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Pathology > Exam 1 The Immune System > Flashcards

Exam 1 The Immune System Flashcards

1
Q

What is included in the innate immune system?

A

1) Epithelial barriers of the skin, gastrointestinal and respiratory tracts
2) Phagocytic cells (neutrophils and macrophages
3) NK cells
4) Acute phase proteins (complement, c-reactive protein)

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2
Q

What is included in adaptive immunity?

A

1) Humoral: B cells, plasma cell, antibodies
- important for fighting agents in the blood, mucosal secretions, and tissues
2) Cell-mediated: work by directly killing infected cells and activating phagocytes to kill the offending agent
- important in reacting to intracellular agents–>tumors, parasites

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3
Q

What are the two hallmarks of the adaptive i/s?

A
  • specificity

- memory

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4
Q

Do macrophages recognize bacteria yeast and fungi as different?

A

No–just knows its not self

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5
Q

What are specific killers?

A

Its and T cells

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6
Q

What is the culmination of innate and adaptive immune system?

A

inflammation

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7
Q

How many antigens does a T cell receptor see?

A

one–each t cell receptor on an individual cell has the same specificity

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8
Q

What cell has CD4+?

A

Helper t cells

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9
Q

What cell has CD8+?

A

Cytotoxic t cells

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10
Q

What is the ultimate boss of the immune system?

A

Helper t cells

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11
Q

What T helper cell:

  • Releases: IL-2, IFN-y
  • Causes cell mediated responses: neutrophils, macrophages, and some CD8+ t cells to kill things
A

TH1

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12
Q

What binds MHC class II?

A

CD4+

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13
Q

What binds MHC Class I?

A

CD8+

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14
Q

What is the job of CD8+ cells?

A

their job is to kill things in association with MHC class I

  • intracellular parasites
  • viruses
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15
Q

What is CD3+ used for?

A

part of TCR complex important in cell signaling

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16
Q

Do B cells secrete antibodies?

A

no-PLASMA cells

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17
Q

What is the surface ig? (sIg)

A
  • it is on B cells and is a receptor for antigen

- when a B cell gets help from a CD4+ t cell it becomes a plasma cell

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18
Q

What secretes antibodies and then dies?

A

Plasma cells

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19
Q

How many subclasses does IgG have?

A

4

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20
Q

How many subclasses does IgA have?

A

2

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21
Q

What are the major isotypes of Igs?

A

IgG, IgM, IgA, IgD, IgE

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22
Q

What cell has these functions:

1) Process and present antigen as they have MHC class II
- internalize foreign materials, breaks them into pieces, and then puts them on the cell surface in association with MHC class II
2) Release cytokines like IL-12, which is important for activating neutrophils and other macrophages
3) immune surveillance of bacteria and tumors is a major function of this cell

A

Macrophages

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23
Q

What is the job of dendritic cells (nodes) and langerhans (skin) cells?

A

1) Their job is to present antigen through both MHC Class I and MHC class II
- class I and class II are found at high levels on the cell surfaces of this unique cell type
- poorly phagocytic, but they pinocytose everything in their surroundings

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24
Q

What is the job of dendritic cells (nodes) and langerhans (skin) cells?

A

1) Their job is to present antigen through both MHC Class I and MHC class II
- class I and class II are found at high levels on the cell surfaces of this unique cell type
- poorly phagocytic, but they pinocytose everything in their surroundings
- professional APCs

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25
Q

Explain NK cells

A 
Definition and morphology: 
-large granular lymphocytes (LGLS)
-granules contains enzymes
Function: lyse (break open)-
1) tumor cells
2) virally infected cells
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26
Q

Most cytokines are?

A

paracine-on adjacent cell

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27
Q

few cytokines are?

A

endocrine-at a distant site from the cell that produced the cytokine
-IL-1

28
Q

what are pleiotropic?

A

Interleukins affect MANY cell types,

EX: IL-1 stimulates fever but also activates T cells and macrophages

29
Q

what are redundant?

A

different interleukins have the same effects

  • EX: IL-4 causes the production of IgE, but so does IL-13
  • gives us a back up plan
30
Q

Where do out MHC genes come from?

A

mom and dad

  • why you can’t mix them during transplant
  • make same proteins
31
Q

Genes of the MHC complex or HLA that start D

A 
MHC CLASS II
everything else is class I
32
Q

What is the function of MHC?

A
  • polymorphism: many types of the same molecules

- to present antigen in the form of peptides to TCRs on t cells

33
Q

Does MHC present self or non self?

A

BOTH DUH

-MHC don’t give a shit. Just presents whatever it has inside and show it to TCR to see if they care

34
Q

How are the MHC molecules expressed from parents?

A

Co-dominantly

  • expressed equally, and you get one from both parents
  • this means that you have two of every MHC molecules, but 100s of them on the cell surface
35
Q

Explain Haplotype

A
  • linked MHC genes
  • this is what makes you from the immunological standpoint
  • used for determining: transplantation, DNA typing, etc
36
Q

What is distributed on all nucleated cells of the body?

A 
MHC class I
MHC Class 1 = single polypeptide change
37
Q

Where is MHC Class II molecules distributed?

MHC Class II = 2 poly peptide chain

A

-APCS; macrophages, dendritic cells, Langerhans cells and B cells

38
Q 
Type of hypersensitivity:
-Anaphylactic or immediate 
-sequence of events: 
A) Sensitization by allergen
1) No i/r
2) Activation of Th2 cells (Ig production)
3) Secretion of IL-4 and IL-13
4) Plasma cell secrete IgE
5) Arms Mast cells

B) Pre-sensitized Mast cells
1) cross-linking of sIg- causes Ca influx, signals degranulation and release of many different mediators of inflammation

C) Other factors: heparin affects complement activation

A

Type 1

39
Q

Hypersensitivity means?

A

it attacks you

40
Q

What are clinical manifestations of Type I?

A

A) Intake of protein antigens or drugs into: skin, food allergens and pollens
B) within minutes urticaria, itching, erythema (hives)
C) can lead to anaphylaxis, shock and even death

41
Q

What type of hypersensitivity activated Th2 and secretes IL-4 and IL-13

A

Type 1

42
Q

What type of hypersensitivity is antibody dependent?

  • IgM or IgG antibodies are directed at the cell or tissue that is directly responsible for tissue damage or altered function:
    1) opsonization and and phagocytosis
    2) complement-mediated and Fc receptor mediated inflammation
  • -transfusion reactions
  • -Rh incompatibility
  • -autoantibodies
    3) Antibody mediated cellular dysfunction
  • -can create Ig to your own receptors like Graves disease
A

Type II

43
Q

What hypersensitivity type is the Ig specific for the cell type?

A

Type II

44
Q

What is the same between Type II and type III?

A

Complement, Ig, and neutrophils

-only difference is how its initiated

45
Q

What type of Hypersensitivity is immune complex mediated?
1) Systemic immune complex
-Formation in the circulation; overload of the phagocytic system so the complexes continue to circulate
-Deposition of immune complexes-increase in vascular permeability due to cytokine release
Favored sites: kidneys, joints, skin, heart and small vessels (BUT NOT SPECIFIC FOR THESE CELLS)
-Inflammatory response initiated
–Fever, urticaria, artsralgias, lymph node enlargement, proteinuria
–C3a and C5a are complement components that recruit neutrophils and macrophages into the site

A

Type 3

46
Q

What type of hypersensitivy that is cell mediated?

1) T cell mediated
- CD4+ t cells, predominantly Th1 cells
2) Cellular cytotoxicity
- in some cases CD8+ t cells are recruited to kill things but primarily CD4+ t cells activated the response
3) Granulomas–walling off
- -persistent antigens, TB, parasites, fungi (fungi are almost always this type)
- -macrophage wall of the organism and turn into fibroblasts to for the granuloma (granulomas are almost always this type)

A

Type 4

47
Q

Type of Transplant rejection:

1) Hyper acute rejection occurs within a few hours
- performed anti-donor antibodies
- -sources are transfusions and multiple pregnant individuals
2) Concurrent with T cell mediated damage

A

Antibody-mediated rejection

48
Q

Type of Transplant rejection:
10-14 days
-Pre-sensitized CD4+ T cells direct CD8+ t cells, neutrophils and macrophages to attack and kill

A

T cell mediated rejection (acute)

49
Q

Type of Transplant rejection:

1) occurs first months after transplantation
2) histologically there is extensive (non presensitized) CD4+ and CD8+ infiltration with mild edema and mild interstitial hemorrhage

A

Acute cellular rejection

50
Q

Type of Transplant rejection:

1) rejection vasculitis
2) caused by antibodies and t cells of vasculature
3) histologic lesions may take the form of necrotizing vasculitis with endothelial cell necrosis, neutrophil infiltration, deposition of antibody, complement, fibrin and thrombosis

A

Acute vascular rejection

51
Q

Type of Transplant rejection:

1) presents clinically late after transplantation (months to years)
2) the vascular lesions are caused by cytokines released by activated t cells that act on the cells of the vascular wall
3) does not respond to standard immunosuppression regimens

A

Chronic rejection

52
Q

What are some methods of increasing graft survival?

A

1) matching at MHC class II–>because these are the T helper cells that tell everyone what to do
2) immunosuppression is used to manage rejection, but can result in tumors
- -drugs–cyclosporin A and FK506 target CD4+ T cells (turning off CD4+ t cells)
- -antibodies like anti-CD3 do not allow the T cell to trigger a response

53
Q

What are some complications associated with the transplantation of other solid organs (i.e. kidneys, livers, heart, lung, pancreas)
Should matching be done?

A

1) Host versus Graft disease (HVGD)
- -host must be immune competent
- -graft must be immune incompetent
2) there is not usually time

54
Q

What are some complications associated with the transplantation of allogeneic hematopoietic cells? (i.e. aplastic anemia, leukemia)
Should matching be done?

A

1) Graft versus Host disease (GVHD)
- -host must be immune incompetent
- graft must be immune competent–because the graft could kill the host and attack every cell in the body
2) absolutely

55
Q

What is the purpose of self tolerance–clonal deletion?

A

kill off all the T cells that recognize self

-central tolerance

56
Q

What is the purpose of clonal anergy?

A

Peripheral tolerance

  • T cells need a 2nd signal to be activated
  • B7 on the APC needs to bind to CD28 on the T cell
  • if no second signal then the T cell dies by apoptosis
57
Q

What are the mechanisms of autoimmune disease?

A

1) loss of self tolerance
- inheritance of susceptibility genes
- environmental triggers (inflammation or inflammatory stimuli (bacteria))
- activation of self-reactive lymphocytes
- tissue injury
* autoimmune diseases basically occurs because break self tolerance and attack self

58
Q

What type of hypersensitivity is malar skin rash?

  • DNA Igs get deposited at face (Ig doesn’t bind to cell to kill cell)
  • symmetrical, raised, red rash on cheeks and nose called a butterfly rash
  • related to sun exposure
A

Type 3

59
Q

What type of hypersensitivity is SLE?

  • kidney involvement is very important and most common cause of death in SLE patients
    1) Mesangial Lupus Nephritis
  • -immune complexes deposit in the mesangium
A

Type 3

60
Q

What type of hypersensitivity is RA
-a systemic chronic inflammatory disease, primarily affecting the joints
-1 of every 100 people affected, usually in the 4th and 5th decade of life
Clinical manifestations: symmetric, polyarticular (many joints) arthritis
-thought to be initiated by CD4+ t cells (activate macrophages and b cells)

A

Type 3

61
Q

What syndrome occurs in women between the ages of 35 and 45 years of age
-presents with dry mouth, lack of tears, complications associated with a lack of lubrication in these areas

A

Sjogren’s syndrome

62
Q

What uses CREST as a diagnosis

-can involve multiple organs, but primarily skin

A

Systemic sclerosis

63
Q

What is the type of hypersensitivity where Plasma cells start producing Igs against your thyroid cell and thus block your TSH receptors? Basically Igs attacking our own cells

A

Type 2

Graves disease

64
Q

What is the type of hypersensitivity where you have antibodies blocking your Ach receptors so you have muscle weakness?

A

Type 2

Myasthenia gravis

65
Q

What type of hypersensitivity occurs when our Ig binds with an antigen and lodges somewhere? Where ever it lands it will stick and and then stimulate complement

  • this causes neutrophils to combine and MAC
  • localized destruction where ever this complex lands
A

Type 3

66
Q

What type of hypersensitivity occurs when there are no Igs and it is cell mediated?
-You have your tissue antigen then the helper T cells respond and kill that cell or activate macrophages to kill cell

A

Type 4
also know as delayed type
(1-3 days later)

67
Q

What is an Amyloid?

A

disorder of tissue folding

  • not a structurally homogenous protein
  • deposit in tissues
  • associated with alzheimers

Pathology (4 decks)

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