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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
Pt's neutrophils fail to turn blue on nitro blue tetrazolium testing?
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.
26
Citrullinated Peptide Antibodies... Dx?
Rheumatoid Arthritis
27
TGF beta
-controls cell proliferation, inhibits macrophages | Healing and resolution molecule with IL 10. AtTENunates immune response.
28
Regulatory T Cell Phenotype
- CD4+ - CD25+ - foxp3+
29
4 things that attract neutrophils?
leukotriene B4, C5a, IL8, bacterial products
30
3 Things that activate mast cells?
Tissue trauma C3a and Ca Cross linking of cell surface IgE by antigen
31
Substances that mediate pain?
PG E2 | Bradykinin
32
Cytochrome C
Mitochondrial enzyme that leads to cell death through apoptosis.
33
Polymyocitis
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
IL10
Healing and resolution molecule secreted with TGFbeta. AtTENuate immune response.
35
Acute Graft Rejection
Usually cell mediated pathway. Expect to see dense interstitial lymphocyte infiltrate.
36
Where do T cells live in the lymph node?
Paracortex
37
Schaumann Bodies, Noncaseating Granulomas, and Asteroid Bodies?
Sarcoid
38
What causes green color of sputum?
-myeloperoxidase released by neutrophils during infection
39
2 Tests for CGD
1. nitroblue tetrazolium test: no blue = CGD | 2. dihydrorhodamine flow cytometry: dec. green fluorescence = CGD
40
What disease is HLA DR2?
MS
41
Calcineurin
- 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
Langerhans Cell Histiocytosis
- disorder of langerhans cells - lytic bone lesions, skin rash, otitis media, - S100 - birbeck granules
43
IFNgamma
- 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
What cytokines mediate septic shock response?
TNF-a, IL1, IL6
45
Interferon alpha and beta
- 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
Anti-dsDNA
-specific for SLE
47
Anti-histone Antibodies
- drug induced lupus | - procainamide, hydralazine, isoniazid, D-penicillamine
48
Anti-Ro/SSA and anti-La/SSB antibodies
-sjogren syndrome
49
Anti-phsopholipid Antibodies
-SLE and antiphospholipid antibody syndrome
50
Anti-DNA topoisomerase
-highly specific for systemic sclerosis-diffuse type
51
Anti-centromere Antibodies
``` CREST syndrome-systemic sclerosis limited type C-calcinosis R-raynauds E-esophageal dysmotility S-sclerodactyly T-telangectasias ```
52
Leukemoid Reaction
- 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
Systemic Mastocytosis
- abnormal proliferation of mast cells and inc. histamine release - histamine causes inc. gastric acid as well as hypotension, flushing, and pruritis (with rash)
54
Leukocyte Adhesion Deficiency
- 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
What immune cells are involved in the candida skin test?
-CD4+ T lymphocytes and macrophages
56
Graft Vs. Host Disease
- fever - cytolytic destruction of mucous membranes such as GI and skin (maculopapular rash) - follows organ transplant - T lymphocytes from graft reject host cells
57
Cytokines involved in rheumatoid arthritis?
- IL1 - IL6 - TNFa
58
Myeloperoxidase Deficiency
- dec. myeloperoxidase - pt cannot form HOCl- (bleach/ hypochlorus acid.hydroxyl halide radicals) - inc. risk candida infections
59
Bence Jones Proteins
- monoclonal globulin protein found in the urine | - suggestive of multiple myeloma
60
What happens to endothelial tight junctions during inflammation?
-the tight junction permeability increases to allow for white cell migration to site of injury
61
IgE Independent Degranulation
- 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
Caspases
- common to both intrinsic and extrinsic apoptosis pathways - proteolytic enzymes that cleave cellular proteins - stand for cysteine aspartic acid proteases
63
Maternal Antibodies
- 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
Chediak Higashi
- defect in lysosomal trafficking regulator gene - AR - recurrent pyogenic infections - partial albinsim - progressive neurodegeneration - pancytopenia - mild coagulation defects

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