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step 1 - immuno > immune responses > Flashcards

immune responses Flashcards

1
Q

which are the acute phase reactants involved in iron metabolism?

A

ferritin (increases)
hepcidin (increases)
transferrin (decreases)

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2
Q

pathways of complement

A

classic - IgG or IgM mediated
alternative - microbe surface molecules
lecthin - mannose/sugar on microbe surface

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3
Q

what does C3b do?

A

opsonization

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4
Q

what do C3a, C4a, C5a do?

A

anaphylaxis

C5a also does neutrophil chemotaxis

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5
Q

what do C5b-9 do?

A

MAC ATTACK!!!!&@^$^#!^!@!@!

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6
Q

what is DAF?

A

aka CD55
complement cascade inhibitor - prevents auto-activation
DAF deficiency –> lysis of RBCs, PNH

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7
Q

what is C1 esterase inhibitor?

A

complement cascade inhibitor
deficiency –> hereditary angioedema
** ACE inhibitors CONTRAINDICATED

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8
Q

severe recurrent pyogenic sinus and respiratory infx; increase susceptibility to type III hypersensitivity?

A

C3 deficiency

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9
Q

susceptibility to recurrent Neisseria bacteremia?

A

C5-C9 deficiency

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10
Q

IL-1 function?

A

FEVER
inflammation
recruit WBCs
activates endothelium –> adhesion molecules

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11
Q

IL-6 function?

A

ACUTE PHASE PROTEINs stimulated

fever

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12
Q

IL-8 function?

A

neutrophil chemotaxis

clean up on aisle 8!

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13
Q

IL-12 function?

A

differentiation of TH to TH1

activation of NK cells

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14
Q

TNF-a function?

A

septic shock
endothelial activation
WBC recruitment
vascular leakage

** cachexia in malignancy

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15
Q

IL-2 function?

A

stimulates growth of T cells and NK cells

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16
Q

IL-3 function?

A

supports growth/diff of bone marrow stem cells (GM-CSF-like)

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17
Q

IFN-g function?

A

made by NK cells
stimulates macrophages
NK cell activation
increase MHC expression and antigen presentation

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18
Q

IL-4 function?

A

TH2 differentiation
IgE production (and IgG)
B cell growth

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19
Q

IL-5 function?

A

B cell differentiation
IgA production
eosinophil growth

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20
Q

IL-10 function?

A

modulates inflammatory response
decreases MHCII and TH1
inhibits macrophages and dendritic cells

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21
Q

what is pyocyanin?

A

made by PsA

generates ROS to kill competing microbes

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22
Q

what is lactoferrin?

A

protein in secretory fluids and neutrophils

inhibits microbial growth via iron chelation

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23
Q

T cell surface proteins?

A

TCR
CD3 (assoc with TCR - signal transduction)
CD28 (binds B7)
CD4/CD8

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24
Q

helper T cell surface proteins?

A

CD4

CD40L

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25
Q

regulatory T cell surface proteins?

A

CD4
CD25 (binds IL-2)
FOXP3

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26
Q

B cell surface proteins?

A

Ig
CD19, CD 20, CD 21 (EBV), CD40 (binds TH cell CD40L)
MHCII
B7 (binds T cell CD28)

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27
Q

macrophage surface proteins?

A 
CD14 (binds LPS/endotoxins)
CD40
MHCII
B7
receptors for Fc and C3b - phagocytosis
28
Q

NK cell surface proteins?

A 
CD 16 (binds IgG Fc)
CD56 (unique)
29
Q

hematopoietic cell surface protein?

30
Q

classic examples of antigenic variation?

A 
salmonella (2 flagella)
borrelia recurrentis 
N gonorrhea (pilus)
flu, HIV, HCV
trypanosomes
31
Q

when do you give preformed antibodies to people?

A 
post-exposure ppx in:
tetanus
botulinum
HBV
varicella
rabies
32
Q

anaphylaxis, atopy, IgE, mast cells, basophils, histamine, preformed Ab, delayed response from leukotrienes?

A

type I hypersensitivity

dx: skin test for IgE

33
Q

IgM/IgG bind antigen, cellular destruction?

A

type II hypersensitivity
antibody and complement –> MAC attack
direct and indirect Coombs

34
Q

serum sickness, arthus reaction?

A

type III hypersensitivity
antigen-antibody-complement complex –> tissue damage
drug reaction - fever, urticaria, arthralgia, proteinuria, LAN

35
Q

delayed; T cells make cytokines, macrophage activation, no antibodies?

A

type IV hypersensitivity
transplant rejection
PPD
contact dermatitis

36
Q

what is the arthus reaction?

A

edema, necrosis, complement activation at site of intradermal injection

37
Q

examples of type I hypersensitivity?

A

anaphylaxis

allergies

38
Q

examples of type II hypersensitivity?

A 
AIHA
transfusion rxns
Goodpasture
Graves
GBS
MG
ITP
39
Q

examples of type III hypersensitivity?

A

arthus rxn
SLE
PSGN
serum sickness

40
Q

examples of type IV hypersensitivity?

A

contact dermatitis
GVH
MS
PPD

41
Q

antidesmosome/antidesmoglein?

A

pemphigus vulgaris

42
Q

anti GAD 65?

43
Q

antihemidesmosome?

A

bullous pemphigoid

44
Q

anti-smooth muscle?

A

autoimmune hepatitis

45
Q

p ANCA?

A

EGPA (churg Strauss)

microscopic polyangiitis

46
Q

c ANCA?

47
Q

BTK defect, recurrent bacterial and enteroviral infx, no LN or tonsils?

A

X-linked/Bruton’s agammaglobulinemia

absent B cells, decreased Ig

48
Q

most common 1ary immunodeficiency, often asx, airway/GI infx, autoimmune, atopy?

A

selective IgA deficiency

49
Q

defect in B cell differentiation, acquired/inherited, autoimmune, bronchiectasis, lymphoma, sinopulm infx?

50
Q

22q11, absent thymus and parathyroids, tetany, viral/fungal infections?

A

DiGeorge - CATCH22

FISH for 22q11 deletion

51
Q

decreased TH1 response, mycobacterial and fungal infections, presents after getting BCG vaccine, decreased IFN-g?

A

IL-12 receptor deficiency

autosomal recessive

52
Q

STAT3 mtn, TH17 deficiency, coarse facies, abscesses, retained teeth, high IgE, low IFN-g, eczema?

A

Job syndrome = autosomal dominant hyper-IgE syndrome

53
Q

noninvasive candida infections of skin and mucous membranes

A

chronic mucocutaneous candidiasis

T cell dysfunction

54
Q

FTT, chronic diarrhea, thrush, recurrent infx of all types, absent thymic shadow, germinal centers?

A

SCID

tx: BM txp

55
Q

types of SCID?

A

IL-2R gamma chain - XL

adenosine deaminase deficiency - AR

56
Q

ataxia, spider angiomas, IgA deficiency, increased AFP?

A

ataxia teleangiectasia
ATM gene defects –> dsDNA repair impaired
all Ig decreased
lymphopenia, cerebellar atrophy

57
Q

severe pyogenic infections early in life, opportunistic infections, increased IgM, decreased IgG/A/E?

A

hyper IgM syndrome
XLR
defective CD40L

58
Q

thrombocytopenia, recurrent infections, eczema?

A

Wiskott Aldrich
XLR
mutation in WAS - can’t reorganize actin

** increased risk autoimmune dz, malignancy

59
Q

recurrent bacterial skin/mucosal infections, absent pus formation, impaired wound healing? umbilical cord takes forever to fall off?

A

leukocyte adhesion deficiency
AR
defect in CD18 (LFA-1) - impaired migration and chemotaxis
increased neutrophils but absent at infection sites

60
Q

albino with recurrent pyogenic infections, peripheral neuropathy, infiltrative lymphohistiocytosis?

A 
Chediak Higashi
AR
defect in LYST (lysosomal gene)
giant granules in granuloctyes and platelets
pancytopenia
61
Q

infections by catalase+ organisms?

A

CGD
XLR
dx: abnormal dihydrorhodamine test, negative nitroblue tetrazolium dye reduction test

62
Q

mechanism of hyperacute txp rejection?

A

type II hypersensitivity
complement activation via pre-existing Abs
ischemia/necrosis of grafts

63
Q

mechanism of acute txp rejection?

A

weeks to months
cellular - CD8 to donor MHC
humoral - Abs develop post-txp
–> interstitial lymphocytic infiltrate

** prevented/reversed with immunosuppressants

64
Q

mechanism of chronic txp rejection?

A

months to years
CD4 –> recipient APCs with donor peptides
arteriosclerosis

65
Q

sx of GVH

A 
rash
jaundice
diarrhea
HSM
usually in BM and liver txp

step 1 - immuno (4 decks)

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