18
Q

___________ are used to heighten the effectiveness of a vaccination

A

Adjuvants

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19
Q

Adjuvants are normally composed of __________ components or other substances suspended in a medium such as ______

A

Bacterial

Oil

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20
Q

What is the benefit to using oil as an adjuvant

A

Prolongs dispersal in tissues

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21
Q

Adjuvants invoke a mild inflammation that attracts ___________ and accelerates _____ activation and antigen presentation to T cells

A

Phagocytes; APC

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22
Q

_________ vaccines utilize capsular polysaccharides from pathogenic bacteria that elicit TI responses

They do this via linkage of a polysaccharide to either an antigen or ______, forming an _______________

This stimulates a _____ T cell response

A

Conjugate

Toxoid; immunogen

CD4+

[TI responses are weak in children under the age of 18 months and in the elderly]

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23
Q

___________ ___________ refers to the unresponsiveness of adaptive immune system to antigens as a result of inactivation or death of antigen-specific lymphocytes, induced by exposure to the antigens

A

Immunological tolerance

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24
Q

_________ is a collection of circulating and cell membrane proteins that play important roles in host defense

It does this through a coordinated, sequential, proteolytic cleavage of C’ proteins aka _______

A

Complement

Zymogens

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25
Q

C’ functions to:

Trigger and amplify __________ reactions.

Attraction of ___________ by chemotaxis.

Clearance of immune __________.

Cellular activation and direct microbial _______

Development of _________ responses

A 
Inflammation
Phagocytes
Complexes
Killing
Humoral
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26
Q

When a convertase cleaves a complement component, which fragment is larger?

A

Larger fragment is “b”

Smaller fragment is “a”

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27
Q

Which fragment of the complement system is the active component?

A

“b” fragment which binds to the target near the site of activation

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28
Q

Which complement fragment is the anaphylatoxin?

A

The “a” fragment, which diffuses from the site and plays a role in localized inflammatory response

29
Q

How is the classical complement pathway activated?

A

IgM (or IgG) binds Ag (functions in adaptive immunity)

30
Q

Which complement pathway is always on guard due to constant trickle of an activated component?

A

Alternative

31
Q

Which complement pathway is activated by binding of a serum mannose binding protein to bacteria initiating the cascade?

A

Lectin

32
Q

What are the serine proteases associated with each complement pathway?

A

Classical: C1r and C1s

Lectin: MASPs

Alternative: Bb

33
Q

What is the enzymatically active complex that begins the complement cascade in the classical pathway?

A

C1qrs

34
Q

Which complement component is responsible for the distinction between self and nonself?

A

C3

35
Q

What is the main amplification step of the complement cascade?

A

Cleavage of C3

36
Q

Which complement component forms the pore of the MAC?

A

C9

37
Q

What component of complement acts as an antibody independent surveillance system by identifying and binding to non-self membranes?

A

Alternative pathway

38
Q

Self membranes have ______ levels of sialic acid, which rapidly ____________ bound C3b molecules on host cells

A

High; inactivates

39
Q

Non-self membranes have _____ levels of sialic acid, so bound C3b will remain active longer

A

Low

40
Q

MBL is a member of the _________ family

A

Collectin

41
Q

______ deficiencies lead to life-threatening problems associated with severe, recurrent infections that begin soon after birth due to the central role that ____ plays in opsonin.

A

C3; C3b

42
Q

Deficiencies in ________ and ________ mimic C3 deficiencies as unregulated C3b generation completely exhausts C3 from the serum

A

Factor H; Factor I

43
Q

Those with _______ deficiencies are generally healthy other than an increase in infection by Neisseria gonorrhoeae and meningitidis.

A

MAC

44
Q

What is the most commonly identified form of complement deficiency?

A

C2 deficiency

45
Q

A _______ deficiency results in a high degree of systemic lupus erythematosus and may arise from failure to efficiently clear circulating immune complexes (which deposit in blood vessel walls and tissues, activating the alternative complement cascade)

A

C2

[may lead to autoimmunity]

46
Q

What are the primary mechanisms of regulation of the complement system?

A

Regulation occurs primarily during activation, amplification, and membrane attack.

The two main functions are binding with dissociation and proteolytic digestion

47
Q

What is the first level of control of convertases?

A

Decay acceleration

48
Q

Generation of _____ is a major amplification step in the complement cascade; rapid hydrolysis limits deposition on nearby cells, limiting formation of the _____ convertase

The same mechanism is used by C4b to regulate formation of the _____ convertase; the majority of C4b formed reacts with water and is inactivated

A

C3b; C5

C3

49
Q

What is the effect of C1 inhibitors on complement regulation?

A

Binds C1r and C1s and dissociates them from C1q

Removes MASP enzymes from MBL complex

[Control of classical and lectin events]

50
Q

What type of complement deficiency results in hereditary angioneurotic edema?

A

C1inh deficiency

51
Q

With C1inh deficiency, C1 is not regulated properly, leading to chronically low levels of ____ and ____

A

C4; C2

52
Q

Treatment with _________ has caused some patients to produce near normal levels of C1inh

A

Androgens

53
Q

_________ is also known as a C3b inactivator due to its ability to cleave C4b or C3b; requires presence of a cofactor and prevents formation of convertases

A

Factor I

54
Q

______ promotes dissociation of the C3 convertase, affecting the classical and alternative pathways

A

DAF (decay-accelerating factor)

55
Q

What is the acquired hemolytic disorder with spontaneous episodes of RBC lysis, and patient presentation includes morning hematuria?

A

Paroxysmal nocturnal hemoglobinuria

56
Q

What is the treatment for paroxysmal nocturnal hemoglobinuria?

A

Erythropoietin

57
Q

_________ regulates the MAC by blocking C9 binding to C5bC678 complex on the cell surface

A

CD59

58
Q

____________ regulates the MAC by binding to the fluid phase form of C5b67, preventing its ability to bind membranes but does not prevent association with C8 and 9 proteins

A

Vitronectin (S protein)

[since it is not in the membrane the MAC has no effect, although it still fully forms]

59
Q

______ is the major opsonin in the complement system

A

C3b; C4b can also function as an opsonin

60
Q

Opsonins such as C4b and C3b bind complement receptors on phagocytic cells like —-?

A

CR1, CR2, CR3, etc.

61
Q

How does C5a act to increase inflammatory response?

A

As an anaphylatoxin, it increases the numbers of complement receptors on the cell surface and greatly facilitates their phagocytosis of C3b-coated antigen

62
Q

How are immune complexes with bound C3b removed from tissues and circulation?

A

Monocytes and other phagocytes
Erythrocytes

Usually transported to spleen and liver

63
Q

Immune complexes normally bind complement and are removed by the liver and spleen after binding CR1 on RBCs. What pathologic condition is characterized by an issue in this process, leading to increases in blood pressure, vascular turbulence, and complex deposition?

A

Type III Hypersensitivity

64
Q

How many MACs are required to lyse an RBC?

A

One

65
Q

What type of cells are most resistant to complement mediated lysis?

A

Nucleated cells

66
Q

What are the primary functions of anaphylatoxins?

A

Bind receptors on mast cells and blood basophils –> induce degranulation with release of histamine and othe active mediators

Induce smooth muscle contraction

Induce monocytes and neutrophils to adhere to vascular endothelial cells

67
Q

Which complement fragment is cleaved by plasmin to yield kinin, which results in edema?

A

C2b: Prokinin

68
Q

Normal complement components can enhance infectivity of what viruses?

A

EBV - uses CR2 as a receptor for attachment

Measles uses MCP as a receptor

West Nile gains entry via CR3 receptor

HDM Midterm (10 decks)

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