Immune Responses

Question 1

What three things contribute to the diversity of an antibody?

Answer 1

1. Random Recombination
2. Random addition of nucleotides by terminal deoxynucletotidyl transferase
3. Random combination of heavy chain with light chain

Question 2

Which part of the antibody determines the isotype?

Answer 2

Fc portion

Question 3

What are the three functions of antibodies?

Answer 3

1. Compliment
2. Neutralization
3. Opsonization

Question 4

Which portion of the antibody has the carboxy terminal?

Answer 4

Fc

Question 5

Which portion of the antibody participates in antigen binding?

Answer 5

Fab

Question 6

Which portion of the antibody has carbohydrate side chains?

Answer 6

Fc

Question 7

Mature B cells have what three things on them?

Answer 7

MHC Class II
IgD antibody
IgM antibody

Question 8

Which two antibody isotypes fix complement?

Answer 8

IgG and IgM

Question 9

What antibody can cross the placenta?

Answer 9

IgG

Question 10

Which antibody is produced in the primary immune response?

Answer 10

IgM

Question 11

Which antibody requires a secretory component?

Answer 11

IgA

protects it from lipases

Question 12

Which ab contributes to immunity against parasites?

Answer 12

IgE (eosinophils)

Question 13

Which antibody is given to the baby thru breast milk?

Answer 13

IgA

Question 14

Which antibody protects against GI infection?

Answer 14

IgA

Question 15

Which antibody neutralizes bacterial toxins and viruses>

Answer 15

IgG

Question 16

What form does IgM take in a B cell?

Answer 16

Monomer

becomes tetratmer when released into serum

Question 17

What class switching will occur if a B cells presents to Th1 cell?

Answer 17

IgG

Question 18

What class switching will occur if a B cell presents to a Th2 cell?

Answer 18

IgE

Question 19

Which type of memory is the most robust and why?

Answer 19

Thymus Dependent
The most robust memory is the one that includes IgG and B cells can not undergo class switching without T cells.

Question 20

Why is thymus independent memory not as strong?

Answer 20

Antigens that lack a peptide component (gram negative) means that B cells can not display the antigen on MHC molecules therefore only IgM can be produced. IgM is not as robust as IgG

Question 21

Which complement molecules vasodilate?

Answer 21

C3a, C4a, C5a

Question 22

Which complement molecule acts as an opsonin?

Answer 22

C3b

Question 23

Which pathway is initiated with gram negative bacterial endotoxin A?

Answer 23

Alternative pathway

Question 24

What sets off the classical pathway?

Answer 24

Antibody-Antigen Complex

Question 25

What inhibits the complement cascade?

Answer 25

CD55 or DAF and C1 esterase inhibitor

Question 26

What are the two primary opsonins in bacterial defense?

Answer 26

C3b and IgG

Question 27

Classical pathway is mediated by what ab?

Answer 27

IgM and IgG

Question 28

Classical pathway is important for protection against what specific bacteria?

Answer 28

Neisseria

Question 29

IL-1 Has what functions?

Answer 29

Induces fever thru PGE-2 Acute inflammation Activates endothelium to express adhesion molecules Induces chemokine secretion to recruit WBCs Also known as osteoclast activating factor (multiple Myeloma)

Question 30

IL-6 has what functions?

Answer 30

Fever and stimulates production of acute phase proteins

Question 31

IL-8 has what function?

Answer 31

Major chemotactic factor for neutrophils

Question 32

IL-12 has what function?

Answer 32

Induces differentiation of T cells into Th1 cells and activates NK cells

Question 33

TNF alpha function?

Answer 33

Activates endothelium and causes WBC recruitment, vascular leak

Question 34

IL-2 function?

Answer 34

Stimulate growth of helper, cytotoxic, and regulatory T cells

Question 35

IL-3 function?

Answer 35

Supports growth and differentiation of bone marrow stem cells. Functions like GM-CSF

Question 36

Interferon gamma?

Answer 36

Secreted by NK cells and T cells into Th 2 cells in response to antigen or IL-12 from macrophages Stimulates macrophage to kill phagocytosed pathogens Inhibits differentiation of Th2 cells

Question 37

IL-4 function

Answer 37

Induced differentiation of T cells in Th2 cells Promotes growth of B cells Enhances class switching to IgE and IgG

Question 38

IL-5 function

Answer 38

Promotes growth and differentiation of B cells Enhanced class switching to IgA Stimulates growth and differentiation of eosinophils

Question 39

IL-10 function

Answer 39

Attenuates inflammatory response Decreases expression of MHC class II and Th1 cytokines Inhibits activated macrophages and dendritic cells Also secreted by reg T cells

Question 40

Pt who are deficient in NADPH oxidase are at an increase risk for what pathogens?

Answer 40

Catalase positive pathogens

Question 41

Which molecules are important in viral immune response?

Answer 41

``` Interferon alpha, beta, gamma They decrease the synthesis of viral mRNA via ribonuclease and increase the expression of MHC class I ```

Question 42

What is the receptor on B cells responsible for EBV entry?

Answer 42

CD 21 (Eptein Barr must be over 21)

Question 43

What are the receptors on T cells that are responsible for HIV entry?

Answer 43

CXCR4 and CCR5

Question 44

What receptors on macrophages is responsible for PAMPs?

Answer 44

CD14

Question 45

What is anergy?

Answer 45

Is type of self tolerance where a T or B cells is in a state that they can not become activated by exposure to antigen. Usually do to lack of signal 2 in the co-stim cascade

Question 46

After exposure to tetanus, botulinum, HBV, varicella, and rabies patient are given PREFORMED Ab. What type of immunity is this?

Answer 46

Passive -> RAPID

Question 47

What are the toxoid vaccines? (2)

Answer 47

Clostridium Tetani | Corynebacterium diptheriae

Question 48

What are the subunit vaccines? (7)

Answer 48

``` HBV HPV Acellular pertusis N. meningitidis S. pneumoniae Haemophilus influenzae B ```

Question 49

What are the Killed or Inactivated vaccines? (4)

Answer 49

``` Rabies Influenza Polio Hep A (Killed vaccine -> RIP Always) ```

Question 50

Killed vaccines mainly induce what response?

Answer 50

Humoral | as compared to live vaccines which induce Cellular response

Question 51

What is one example of a type 1 HS rxn?

Answer 51

Anaphylaxis | IgE and mast cell degranulation

Question 52

What are some examples of a type 2 HS rxn?

Answer 52

``` Autoimmune-Hemolytic Anemia Immune Thrombocytopenia Hemolytic Disease of a Newborn Goodpasture Rheumatic Fever Graves Disease Myasthenia Gravis Pemphigus Vulgaris ```

Question 53

What are some examples of type 3 HS rxn?

Answer 53

SLE Polyarteritis nodosa Post-strep glomerulonephritis

Question 54

What are some examples of type 4 HS rxn?

Answer 54

Contact Dermatitis Graft vs Host Disease PPD Skin Test Patch Test

Question 55

If a women has been pregnant before but has had no blood transfusions, the pregnancy put her at increase risk for what type of transfusion reaction?

Answer 55

Febrile Non-Hemolytic (Host Ab against donor HLA and WBC- a person that has never had a transfusion SHOULD NOT have ab against HLA or WBC but a women who has prev been pregnant can have them due to babies blood)

Question 56

What is delayed hemolytic transfusion reaction?

Answer 56

Memory B cells present from a prev exposure (pregnancy or transfusion) but no antibodies so you get a massive proliferation of B cells leading to plasma cells. Presents about a week later with jaundice