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EBSE > Immuno > Flashcards

Immuno Flashcards

1
Q

LN follicles (general and primary vs secondary)

A

general - B cells are here, found in outer cortex
primary - dense and dormant
secondary - pale central germinal centers > active

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2
Q

where do T cells live in LNs?

A

paracortex

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3
Q

high endothelial venules - where and function

A

in paracortex of LN

where T and B cells enter from blood

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4
Q

LN drainage of rectum above pectinate line

A

internal iliac nodes

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5
Q

LN drainage of anal canal below pectinate line

A

superficial inguinal

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6
Q

LN drainage of testes

A

superficial and deep plexuses > para aortic

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7
Q

where are B and T cells found in spleen, respectively

A

B - follicles in white pulp

T - periarterial lymphatic sheath (PALS) in white pulp

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8
Q

3 postsplenectomy PBS findings

A

Howell Jolly Bodies
target cells
thrombocytosis

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9
Q

embyro origin of thymus

A

3rd branchial pouches

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10
Q

Hassall’s corpuscles found where

A

medulla of thymus

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11
Q

where do pos and neg selection take place in thymus respectively?

A

pos - cortex

neg - medulla

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12
Q

MHC bind to

A

T cell receptor

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13
Q

MHC I vs MHC II types (ex HLA-__)

A

MHC I : A, B, C

MHC II: DR, DP, DQ

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14
Q

MHC I:

binds to? expressed by? antigen loading?

A

TCR and CD8
all nucleated cells
loaded in RER - intracellular peptides

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15
Q

MHC II:

binds to? expressed by? antigen loading?

A

TCR and CD4
APCs
loaded after release of invariant chain in acidified endosome

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16
Q

which MHC pairs w/ beta 2 microglobulin?

A

MHC I

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17
Q

HLA A3 assoc w/

A

hemochromatosis

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18
Q

HLA B27 assoc w/

A

psoriasis, ankylosing spondylitis, IBD, Reiter’s syndrome

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19
Q

HLA DQ2/DQ8 assoc w/

A

celiac dz

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20
Q

HLA DR2 assoc w/

A

MS, hay fever, SLE, Goodpasture’s

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21
Q

HLA DR3 assoc w/

A

DM type 1, Grave’s dz

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22
Q

HLA DR4 assoc w/

A

DM type 1, RA

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23
Q

HLA DR5 assoc w/

A

pernicious anemia, Hashimoto’s thyroiditis

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24
Q

fn of NK cells

A

use perforin and granzymes to indue apoptosis of virally infected or tumor cells

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25
Q

cytokines that inc NK activity (4)

A

IL2, IL12, IFN beta, IFN alpha

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26
Q

when do NK cells kill another cell?

A

cell expresses nonspecific activation signal and/or absence of self MHC I

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27
Q

4 types of hypersensitivity rxn

A

1 - allergy, IgE mediated
2 - cytotoxic (ab mediated)
3 - immune complex mediated
4 - delayed cell mediated

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28
Q

APCs

A

dendritic cell (*only one that can activate naive T cell)
macrophage
B cell

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29
Q

signal 1 and 2 for T cell activation

A

signal 1 - antigen on MHC

signal 2 - B7 and CD28 complex

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30
Q

signal 1 and 2 for B cell activation

A

1 - antigen on MHC II binds to TCR

2 - CD40L on T cell binds to CD40 on B cell

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31
Q

Th1 cells - secrete? main function? inhib by?

A

IFN gamma
activate macrophages
IL4 and IL10

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32
Q

Th2 cells - secrete? main function? inhib by?

A

IL4, IL5, IL10, IL13
recruits eosinophils, promotes IgE production
IFN gamma

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33
Q

3 components of CD8 cytotoxic granules

A

perforin, granzyme, granulysin

34
Q

Tregs - secrete? main function? surface markers?

A

IL10, TGF beta
immune tolerance - suppress CD4/8 functions
CD3, CD4, CD25

35
Q

function of Fc region of Ab

A

fixes complement

36
Q

2 main processes that create antibody diversity

A

VDJ recombination

somatic hypermutation following antigen stimulation

37
Q

IgD

A

found of surface of many B cells, unk function

38
Q

thymus indepedent vs dependent antigens

A 
independent - no protein component. stim release of abs, but no immunologic memory
dependent - protein component. cause class switching and immunologic memory
39
Q

3 pathways of complement activation

A

classic - IgG or IgM
alternative - microbe surface molecule
lectin - mannose or other sugars

40
Q

functions of C3b, C3a, C5a, C5b-9

A

3b - opsonization (b for bind)
3a - anaphylaxis
5a - anaphylaxis and neutrophil chemotaxis
5b-9 - cytolysis by MAC

41
Q

inhibitors of complement pathway

A

DAF (decay accelerating factor), C1 esterase inhibitor

42
Q

C1 esterase inhibitor def

A

hereditary angioedema - cant use ACEIs

43
Q

C3 def

A

severe recurrent sinus and resp tract infections, inc type 3 hypersensitivity reaction

44
Q

C5-9 defs

A

recurrent Neisseria bacteremia

45
Q

DAF (decay accelerating factor) def

A

complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria

46
Q

fn of IL1-5

A 
Hot T-Bone stEAk
1 - hot (fever)
2 - stim T cells
3 - stim Bone marrow
4 - IgE production
5 - IgA production
47
Q

IL6

A

pyrogen and acute phase reactants

48
Q

IL8

A

major chemotactic agent for neutrophils

49
Q

IL12

A

Th1 differentiation, activates NK cells

50
Q

TNFalpha

A

mediates septic shock, activates endothelium, leukocyte recruitment, vascular leak

51
Q

IFNgamma

A

activates macrophages and Th1, suppresses Th2

52
Q

IL10

A

inhibits activated T cells and Th1. dec immune response

53
Q

surface marker for macrophages

A

CD14

54
Q

surface marker for NK cells

A

CD56

55
Q

superantigens

A

cross link beta region of TCR to MHC II on APCs > activate any T cell > massive release of cytokines

56
Q

endotoxin/LPS immune response

A

directly stimulates macrophages by binding to endotoxin receptor CD14 - no Th involvement

57
Q

for what infxns are preformed abs indicated? (4)

A

tetanus, botulinum, HBV, rabies

58
Q

2 examples of type 3 hypersensitivity

A

serum sickness, arthus reaction

59
Q

pts w/ what condition are more likely to get an anaphylactic reaction to a transfusion?

A

IgA deficiency

60
Q

Bruton’s agammaglobulinemia - inheritance, gene, presentation/findings

A

XLR
BTK gene
recurrent bacterial infxns after 6 mo, dec B cells and Igs of all classes

61
Q

combined variable immunodeficiency (CVID)

A

defect in B cell maturation (many causes)
inc risk of autoimmune dz, lymphoma, sinopulmonary infxns
normal # b cells but dec plasma cells and Igs

62
Q

thymic aplasia - aka, genetic cause, presentation/findings

A

DiGeorge syndrome
22q11 deletion (3rd and 4th pharyngeal pouches dont form)
tetany (hypoCa), recurrent viral/fungal infxns, congenital heart/great vessel defects
dec T cells, dec PTH, dec Ca

63
Q

IL12 receptor def pts get

A

disseminated mycobacterial infxns

64
Q

hyper IgE syndrome (Job’s) findings

A

coarse facies, cold staph abscesses, retained primary teeth, inc IgE, dermatologic problems

65
Q

MCC SCID

A

defective IL2 receptor

66
Q

hyper IgM syndrome - MCC and presentation

A 
defective CD40L on Th cells > inability to class switch
severe pyogenic infxns early in life
67
Q

Wiskott Aldrich syndrome - inheritance, problem, presentation

A

XL
T cells can’t recognize actin
thrombocytopenic purpura, infections, eczema

68
Q

Chediak Higashi syndrome - inheritance, problem, presentation

A

AR
defect in LYST - MT dysfunction in phagosome/lysosome fusion
Recurrent pyogenic infxns, partial albinism, peripheral neuropathy

69
Q

chronic granulomatous dz - cause, presentation

A

lack of NADPH oxidase > dec ROS / respiratory burst

inc susceptibility to catalase pos organisms

70
Q

sx of GvHD

A

maculopapular rash, jaundice, hepatosplenomegaly, diarrhea

71
Q

cyclosporine - mech, use, tox

A

inhib calcineurin > prevent production of IL2/IL2R
suppress organ rejection, some autoimmune
nephrotox, HTN, hyperlipidemia, hyperglycemia, tremor, gingival hyperplasia, hirsutism

72
Q

tacrolimus

A

similar to cyclosporine, but no gingival hyperplasia or hirsutism
Hamill - “AIDS in a bottle”

73
Q

sirolimus - mech, use, tox

A

inhibits mTOR > inhib T cell prolif
after kidney transplants
hyperlipidemia, thrombocytopenia, leukopenia

74
Q

azathioprine - mech, use, tox

A

precursor of 6MP, toxic to proliferating lymphocytes
kidney transplants, autoimmune disorders
bone marrow suppression, c/i w/ allopurinol

75
Q

muromonab - mech, use, tox

A

anti-CD3, prevents T cell signal transduction
kidney transplants
cytokine release syndrome, hypersensitivity rxn

76
Q

aldesleukin - what is it, use

A

synthetic IL2

RCC, metastatic melanoma

77
Q

filgrastim and sargramostim are

A

synthetic GCSF and GMCSF

78
Q

oprelvekin - what is it, use

A

synthetic IL11

thrombocytopenia

79
Q

abciximab - what is it, use

A

anti GP 2b/3a

prevent cardiac ischemia in unstable angina and PCI pts

80
Q

trastuzumab - what is it, use

A

anti HER2

some breast cancers

81
Q

rituximab - what is it, use

A 
anti CD20 (b cell)
B cell NHL
82
Q

omalizumab - what is it, use

A

anti IgE

severe asthma

EBSE (18 decks)

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