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MSc Integrated Immunology > Hillary Revision > Flashcards

Hillary Revision Flashcards

1
Q

What are the 6 adjuvants approved for use in humans

A 
Alum
ASO1
ASO3
ASO4
MF59
CpG ODN
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2
Q

What is a prime boost

A

Administratoring a second, different vectored vaccine to boost responce.
First vector will induce vector-specific responce.
Homologous - same second vector
Heterologous - different second vector

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3
Q

Meningitis vaccine coverage - which strains have good coverage

A

A, C, W, X, Y

B does not

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4
Q

Meningococcal disease - what type of infection leads to shedding and trasmission?

A

Carrige - asymptomatic infection keadsnto shedding.

Symptomatic infection does not lead to transmission.

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5
Q

Meningococcal clonocal complexes- what determines the CC?

A

Housekeeping genes

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6
Q

Why is there poor immune responces to serogrouop B and poor vaccine coverage?

A

B has similarity to human antigens

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7
Q

Which HIV type and clade causes pandemics?

A

HIV-1 clade M

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8
Q

HIV DNA type? And baltimore group

A

+ ssRNA

Baltimore group 6 - reterovirus

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9
Q

Number of HIV mature proteins?

A

16

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10
Q

The open reading frames of HIV?

A

gag
pol
env

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11
Q

The proteins produced by Gag and there function?

A

P24 - capsid
P18 - structual envelope protein
P6 - chaperones RNA genome

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12
Q

The proteins produced by Pol and there function?

A

Protease - cleaves gag-pol precursor
rt - catalyses DNA production
RNA acetyl - degrades RNA genome template
Integrase - catalyses proviral integration

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13
Q

What are the proteins produced by Env and there function?

A

Receptor binding and membrane fusion protein

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14
Q

Other HIV orf’s - function of Tat

A

Transactivates viral gene transcription

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15
Q

Other HIV orf’s - function of Rev

A

Regulates viral RNA splicing

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16
Q

Other HIV orf’s - function of Nef

A

Inhibits SERINC5
Immune evasion via MHC1 down regulation and CD4 evasion.
Lowers the threshold for CD4 activation.

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17
Q

Other HIV orf’s - function of vif

A

Overcomes deaminase APOBEC

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18
Q

Other HIV orf’s - function of VPU

A

Downregulates tetherin to increase viral release

Downregulates CD4 by connecting it to a E3 ligase

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19
Q

Other HIV orf’s - function of VPR

A

G2 cell cycle arrest and appoptosis in proliferating cells

Nuclear import of pre integration complex - required for viral replication in non-proliferative cells (macrophages)

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20
Q

8 stages of the HIV lifecycle

A 
Attachment and entry
Reverse transcription
Nuclear import
Integration
Transcription
Translation
Assembly
Budding
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21
Q

Which HIV protein facilitates cell entry, and what is the structure of the protein?

A

Glycoprotein ENV receptor.

Tetramer of dimers.

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22
Q

ENV is expressed as a single polyprotein gp160 cleaved into what two proteins?

A

gp120 and gp41

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23
Q

How do gp120 and gp41 allow HIV entry?

A

gp120 binds CD4 then CCR5/CXCR4. This causes a conformational change in the gp120 complex
gp 41is then exposed and pierces cell membrane to fuse the membranes.

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24
Q

HIV cellular tropism types?

A

R5 - infects CCR5+ cells

X4 - infects CXCR4+ cells

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25
Q

HIV integrase structure

A

Dimer of dimers

3 domains - N terminal, catalytic core, C terminal domain

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26
Q

6 types of antireteroviral drugs

A 
1 Reverse transcriptase inhibitors
2 Non-nucleoside reverse transcriptase inhibitors
3 Protease inhibitors
4 Fusion inhibitors - inhibits entry
5 CCR5 inhibitors - inhibits entry
6 Integrase inhibitors
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27
Q

First line cART is mare up of what antiretroviral drug types

A

2 RTI plus 1 NNRI / PI / INI

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28
Q

Salvage cART therapy is made up of what antiretroviral drug types?

A

Fusion inhibitor and CCR5 inhibitor

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29
Q

The different uses of cART

A

Pre exposure prophylactic (PrEP)
Post exposure prophylactic (PEP)
Treatment as prevention (TasP)

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30
Q

Where does HIV home to?

A

The GALT

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31
Q

what does IEI mean

A

inborn errors of immunity

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32
Q

Gene responsible for XLA?

A

BTK - brutons tyrosine kinase

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33
Q

Wiskott-Aldrich syndrome, mode of inheritance?

A

X-linked reccesive

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34
Q

Wiskott-Aldrich syndrome, gene defect?

A

WASp gene

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35
Q

Wiskott-Aldrich syndrome, immune defect?

A

Defective anti-polysaccharide antibody
impaired T cell activation
Treg dysfunction

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36
Q

Hyper-IgM syndrome, gene defect?

A

CD40/ligand
NEMO
NEMO - NFkappaB modulator

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37
Q

Hyper-IgM syndrome, immune defect?

A

No isotype switching and somatic hypermutation

T defects

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38
Q

Hyper-IgE syndrome, gene defect

A

STAT3

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39
Q

Hyper-IgE syndrome, immune defect

A

block in Th17 differentiation

elevated IgE

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40
Q

Cronin 1A defficiency, immune phenotype

A

T-B+NK+

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41
Q

Reticular dysgenesis, gene defect?

A

AK2 - controls mitochondrial metabolism

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42
Q

common gamma chain, cytokines signalling via IL2R

A

IL2,4,7,9,15,21

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43
Q

Defects in V(d)J recombination?

A

RAG1/2, Artemis, DNS-PKcs, DNA ligase IV,

Cernunnos (xlf) - not clear

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44
Q

AIDs diagnosis requires

A

CD4 count < 200 cells / microL

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45
Q

AIDs defining malignancies and virus associated with them

A

Kaposi Sarcoma - KSHV
NHL - EBV
Cervical cancer - HPV

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46
Q

Functional T cells secrete which cytokines

A

IL2, IFNgamma, TNF

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47
Q

Markers of T cell exhaustion?

A

PD-1, LAG-3, CD160

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48
Q

LCMV model, control associated with what type of t cells

A

multispecific, low CD39 and PD-1 expression

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49
Q

In HCV, what cytokine and cell type are associated with a reduces viremia?

A

IFNgamma, CD8

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50
Q

Protective HLA molecules against HCV infection

A

HLA - B27 & A3

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51
Q

Alpha herpesviruses

A

herpessimplex 1 and 2

52
Q

beta herpesviruses

A

CMV
HHV6
HHV7

53
Q

gamma herpesvirus

A

KSHV

EBV

54
Q

type of herpesviruses which achive true latency?

A

gamma herpesviruses

55
Q

What is the genetic structure of EBV

A

dsDNA

56
Q

What is the genetic structure of CMV

A

dsDNA

57
Q

IRAK 4 mutations, lead to susceptibility to what infections

A

Bacteria - pyogenic, gram positive

58
Q

Assay for IRAK 4 mutation

A

CD62L shedding assay. Cleavage of CD62 is the normal function when bound to PAMP.

59
Q

UNC93B common presentation

A

Herpes simplex encephalitis

On CD62L assay - no response to intracellular agonists.

60
Q

NLRP3 mutation Is associated with what conditions?

A

Cryopyrin associated periodic syndrome

61
Q

NOD 2 mutation is associated with what disease?

A

Crohns

62
Q

HOil1 deficiency has what presentation?

A

Autoimmunity and immunodeficiency

63
Q

HOIL is associated with what complex and what is its role

A

LUBAC - ubiquitinates regulatory proteins of NFkappaB

64
Q

Defects in IL12/IFNgamma leads to susceptivity to what infection

A

Non Tb pyogenic bacteria and salmonella

65
Q

Infections associated with complement classical pathway defects

A

pneumococcal

66
Q

Infections associated with complement common pathway defects

A

Meningococcal

67
Q

Causes of angioedema in complement defects

A

C1 inhibitor deficiency - bradykinin increase

68
Q

CD59 function in complement

A

Prevents c9 binding c5 - c8

69
Q

PNH deficiency, what component is affected? And it’s function

A

PIG-A, synthesises GPI

70
Q

Glycol phosphatidyl inositol (GPI) function? And how is it relevant in PNH deficiency

A

Anchor on RBCs for Decoy accelerating factor, CD59, CD55.

Prevents CD59 expression on CS, therefore increased MAC formation and RBC haemolysis

71
Q

TIMs, secrete what pro-angiogenic factors

A

VEGF, TNFa and IL8

72
Q

XLP is a responce to what infection

A

EBV

73
Q

Gene responceible for inherated XLP

A

SH2D1A

74
Q

MRSA gene responsible for methesilin and beta lactam resistance

A

mecA

75
Q

Vaccines given to old folks?

A

Pneumococcal vaccine (PPV)
Flu
Shingles

76
Q

Vaccines given to teenagers?

A

HPV

3 in 1 booster menACWY

77
Q

6 in 1 vaccines contains?

A

diphtheria, tetnus, polio, pertussis, Hep B, Hib

78
Q

NEMO deficiency mode of inheritance?

A

X linked

79
Q

CGD people are susceptible to what type of bacteria

A

Catalyse positive

80
Q

LAD1 is due to a deficiency in what?

A

CD18 ( beta 2 integrin)

81
Q

LAD1, CD18 binds to what during extraversion?

A

ICAM1 on endothelium

82
Q

LAD 2 is due to a deficiency in what?

A

Sialyl Lewis x

83
Q

LAD2, Sialyl Lewis x binds to what in neutrophil extravasation?

A

E/P selectin on endothelium

84
Q

RAC 2 deficiency results in what functional defects

A

Neutrophil phagocytosis, migration and oxidative burst impaired.

85
Q

Whiskott Aldrich syndrome, is associated with what antibody phenotype?

A

Decreased IgM, increased IgA and IgE

86
Q

Chediak-Higashi syndrome, is due to a mutation in what gene? And what is its function

A

LYST gene, protein trafficking gene.

87
Q

Giant cytoplasmic granules in neutrophils is associated with what condition

A

Chediak higashi syndrome

88
Q

Most common gene which is mutated leading to severe congenital neutropenia

A

ELANE

89
Q

Type 2 hypersensitivity, immune complexes form when?

A

Excess antigen to little antibody, small ICs develop

90
Q

SLE, auto antibodies bind to?

A

Nuclear antigens eg dsDNA

91
Q

Why is crypthudia useful for SLE diagnosis

A

Pure source of dsDNA. No RNA

92
Q

Normally immune complexes activate which complement pathway?

A

Classical

93
Q

Antiphospholipid syndrome is associated with auto antibodies to what?

A

Beta 2 glycoprotein

94
Q

RA autoantibodies to what proteins?

A

RA factor and CCP

95
Q

T2 athsma diagnosed when blood ensophilia count is?

A

Over 300 /ml.

Under then T1

96
Q

Why are ILC2s important in allergy?

A

Resistant to corticosteroids

97
Q

HLA2 associated hypersensitivity diseases?

A

SLE, RA

98
Q

Ankylosing spondylitis associated with what HLA

A

HLA B27

Class 2

99
Q

Other genes associated with ankylosing spondylitis?

A

IL23R and ERPI

100
Q

When is ERAP associated with Ankylosing spondylitis

A

When HLA B27 +

- it is epistasis

101
Q

CD8 important in Ankylosing spondylitis?

A

Nope, CD8-/- still get disease

102
Q

Autoantibodies in RA

A

Rheumatoid factor antibody - Anti- IgGFC

CCP - Citrolinated peptides

103
Q

HLA associated with RA

A

HLA DR4

HLA DRB1

104
Q

Autoantibodies in autoimmune hepatitis? Type 1

A

Anti - nuclear (chromatin)

Anti - smooth muscle

105
Q

Autoantibodies in autoimmune hepatitis? Type 2

A

Anti - liver/kidney microsome antibodies. To crytochrome P450

106
Q

IgG4 antibodies affinity to adapter proteins

A

Low affinity to complement and FcgammaR3

107
Q

Autoantibodies in primary binary cholangitis

A

Anti-PDC-E2 (Mt protein)

108
Q

Treatment for primary biliary cholangitis?

A

Treatment with bile acid

109
Q

What’s a syngenic transplant?

A

Between genetically identical donor and recipients

110
Q

Types of graft rejection

A

Acute
Hyperacute
Chronic

111
Q

Warm ischemia time is?

A

Time since withdrawal of life support to systolic pressure below 50mmHg

112
Q

autoantibodies in P. vulgaries are against

A

Desmoglein 3

113
Q

A marker of poor outcome in breast cancer?

A

M-CSF

114
Q

Breast cancer metastasises to which organs? and what chemokines mediate this?

A

lungs, liver, BM, lymph nodes.

CXCL4 homing to CXCL12

115
Q

gammaDelta T cell K/O leads to susceptibility to what type of cancer?

A

Skin

116
Q

CTLA4 ligands on the tumour cell?

A

CD80 and CD86

117
Q

CTLA4 mutations cause haploinsufficiency, what disease is associated with this?

A

CHAI disease

118
Q

An anti-CTLA4 antibody is called?

A

ipilimumab

119
Q

High interstitial pressure in tumours affects vasculature?

A

hyperpermeability and fluids leaks into interstitium

- avoids drugs and Abs as no diffusion

120
Q

Hypoxia in tumours benefit tumour survival as?

A

P-glycoprotein upregulated, selects for loss of P53, increased resistance to radiation.

121
Q

low extravascular pH benefits tumour survival as?

A

VEGF release, high lactate = metastasis, reduces effect of chemotherapy, perforin release reduced

122
Q

Anti-angiogenic factors?

A

angiostatin and endostatin

123
Q

How does hypoxia affect immune cells?

A

oxygen radical killing impaired

124
Q

testies antigens found in what tumours?

A

melanoma, liver cancer, lung cancer, bladder cancer,

125
Q

testis antigens?

A

MAGE, BAGE, GAGE, NY-ESO-1

126
Q

Melanocyte differentiation antigens?

A

MelaA, gp100, tyrosinase

127
Q

Tregs are recruited to tumours by what chemokine?

A

CCL22

MSc Integrated Immunology (4 decks)

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