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gen path lec > immunity 1 and 2 ppt (dr esgana) > Flashcards

immunity 1 and 2 ppt (dr esgana) Flashcards

1
Q

biological system that helps protect the body from harmful microorganisms

A

immunity

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2
Q

cells that are called the first line of defense

A

innate cells

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3
Q

does innate lymphoid cells has receptors?

A

nope

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4
Q

immunity that develops overtime as the body encounters specific pathogens or foreign substances. characterized by its specificity and memory

A

adaptive immunity

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5
Q

two cells of adaptive immunity

A

B cells - humoral
T cells - cell mediated

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6
Q

function of B cell

A

neutralize of microbe, phagocytosis and complement activation

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7
Q

reaction of innate immunity

A

inflammation
antiviral defense - type 1 interferons

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8
Q

3 types of t cells

A

T helper cells
cytotoxic T lymphocyte
Regulatory T lymphocyte

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9
Q

3 function of t helper cells

A

activation of macrophages
inflammation
proliferation and differentiation of t and b cells

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10
Q

function of cytotoxic T lymphocyte

A

killing of infected cell

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11
Q

function of regulatory t lymphocyte

A

suppression of immune response

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12
Q

B cells differentiates into what cell

A

plasma cell

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13
Q

6 functions of antibodies

A

neutralization of microbe and toxins
opsonization and phagocytosis
antibody-dependent cytotoxicity - kills also the cell
lysis of microbe
phagocytosis
inflammation

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13
Q

what t cells recognizes the dendritic cells with antigen

A

CD 4 T cells and CD8 T cells

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14
Q

identifications of humoral immunity

A
  1. circulates in the blood as a soluble protein
  2. B cells
  3. acts on extracellular microbes and their toxins
  4. recognized unprocessed antigens
  5. plasma B cells secrete antibodies
  6. rapid
  7. DOES NOT ACT ON THE TUMOR CELLS AND TRANSPLANTS
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15
Q

identifications of cell mediated immunity

A
  1. mediated by the activated antigen-specific T cells
  2. T cells
  3. acts on intracellular microbes
  4. presented by MHC complex
  5. secretes cytokines
  6. a delayed type hypersensitivity
  7. acts on tumor cells and transplants
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16
Q

memory of innate and adaptive

A

innate - no
adaptive - yes

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17
Q

potency of innate and adaptive

A

innate - lower
adaptive - higher

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18
Q

speed of onset innate and adaptive

A

innate - immediate
adaptive - approx 3 day lag

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19
Q

specificity of innate and adaptive

A

innate - unspecific
adaptive - highly specific

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20
Q

pathological, excessive, and injurious immune
response to antigen leading to tissue injury, disease or sometimes death in a sensitized individual

the resulting diseases are name as?

A

hypersensitivity diseases

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21
Q

rapid immunologic reaction occurring in a previously
sensitized individual that is triggered by the binding of
an antigen to IgE antibody on the surface of mast cells

A

type 1 immediate hypersensitivity

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22
Q

a hypersensitivity that is often called allergy, and the antigens that elicit them are
allergens

may occur as a systemic disorder or as a local
reaction

A

type 1 immediate hypersensitivity

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23
Q

how many hrs does the late phase reaction occur

A

2-24 hrs after repeated allergen exposure

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24
Q

prototypical disorder of type 1 hypersensitivity

A

anaphylaxis; allergies; bronchial asthma

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25
Q

Ige triggered reaction can be divided into two phases

A

Immediate response

late phase reactions

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26
Q

a phase of IgE reaction that becomes evident within minutes

A

immediate response

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27
Q

a phase of IgE reaction that develops in ___ hrs after the exposure to
antigen which may last for several days

A

2 -24

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28
Q

immediate response is characterized by

A

vasodilation, vascular leakage, SM spasm or glandular secretion

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29
Q

released rapidly from mast cells

A

histamine and leukotrienes

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30
Q

most common form of acute interstitial nephritis

generally after 2-3 wks after exposure

A

acute allergic interstitial nephritis

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31
Q

heterogenous disease, usually characterized by chronic airway inflammation

produces symptoms such as wheezing, shortness of breath, chest tightness and cough

A

asthma

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32
Q

examples of type 1 immediate hypersensitivity diseases

A

acute allergic interstitial nephritis

allergic rhinitis

anaphylaxis

bronchial asthma

food allergies

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33
Q

production of igE antibody

A

immediate hypersensitivity

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34
Q

production of IgG and IgM

A

type 2 antibody-mediated hypersensitivity

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35
Q

mechanism of type 2 antibody mediated hypersensitivity

A

A. opsonization and phagocytosis

B. complement and Fc receptor mediated inflammation

C. antibody mediated cellular dysfunction

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36
Q

noncollagenous protein in basement membrane of kidney glomeruli and lung alveoli

complement and Fc receptor mediated inflammation

nephritis, lung hemorrhage

A

goodpasture syndrome

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37
Q

gross:
- lungs are heavy, with areas of red - brown consolidation

microscopic
- focal necrosis of alveolar walls associated with intra-alveolar hemorrhages
- alveoli contain hemosiderin-laden macrophage

A

goodpasture lung

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38
Q

most common cause of endogenous hyperthyroidism

A

graves disease (antibody mediated disease)

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39
Q

autoimmune disorder characterized by the production of autoantibodies against multiple thyroid proteins, most importantly the TSH RECEPTOR

A

graves disease (antibody mediated disease)

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40
Q

most common antibody subtype, known as thyroid-stimulating
immunoglobulin (TSI), is observed in approximately 90% of patients.

A

graves disease (antibody mediated disease)

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41
Q

TSH receptor

antibody mediated stimulation of TSH receptors

hyperthyroidism

A

graves disease (antibody mediated disease)

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42
Q

gross:
- thyroid gland is usually symmetrically enlarged due to
diffuse hypertrophy and hyperplasia of thyroid follicular
epithelial cells

microscopic
- Follicular epithelial cells are tall and more crowded than usual. Lymphoid infiltrates, consisting predominantly of T cells

A

graves disease (antibody mediated disease)

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43
Q

caused by
autoantibodies against epidermal cell junction proteins
(DESMOGLEINS), commonly presenting with flaccid
blisters, erosions or scaling

Most common form (80%)

A

PEMPHIGUS

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44
Q

proteins in intracellular junction of epidermal cells (desmogleins)

antibody-mediated activation of proteases, disruption of intracellular adhesion

skin vesicles (bullae)

A

pemphigus vulgaris

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45
Q

Suprabasal acantholysis

Basal layer remains attached (tombstone sign)

A

pemphigus vulgaris

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46
Q

desposition of antigen-antibody complexes -> complement activation

A

immune complex mediated type III hypersensitivity

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47
Q

characterized by formation of immune (antigen and
antibody) complexes in the circulation and may get
deposited in blood vessels, leading to complement
activation and inflammation

A

IMMUNE COMPLEX–MEDIATED (TYPE III)
HYPERSENSITIVITY REACTIONS

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48
Q

IMMUNE COMPLEX–MEDIATED (TYPE III)
HYPERSENSITIVITY REACTIONS

in blood vessels:
in renal glomeruli:
in joints:

A

vasculitis
glomerulonephritis
arthritis

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49
Q

necrosis of the vessel wall and intense neutrophilic
infiltration.

A

acute vasculitis

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50
Q

The necrotic tissue and deposits of immune
complexes, complement, and plasma protein appear
as a smudgy eosinophilic area of tissue destruction,
an appearance termed as?

A

fibrinoid necrosis

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51
Q

characterized by diffuse thickening of the glomerular capillary wall due to the accumulation
of deposits containing Ig

A

membranous glomerulopathy

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52
Q

examples of immune complex-mediated disease

A

systemic lupus erythematosus
poststreptococcal glomerulonephritis
polyarteritis nodosa
reactive arthritis
serum sickness
arthus reaction

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53
Q

A type of hypersensitivity which activates T lymphocyte
1. release of cytokines
2 T-cell mediated cytotoxicity

A

cell mediated type IV hypersensitivity

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54
Q

A chronic inflammatory dermatosis that appears to have an autoimmune basis.

Mostly frequently affects the skin of the elbows, knees, scalp, lumbosacral areas, intergluteal cleft,
and glans penis

A

PSORIASIS

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55
Q

characteristic of psoriasis

A

silver-white scale

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56
Q

differentiate crohn disease and ulcerative colitis
(mga gi discuss ni doc esgana)
MACROSCOPIC
bowel region
distribution
structure
wall appearance

MICROSCOPIC
inflammation
pseudopolyps
ulcers
granulomas
fistulae/sinuses

CLINICAL
malignant potential
toxic megacolon

A

MACROSCOPIC
ileum +- colon |colon only, rectum
skip lesions |diffuse
yes | rare
Thick | normal

MICROSCOPIC
transmural | limited to mucosa
moderate | marked
deep knife like | superficial, broad-based
yes -35% | no
yes | no

CLINICAL
common | no
no | yes

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57
Q

give 3- 4 organ - specific diseases mediated by antibodies type ll hypersensitivity

A

autoimmune hemolytic anemia
autoimmune thrombocytopenia
autoimmune atrophic gastritis of pernicious anemia
myasthenia gravis
graves disease
goodpasture syndrome

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58
Q

systemic disease mediated by antibodies

A

systemic lupus and erythematosus

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59
Q

organ specific disease mediated by T cells

A

type 1 diabetes mellitus
multiple sclerosis

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60
Q

systemic diseases mediated by T cells

A

rheumatoid arthritis
systemic sclerosis
sjorgen syndrome

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61
Q

organ-specific diseases postulated to be autoimmune

A

crohn disease
primary biliary cirrhosis
autoimmune hepatitis

62
Q
A
63
Q

T lymphocytes and antibodies produced against graft antigens react against and destroy tissue grafts

A

REJECTION

64
Q

Grafts that belong to the same specie

A

Allografts (human to humans)

65
Q

Grafts that belong to different species

A

Xenografts ( ex. Pig to human)

66
Q

Major antigenic difference between a donor and recipient that result in rejection of transplants are differences in????

A

HLA allele

67
Q

2 pathways where recipients T cell recognize donor HLA antigens from the graft

A

Direct
Indirect

68
Q

Graft antgiens are presented directly to recipientT cels by graft APC

A

DIRECT

69
Q

Graft antigens are picked up by host APCs processed (like any other foreign antigen), and presented to host T cells

A

INDIRECT

70
Q

Which Will have a stronger immune response? Allografts or pathogens

A

Allografts

71
Q

Patterns of graft rejection

A

Hyperacute
Acute
Chronic

72
Q

A mechanism of graft that is immediate. Mediated by performed atibodies specific for antigens on graft endothelial cells

It is also rare

A

Hyperacute

73
Q

Mechanism of graft rejection that occurs in days or weeks. Mediated by T cells and antibodies that are activated by alloantigens in the graft

A

Acute graft rejection

74
Q

2 patterns of acute cellular injury

A

Tubulointerstitial pattern type 1
Vascular pattern type 2

75
Q

patten of injury where extensive interstitial inflammation and tubular inflammation associated with focal tubular injury

A

Tubulointerstitial pattern type 1

76
Q

Pattern of injury where it shows inflammation of vessls and sometimes necrosis of vessel walls

A

Vascular pattern type II

77
Q

2 types of acute rejection

A

Acute cellular ( T cell mediated ) rejection and acute antibody-mediated rejection ( vascular, or humoral )

78
Q

A type of acute rejection that is manifested mainly by damage to glomeruli and small blood vessels

A

Acute antibody mediated rejection ( a type of acute graft rejection )

79
Q

Mechanism of graft rejection that occurs in months or years. The culprit is believed to be T cells. Manifested as interstitial fibrosis and gradual narrowing of graft blood vessels. DOMINATED BY VASCULAR CHANGES

A

Chronic graft

80
Q

2 types of immunodeficiency disease

A

Primary (or congenital) immunodeficiencies
- genetically determined
Secondary ( or acquired ) immunodeficiencies
- complications of caners, infections, malnutrition and other disease

81
Q

In primary immunodeficiencies defects occurs in where?

A

Innate immunity
Lymphocytes and the adaptive immune response
Systemic disease

82
Q

Defects in innate immunity of the primary immunodeficiencies are in?

A

Leukocyte function and complement system

83
Q

Defects in leukocyte function that both result in a failure of leukocyte adhesion to endothelium, preventing the ceols from migrating into tissue

A

Inherited defects in leukocyte adhesion
(2 types of leukocyte adhesion)

Leykocyte adesion deficiency type 1 - defect by the integrin LFA-1 and Mac-1

Leukocyte adhesion deficiency type 2 - E- and P- selectins

84
Q

A inherited defect in phagolysosome that has defective fusion of phagosomes and lysosomes

A

Chediak higashi syndrome

85
Q

Main leukocyte abnormalities are?

A

Neutropenia, defective degranulation and delayed microbial killing

86
Q

Does chediak higashi syndrome has leukocytes containing giant granules?

A

Yes

87
Q

Inherited defects in microbial activity that is characterized by defects in bacterial killing

A

Chronic granulomatous disease

88
Q

4 Defects in leukocyte function

A

Inherited defects in leukocyte adhesion
Injerited defects in phagolysosome function
Inherited defects in microbial activity
Defects in TLR signaling

89
Q

Defects in leukocyte function that results in herpes simplex encephalitis and are associated with destructive bacterial pneumonias

A

DEFECTS IN TLR 3 - herpes simplex encephalitis
DEFECTS IN MyD88 - destructive bacterial pneumonias

90
Q

Defects in the complement system that is most common complement protein deficiency

A

C2, C4 DEFICIENCY

91
Q

Defects in the complement system is required for both the classical and alternative pathways, and hence a deficiency of this protein results in susceptibility to serious and RECURRENT PYOGENIC INFECTIONS

A

C3 DEFICIENCY

92
Q

Defects in the complement system that are required for the assembly of the membrane attack complex.

Deficiency of these late-acting components is associated with increased susceptibility to recurrent neisseria (gonococcal and meningococcal) infections

A

C5,6,7,8,and 9 DEFICIENCY

93
Q

4 subtypes of defects in the complement system

A

C2, C4 deficiency
C3 deficiency
C5, 6,7,8, and 9 deficiency
Deficiency of C1 inhibitor (C1 INH)

94
Q

An AD disorder that are C1 inhibitor’s targets the proteases. Episodes of edema affecting skin and mucosal surface

A

Deficiency of C1 inhibitor

95
Q

Disease affecting lymphocytes and the adaptive immune response

Common defect in both humoral and cell-mediated immune response

A

Severe combined immunodeficiency SCID

96
Q

Two types of severe combined immunodeficiency

A
  1. X-linked SCID
  2. Autosomal recessive SCID
97
Q

a type of SCID that is more common in boys. Mutation in the common y-chain subunit of cytokine receptor resulting in a defective IL-7 receptor signaling

A

X-linked SCID

98
Q

A type of SCID

A most common cause of autosomal recessive cause by a deficiency of the enzyme adenosine deaminase (ADA)

A

Autosomal recessive SCID

99
Q

A disorder affecting lymphocytes and the adaptive immune response

That is characterized by the failure of B-cell precursors to develop into mature B cells. Caused by mutation in a cytoplasmic tyrosine kinase called bruton tyrosine kinase (BTK)

A

X-linked agammaglobulinemia

100
Q

A disorder affecting lymphocytes and the adaptive immune response

A T-cell deficiency that results from failure of development of the thymus. They have a variable loss of T-cell mediated immunity, tetany, and congenital defects of the heart and great vessels

Caused by a small germline deletion that maps to chromosome 22q11

A

DIGEORGE SYNDROME (THYMIC HYPOPLASIA)

101
Q

Symptoms of digeorge syndrome (thmic hypoplasia)

A

CATCH 22
1. Cardiac anomalies
2. Abnormal facies
3. Thymic hypoplasia
4. Cleft palate
5. Hypocalcemia

102
Q

A disorder affecting lymphocytes and the adaptive immune response

Caused by mutations in transcription factors that are required for class II MHC gene expression

A

BARE LYMPHOCYTE SYNDROME

103
Q

A disorder affecting lymphocytes and the adaptive immune response

Affects patients have IgM antibodies but are deficient in IgG, IgA and IgE antibodies

A

HYPER-IGM SYNDROME

104
Q

A disorder affecting lymphocytes and the adaptive immune response

Common feature is hypogammaglobulinemia, generally affecting all the antibody classes but sometimes only IgG

A

Common variable immunodeficiency

105
Q

A disorder affecting lymphocytes and the adaptive immune response

Common immunodeficiency caused by impaired differentiation of naive B lymphocytes to IgA-producing plasma cells

Individuals have extremely low levels of both serum and secretory IgA

A

ISOLATED IGA DEFICIENCY

106
Q

A disorder affecting lymphocytes and the adaptive immune response

Characterized by an inability to eliminate Epstein Bar Virus. eventually leading to fulminant infectious mononucleosis and the development of B-cell tumors

A

X-linked lymphoproliferative disease

107
Q

A disorder affecting lymphocytes and the adaptive immune response

Mutation affecting th1 responses are associated with atypical mycobacterial infections

A

Mendelian susceptibility to mycobacterial disease

108
Q

A disorder affecting lymphocytes and the adaptive immune response

Inherited defects in Th17 response lead to chronic mucocutaneous candidiasis and bacterial infections of the skin

A

JOB SYNDROME

109
Q

2 types of immunodeficiencies assoiated with systemic disease

A

Wiskitt-aldrich syndrome
Ataxia telangiectasia

110
Q

Caused by mutation in the gene located at Xp11.23 that encodes Wiskott Aldrich syndrome protein (WASP)

Characterized by thrombocytopenia, eczema, and a marked vulnerability to recurrent infection, resulting in early death

They are prone to developing B-cell lymphomas

A

WISKOTT-ALDRICH SYNDROME

111
Q

A immunodeficiency associated with systemic disease

Autosomal recessive disorder characterized by abnormal gait (ataxia), vascular malformations, neurologic deficits , increased incidence of tumors, and immunodeficiency

Most prominent humoral immune abnormalities are defective production isotype-switched antibodies, mainly IgA and IgG2

Gene responsible for this disorder is located on chromosome 11 and encodes a protein kinase called ATM (ataxia telangiectasia mutated) n

A

ATAXIA TELANGIECTASIA

112
Q

an immunodeficiency that is encountered in individuals with cancer, diabetes and other metabolic diseases, malnutrition, chronic infection, and in persons receiving chemotherapy or radiation therapy for cancer, or immunosuppressive drugs to prevent graft rejection or to treat autoimmune diseases

more common than the disorders of primary genetic origin

A

Secondary ( or acquired ) immunodeficiency

113
Q

Causes of secondary acquired deficiency

A

Human immunodeficiency virus (HIV)
Irradiation and chemotherapy treatment for cancer
Involement of bone marrow by cancers
Protein calorie malnutrition
Removal of spleen

114
Q

Mechanism of secondary immunodeficiencies in:

HIV
Irradiation and chemo treatment
Bone marrow cancers
Protein-calorie malnutrition
Removal of spleen

A
  1. Depletion of CD4+ helper T cells
    2/ decrease bone marrow precursors for all leukocytes
  2. Reduced site of leukocyte development
  3. Metabolic derangements inhibit lymphocyte maturation and function
  4. Decreased phagocytosis of microbes
115
Q

What is AIDS

A

Acquired immunodeficiency Syndrome

116
Q

Three major routes of transmission

A

Sexual transmission
Parenteral transmission
Mother-to-infant transmission

117
Q

A major route of transmission that is the dominant mode of infection worldwide

A

Sexual transmission

118
Q

2 mechanism of sexual transmission infections

A
  1. Direct inoculation into the BV breached by trauma
  2. Infection of DCs or CD4+ cells within the mucosa
119
Q

A major route of transmission that is used by IV drug users. Hemophiliacs who received factor VIII and factor IX concentrates

Random recipients of blood transfusion

A

Parenteral transmission

120
Q

A major route of transmission that is a major cause of pediatric AIDS
It has 3 routes
1. In utero by transplacental spread
2. During delivery through an infected birth anal

A

Mother to infant transmission

121
Q

Transmission in health care workers:

After needlestick accidents, the risk to be contamined is about 0.3%

Antiretroviral therapy given within ___ to ___ of a needle stick can reduce the risk of infection eightfold

A

24 - 48 hrs

122
Q

Properties of HIV

A

They belong to the lentivirus family which has 2 types

HIV-1
HIV-2

123
Q

Most abundant viral antigen of HIV-1

A

P24 antigen (detected by ELISA)
Also a major capsid protein

124
Q

Profound immune deficiency primarily affecting _____, is the hallmark of AIDS

A

Cell-mediated immunity ( T cells )

125
Q

HIV infects cells by using the ___ molecule as a receptor

A

CD4 receptor

126
Q

Aside from the binding of HIV to CD4 receptor, HIV ____ must also bind to other cell surface molecule for entry into the cell. Chemokine receptors, particularly ___ and ____ serve this role .

A

Gp120

CCR5 and CXCR4

127
Q

Three categories of the basis of CD4+ cell counts

A

A. Asymptomatic
B. Symptomatic
C AIDS indicator conditions

128
Q

Major death in untreated patients with AIDS

A

Opportunitsic infection

129
Q

Most common fungal infection in patients with AIDS

A

Candidiasis

130
Q

May cause disseminated disease or may be localized to the eye and GI tract

A

Cytomegalovirus (CMV)

131
Q

Major clinical manifestation of cryptococcosis of opportunistic infection

A

Meningitis

132
Q

Toxoplasma gondii in opportunistic infection

A

Encephalitis

133
Q

Progressive multifocal leukocenphalopathy in opportunistic infections

A

JC virus

134
Q

Opportunistic infection
Mucocutaneous ulcerations involving the mouth, esophagus, external genitalia and perianal region

A

Herpes simplex virus

135
Q

Caused by oncogenic DNA viruses, specifically humanherpesvirus-8 KS, EBV and human papillomavirus
25-40% of untreated HIV-infected individuals

A

Tumors

136
Q

Types of tumors

A

Kaposi sarcoma
Lymphomas
HPV-associated carcinomas of the uterine cervix and the anus

137
Q

A vascular tumor that is the most common neoplasm in patients with AIDS

A

Kaposi sarcoma widespread, affecting the skin, mucous membrane, GI tract, lymph nodes and lungs

138
Q

Caused by human herpesvirus 8 (HHV8), also called KS herpesvirus (KSHV)

A

Kaposi sarcoma

139
Q

Roughly 5% of people with AIDS has this disease. Virtually all of which originate from transformed B cells

Increased risk of B-cell tumors in HIV infected individuals

A

Lymphoma

140
Q

10 times more common in HIV-infected women with less than 500cells /ul CD4 counts

A

Human papilloma virus (HPV) associated carcinomas of the uterine cervix and the anus

141
Q

Extracellular deposits of fibrillar proteins are responsible for tissue damage and functional compromise

A

Amyloidosis

142
Q

3 most common forms of amyloid are

A
  1. Amyloid light chain (AL) protein
  2. Amyloid associated AA protein
    B amyloid AB protein
143
Q

Properties of amyloid proteins

A

It is a group of disease having in common of deposition of similar appearing proteins

Fibrils are diameters of approx 7.5 to 10nm

Distinctive Congo red staining and birefringence of amyloid

144
Q

Made up of complete immunoglobulin light chains, produced from free Ig light chains secreted by a monoclonal population of plasma cells, and its deposition is associated with certain plasma cell tumor

A

Amyloid light chain (AL) protein

145
Q

Derived from a unique non-Ig protein made by the liver.created by proteolysis of a larger precursor SAA (serum amyloid associated) protein
P
Production is increased in inflammatory states as part of the acute phase response

A

Amyloid associated (AA) protein

146
Q

Constitutes the core of cerebral plaques found in alzheimer disease

A

B-amyloid AB protein

147
Q

rare forms of amyloid

A

Transthyretin (TR)
B2-macroglobulin
Misfolded prion protein

148
Q

Types of transthyretin (a rare form of amyloid)

A

Mutant form: familial amyloid polyneuropathies
Unmutated TTR: senile systemic amyloidosis

149
Q

Pattern of organ involvement in amyloidosis

It is deposited in the glomeruli, but the interstitial peritubular tissue, arteries and ateriorles are also affected

A

Kidney

150
Q

Pattern of organ involvement in amyloidosis

Amyloid appears first in the space of disse and then progressivly encroaches on adjacent hepatic parenchymal cells and sinusoids

A

Liver

151
Q

Pattern of organ involvement in amyloidosis

The deposits begin as focal subendocardial accumulations and within the myocardium between the muscle fibers

A

Heart

152
Q

Pattern of organ involvement in amyloidosis

  1. Nodular deposits in the tongue may cause macroglossia
  2. Larynx down to the smallest bronchioles, brains, peripheral and autonomic nerves

3.seen in long term hemodialysis

A
  1. Tumor forming amyloid of the tongue
  2. Respiratory tract
  3. Carpal ligament of the wrist/joints

gen path lec (7 decks)

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