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Step 1 > Immuno > Flashcards

Immuno Flashcards

1
Q

anti hemagglutinin (IgG and IgA)

A

hemagluttinin promotes Influenza viral entry into the cell

these antibodies in circulation and mucous account for decrease in reinfection

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2
Q

recurrent sinus/airway infection, lymphoid hyperplasia

A

hyper IgM
-def in isotype/class switching
either def in CD40R on B cell or CD40 ligand on T cell,
tx: IVIG

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3
Q

proximal muscle weakness, endomysial infiltration with Macrophages and CD8+, MHC overexpression, anti Jo, increased CK anti SRP, anti Mi2

A

polymyositis

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4
Q

recurrent skin infections without pus, delayed umbilical cord attachment, poor wound healing

A

leukocyte adhesion deficiency (type 1)
lack CD 18 and no formation of Beta 2 integrins necessary to leukocyte tight adhesion with integrin ligand ICAM
+bleeding complications=LAD type 3 (caused by impaired cytokine signaling which prevents integrin activation)

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5
Q

IgA protease

A

cleaves IgA at hinge region

produced by N. gonorrhea and N meningitid, prevent IgA from binding pili/fimibriae and preventing mucosal penetration

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6
Q

recurrent sinopulm/Gi infections, anaphylaxis wtih blood products

A

IgA deficinecy

have IgG against IgA

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7
Q

CD 19, 20, 21

A

B cell surface markers
low in agammaglobulinemia
(Bruton)

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8
Q

common otitis media organisms

A

strep pneumo
moraxella
H flu

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9
Q

clustered gram + with polar granules that stain deeply with aniline dyes

A 
Corynebacterium diptheriae 
-non-motile unencapsulated, 
produces AB exotoxin 
B: binding-binds heparin-binding epidermal growth factor on cardiac an neural tissue 
A: inhibits cell protein synthesis
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10
Q

superantigens

A

produced by staph and strep, bind to t cells and MHC II causing widespread T cell activation

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11
Q

Botulinum toxin

A

blocks release of Ach causing cranial and peripheral nerve palsies

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12
Q

tetanus toxin

A

inhibts the release of inhibitory GABA and glycine neurotransmitters

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13
Q

ETEC, camplyobacter jejnia, vibiocholera, yersinia entercolitica

A

have tAB exotoxins that activate electrolyte transport

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14
Q

alpha toxin/lecithinase/phospholipase C

A

a cytolytic toxin that is released by clostridium perfringens that degrades cell membrane phospholipids, causing cell destruction
increases platelet aggregation and adherence molecule expression

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15
Q

nitroblue tertrazolium testing

A

characteristic of CGD
-susceptible to catalase + organisms
impaired intracellular killing by neutrophils and macrophages

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16
Q

omalizumab

A

anti IgE antibody used for moderate to severe persistent asthma, sensitivity to perennial allergen and incomplete response with steroiids,

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17
Q

bilateral hilar adenopathy, high ace, high Ca

A

sarcoid

  • non caseating graulomas
  • granulomas produce ACE and vita D
  • predominance of CD4+ cells in bronchoalveolar lavage fluid
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18
Q

hypersensitivity pneumonitis

A

expsure to birds

high predominance of CD8+ cells in bronchoalveolar lavage

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19
Q

acute hemolytic transfusion reaction

A

wihtin minutes to hours
-fever/chills hypotension, dyspnea, chest and/or back pain, and hemoglobinuria
type II antibody mediated
-complement activated leading to cell lysis
ABO blood group incompatibility or extravascular hemolysis (host antibody reaction against foreign antigen on donor RBCs)

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20
Q

green metallic sheen on EMB agar

A

organism that can ferment lactose ie E. COli

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21
Q

anti ANA
anti dsDNA
anti SM

A

SLE

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22
Q

anticardiolipin antibody

beta 2 glycoprotein I antibody

A

antiphospholipid antibody syndrome
-paradoxical aPTT prolongation (although actually hypercoaguable)
FALSE RPR
can be primary or secondary to SLE

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23
Q

defects in interferon gamma signaling pathway

A

lead to increased mycobacterial infections in infancy or early childhood, patients require lifelong treatment with anitmycobacterial agents (also disseminated infection by the bcg vaccine strain if administered)

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24
Q

recurrent pyogenic infections, albinism, nystagmus, peripheral/cranial neuropathy

A

chediak higashi defect in neutrophil phagosome lysosome fusion

  • abnormal giant lysosomal inclusions seen on light microscopy of peripheral blood smear
  • abnml melanin storage in melanocytes
  • recurrent staph/strep infections
  • defective neutrophil funciton
  • autosomal recessive
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25
Q

immunodeficinecy, eczema, thrombocytopenia

A

wiskott-aldrich syndrome
X linked
-combined t and B disorder

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26
Q

neurological sx (nystagmus, ataxia), superficial blanching nests of distended capillaries, recurrent pulmonary infections

A

ataxia telangiectasia
-due to deficiency in DNA break repair mechanisms, highly sensitive to radiation causing DNA breaks
-immunodef, usually manifests as IgA def
increased risk of hematologic malignancies
ATM gene

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27
Q

defect in expression of HLA class II antigens on surfaces of APCs

A

bare lymphocyte syndrome

-

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28
Q

HIV viral entry into cell

A

HIV gp120 binds CD4 protein + CCR% chemokine co receptor

  • deletion of both CCR5 receptors renders individuals resistant to HIV
  • one deled copy get symptoms later
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29
Q

persistent fever, splenomegaly, anterior and posterior cervical LAD

A

infectious mono due to EBV-which infects B lymphocytes via CD21+ cel surface receptor
-CD8+ clonally expand in response to virus

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30
Q

stellar cells with intracytoplasmic granules haveing the shape of a tennis racket, found on epidermis and interact closely with T cells

A

Langerhans cell, skin dendritic cell

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31
Q

kupffer cells

A

macrophage derived cells that present int the liver-remain in the hepatic sinuisoids

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32
Q

urethritis, conjunctivits, mono-oligoarticular arthritis

A

reactive arthritis
-seronegative HLA b27
sx 1-4 week safter infection causing urethritis or enteritis
caused by an autoimmune reaction initiated by the infecting pathogen
-keatderma blennorrhagicum (hyperkeratotic vesicles on the palsm and soles)

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33
Q

IgM antibody specific for the Fc component of self IgG

A

rheumatoid factor

  • binds IgG and forms immune complexes that circulate in the serum
  • cartilage activate CD4+ which stimulate B cells cells to make Rf
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34
Q

antiinflammatory cytokine

A

IL 10 and TGF beta

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35
Q

cytokines critical to granuloma formation

A

Il12, infgamma tnfalpha are crucial in recruiting macrophages and forming a granuloma to wall off an infection ie mycobacterium

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36
Q

interluekin involved in pus formation

A

IL 8

responsible for neutrophil chemotaxis

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37
Q

bradykinin

A

causes vasodilation, increased vasc permeability, stimulates nonvascular smooth muscle contraction, mediates pain

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38
Q

inflammatory anaphylotoxins in complement pathway

A

C3a, C4a, C5a

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39
Q

Interleukin that stimulates hematopoiesis

A

IL 3

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40
Q

leukotriene C4

A

triggers intense vasoconstriction, increased vascualr permeability, bornchospasm

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41
Q

chemotactic agents

A

interleukin 8, n forylated peptides, leukotrience B4, 5HETE (a leukotrience precursor) and complement component 5a

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42
Q

lysozyme

A

hydrolyzed peptidoglycan walls of bacterial organisms

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43
Q

lymph node drain of head and neck

A

cervical

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44
Q

LN drainage of lungs

A

hilar

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45
Q

LN drainage of trachea and esophagous

A

mediastinal

46
Q

LN drainage of upper limb, breast, skin above umbillicus

A

axillary

47
Q

LN drainage of upper duodenum, liver, pancreas, stomach, spleen

A

Celiac

48
Q

LN drainage of Lower duodenum, jejunum, iluem, colon to splenic flexure

A

superior mesenteric

49
Q

LN drainage of colon from splenic flexure to upper rectum

A

inferior mesenteric

50
Q

LN drainage from lower rectum to anal canal (above pectinate line,) bladder, vagina (middle third), prostate

A

internal iliac

51
Q

LN drainage from testes, ovaries, kidneys, uterus

A

para-aortic

52
Q

LN drainage of anal canal (below pectinate line), skin below umbilicus (except popliteal territory), scrotum

A

superficial inguinal

53
Q

Ln drainage of dorsolateral foot, posterior calf

A

popliteal

54
Q

end of Lymphatic drainage

A

right lymphatic duct drains everything on right side above the diaphragm, thoracic duct drains everything else into the junction of the left subclavian and internal jugular veins

55
Q

encapsulated organisms

A 
Strep pneumo 
Hib 
Neisseria Menigitidis 
E coli
Salmonella 
Klebsiessa
GB Strep
56
Q

antibody dependent cellular toxicity

A

mech of killing parasite infested cells, EOS help IgE mediate damage.destruction of parasites

57
Q

multiple nuclei organized peripherally in the shape of a horseshoe

A

formedby actiated macrophages (epitheliod cells)

macrophages are stimulated by CD4 Th1 hefcells and give them the ability to kill intracellular M tuberculosis orgnaisms

58
Q

CD14

A

marker of themonocyte/macrophage lineage

59
Q

CD7

A

mulitchain complex T cell markeer

60
Q

HBeAg

A

marker of infectivity and viral replication

61
Q

newborn of all mothers with active Hep B

A

passively immunized at birth with Hep B immune globin folowed by activae immunization with recombinant HBV vaccine

62
Q

diagnosis of acute hepatitis B

A

IgM and anti-HBc (once HBs has cleared and anti Hbs has not been formed yet )

63
Q

superantigens

A

like TSS, enterotoxin, exfoliative toxin –> cause a large inflammatory response through the activaion of Th cells through MHC II antigen presentation, bind beta region of T cell receptor the large immune response is responsible for the effects of the superantigens

64
Q

athralgias, fever, pruritic rash, LAD, small vessel vasculitis with fibrinoid necrosis and intense neutrophil infiltration, hypocomplementemia

A

Serum sickness caused by tissue depoisiotn of circulating immune complexes
Type III hypersensitivity
occurs after exposure to chimeric monoclonal antibodies (rituximan or infliximab) or nonhuman immunoglobulins (venom antitoxins) can also occur with penicillin or bactrim

65
Q

nitrobluetetrazolium test

A

tests amount of nuetrophil superoxide production

  • used to diagnose CGD
  • also can use dihydrorhodamine test
66
Q

palpable purpura, arthralgias, abdominal pain

A

Henoch Schonlein Purpura
-a preceding infection (usually URI) causes formation of IgA and C3immune complexes which deposit on blood vessel walls, in renal mesagnium,
have elevated IgA

67
Q

why does isoimmunization not occur due to AB mismatch?

A

antibodies against specific bloody types are IgM and do not cross the placenta
-can occur with type O because they have IgG antibodies (Anti-A and Anti B)

68
Q

third and fourth pharyngeal pouch deformity

A

DiGeorge syndrome

69
Q

mechanism of injury in hepatitic B reaction

A

CD8+ lymph response to viral antigen on the cell surface result in hepatocyte damage

70
Q

acute sore throat, fever, lymphadenopathy, upper airway dyspnea, gray pharyngeal exudate odynophagia in pt without vaccination

A

Diptheria

  • corynebacterium diphtheriae causes pseudomembranous pharyngitis
  • produces exotoxin AB that is specific for neural and cardiac tissue
  • treatment includes :
    1. diptheria antitoxin: inactivates circulating toxin
    2. Penicillin or erythromycin: kills bacteria and prevents further release of exotoxin
    3. DPT vaccine
71
Q

pseudomembransous pharyngitis

A

corynebacterium diphtheriae

72
Q

IgA and C3 deposition presentation

A

skin rash and abdominal pain
-Leukocytoclastic angiits, HSP
-acute glomerulonephritis is a possible complication
common in male children aged 3-11

73
Q

saddle nose and oliguria

A

granulomatosis with polyangiits
wegener’s
associated with C ANCA (cytoplasmic staining antineutophil cytoplasmic antibodies)
C anca target neutophil-3 proteinase

74
Q

Il-1, Il-6, TNF alpha

A

mediators of shock

75
Q

facial swelling, difficulty breathing, recently started on ACEi

A

angioedema-swelling og tongue, lips or eyelide with larygneal edema and difficulty breathing
due to bradykinin accumulation (bradykinin normally broken down by ACE) bradykinin potent vasodilator

76
Q

HLA3

A

hemochromatosis

77
Q

HLA B27

A 
seronegative arthopathies 
Psoriatic arthritis
Ankylosing arthritis 
Ibd associated arthritis
Reactive arthritis
78
Q

HLA DQ2/DQ8

A

celiac disease

79
Q

types of cells killed by CD8+

A

tumor, viral infected, donor graft cells -induce apoptosis via perforin and granzymes

80
Q

HLA DR2
HLA DR3
HLA DR4
HLA DR5

A

2: Multiple sclerosis, Hay fever, SLE, Good pastures
3: Diabetes, SLE, Graves disease, Hashimoto
4: Rheumatoid arthritis, Diabetes Mellitus
5: Pernicious anemia(B12 def), Hashimoto,

81
Q

CD3 CD4 CD25 FOXP3

A

regulatory T cells-suppress CD4 CD8

can pro duce anti inflammatory cytokine IL10, TGF beta

82
Q

two signals necessary for T cell activation

A

antigen must bind TCR and B7 on APC must bind CD 28 on T cell

83
Q

two signals necessary for B cell activation

A

MCH II/antigen must bind TCR on Th, CD40 on B cell must bind CD40L on Th

84
Q

3 mechs of antibodies

A

opsonization, neutralization, complement activation

85
Q

acute phase reactants

A

produced in liver
elevated:
ferritin (binds free iron and prevents microbial scavenging),
hepcidin (keeps iron bound to ferritin), fibrinogen (repairs endotheial breaks),
CRP (opsonin, fixes complement, facilitates phagocytosis)
serum amyloid A (prolonged elevated can lead to amyloidosis)
decreased:
albumin (to save protein for upregulated reactants)
transferrin (to sequester iron stores)

86
Q

PAMPS

A

pathogen associated molecular pattern

CD14 on macrophages-TLR recognizes LPS-on outer membrane of gram - and activates immune system via NFKbeta

87
Q

C3a, C4a, C5a

A

complement products that cause anaphylaxis, mast cell degraulation
C5a also neutrophil chemotaxis

88
Q

MAC

A

C5b-9

89
Q

C3b, IgG

A

primary opsonins

90
Q

decay accelerating factor/CD55

A

prevent complement from occuring on self cells ie RBCs

works with Cl esterase

91
Q

C3 deficiency

A

increased risk of severe pyogenic sinopulomary infections (less opsonization), increased susceptibility to type III hypersensitivity reactions

92
Q

recurrent Neisseria bactermia

A

C5-9 deficinecy

no MAC

93
Q

paroxysmal nocturnal hemoglobinuria

A

complement mediated RBC lysis due to decay accelerating factor DAF deficiency (nmly prevents complement from affecting RBCs)

94
Q

HOT T-BONE stEAK

A 
IL 1-(hot) fever 
IL 2-T cell stimulation
IL 3-bone-hematopoiesis 
IL 4- igE
IL 5- IgA
IL 6-aKute phase reactants
95
Q

pyocyanin

A

made from P auruginosa and generates ROS to kill compting microbes

96
Q

CD34

A

hematopoietic stem cells

97
Q

CD16, Cd56

A

NK cells
16 binds FC of IgG
CD56 NK unique marker

98
Q

CD14, 40

A

macrophages

99
Q

calssic antigenic variation examples

A 
salmonella-2 flagellar variants 
borrelia-recurrent fever 
n gonorrhoeae-pilus protein
viruses-influenza, HIV, HCV
parasites-typanosomes
100
Q

passive immunity

A

IgA in breast milk, IgG from placenta, antitoxin, humanized monoclonal antibodies
-shorter duration of action

101
Q

when to used antitoxin

A 
To Be Healed Very Rapidly
-tetanus
-Botulinium
-HBV
-Varicella
-Rabies 
(also corynea diptheriae)
102
Q

only live attenuated virus given to HIV pts

A

MMR

103
Q

live vax

A

MMR, polio, intranasal influenza, varicella, yellow fever

-cellular and humoral response

104
Q

inactivated vax

A

RIP A
-Rabies, Influenza, Polio, hepatits A
only humoral response

105
Q

fever, hypotension, hemoglobinuria, tachypnea, tachycardia, flank pain, jaundice

A

acute hemolytic transfusion reaction

-antibodies against donor RBC or ABO incompatibility or foreign antigen

106
Q

fever, chills, headache, flushing

A

febrile nonhemolytic transfucion reaction

107
Q

dyspnea, bronchospasm, hypotension, resp arrest, shock

A

anaphylactic reaction

treat with epi

108
Q

defect in BTK

A

agammaglobinulinemia

defective B receptor tyrosine kinase-no B cell maturation

109
Q

decreased plasma cells, decreased immunoglobulins

A

common variable immunodeficiency
-unown cause, can be acquired
icnreased risk of autoimmune disease, bronchieectasis, lymphoma, sinopulmonary infections

110
Q

coarse faces, cold inflamed staph abscesses, retained primary teeth, increased IgE, dermatologic problems

A

Job, hyper IgE syndrome
increased IgE, decreased IFN gamma
-STAT 3 mutations def of th17 cells–>impaired recruitment of neutrophils

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