HLA System Flashcards

1
Q

Locus of genes that encode for proteins on surface of cells that are responsible for regulation of the immune system in humans

A

Human leukocyte antigen system

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2
Q

Location of HLAs

A

All nucleated cells and solid tissue cells

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3
Q

Chromosome location of HLA genes

A

Short arm of chromosome 6

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4
Q

HLA gene inheritance

A

Codominant

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5
Q

MHC class I antigens

A

HLA-A
HLA-B
HLA-C

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6
Q

MHC class II antigens

A

HLA-DR
HLA-DQ
HLA-DP
HLA-DN

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7
Q

Functions of HLA antigens

A

Recognize self from non-self
Involved in immune response through antigenic stimuli
Coordinate cellular and humoral immunity
Solid organ transplant survival

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8
Q

Populations where combinations of alleles or genotypes can be found in expected proportions

A

Linkage equilibrium

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9
Q

Occurrence of some combinations of alleles or genetic markers in a population more often or less often than would be expected from random formation of haplotypes from alleles based on their frequencies

A

Linkage disequilibrium

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10
Q

HLA antigens found on platelets

A

HLA-A

HLA-B

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11
Q

Location of class I antigens

A

T cells
Most nucleated cells
Solid tissue

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12
Q

Location of class II antigens

A
B lymphocytes
Monocytes
Macrophages
Dendritic cells
Intestinal epithelium 
Early hematopoietic cells
Epithelial cells
Spermatozoa
Activated T lymphs
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13
Q

Which HLA class is derived from exogenous proteins (proteins taken up by cell)

A

Class II

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14
Q

Which HLA class is derived from endogenous proteins (proteins made by the cell)

A

Class I

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15
Q

HLA class that interacts with T lymph’s that are CD8 positive

A

Class I

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16
Q

HLA class that interacts with T lymph’s that are CD4 positive

A

Class II

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17
Q

HLA class important for host defense against malignancy transformation and viral pathogens

A

Class I

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18
Q

HLA class that secretes immunostimulatory cytokines, important for antibody production

A

Class II

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19
Q

Testing for HLA class I molecules done by:

A

Microcytotoxicity testing

Sequence-specific primers

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20
Q

Testing for HLA class II molecules done by:

A

Mixed lymphocyte culture
PCR
Sequence-specific primers

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21
Q

HLA inheritance in which individuals share a common haplotype

A

Haploidentical

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22
Q

HLA inheritance in which individuals share no common haplotype

A

Haplodistinct

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23
Q

HLA inheritance in which individuals have exact or full-house match

A

HLA identical

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24
Q

Possibility that 2 siblings will be HLA identical

A

25%

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25
Q

Cause of absence of HLA antigens

A

Homozygosity at particular locus and/or to a null allele

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26
Q

Occurs when chromosome segments which contain genetically linked material are switched between the 2 chromosomes that are present during gametogenesis or meiosis

A

Crossing over

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27
Q

Originally identified as RBC antigens but now determined to be soluble antigens associated with plasma lipoproteins that readily absorb to RBC surfaces

A

Bg antigens

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28
Q

Bga = HLA __

A

HLA-B7

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29
Q

Bgb = HLA ___

A

HLA-B17

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30
Q

Bgc = HLA___

A

HLA-A28

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31
Q

What do Bg antibodies react with?

A

HLA remnants on mature red cell membrane

32
Q

Measure corresponding to increased frequency a certain disease occurs when individuals have a certain HLA type when compared to individuals who do not have the certain HLA type

A

Relative risk

33
Q

Celiac disease associated with HLA ___

A

DQ2

34
Q

Ankylosing spondylitis associated with HLA___

A

B27

35
Q

Narcolepsy associated with HLA___

A

DQ6

36
Q

Chronic active hepatitis associated with HLA___

A

DR3

37
Q

Type I diabetes associated with HLA___

A

DQ8

38
Q

Multiple sclerosis associated with HLA___

A

DR15, DQ6

39
Q

Rheumatoid arthritis associated with HLA___

A

DR4

40
Q

Graves’ disease associated with HLA___

A

DR17

41
Q

Lupus associated with HLA___

A

DR3

42
Q

Hereditary C2 deficiency associated with HLA___

A

A10, B18

43
Q

HLA antigens tested for transplant

A

A, B, C, DR, DQ, DP

44
Q

Optimal allele-level match important for which HLA antigens

A

A, B, C, DR

45
Q

Best choice of donors for HPC transplant

A

HLA-identical siblings,followed by mismatched donors and umbilical cord HPCs

46
Q

Collective term for HLA antigen groups that have cross-reactivity

A

Cross-reactive group (CREG)

47
Q

ABO and/or HLA match requirement for heart transplant

A

ABO only

48
Q

ABO/HLA match requirement for cornea transplant

A

ABO

A, B, Dr

49
Q

ABO/HLA match requirement for pancreas transplant

A

ABO

A, B, DR

50
Q

ABO/HLA match requirement for liver transplant

A

ABO

DR

51
Q

ABO/HLA match requirement for kidney transplant

A

ABO

A, B, DR

52
Q

ABO/HLA match requirement for bone marrow transplant

A

A, B, C, DR, DQ

ABO not required

53
Q

AABB standards requirement for kidney transplant candidate HLA testing

A

Testing for HLA antibodies once a month

54
Q

“A” in HLA matching

A

4 antigens match

55
Q

“B1U” in HLA matching

A

3 antigens detected in the donor, all match

56
Q

“B1X” in HLA matching

A

3 donor antigens match, 1 cross-reactive

57
Q

“B2U” in HLA matching

A

2 antigens detected in donor, both match

58
Q

“B2UX” in HLA matching

A

3 antigens detected in donor, 2 match and 1 cross-reactive

59
Q

“B2X” in HLA matching

A

2 donor antigens match, 2 cross-reactive

60
Q

“C” in HLA matching

A

1 antigen in donor not present in recipient and not cross-reactive

61
Q

“D” in HLA matching

A

2 antigens in donor not present in recipient and not cross-reactive

62
Q

Current methods for HLA testing

A

Cellular assays
Molecular
Serologic

63
Q

Sample requirement for HLA typing

A

Heparin anticoagulant

Room temp storage

64
Q

Lymphocyte populations from 2 different individuals mixed and incubated with each other in tissue culture

A

Mixed lymphocyte culture reactions

65
Q

2 populations used in mixed lymphocyte cultures

A

Responders and stimulators

66
Q

Function of responder population in mixed lymphocyte culture reactions

A

Recognizes differences in HLA D loci on surface of stimulator population
Undergoes blastogenic transformation, DNA synthesis occurs and can be measured by feeding cells a radio labeled DNA precursor

67
Q

Function of stimulator population in mixed lymphocyte culture reactions

A

Breaks foreign antigen

Pretreated with X-ray or mitomycin C to make it incapable of also responding

68
Q

Testing used for HLA-A, B, C antigen typing

A

Microlymphocytotoxicity testing

69
Q

Principle of microlymphocytotoxicity testing

A

Interaction of specific antibodies with HLA surface antigens on lymphocytes activates C’ and results in opaque looking cells due to cell death

70
Q

Positive reaction in microlymphocytotoxicity testing

A

High percentage of dead cells (indicates that patient’s lymph’s have that HLA antigen corresponding to antigen in the well)

71
Q

Gold standard testing for HLA typing

A

Sequence-based PCR

72
Q

Percentage of cells that are dead after they react with cytotoxic antibodies

A

Panel-reactive antibody level

73
Q

Methods for crossmatch and detection of HLA antibodies

A

Serologic microlymphocytotoxicity testing
Solid-phase/microarray
Flow cytometry

74
Q

HLA antigens matched in platelet refractoriness

A

HLA-A and HLA-B

75
Q

Reaction caused by HLA class I and II antigens in the patient against donor antibodies

A

TRALI