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First Aid Immunology > Immune Responses > Flashcards

Immune Responses Flashcards

1
Q

Portion of IgM and IgG that fixes complement

A

Fc portion

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2
Q

Light chain contribute to what part of the antibody?

A

Fab portion

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3
Q

4 C’s of Fc portion of antibody

A

Constant, Carboxy terminal, Complement binding, Carbohydrate side chain

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4
Q

Somatic hypermutation

A

Increase antibody diversity, this occurs following antigen stimulation

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5
Q

Recombination of VJ

A

Light chain antibody diversity

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6
Q

Recombination of VDJ

A

heavy Chain antibody diversity

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7
Q

Part of antibody that recognizes antigens

A

Variable part of L and H chains

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8
Q

Complement binds where on the antibody?

A

Y - just below the hinge on the antibody

pretend the Y is the antibody

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9
Q

Macrophage binds where on the antibody?

A

Y - halfway point of the stem of the antibody

pretend the Y is the antibody

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10
Q

Antigen binding site on the antibody

A

Y - on either of the top 2 tips of the antibody

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11
Q

Mature B cells express these 2 Igs on their surface

A

IgM and IgD

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12
Q

Isotype Switching

A

Gene rearrangement mediated by cytokines and CD40 ligand into plasma cells that secrete IgA, IgE or IgG

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13
Q

Main antibody in secondary (delayed) response to an antigen

A

IgG

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14
Q

Most abundant Ig in serum

A

IgG

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15
Q

Crosses placenta to provide infant with passive immunity

A

IgG

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16
Q

Opsonizes bacteria, neutralizes bacterial toxins and viruses

A

IgG

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17
Q

Prevents attachment of bacteria and viruses to mucous membranes

A

IgA

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18
Q

IgA in circulation and when secreted

A

Circulation - monomer

Secreted - dimer

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19
Q

Most produced antibody

A

IgA

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20
Q

Early in breast milk, colostrum

A

IgA

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21
Q

How IgA crosses epithelial cells

A

Transcytosis

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22
Q

Produced as primary (immediate) response to an antigen

A

IgM

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23
Q

fixes complement but does not cross placenta

A

IgM

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24
Q

pentamer

A

IgM

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25
Q

Binds mast cells and basophils

A

IgE

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26
Q

Ig in type I HS

A

IgE

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27
Q

IgE activates this cell type when wormies are around

A

Eosinophils

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28
Q

Lowest Ig in serum

A

IgE

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29
Q

Prolonged elevation of serum amyloid A

A

amyloidosis

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30
Q

Measured clinically as a sign of ongoing inflammation

A

C-reactive protein

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31
Q

Binds and sequesters iron to inhibit microbial iron scavenging

A

Ferritin

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32
Q

Coagulation factor; promotes endothelial repair

A

Fibrinogen

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33
Q

Prevents release of iron bound by ferritinand will cause anemia of chronic disease

A

Hepcidin

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34
Q

Internalized by macrophages to sequester iron

A

Transferrin

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35
Q

IgG or IgM mediated complement pathway

A

Classical pathway

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36
Q

Mannose or other sugars on microbe surface activate this complement pathway

A

Lectin Pathway

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37
Q

Microbe surface molecules activate this pathway

A

Alternative pathway

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38
Q

Complement(s) in anaphylaxis

A

C3a, C4a, C5a

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39
Q

Neutrophil chemotaxis

A

C5a

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40
Q

Cytolysis of membrane attack complex

A

C5b-9

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41
Q

Two primary opsonins in bacterial defense

A

C3b and IgG, C3b also helps clear immune complexes

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42
Q

Used to help prevent complement activation on self cells

A

Decay-accelerating factor (DAF) and c1 esterase inhibitor

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43
Q

C1 esterase inhibitor deficiency

A

Causes hereditary angioedema. ACE-I are contraindicated

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44
Q

Increase risk of severe, recurrent pyogenic sinus and respiratory tract infection; increases susceptibility to type III HS reactions

A

C3 deficiency

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45
Q

C5-C9 deficiencies

A

increased susceptibility to recurrent Neisseria bacteremia

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46
Q

Causes complement-mediated lysis of RBCs and paroxysmal nocturnal hemoglobulinuria

A

DAF (GPI anchored enzyme) deficiency

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47
Q

Osteoclast-activating factor

A

IL-1

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48
Q

Activates endothelium to express adhesion molecules; induces chemokines secretion too recruit leukocytes

A

IL-1

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49
Q

Causes fever and stimulates production of acute-phase proteins

A

IL-6

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50
Q

interleukin that is a major chemotactic factor for neutrophils

A

IL-8

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51
Q

Induces differentiation of T cells into Th1 cells/ Activates NK cells/ Also secreted by B cells

A

IL-12

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52
Q

Mediates septic shock, activates endothelium, causes leukocyte recruitment, vascular leak

A

TNF-alpha

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53
Q

Cytokines secretes by macrophages

A

IL-1, IL-6, IL-8, IL-12, TNF-alpha

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54
Q

Supports the growth and differentiation of BM stem cells.

A

IL-3

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55
Q

Secreted from Th1 cells

A

IFN-gamma

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56
Q

Effects of IFN-gamma

A

antiviral and anti-tumor properties
activates NK cells to kill virus-infected cells
increases MHC expression and antigen presentatio in all cells

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57
Q

Secreted from Th2 Cells

A

IL-4, IL-5, IL-10

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58
Q

IL-10 and TGF-beta share this feature

A

inhibit inflammation

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59
Q

Enhances class switching to IgE and IgG

A

IL-4

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60
Q

Enhances class-switching to IgA and stimulates the growth and differentiation of eosinophils

A

IL-5

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61
Q

T reg secretes this Interleukin

A

IL-10

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62
Q

Glycoproteins synthesized by viral-infected cells

A

IFNs

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63
Q

RNAase L

A

released from interferons to degrade viral/host mRNA

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64
Q

IFNs secrete Protein kinase to:

A

inhibit viral/host protein synthesis

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65
Q

CD28 from T cell binds to:

A

B7 on APC

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66
Q

Receptor for EBV

A

CD21 on B cell

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67
Q

CD19, 20, 21, 40

A

B cell surface proteins

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68
Q

CD14, 40, MHC II, B7, Fc and C3b receptors

A

Macrophage surface proteins

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69
Q

CD16, CD56

A

CD 16 binds Fc of IgG, these are for NK cells

70
Q

Self-reactive T cells become nonreactive without costimulatory molecule

71
Q

SuperAntigens MoA

A

Cross-link the beta region of the T-cell receptor to MHC II on APCs. Can activate any T cell causing massive release of cytokines

72
Q

Endotoxins/LPS from Gram (-) stimulate what?

A

Macrophages by binding to edotoxin receptor CD14

73
Q

Type of Vaccine that induces a cellular response

A

Live attenuated

74
Q

Examples of Live Attenuated Vaccines

A

MMR, polio (Sabin), influenza (intranasal), varicella, yellow fever

75
Q

Examples of Inactivated or Killed Vaccine

A

Cholera, HepA, polio (Salk), influenza (injection), rabies

76
Q

Type of Vaccine that causes Humoral Immunity

A

Inactivated or Killed Vaccine

- pathogen maintains its epitope structure on surface Ags

77
Q

HS with anaphylactic shock

78
Q

Free Ag crosslinks IgE on presensitized mast cells and basophils, causing release of vasoactive amines at postcapillary vanules

79
Q

Coomb’s test is associated with this HS

A

Type II HS

80
Q

IgM, IgG bind to fixed Ag on “enemy” cell leading to cellular destruction

A

Type II HS

81
Q

Detects Antibodies that HAVE adhered to patient’s RBCs

Ex. test an Rh (+) infant of an Rh (-) mom

A

Direct Coombs

82
Q

Detects antibodies that CAN adhere to other RBCs

Ex. test an Rh (-) mom for Rh(+) Abs

A

Indirect Coombs

83
Q

Serum Sickness is associated to which HS?

A

Type III HS

84
Q

Type III Hypersensitivity

A

Immune complex

Ag-Ab complexes activate complement which attracts neutrophils to release lysosomal enzymes

85
Q

Antibodies to foreign proteins are produce (5days) and depositied in membranes where they fix complement

A

Serum Sickness

86
Q

Local subacute antibody-mediated hypersensitivity. Intradermal injection of Ag induced antibodies which form Ag-Ab complexes in skin.

A

Arthus rxn - Type III HS

87
Q

Delayed, T cell type reaction

A

Type IV hypersensitivity

88
Q

Anaphylaxis, Bee sting, food/drugs allergies

89
Q

Autoimmune hemolytic anemia, pernicious anemia, idiopathic TPP

A

Type II HS

90
Q

erythroblastosis fetalis

A

Type II HS

91
Q

Rheumatic fever

A

Type II HS

92
Q

Goodpastures

A

Type II HS

93
Q

Bullous Pemphigoid and Pemphigous Vulgaris

A

Type II HS

94
Q

SLE

A

Type III HS

95
Q

Polyarteritis nodosa

A

Type III HS

96
Q

Poststreptococcal glomerulonephritis

A

Type III HS

97
Q

Multiple Sclerosis

A

Type IV HS

98
Q

Guillain-Barre syndrome

A

Type IV HS

99
Q

Graft vs Host Dx

A

Type IV HS

100
Q

Contact Dermatitis and PPD

A

Type IV HS

101
Q

Reaction against plasma proteins in the blood causing urticaria, pruritis, wheezing and fever

102
Q

Anaphylactic rxn to blood transfusion

A

IgA deficient patients, (prevent with giving blood without IgA)

103
Q

Host Ab against donor HLA Ags and leukocytes

A

Type II HS, Febrile nonhemolytic transfusion reaction

gets fever HA, chills and flushing

104
Q

ABO blood group incompatibility

A

Type II HS. Acute hemolytic transfusion rxn

105
Q

Anti-ACh receptor

A

Myasthenia Gravis

106
Q

Anti-basement membrane

A

Goodpasture syndrome

107
Q

Anti-cardiolipin, lupus anticoagulant

A

SLE, antiphopholipid syndrome

108
Q

Anticentromere

A

CREST syndrome, limited scleroderma

109
Q

Anti-desmoglein

A

Pemphigus Vulgaris

110
Q

Anti-dsDNA, anti-Smith

111
Q

Anti-glutamate decarboxylase

112
Q

Anti-hemidesmosome

A

Bullous pemphigoid

113
Q

Antihistone

A

Drug-induced lupus

114
Q

Anti-Jo1, anti-SRP, anti-Mi-2

A

Polymyositis, Dermatomyositis

115
Q

Antimicrosomal, Antithyroglobulin

A

hashimoto thyroiditis

116
Q

Anti-mitochondrial

A

Primary biliary cirrhosis

117
Q

Antinuclear antibodies

A

SLE, nonspecifc

118
Q

Anti-Scl-70, Anti-DNA topoisomerase I

A

Scleroderma (diffuse)

119
Q

Anti-smooth muscle

A

autoimmune hepatitis

120
Q

Anti-SSA, anti-SSB (anti-Ro, anti-La)

121
Q

Anti-TSH receptor

A

Graves Disease

122
Q

Anti-U1 RNP (ribonucleoprotein)

A

Mixed CT disease

123
Q

c-ANCA (PR3-ANCA)

A

Wegener or Granulomatosis with polyangiitis

124
Q

IgA antiendomysial, IgA anti-tissue transglutaminase

A

Celiac Disease

125
Q

p-ANCA (MPO-ANCA)

A

microscopic polyangiitis, Churg-Strauss syndrome

126
Q

Rhematoid factor, anti-CCP

A

Rheumatoid arthritis

127
Q

If patient lacks B cells which bacteria will affect them?

A

SHiNESKIS

S. pneumonia, Hib, Neisseria meningitidis, E. coli, Salmonella, Klebsiella pneumonia (Strep B)

128
Q

Defect in BTK, a tyrosine kinase gene

A

no B cell maturation, X-linked (Bruton) agammaglobulinemia

129
Q

Recurrent bacterial and enteroviral infections after 6 months

A

X-linked (Bruton) agammaglobulinemia

130
Q

Normal CD19+ B cell count, absent/scanty LN and tonsils

A

CD19 normal but decrease in pro-B and Ig, you see this in X-linked (Bruton) agammaglobulinemia

131
Q

Most common primary immunodeficiency

A

Selective IgA deficiency (majority of people are asymptomatic)

132
Q

Increase risk of autoimmune disease, bronchiecstasis, lymphoma, ainopulmonary infections, can be acquired in 20s-30s

A

Common variable immunodeficiency

133
Q

22q11 deletion

A

failure to develop 3rd and 4th pharyngeal pouches

DiGeorge Syndrome

134
Q

Tetany (hypocalcemia), recurrent viral.fungal infections, conotruncal abnormalities

A

DiGeorge Syndrome

135
Q

How to detect 22q11 deletion

136
Q

Decrease in Th1 response, decrease in IFN-gamma

disseminated mycobacterial and fungal infections

A

IL-12 receptor deficiency

137
Q

STAT3 mutation

A

Deficiency of Th17 - AD hyper-IgE syndrome (aka Job)

138
Q

Retain primary teeth, increase IgE, eczema, staph abscesses without inflammation

A

Job, or hyper-IgE syndrome

139
Q

Noninvasive Candida albicans infections of skin and mucous membranes

A

Chronic mucocutaneous candidiasis

140
Q

Defective IL-2R gamma chain

A

Adenosine Deaminase Deficiency - SCID

141
Q

Tx of SCID

A

BM transplant

142
Q

Defects in ATM gene, DNA double strand breaks

A

Ataxia-Telangiectasia

143
Q

Cerebellar defects, spider angiomas, IgA deficiency, increase AFP

A

Ataxia-telangiectasia

144
Q

Defective CD40L on Th cells = class-switching defect

A

Hyper-IgM syndrome

145
Q

Severe pyogenic infections early in life; opportunistic infection with pneumocystis, cryptosporidium, CMV

A

Hyper-IgM Syndrome

146
Q

Mutation in WAS gene

A

Wiskott-Aldrich Syndrome, T cells unable to reorganize actin cytoskeleton

147
Q

Thrombocytopenic purpura, Eczema, Recurrent Infections

A

Wiskott-Aldrich Syndrome

148
Q

Absent pus formation

A

Leukocyte adhesion deficiency (type 1)

149
Q

Defect in LFA-1 integrin (CD18)

A

Leukocyte adhesion deficiency (type 1)

recurrent bacterial and mucosal infections

150
Q

Defect in lysosomal trafficking regulator gene (LYST)

A

Chediak-Higashi Syndrome

151
Q

Microtubule dysfunction in phagosome-lysosome fusion

A

Chediak-Higashi Syndrome

152
Q

Defect of NADPH oxidase

A

Chronic Granulomatous Disease

153
Q

Abnormal dihydrorhodamine test

154
Q

Negative nitroblue Tetrazolium Dye Reduction Test

155
Q

Graft from different species

156
Q

Graft from nonidentical individual of same species

157
Q

Graft from self

158
Q

Syngraft or isograft

A

identical twin or clone

159
Q

Pre-existing recipient antibodies react to donor antigen *(type II reaction) activate complement

A

Hyperacute Transplant Rejection

happens within minutes

160
Q

Cellular Acute Transplant Rejection

A

CTLs activated against donor MHCs

takes weeks to months

161
Q

Humoral Acute Transplant Rejection

A

Antibodies develop after the transplant

takes weeks to months

162
Q

How to prevent Acute Transplant rejection

A

Immunosuppressants

163
Q

Recipient T cells perceive donor MHC as recipient MHC and rxt against donor Ags presented

A

Chronic Transplant Rejection, takes months to years

164
Q

Chronic Transplant Rejection in Heart

A

Atherosclerosis

165
Q

Chronic Transplant Rejection in Lungs

A

Bronchiolitis Obliterans

166
Q

Chronic Transplant Rejection in Liver

A

Vanishing Bile Ducts

167
Q

Chronic Transplant Rejection in Kidney

A

Vascular fibrosis, glomerulopathy

168
Q

Someone without MHCII won’t develop what Dx?

A

Graft vs Host Disease

169
Q

Maculopapular rash, jaundice, diarrhea, hepatosplenomegaly

A

Graft vs Host Disease

170
Q

What restaurant should you take Jenny to every Friday? or Monday? or anytime she is hungry?

A

Moe’s.. That’s right, take her to Moe’s.

First Aid Immunology (3 decks)

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