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Immune System, TBP Flashcards

1
Q

Hypersensitivity reactions, type: IgE mediated

A

Type I

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2
Q

Hypersensitivity reactions: TH2 cells release this substance that stimulates eosinophils

A

IL-5

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3
Q

Hypersensitivity reactions: TH2 cells release this substance that activates IgE-producing b-cells

A

IL-4

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4
Q

Hypersensitivity reactions: IgE binds to what cells

A

Mast cells

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5
Q

Hypersensitivity reactions: Binding of antigen to IgE on mast cells result in

A

Mast cell degranulation and release of mediators

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6
Q

Type I hypersensitivity: Phases

A

Early and late

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7
Q

Type I hypersensitivity: Early phase occurs within

A

5-30 minutes

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8
Q

Type I hypersensitivity: Early phase is due to

A

Binding of antigen to IgE bound to mast cells and release of mediators

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9
Q

Type I hypersensitivity: Late phase occurs within

A

2-24 hours

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10
Q

Type I hypersensitivity: Late phase is characterized by

A

Infiltration of inflammatory cells and release of mediators by these cells

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11
Q

Type I hypersensitivity: Marker of anaphylaxis

A

Serum tryptase

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12
Q

Hypersensitivity reactions, type: Antibody-mediated

A

Type II

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13
Q

Type II hypersensitivity: Mechanisms (3)

A

1) Complement-dependent
2) Antibody-dependent cell-mediated cytotoxicity
3) Antibody-mediated cellular dysfunction

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14
Q

Type II hypersensitivity mechanism: Cell types that bear receptors for Fc of IgG mediate removal of antigen

A

Antibody-dependent cell-mediated cytotoxicity

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15
Q

Type II hypersensitivity mechanism: Antibodies themselves affect function of antigen

A

Antibody-mediated cellular dysfunction

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16
Q

Hypersensitivity reactions, type: Immune complex-mediated

A

Type III

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17
Q

Hypersensitivity reactions, type: T cell-mediated

A

Type IV

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18
Q

Type IV hypersensitivity: Mechanisms

A

1) Delayed form in which CD4+ Th1 cells sensitised from previous exposure to antigen secretes IF-γ that activates macrophages
2) Cell-mediated form in which CD8+ cytotoxic T cells kill antigen-bearing cells

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19
Q

Type IV hypersensitivity: Mechanisms of cell-mediated cytotoxicity

A

1) Perforin-granzyme system

2) FAS-FAS ligand system

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20
Q

Type IV hypersensitivity, mechanism: Holes are produced in the plasma membrane of cells, allowing granzyme to enter cells and activate apoptosis

A

Perforin-granzyme system

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21
Q

Type IV hypersensitivity, mechanism: FAS ligamnd on T lymphocytes bind to FAS on target cells leading to apoptosis

A

FAS-FAS ligand system

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22
Q

Type of hypersensitivity: Bee sting

A

Type I

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23
Q

Type of hypersensitivity: Drug allergy

A

Type I

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24
Q

Type of hypersensitivity: Glomerulonephritis

A

Type II or III

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25
Q

Type of hypersensitivity: Transfusion reactions

A

Type II

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26
Q

Type of hypersensitivity: Tuberculin reaction

A

Type IV, CD4+-mediated

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27
Q

Type of hypersensitivity: Erythroblastosis fetalis

A

Type II

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28
Q

Type of hypersensitivity: Contrast media allergy

A

Type I

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29
Q

Type of hypersensitivity: Serum sickness

A

Type III

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30
Q

Type of hypersensitivity: Urticaria

A

Type I

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31
Q

Type of hypersensitivity: AIHA

A

Type II

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32
Q

Type of hypersensitivity: Graves disease

A

Type II

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33
Q

Type of hypersensitivity: Insect venoms

A

Type I

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34
Q

Type of hypersensitivity: Food allergy

A

Type I

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35
Q

Type of hypersensitivity: Myasthenia gravis

A

Type II

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36
Q

Type of hypersensitivity: Contact dermatitis

A

Type IV

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37
Q

Type of hypersensitivity: Transplant rejection

A

Type II and IV

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38
Q

Mechanisms of transplant rejection (2)

A

Cell-mediated or humoral mediated

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39
Q

Classifications of transplant rejection

A

1) Hyperacute
2) Acute
3) Chronic

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40
Q

Mechanisms by which cytotoxic T cells kill graft cells

A

1) Perforin-granzyme pathway

2) FAS-FAS ligand pathway

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41
Q

Forms of cellular rejection: Body recognises MHC molecules on surface of APCs in the graft

A

Direct

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42
Q

Forms of cellular rejection: Antigens of the graft are presented by recipient’s cells

A

Indirect

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43
Q

Classification of transplant rejection: Humoral reaction due to preformed antibodies to graft endothelium

A

Hyperacute rejection

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44
Q

Classification of transplant rejection: Cellular or humoral reaction

A

Acute rejection

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45
Q

Classification of transplant rejection: 4-6 months to years following graft

A

Chronic rejection

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46
Q

Classification of transplant rejection: Possibly due to indirect form of cellular rejection

A

Chronic rejection

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47
Q

Classification of transplant rejection: Minutes following transplantation

A

Hyperacute

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48
Q

Classification of transplant rejection: Days to months to years following transplantation

A

Acute

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49
Q

Classification of transplant rejection: Cyanosis of organ and mottled parenchyma

A

Hyperacute

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50
Q

Classification of transplant rejection: Endothelial injury, neutrophils in arterioles, infarcts of parenchyma

A

Hyperacute

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51
Q

Classification of transplant rejection: Vascular changes and interstitial fibrosis

A

Chronic

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52
Q

Classification of transplant rejection: Interstitial mononuclear infiltrate and edema

A

Acute

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53
Q

Classification of transplant rejection: Interstitial hemorrhage and endothelia’s (swollen endothelial cells)

A

Acute

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54
Q

Classification of transplant rejection: Interstitial mononuclear infiltrate and schema with loss of tissue

A

Chronic

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55
Q

Classification of transplant rejection: Necrotizing vasculitis, neutrophilic infiltrates, and infarcts of parenchyma

A

Acute

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56
Q

Classification of transplant rejection: Will respond to cyclosporine

A

Acute

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57
Q

Immune competent cells in the graft recognize antigens in the host

A

GVHD

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58
Q

GVHD: Occurs in transplant of what

A

1) Bone marrow transplant
2) Solid organ transplant when organ is rich in lymphocytes
3) Non-irradiated blood

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59
Q

GVHD: Forms

A

1) Acute

2) Chronic

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60
Q

GVHD, acute vs chronic: Days to weeks

A

Acute

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61
Q

GVHD, acute vs chronic: Skin rash

A

Acute

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62
Q

GVHD, acute vs chronic: Fibrosis of dermis and skin appendages

A

Chronic

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63
Q

GVHD, acute vs chronic: Cholestatic jaundice

A

Chronic

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64
Q

GVHD, acute vs chronic: Jaundice

A

Acute

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65
Q

GVHD, acute vs chronic: Esophageal strictures

A

Chronic

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66
Q

GVHD, acute vs chronic: Bloody diarrhea

A

Acute

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67
Q

GVHD, acute vs chronic: Immunodeficiency

A

Acute and chronic

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68
Q

GVHD: Infection commonly associated with immunodeficiency in GVHD

A

CMV pneumonia

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69
Q

General mechanism of autoimmune diseases

A

Loss of self-tolerance

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70
Q

Autoimmune diseases: Contributing factors to loss of self-tolerance (2)

A

1) Susceptibility genes such as HLA B27 in ankylosing spondyltitis
2) Infections that upregulate costimulatory proteins on APCs or molecular mimicry

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71
Q

Associated antibodies: SLE

A

1) Anti-dsDNA

2) Anti-Smith

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72
Q

Associated antibodies: Drug-induced lupus

A

Antihistone

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73
Q

Associated antibodies: RA

A

IgM vs Fc of Ig

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74
Q

Associated antibodies: Sjogren

A

Anti-SSA and anti-SSB

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75
Q

Associated antibodies: CREST syndrome

A

Anti-centromere

76
Q

Associated antibodies: Diffuse scleroderma

A

Anti-scl70

77
Q

CREST in CREST syndrome

A

1) Calcinosis
2) Raynaud phenomenon
3) Esophageal dysfunction
4) Sclerodactyly
5) Telangiectasia

78
Q

SLE: Age of predilection

A

Child-bearing age

79
Q

SLE: Male vs female

80
Q

SLE: Male to female ratio in children and older adults

A

More or less equal

81
Q

SLE: Criteria

A

SOAP BRAIN MD

1) Serositis
2) Oral ulcers
3) Arthritis
4) Photosensitivity
5) Blood disorders
6) Renal involvement
7) ANA
8) Immunologic phenomena
9) Neurologic didorder
10) Malar rash
11) Discoid rash

82
Q

SLE: # of criteria to be fulfilled for diagnosis

83
Q

SLE: Proteinuria

84
Q

SLE: Presence of antiphospholipid Ab is detected by what tests

A

1) Positive lupus anticoagulant test
2) Abnormal level of IgG or IgM anticardiolipin
3) False-positive syphilis test

85
Q

SLE: Best screening test

86
Q

SLE: SLE-specific

A

Anti-dsDNA, anti-Sm

87
Q

SLE: Associated with decreased risk for nephritis

A

Anti-Ro (SSA) and anti-La

88
Q

SLE: Associated with neonatal lupus with congenital heart block

89
Q

SLE: Type of hypersensitivity

90
Q

SLE: Risk factors

A

Genetics and environment

91
Q

SLE: Most common cause of death

A

Renal disease and intercurrent infections

92
Q

SLE: Second most common cause of death

A

CNS diseases

93
Q

SLE: Endocarditis

A

Libman-Sacks

94
Q

SLE: T/F Vegetations in SLE endocarditis is sterile

95
Q

SLE: LE cell

A

Neutrophil with phagocytized nuclei

96
Q

SLE: Classes of nephritis

A 
I - No disease
II - Increase in mesangial matrix with deposition of immune complexes
III- FPGN
IV - DPGN
V - MGN
97
Q

SLE: Characteristic pattern seen in Class V SLE nephritis

A

Wire-loop pattern

98
Q

Due to antibody that delays clotting in vitro and induces a hyper coagulable state in vivo

99
Q

APAS: Classic clinical triad

A

1) Thrombosis
2) Thromobocytopenia
3) Recurrent abortions

100
Q

Forms of APAS: Occurs as sole entity and not associated with SLE

101
Q

Forms of APAS: Occurs in patients with SLE

102
Q

SLE: Drugs associated with drug-induced lupus

A

PIMCH

1) Procainamide, Penicillamine
2) Isoniazid
3) Methyldopa
4) Chlorpromazine
5) Hydralazine
6) Quinidine

103
Q

Characteristics of drug-induced lupus that differentiates it from SLE (5)

A

1) Gender ratios nearly equal
2) Predominancy of anti-histone abs
3) Renal and CNS manifestations are uncommon
4) No anti-dsDNA or hypocomplementemia
5) Discontinuation of drugs lead to resolute of symptoms and lab parameters

104
Q

RA: Men vs women

105
Q

RA: Type of arthritis

A

Non-suppurative, proliferative

106
Q

RA: Joints affected

A

Bilateral, most commonly in hands

107
Q

RA: Classic presentation

A

Morning stiffness >1 hour in duration

108
Q

RA: Classic signs

A

1) Boutonniere deformity
2) Swan neck deformity
3) Baker’s cyst
4) Rheumatoid nodules

109
Q

RA: Arthritis of PIP

A

Swan neck deformity

110
Q

RA: Arthritis of DIP

A

Boutonniere deformity

111
Q

RA: Antibody

A

Rheumatoid factor

112
Q

RA: Type of hypersensitivity reaction

113
Q

RA: Proliferating synovial cells mixed with inflammatory cells and granulation tissue

114
Q

RA: Pannus formation can lead to

A

Ankylosis (fibrosis and calcification of joint space)

115
Q

RA: Central fibrinoid necrosis surrounded by palisading macrophages, with an outer rim of lymphocytes and plasma cells

A

Rheumatoid nodules

116
Q

Sjogren syndrome: Age of predilection

A

50-60 years

117
Q

Sjogren syndrome: Men vs women

118
Q

Sjogren syndrome: Triad

A

1) Xerostomia
2) Xerophthalmia
3) Autoimmune disorder (usually RA)

119
Q

Sjogren syndrome: Antibody associated with higher likelihood of having systemic manifestations

120
Q

Sjogren syndrome: Neoplastic complication

A

MALToma (neoplasm of mucosa-associated lymphoid tissue

121
Q

Autoimmune disorder associated with fibrosis of organs

A

Scleroderma

122
Q

Scleroderma: Age of predilection

123
Q

Scleroderma: Male vs female

124
Q

Scleroderma: Clinical presentations (2)

A

1) Limited scleroderma or CREST syndrome

2) Diffuse scleroderms

125
Q

Scleroderma: Anti-Scl70 is an antibody against

A

DNA topoisomerase I

126
Q

Autoimmune disorder with findings suggestive of SLE, polymyositis, RA, and systemic sclerosis

A

Mixed CT disorder

127
Q

Mixed CT disorder: Associated antibodies

A

Anti-RNP particle containing U1

128
Q

Mixed CT disorder: Renal disease

A

Little or none

129
Q

Mixed CT disorder: Response to corticosteroids

130
Q

Autoimmune disorders, microscopic: Lymphocytic and plasmacytic infiltrate of salivary and lacrimal glands, associated with ductal damage

A

Sjogren syndrome

131
Q

Autoimmune disorders, microscopic: Fibrosis involving dermis, muscularis of GIT, and alveolar septae in the lung and interlobular arteries in kidney

A

Scleroderma

132
Q

Amorphous, hylaine deposition that has apple-green birefringence upon polarisation after Congo red staining

A

Amyloidosis

133
Q

Amyloidosis: Due to

A

Abnormal production and deposition of protein

134
Q

CKD with large kidneys (4)

A

1) Amyloidosis
2) HIV
3) DM
4) Polycystic kidney disease

135
Q

Hereditary immunodeficiency states: Failure of maturation of B cells

A

X-linked agammaglobulinemia of Bruton

136
Q

X-linked agammaglobulinemia of Bruton: Mutated gene

A

Gene for B cell tyrosine kinase

137
Q

X-linked agammaglobulinemia of Bruton: Inheritance pattern

A

X-linked recessive

138
Q

X-linked agammaglobulinemia of Bruton: Manifests by age of

139
Q

X-linked agammaglobulinemia of Bruton: Delay in manifestation due to

A

Presence of maternal IgG

140
Q

Forms of amyloidosis, associated disease: Ig light chain

A

Multiple myeloma

141
Q

Forms of amyloidosis, associated disease: Serum amyloid-associated protein

A

Hereditary amyloidosis

142
Q

Forms of amyloidosis, associated disease: Transthyretin

A

Systemic senile amyloidosis

143
Q

Forms of amyloidosis, associated disease: Amyloid precursor protein

A

Alzheimer disease

144
Q

Forms of amyloidosis, associated disease: Calcitonin

A

Medullary thyroid carcinoma

145
Q

Hereditary immunodeficiency states: No one mode of inheritance

A

Common variable immunodeficiency

146
Q

Hereditary immunodeficiency states: X-linked inheritance with mutation of CD40L

A

Hyper-IgM syndrome

147
Q

Hereditary immunodeficiency states: Wiskott-Aldrich syndrome inheritance

A

X-linked recessive

148
Q

Hereditary immunodeficiency states: B cells proliferate in response to antigen but cannot produce Ig

A

Common variable immunodeficiency

149
Q

Hereditary immunodeficiency states: Defect in differentiation of B lymphocytes to IgA-producing cells

A

Isolate IgA deficiency

150
Q

Hereditary immunodeficiency states: T cells fail to stimulate B cells to produce antibody other than IgM

A

Hyper-IgM syndrome

151
Q

Hereditary immunodeficiency states: Defect in cytokine receptor for IL-7 which is required for lymphocyte proliferation

A

SCID, X-linked recessive

152
Q

Hereditary immunodeficiency states: Accumulation of deoxy-ATP, which is toxic to lymphocytes

A

SCID, autosomal recessive

153
Q

Hereditary immunodeficiency states: Recurrent infections before the age of 6 months with wide range of pathogens

154
Q

Hereditary immunodeficiency states: Thrombocytopenia with resultant bleeding at circumcision site, eczema, and recurrent infections

A

Wiskott-Aldrich syndrome

155
Q

Hereditary immunodeficiency states: Mutation in gene for adenosine deaminase

A

SCID, autosomal recessive

156
Q

Hereditary immunodeficiency states: Autosomal vs X-linked SCID, male predominance

157
Q

Hereditary immunodeficiency states: Mutation in gene for common γ chain subunit of cytokine receptors

A

SCID, X-linked recessive

158
Q

Hereditary immunodeficiency states: Recurrent pyogenic infections and pneumocystis pneumonia

A

Hyper-IgM syndrome

159
Q

Hereditary immunodeficiency states: Hyper-IgM syndrome, mutated in autosomal inheritance

160
Q

Hereditary immunodeficiency states: Recurrent sinopulmonary infections, diarrhea, and increased incidence of autoimmune diseases

A

Isolated IgA deficiency

161
Q

Hereditary immunodeficiency states: Isolated IgA deficiency may be acquired due to what infections

A

1) Toxoplasmosis

2) Measles

162
Q

Hereditary immunodeficiency states: Lymphoid follicular hyperplasia

A

Common variable immunodeficiency

163
Q

Hereditary immunodeficiency states: Common variable deficiency, age of presentation

A

Later childhood and adolescence

164
Q

Hereditary immunodeficiency states: Underdeveloped germinal centres in lymphoid organs

A

X-linked agammaglobulinemia of Bruton

165
Q

Hereditary immunodeficiency states: Hypoplasia of tonsils and adenoids

A

X-linked agammaglobulinemia of Bruton

166
Q

AIDS: HIV, type of virus

A

RNA retrovirus

167
Q

AIDS: Modes of transmission

A

1) Sexual
2) Parenteral
3) In-utero, transplacental, or intrapartum

168
Q

AIDS: Major capsid protein

169
Q

AIDS: Encodes p24

170
Q

AIDS: Encodes reverse transcriptase

171
Q

AIDS: Binds to CD4

172
Q

AIDS: Binding of gp120 to CD4 results in exposure of binding site of ___ on T cells

173
Q

AIDS: Binding of gp120 to CD4 results in exposure of binding site of ___ on macrophages

174
Q

AIDS: Binding of gp120 to CD4 results in a change in gp41 resulting in

A

Viral-cell fusion

175
Q

Organs colonised by HIV

A

Lymphoid organs

176
Q

Pneumonia that produces a fluffy-pink exudate in the alveolar spaces

A

Pneumocystis pneumonia

177
Q

AIDS: Risk factor for pneumocystis pneumonia

A

CD4+ count

178
Q

AIDS: Opportunistic infection that causes enteritis

A

Cryptosporidiosis

179
Q

AIDS: Chest radiograph of pneumocystis

A

Diffuse interstitial ground-glass pattern

180
Q

AIDS: Common associated malignancies (2)

A

1) Kaposi sarcoma

2) Non-Hodgkin lymphoma (B cell lymphoma of brain)

181
Q

AIDS: Kaposi sarcoma is derived from

A

Blood vessels

182
Q

AIDS: Opportunistic infection that causes pneumonia or CNS infection

A

Toxoplasmosis

183
Q

AIDS: opprotunistic infection that causes meningitis

A

Cryptococcosis

184
Q

AIDS: Mycobacteria that are opportunistic in patients with AIDS

A

M. tuberculosis and M. avium intracellulare

185
Q

AIDS: Kaposi sarcoma is related to what virus

Pathology (14 decks)

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