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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
cytokines that inc NK activity (4)
IL2, IL12, IFN beta, IFN alpha
26
when do NK cells kill another cell?
cell expresses nonspecific activation signal and/or absence of self MHC I
27
4 types of hypersensitivity rxn
1 - allergy, IgE mediated 2 - cytotoxic (ab mediated) 3 - immune complex mediated 4 - delayed cell mediated
28
APCs
dendritic cell (*only one that can activate naive T cell) macrophage B cell
29
signal 1 and 2 for T cell activation
signal 1 - antigen on MHC | signal 2 - B7 and CD28 complex
30
signal 1 and 2 for B cell activation
1 - antigen on MHC II binds to TCR | 2 - CD40L on T cell binds to CD40 on B cell
31
Th1 cells - secrete? main function? inhib by?
IFN gamma activate macrophages IL4 and IL10
32
Th2 cells - secrete? main function? inhib by?
IL4, IL5, IL10, IL13 recruits eosinophils, promotes IgE production IFN gamma
33
3 components of CD8 cytotoxic granules
perforin, granzyme, granulysin
34
Tregs - secrete? main function? surface markers?
IL10, TGF beta immune tolerance - suppress CD4/8 functions CD3, CD4, CD25
35
function of Fc region of Ab
fixes complement
36
2 main processes that create antibody diversity
VDJ recombination | somatic hypermutation following antigen stimulation
37
IgD
found of surface of many B cells, unk function
38
thymus indepedent vs dependent antigens
``` independent - no protein component. stim release of abs, but no immunologic memory dependent - protein component. cause class switching and immunologic memory ```
39
3 pathways of complement activation
classic - IgG or IgM alternative - microbe surface molecule lectin - mannose or other sugars
40
functions of C3b, C3a, C5a, C5b-9
3b - opsonization (b for bind) 3a - anaphylaxis 5a - anaphylaxis and neutrophil chemotaxis 5b-9 - cytolysis by MAC
41
inhibitors of complement pathway
DAF (decay accelerating factor), C1 esterase inhibitor
42
C1 esterase inhibitor def
hereditary angioedema - cant use ACEIs
43
C3 def
severe recurrent sinus and resp tract infections, inc type 3 hypersensitivity reaction
44
C5-9 defs
recurrent Neisseria bacteremia
45
DAF (decay accelerating factor) def
complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
46
fn of IL1-5
``` Hot T-Bone stEAk 1 - hot (fever) 2 - stim T cells 3 - stim Bone marrow 4 - IgE production 5 - IgA production ```
47
IL6
pyrogen and acute phase reactants
48
IL8
major chemotactic agent for neutrophils
49
IL12
Th1 differentiation, activates NK cells
50
TNFalpha
mediates septic shock, activates endothelium, leukocyte recruitment, vascular leak
51
IFNgamma
activates macrophages and Th1, suppresses Th2
52
IL10
inhibits activated T cells and Th1. dec immune response
53
surface marker for macrophages
CD14
54
surface marker for NK cells
CD56
55
superantigens
cross link beta region of TCR to MHC II on APCs > activate any T cell > massive release of cytokines
56
endotoxin/LPS immune response
directly stimulates macrophages by binding to endotoxin receptor CD14 - no Th involvement
57
for what infxns are preformed abs indicated? (4)
tetanus, botulinum, HBV, rabies
58
2 examples of type 3 hypersensitivity
serum sickness, arthus reaction
59
pts w/ what condition are more likely to get an anaphylactic reaction to a transfusion?
IgA deficiency
60
Bruton's agammaglobulinemia - inheritance, gene, presentation/findings
XLR BTK gene recurrent bacterial infxns after 6 mo, dec B cells and Igs of all classes
61
combined variable immunodeficiency (CVID)
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
thymic aplasia - aka, genetic cause, presentation/findings
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
IL12 receptor def pts get
disseminated mycobacterial infxns
64
hyper IgE syndrome (Job's) findings
coarse facies, cold staph abscesses, retained primary teeth, inc IgE, dermatologic problems
65
MCC SCID
defective IL2 receptor
66
hyper IgM syndrome - MCC and presentation
``` defective CD40L on Th cells > inability to class switch severe pyogenic infxns early in life ```
67
Wiskott Aldrich syndrome - inheritance, problem, presentation
XL T cells can't recognize actin thrombocytopenic purpura, infections, eczema
68
Chediak Higashi syndrome - inheritance, problem, presentation
AR defect in LYST - MT dysfunction in phagosome/lysosome fusion Recurrent pyogenic infxns, partial albinism, peripheral neuropathy
69
chronic granulomatous dz - cause, presentation
lack of NADPH oxidase > dec ROS / respiratory burst | inc susceptibility to catalase pos organisms
70
sx of GvHD
maculopapular rash, jaundice, hepatosplenomegaly, diarrhea
71
cyclosporine - mech, use, tox
inhib calcineurin > prevent production of IL2/IL2R suppress organ rejection, some autoimmune nephrotox, HTN, hyperlipidemia, hyperglycemia, tremor, gingival hyperplasia, hirsutism
72
tacrolimus
similar to cyclosporine, but no gingival hyperplasia or hirsutism Hamill - "AIDS in a bottle"
73
sirolimus - mech, use, tox
inhibits mTOR > inhib T cell prolif after kidney transplants hyperlipidemia, thrombocytopenia, leukopenia
74
azathioprine - mech, use, tox
precursor of 6MP, toxic to proliferating lymphocytes kidney transplants, autoimmune disorders bone marrow suppression, c/i w/ allopurinol
75
muromonab - mech, use, tox
anti-CD3, prevents T cell signal transduction kidney transplants cytokine release syndrome, hypersensitivity rxn
76
aldesleukin - what is it, use
synthetic IL2 | RCC, metastatic melanoma
77
filgrastim and sargramostim are
synthetic GCSF and GMCSF
78
oprelvekin - what is it, use
synthetic IL11 | thrombocytopenia
79
abciximab - what is it, use
anti GP 2b/3a | prevent cardiac ischemia in unstable angina and PCI pts
80
trastuzumab - what is it, use
anti HER2 | some breast cancers
81
rituximab - what is it, use
``` anti CD20 (b cell) B cell NHL ```
82
omalizumab - what is it, use
anti IgE | severe asthma

EBSE (18 decks)

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