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Boards Review > FA 2014: Immunology > Flashcards

FA 2014: Immunology Flashcards

1
Q

The growth of germinal centers from B cells depends on 3 elements: name them.

A

T cell, antigen, and CD40L

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2
Q

Dense and dormant follicles

A

Primary follicles

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3
Q

Pale central germinal centers, active follicles

A

Secondary follicles

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4
Q

No B cell follicles

A

Agammaglobulinemia

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5
Q

Plasma cells and lymphocytes, tightly packed in LN

A

Medullary cords

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6
Q

The medullary cords in the LN correspond to the ___ in the spleen

A

Red pulp

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7
Q

The diffuse cortex in the LN corresponds to the ____ in the spleen

A

PALS

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8
Q

Postcapillary (high-endothelial) venules

A

Where B/T cells enter paracortex from the blood

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9
Q

No paracortex or poorly developed

A

DiGeorge Syndrome

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10
Q

R. lymphatic duct drains ___

A

R side of body above diaphragm

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11
Q

Popliteal LN drain ___

A

Dorsolateral foot, posterior calf

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12
Q

Superficial inguinal LN drain ___

A

Anal canal below pectinate line, skin below umbilicus (except popliteal territory)

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13
Q

Para-aortic LN drain __

A

Kidneys, ovaries, testes, uterus

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14
Q

Internal iliac LN drain ___

A

Lower rectum to anal canal above pectinate line, bladder, vagina, prostate

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15
Q

Sinusoids of spleen: describe histo

A

Long vascular channels with fenestrated “barrel loop” BM and nearby macrophages (red pulp)

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16
Q

Spleen is protected by ribs ____

A

9-12 posterolaterally

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17
Q

White pulp in spleen contains ___

A

T cells (PALS) and B cells (follicles)

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18
Q

Marginal zone

A

Crossover between white/red pulp, contains APCs and specialized B cells

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19
Q

How does splenic dysfunction lead to susceptibility to encapsulated organisms?

A

IgM down –> complement activation reduced –> reduced C3b opsonization –> increased susceptibility to SHiNE SKiS organisms

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20
Q

SHiNE SKiS

A

Encapsulated organisms: s. pneumo, h.flu, n. meningitidis, e. coli, salmonella spp., klebsiella, group B strep

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21
Q

Post-splenectomy findings

A

Howell-Jowell bodies (nuclear remnants), target cells, thrombocytosis

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22
Q

How does thalassemia impair the spleen?

A

Red pulp SHOVES white pulp THE FUCK OUT OF THE WAY

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23
Q

Spleen produces ____ of the body’s Ig

A

50%

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24
Q

Thymus cortex is ___ and contains immature T cells

A

Dark

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25
Q

Thymus medulla is ___ and contains mature T cells as well as Hassall corpuscles, epithelial reticular cells

A

Pale

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26
Q

Haploidentical means. . .

A

50% of MHC correspond (parents are always haploidentical to kids)

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27
Q

Siblings have ___ chance of being haploidentical and ___ chance of being complete matches

A

75%;25%

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28
Q

Responsible for viruses and intracellular bacteria antigen processing

A

MHC I (9-11aa peptides, CD8 cells)

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29
Q

Responsible for extracellular pathogens and protein vaccines

A

MHCII (12-16aa peptides, CD4 cells)

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30
Q

TLRs

A

1/6 - lipopeptides, 2 - peptidoglycan, 3 - dsRNA, 4 - LPS, 5 - flagellin, 7/8 - ssRNA, 9 - CpG DNA

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31
Q

TLR signaling pathway

A

NFkB

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32
Q

HLA A3

A

Hemochromatosis

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33
Q

HLA B27

A

PAIR - psoriatic arthritic, ankylosing spondylitis, IBD arthritis, reactive arthritis (“seronegative arthropathies”)

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34
Q

HLA DQ2/DQ8

A

Celiac disease

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35
Q

HLA DR2

A

MS, hay fever, SLE, Goodpasture’s

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36
Q

DR3

A

T1D, SLE, Graves disease

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37
Q

DR4

A

RA, T1D

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38
Q

DR5

A

Hashimoto thyroiditis, pernicious anemia

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39
Q

HLA BW22

A

Kawasaki disease

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40
Q

NK cell markers

A

CD16+CD56+

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41
Q

What drives NK cells?

A

il-2, il-12, ifn-beta/alpha

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42
Q

How do NK cells kill?

A
  1. Perforin/granzymes in absence of MHC I

2. ADCC (CD16 binds Fc region of bound Ig)

43
Q

GATA3/IL-4

A

TH2

44
Q

T-bet/IL-12

A

TH1

45
Q

T cell development

A

proT –> beta chain rearrangement (VDJ) –> pre-T cell –> alpha chain arrangement (VJ) –> DP cell –> positive selection –> SP cell –> negative selection –> you pass!

46
Q

Medullary epithelial cells express ___ to demonstrate self-antigens

A

AIRE

47
Q

RORgT/TGF-beta+IL-10

A

Th17

48
Q

TGFb / FOXP3

A

Treg cell

49
Q

T cell producing IFN-gamma, IL-2, lymphotoxin

A

TH1

50
Q

T cell producing IL-4, IL-5, IL-6, IL-10, IL-13

A

TH2

51
Q

T cell producing IL-17

A

TH17

52
Q

T cell producing TGF-beta, IL-10

A

Treg

53
Q

FOREIGN signal

A

MHCII:THC

54
Q

DANGER signal

A

B7:CD28, CD40:CD40L (for B cells)

55
Q

Allelic exclusion

A

B cell only expresses 1 BCR

56
Q

Isotype switching

A

Post CD40:CD40L interaction: class switching, affinity maturation/somatic hypermutation, antibody production

57
Q

What inhibits Th1 cells?

A

IL-4, IL-10

58
Q

What inhibits Th2 cells?

A

IFN-gamma

59
Q

What releases IL-12 for Th1 differentiation?

A

Macrophages

60
Q

Tc cells kill by 3 mechanisms:

A
  1. Perforin (entry into cell)
  2. Granzyme (serine protease activating apoptosis)
  3. Granulysin (antimicrobial, induces apoptosis)
61
Q

Treg cell markers

A

CD3, CD4, CD25 (a chain of IL-2R)

62
Q

Complement binding region of ab

A

CH2 (near hinge)

63
Q

Idiotype of antibody determined by ___

A

Fab

64
Q

Fc: 5 associations (think C)

A

Constant, carboxy terminal, complement binding, carbohydrate side chains, determines isotype (E, D, A etc.)

65
Q

BCR structure

A

Membrane Ig and Ig-alpha/beta

66
Q

TCR structure

A

Alpha chain, beta chain, and CD3 associated

67
Q

Most abundant isotype in serum

A

IgG

68
Q

Main antibody in secondary response

A

IgG

69
Q

Allotype

A

Inherited differences in constant region (i.e. IgG1)

70
Q

Functions of IgG

A
  1. Fixes complement; 2. crosses placenta (passive immunity); 3. opsonization; 4. neutralizes toxins/viruses
71
Q

Most produced isotype

A

IgA

72
Q

Most abundant isotype in secretions

A

IgA

73
Q

Function of IgA

A

Neutralizes/prevents binding by bacteria, viruses

74
Q

Secretory component of IgA

A

Tacked on by epithelial cells during transcytosis –> prevents proteolysis

75
Q

Main isotype in colostrum

A

IgA

76
Q

IgA is found in ____ form and IgM is found in ___ form

A

Monomeric (serum)/dimeric (mucus) ; pentameric

77
Q

Main isotype in primary response

A

IgM

78
Q

Best isotype at fixing complement

A

IgM

79
Q

Binds mast cells and basophils and cross-links receptors when exposed to allergen

A

IgE

80
Q

Mediates immunity to worms by activating eos

A

IgE

81
Q

Lowest concentration in serum

A

IgE

82
Q

Acute-phase reactants

A

Serum amyloid A, CRP, ferritin, fibrinogen, hepcidin, albumin, transferrin

83
Q

CRP function

A

Opsonin, fixes complement and facilitates phagocytosis

84
Q

Ferritin function

A

Binds up iron in cell its hidey-hole (ALL MINE BITCHES); corresponds to amt of total iron in body

85
Q

Fibrinogen function

A

Coagulation factor; promotes endothelial repair; correlates with ESR

86
Q

Hepcidin function

A

Prevents iron release from ferritin –> ACD

87
Q

Downregulated in acute phase response

A

Albumin (reduction conserves amino acids for + reactants), transferrin (internalized by macrophages to conserve iron)

88
Q

Classical complement isotypes

A

GM makes classic cars

89
Q

C1 esterase inhibitor deficiency

A

Hereditary angioedema (painless swelling, abdominal pain, laryngospasm)

90
Q

C3 deficiency

A

Severe, recurrent pyogenic sinus/RT infections; increased susceptibility to T3 HS

91
Q

PNH sx

A

Red urine, thrombosis, pancytopenia, hemolytic anemia (intravasc)

92
Q

Chemotactic factors

A

N-formyl met, LTB4, C5a/C3a, LTA, IL-8, TGFbeta

93
Q

IL 1-6 functions

A

HOT T-bone stEAK: 1 = fever, 2= stimulates T cells, 3= stim bone marrow, 4= stim IgE, 5 = stim IgA, 6 = stim. aKute phase protein production

94
Q

Anti-U1 RNP

A

Mixed CT disorder

95
Q

pANCA alternative name

A

MPO-ANCA

96
Q

cANCA alternative name

A

PR3-ANCA

97
Q

anti-glutamate decarboxylase (GAD

A

T1D

98
Q

Antimicrosomal

A

Hashimoto thyroiditis

99
Q

Antimitochrondial

A

Primary biliary cirrhosis

100
Q

Anti-smooth muscle

A

Autoimmune hepatitis

101
Q

Drug-induced lupus associations

A

Hydralazine, INH, procainamide, quinidine, minocycline in slow acetylators

102
Q

What secretes IL-1

A

Macrophages, B cells, monocytes, osteoblasts

103
Q

What does IL-1 do? (6)

A

Fever, endothelial activation, acute inflammation, chemokine secretion, stim T/B cells, activates osteoclasts

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