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Immune Flashcards

1
Q

Morphology of Acute Transplant Rejection

A
  • humoral (B cell): C4d deposition, neutrophilic infiltrate (PMNs), endotheliitis
  • cellular (T cell): lymphocytic (MONOnuclear) interstitial infiltrate and endotheliits
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2
Q

Humoral Response

A
  • bacteria
  • neutrophils (PMNs)
  • B cells with antibodies
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3
Q

Cellular Response

A
  • viruses
  • lymphocytes (mononuclear)
  • T cells
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4
Q

Acute Rheumatic Fever

A
  • molecular mimicry
  • due to anti group A strep antibodies that cross react with cardiac and nervous antigens
  • pancarditis, arthritis, sydenham chorea
  • mitral regurg/stenosis
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5
Q

Guillain Barre

A
  • ascending paralysis
  • can be caused by campylobacter jejuni
  • demyelinating syndrome of peripheral nerves
  • characterized by endoneural inflammatory infiltration (lymphocytes and macrophages)
  • antibodies from febrile illness cross react with myelin of spinal roots and peripheral nerves
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6
Q

Myasthenia Gravis

A
  • muscle weakness (ptosis, diplopia)
  • weakness worsens with activity or at the end of each day
  • majority of pts also found to have thymoma or thymic hyperplasia
  • antibodies attack the Ach receptor
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7
Q

Lambert Eaton Myasthenic Syndrome

A

-antibody to Ca channel in presynaptic nerve terminal
-weakness improves with exercise
Associated with malignancy in half of cases (esp. Small cell lung cancer)

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8
Q

Amyotrophic Lateral Sclerosis

A
  • most common motor neuron disease
  • combine UMN (spasticity, hyperreflexia) and LMN (weakness, fasciculations) lesions are characteristic
  • damage to motor neurons of an. horn and demyelination of corticospinal tract present
  • atrophy of lateral corticospinal tracts
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9
Q

IL1

A
  • produced by macrophages and epithelial cells
  • pro inflammatory
  • commonly secreted by malignant plasma cells in multiple myeloma
  • osteoclast activating factor that causes lytic bone lesions
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10
Q

IL5

A

-secreted by Th2 cells
-promotes humoral response with class switching to IgA.
Calls in eosinophils.

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11
Q

IL12

A

-secreted by macrophages
-induces differentiation of naive T cells into Th1 helper cells and activation of NK cells
Pts with a def. will have mycobacterial infections and can be tx with IFNgamma

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12
Q

TNFa

A
  • produced by macrophages, NK cells, and T cells
  • proinflammatory
  • inc. expression of adhesion molecules
  • important in septic shock response
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13
Q

IL10

A
  • anti-inflammatory cytokine
  • dec. Th1 cytokines and MHC2 expression
  • protective effect in Crohns Disease
  • Increases TH2 T cells
  • Secreted by TH2 cells
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14
Q

Sarcoidosis

A
  • young black women
  • malaise, cough, erythema nodosum
  • bilateral hilar lymphadenopathy
  • transbronchial biopsy of non-caseating granulomas necessary for dx
  • inflammatory dz of unknown etiology
  • elevated ACE
  • CD4 cells predominate
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15
Q

CREST Syndrome

A
  • calcinosis
  • raynauds
  • esophageal dysmotility
  • sclerodactyly (tightening of skin on fingers)
  • telangiectasias (dilated capillaries)
  • variant of systemic sclerosis
  • can lead to pulmonary HTN
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16
Q

IL2

A

Anti tumor properties through activation of natural killer cells and T cells
Secreted by helper T cells

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17
Q

CD14

A

Surface marker of monocyte/macrophages.

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18
Q

IL4

A 
Secreted by TH2 cells.
Enable class switching to IgE.
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19
Q

Interleukins secreted by TH2 cells?

A

IL4, IL5, IL10

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20
Q

Cytokines and interleukins secreted by TH1 cells?

A

Interferon gamma (also secreted by NK cells)
Stimulates macrophages to kill phagocytosed pathogens.
IL2, IFNgamma, IL12

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21
Q

Cytokines secreted by all T cells?

A

IL2 (stimulates T cells)
IL3 (stimulates bone marrow)
Stimulate and support immune system growth

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22
Q

Cytokines secreted by macrophages?

A 
IL1 (fever)
IL6 (stimulates acute phase protein production)
IL8
IL12
TNFa (mediates septic shock)
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23
Q

HOT Tbone stEAK

A 
IL1 (fever)
IL2 (stimulates T cells)
IL3 (stimulates bone marrow)
IL4 (stimulates IgE)
IL5 (stimulates IgA)
IL6 (aKute phase protein production)
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24
Q

Clean up on aisle 8

A

Neutrophils are recruited by IL8 to clear infections. Produced by macrophages. Causes cont. inflammation.

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25
Q

Pt’s neutrophils fail to turn blue on nitro blue tetrazolium testing?

A

Chronic Granulomatous Disease
X linked mutation affecting NADPH oxidase, which normally generates ROS to kill bugs.
Pt at inc. risk of catalase positive organisms due to dec. effect of neutrophils.

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26
Q

Citrullinated Peptide Antibodies… Dx?

A

Rheumatoid Arthritis

27
Q

TGF beta

A

-controls cell proliferation, inhibits macrophages

Healing and resolution molecule with IL 10. AtTENunates immune response.

28
Q

Regulatory T Cell Phenotype

A
  • CD4+
  • CD25+
  • foxp3+
29
Q

4 things that attract neutrophils?

A

leukotriene B4, C5a, IL8, bacterial products

30
Q

3 Things that activate mast cells?

A

Tissue trauma
C3a and Ca
Cross linking of cell surface IgE by antigen

31
Q

Substances that mediate pain?

A

PG E2

Bradykinin

32
Q

Cytochrome C

A

Mitochondrial enzyme that leads to cell death through apoptosis.

33
Q

Polymyocitis

A

Symmetrical proximal muscle weakness (difficulty combing hair). Elevated muscle enzymes (CK) and autoantibodies against histidyl tRNA synthetase (anti Jo). Over expression of MHC class 1 on the sarcolemma leads to CD8 T cell invasion. Leads to patchy muscle fiber necrosis. Lacks characteristic skin findings of dermatomysitis.

34
Q

IL10

A

Healing and resolution molecule secreted with TGFbeta. AtTENuate immune response.

35
Q

Acute Graft Rejection

A

Usually cell mediated pathway. Expect to see dense interstitial lymphocyte infiltrate.

36
Q

Where do T cells live in the lymph node?

A

Paracortex

37
Q

Schaumann Bodies, Noncaseating Granulomas, and Asteroid Bodies?

A

Sarcoid

38
Q

What causes green color of sputum?

A

-myeloperoxidase released by neutrophils during infection

39
Q

2 Tests for CGD

A
  1. nitroblue tetrazolium test: no blue = CGD

2. dihydrorhodamine flow cytometry: dec. green fluorescence = CGD

40
Q

What disease is HLA DR2?

A

MS

41
Q

Calcineurin

A
  • protein phosphatase in T cells that is essential to IL2 activation
  • dephosphorylates nuclear factor of activated T cells (NFAT) that leads to inc. immune response
  • inhibited by cyclosporine and tacrolimus in pts with organ transplant
42
Q

Langerhans Cell Histiocytosis

A
  • disorder of langerhans cells
  • lytic bone lesions, skin rash, otitis media,
  • S100
  • birbeck granules
43
Q

IFNgamma

A
  • produced by T cells and recruits leukocytes and activates phagocytosis
  • type 2 interferon
  • promotes Th1 differentiation
  • inc. expression of MHC class 2
  • important for mycobacterial infections, and def. will cause infection with these bugs
44
Q

What cytokines mediate septic shock response?

A

TNF-a, IL1, IL6

45
Q

Interferon alpha and beta

A
  • type 1 interferons
  • synthesized by most human cells in response to viral infection
  • autocrine/paracrine signaling halts protein synthesis in presence of dsRNA (viral RNA)
  • inc. MCH class 1 expression
46
Q

Anti-dsDNA

A

-specific for SLE

47
Q

Anti-histone Antibodies

A
  • drug induced lupus

- procainamide, hydralazine, isoniazid, D-penicillamine

48
Q

Anti-Ro/SSA and anti-La/SSB antibodies

A

-sjogren syndrome

49
Q

Anti-phsopholipid Antibodies

A

-SLE and antiphospholipid antibody syndrome

50
Q

Anti-DNA topoisomerase

A

-highly specific for systemic sclerosis-diffuse type

51
Q

Anti-centromere Antibodies

A 
CREST syndrome-systemic sclerosis limited type
C-calcinosis
R-raynauds
E-esophageal dysmotility
S-sclerodactyly
T-telangectasias
52
Q

Leukemoid Reaction

A
  • benign leukocytosis in response to underlying condition like severe infection/hemorrhage, malignancy, or acute hemolysis
  • leukocyte alk phos can be normal or elevated
  • smear shows inc. bands, mature neutrophil precursors, and granules (dohle bodies) in neutrophils (not hypersegmented nuclei)
53
Q

Systemic Mastocytosis

A
  • abnormal proliferation of mast cells and inc. histamine release
  • histamine causes inc. gastric acid as well as hypotension, flushing, and pruritis (with rash)
54
Q

Leukocyte Adhesion Deficiency

A
  • due to absence of CD18 antigens necessary for formation of integrins
  • recurrent skin infections without purulence
  • delayed separation of umbilical cord
  • persistent leukocytosis
  • ICAM deficiency
55
Q

What immune cells are involved in the candida skin test?

A

-CD4+ T lymphocytes and macrophages

56
Q

Graft Vs. Host Disease

A
  • fever
  • cytolytic destruction of mucous membranes such as GI and skin (maculopapular rash)
  • follows organ transplant
  • T lymphocytes from graft reject host cells
57
Q

Cytokines involved in rheumatoid arthritis?

A
  • IL1
  • IL6
  • TNFa
58
Q

Myeloperoxidase Deficiency

A
  • dec. myeloperoxidase
  • pt cannot form HOCl- (bleach/ hypochlorus acid.hydroxyl halide radicals)
  • inc. risk candida infections
59
Q

Bence Jones Proteins

A
  • monoclonal globulin protein found in the urine

- suggestive of multiple myeloma

60
Q

What happens to endothelial tight junctions during inflammation?

A

-the tight junction permeability increases to allow for white cell migration to site of injury

61
Q

IgE Independent Degranulation

A
  • some medications (opioids, radiocontrast agents, vancomycin) induce granulation via protein kinase A and PI3 kinase
  • IgE mediated degranulation is associated with environmental exposures and beta lactam and sulfonamide antibiotics
62
Q

Caspases

A
  • common to both intrinsic and extrinsic apoptosis pathways
  • proteolytic enzymes that cleave cellular proteins
  • stand for cysteine aspartic acid proteases
63
Q

Maternal Antibodies

A
  • type A or B mothers make IgM antibodies that can’t cross placenta if blood type is not compatible
  • type O mothers make IgG that can cross placenta
64
Q

Chediak Higashi

A
  • defect in lysosomal trafficking regulator gene
  • AR
  • recurrent pyogenic infections
  • partial albinsim
  • progressive neurodegeneration
  • pancytopenia
  • mild coagulation defects

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