First Aid Immunology Flashcards
1
Q
Which area of the lymph node englarges in an extreme immune response
A
paracortex
2
Q
Which areas of the body are drained by the axillary lymph node
A
upper limb and breast
3
Q
which areas of the body are drained by the celiac lymph node?
A
stomach
4
Q
Which lymph node drains the anal canal below
A
superficial inguinal pectinate line
5
Q
thwat does the Right lymphatic duct drain?
A
right arm and right half of head
6
Q
what does the thoracic duct drain?
A
everything else, not right arm and right half of head
7
Q
What happens in the follicle of the lymph node
A
b cell localization and proliferation
8
Q
which follicles (primary or secondary) have active germinal centers?
A
secondary
9
Q
What kind of bacteria do macrophages remove from the spleen?
A
encapsulated, S SHiN (salmonella, S.pneumo, H. influ, N. menin
10
Q
What are the three things you find post splenectomy
A
Howell-Jolly bodies, Target cells, thrombocytosis
11
Q
What embryologic tissue are lymphcytes derived from
A
mesenchyme
12
Q
What do you find in the medulla of the thymus?
A
mature t cells, epithelial reticular cells, Hassalls corpuscles
13
Q
Where do positive and negative selection occur in the thymus?
A
corticomedullary junction
14
Q
Which kind of immunity is germline encoded?
A
innate
15
Q
which kind of immunity is characterized by receptors that undergo VDJ recombination?
A
adaptive
16
Q
Which MHC complex to CD8 cells bind
A
MHC I
17
Q
Which MHC complex to CD4 cells bind
A
MHC II 4 x 2=8
18
Q
Where is MHC I expressed, and which HLA molecules code for it
A
all nucleated cells (no RBCs) A, B, C
19
Q
Where is MHC II expressed and and which HLA molecules codes for it
A
APCs, and DR, DP and DQ
20
Q
HLA-A3
A
hemochromocytosis
21
Q
HLA-B27
A
PAIR - psoriasis, ankylosing spondylitis, inflammatory bowel dz, reiter’s syndrome
22
Q
HLA-B8
A
Graves’ dz
23
Q
HLA-D2
A
MS, hay fever, SLE, goodpasture’s
24
Q
HLA-DR3
A
DM type 1
25
HLA-DR4
RA, DM type 1
26
HLA-DR5
Pernicious anemia (to B12 def), hashimotos thyroiditis
27
HLA-DR7
Steroid-responsive nephrotic syndrome
28
How do NK cells kill?
perforins and granzymes to induce apoptosis of virally infected or tumor cells
29
How are NK cells stimulated?
IL-12, IFN-beta. IFN-alpha
30
Which antibody mediates a type Hypersens rxn?
IgE
31
Which antibody mediates type II and type III hypersens rxn
IgG
32
Which cell mediates the type IV hypersens rxn?
CD8 cells
33
What is the role of CD4 cels
help B cells make antibody, secrete IFN gamma to activate macs
34
Which cytokine induces Th1 cell profile in CD4 cells
IL-12
35
Which cytokine induces Th2 cell profile in CD4 cells
Il-4
36
What are the three APCs
Macs, dendritic cell, B cell
37
How many signals are required for T cell activation or B cell class switching?
2
38
What are the two signals in helper T activation?
signal 1 = APC, signal 2 = B7 and CD28
39
What are the two signals in cytotoxic T cells activation?
signal 1 =peptide expressed on MHC I, signal 2 = Il-2
40
What are the two signals required for B cells class switching?
signal 1 = IL-4,5,6 signal 2 = CD40 receptor on b cell binds CD40L on Th cell
41
Which cytokines to Th1 cells secrete?
IL-2 and IFN gamma
42
Which cytokine inhibits Th1 cells
IL-10
43
What does the Th2 response do?
regulates the humoral response
44
What cytokines to Th2 cells secrete?
IL-4, 5 , 10
45
What inhibits Th2 cells
IFN gamma
46
What are the cytokines involved in macrophage/lymphocyte interaction
IFN gamma from lymph activate MAC, IL-1 and TNF alpha from MAC activate lympho
47
How do CD8 cells kill?
perforin, granzyme, granulysin
48
Which parts of the antibody to heavy chain contribute?
Fc and Fab
49
Which parts of the antibody to light chain contribute
Fab
50
Which portion of the antibody determines the isotype
Fc
51
What are the 3 funxtions of antibodies?
Opsonization, neutralization and complement activation
52
Which is the most abundant immunoglobulin in the blood?
IgG
53
What do mature B lymphos express on their surface?
IgM and IgD
54
Which antibody (IgM or IgG) crosses the placenta?
IgG
55
What is the main function of IgA
prevents attachment of bacteria and viruses to mucous membranes
56
Which immunoglobulin is found in breast milk, tears, saliva, and mucous
IgA
57
Which immunoglobulin is a pentamer
IgM
58
Can lipopolysaccharide from cell envelope of of gram neg bacteria induce immunologic memory?
No, peptides only can can be presented on MHC molecules
59
Which B T cell interaction allows for immunologic memory and class switching?
CD40 and CD40L
60
Which antibodies activate the classic pathway
IgG, IgM GM makes classic cars
61
Which complement protein opsonizes bacteria?
C3b
62
Which complement proteins make up the MAC
C5b-9
63
What does a deficiency in C1 esterase inhibitor lead to?
hereditary angioedema
64
What does a deficiency in C3 lead to
severe pyogenic sinus and respiratory infections, inc suscept to type III hypersen rxn
65
What does a deficiency in C5-C8 lead to?
Neisseria bacteremia
66
Deficiency in DAF
complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
67
What does HOT- T-Bone stEAk stand for?
IL-1 = fever, IL-2 = T cells, IL-3 = bone marrow, IL-4 = IgE, IL-5 = IgA
68
What does clean up on Aisle 8 stand for?
PMNs recruited by IL-8 to clear infxns
69
What interferes with viruses?
Interfereon alpha, beta gamma. Alpha/beta inhibit viral protein synthesis, gamma upregulate MHC I and II, all three activate NK cells
70
Cell surface receptors on T cells
CD3, CD28, helper t, CD4, CD40L, cyto t CD8
71
Cell surface receptors on B cels
Ig, CD19, 20, 21, CD40, MHCII, B7
72
Which is the receptors for EBV?
CD21
73
What are the cell surface receptors on MACS
MHC II, B7, CD40, CD14, receptors for Fc and C3b
74
what is the unique cell marker for NK cells
CD56
75
Which bacteria secrete superantigen
S. aureus and S. pyogenes
76
what do superantigens do?
uncoordinated release of IFN gamm leading to IL-1, IL 6 and TNF alpha from MACS, via crosslinking of TCR and MHC II
77
Which receptor on MACS to endotoxin directy stimulate?
CD14
78
What are the classic example of bacterial antigen variation and the unique mechanims
Salmonella, 2 flaggellar variants, Borrelia, relapsing fever, N. gono, pilus protein
79
What is the difference in antigenic variation in viruses
major shift minor drift
80
Which parasites exhibit antigenic variation
trypanosomes, programmed rearrangement
81
Which infections require administering passive immunity?
Tetanus, Botulinum toxin, HBV or Rabies (To Be Healed Rapidly
82
What kind of hypersens rxn in anaphylaxis
I
83
Which type of hypersens rxn is antibody mediated?
II
84
Which type of hypersens rxn is immune complex mediate
III
85
Which type of hypersens rxn is delayed
IV
86
Which type of hypersens rxn is serum sickness?
III
87
Which type of hypersens rxn is the arthus rxn
III
88
What is the clinical picture for serum sickness?
caused by drugs mostly, fever, urticaria, arthralgias, proteinuria, lymphadenopathy 5-10 days after exposure
89
What is the arthus rxn?
type III hypersens rxn after intradermal rxn with antigen-antibodies in the skin causing edema, necrosis and activation of complement
90
What are the 4 T's of type IV hypersense
T-lymphos, Transplant, TB skin test, Touching (contact dermatitis)
91
ANA
SLE, nonspecific
92
Anti ds DNA, anti Smith
SLE
93
Antihistone
drug induced lupus
94
Anti-IgG (RF)
RA
95
Anticentromere
Scleroderma CREST
96
Anti Scl 70 (DNA topo I
Scleroderma diffuse
97
Antimitochondrial
primary biliary cirrohosis
98
antigliadin, antiendomysial
ceilac disase
99
anti basement membrane
goodpastures
100
antidesmoglein
pemphigus vulgaris
101
antimicrosomal, antithyroglobulin
hashimotos
102
anti-Jo 1
poly/dermato myositis
103
anti SS A/B or anti Ro/La
sjorgen's syndrome
104
anti U1 RNP
mixed connective tissue disease
105
antismooth muscle
autoimmune hepatitis
106
anti glutamate decarboxylase
DM type 1
107
c-ANCA
Wegeners granulomatosis
108
p-ANCA
other vasculitidies
109
X linked recessive defect in BTK no B cell differentiation
Bruton's agamma
110
Defect in CD40L on helper T
Hyper IgM
111
Defectin in isotype switching
Selective Ig def, IgA most common
112
Defect in B cell maturation
Common variable immunodeficiency (CVID)
113
22q11 deletion, failure of 3rd and 4th pharyngeal arches
DiGeorge
114
decreased Th1 response
IL-12 def
115
Th cells don't produce IFN gamma, no PMN response
Hyper IgE syndrome (Job's)
116
T cell dysfunction
chronic mucocutaneaous candidiasis
117
X linked IL-2 receptor defect, adenosine deaminase deficiency, failure to synthesize MHC II
SCID
118
Defect in DNA repair enzymes
Ataxia telangectasia
119
X-linked recessive defect with progessive deletion of B and T cells
Wilskott Aldrich (TIE = thrombocytopenia, infections, eczema) high IgE and IgA, low IgM
120
Defect in LFA-1 integrin CD18 protein on phagocytes
Leukocyte adhesion deficiency type 1
121
AR, defect in microtubule fxn with decreased phagocytosis
Chediak Higashi
122
Lack of NADPH oxidase, decreased in ROS, absetn respiratory burst in PMNs
chronic granulomatous disease
123
Transplant rejection: preformed host antibody mediated
hyperacute : occlusion, ischemia, necrosis
124
transplant rejection cell mediated due to cytotoxic t cells reacting against foreign MHCs
acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
125
transplant rejection: T cell and antibody mediated vasular damage
chronic: fibrosis of graft tissue and blood vessels
126
transplant rejection: grafted immunocompetent T cells from donor proliferate and attack host cells
graft versus host: severe organ dysfunction, maculopapular rash, jaundice, hepatosplenomegaly, diarrhea often in bone marrown and liver transplant
