Immuno Flashcards
1
Q
Cervical node
A
Head and neck
2
Q
Hilar node
A
Lungs
3
Q
Mediastinal node
A
Trachea and esophagus
4
Q
Axillary
A
Upper limb, breast, skin above umbilicus
5
Q
Celiac
A
Liver, stomach spleen, pancreas, upper duodenum
6
Q
Superior mesenteric
A
Lower duodenum, jejunum, ileum, colon to splenic flexure
7
Q
Inferior mesenteric
A
Colon from splenic flexure to upper rectum
8
Q
Internal iliac
A
Lower rectum to anal canal (above pectinate line), bladder, vagina (middle third), prostate
9
Q
Para-aortic
A
Testes, ovaries, kidneys, uterus
10
Q
Superficial inguinal
A
Anal canal (below pectinate line), skin below umbilicus (ie. thighs and except popliteal territory), scrotum
11
Q
Popliteal
A
Lateral portion of dorsum foot, posterior calm
12
Q
Right lymphatic duct
A
Drains right side of body above the diaphragm
13
Q
Thoracic duct
A
Drains everything else besides right lymphatic duct
14
Q
Deep inguinal
A
Glans penis and superficial nodes
15
Q
Thoracic duct drains junction of
A
left subclavian and internal jugular veins
16
Q
In a viral infection, what regions of the lymph node enlarges?
A
Paracortex in an extreme cellular immune response
17
Q
How to T/B cells enter paracortex from blood?
A
through high endothelial (postcapillary) venules.
18
Q
All cells express MHC I except what cell?
A
RBCs
19
Q
HLA subtypes associated with diseases?
A3
A
Hemochromatosis
20
Q
HLA subtypes associated with diseases?
B21
A
PAIR
Psoriatic arthritis, Ankylosing spondylitis, Inflammatory bowel disease, Reactive arthritis
21
Q
HLA subtypes associated with diseases?
DQ2/DQ8
A
Celiac disease
22
Q
HLA subtypes associated with diseases?
DR2
A
Multiple sclerosis, hay fever, SLE, goodpasture syndrome
23
Q
HLA subtypes associated with diseases?
DR3
A
Diabetes mellitus type I, SLE, GRaves, Hashimoto thyroiditis
24
Q
HLA subtypes associated with diseases?
DR4
A
Rheumatoid arthritis, diabetes mellitus type 1 (“4 walls in the “rheum” (room”
25
HLA subtypes associated with diseases?
| DR5
Pernicious anemia-->vitamin B12 deficiency, hashimoto thyroiditis
26
Activity of NK cells enchanced by?
IL-2, IL-12, IFN alpha, IFN beta
27
How are regulatory T cells identified?
By expression of CD3, CD4, CD25, and FOXP3 (serves as transcrption factor and absense of it leads to autoimmune diseaseS)
28
Regulatory T cells produce what?
anti-inflammatory cytokines (IL-10, TGF-Beta)
29
TH1 cell secretes?
IFN-gamma, IL2
30
TH2 cell secretes?
IL-4,5, 10, 13
31
TH1 cell activated by and inhibited by what?
activated: IL-12, IFN-gamma
inhibited: IL-4, IL-10
32
TH2 cells activated by and inhibited by what?
Activated: IL-2
Inhibited: IFN-gamma
33
Primary immediate response to antigen
IgM
34
Secondary delayed response to antigen
IgG
35
What are the two forms of IgA?
Monomer (in circulation)
Dimer (when secreted that consists of J-chain, two immunoglobulin monomers and secretory component that is glycopeptide wraps around IgA to protect it like a suit of armor for harsh environment)
36
What are the two forms of IgM?
Monomer (on B cell)
| Pentamer (when secreted-5 IgM molecules joined together at their Fc regions by the J peptide)
37
Acute-phase reactants notably change in response to what?
IL-6 (an TNF alpha and IL-1)
38
What are acute phase reactants a marker of?
Acute/chronic inflammatory states
39
Positive (upregulated) acute phase reactants
C-reactive protein (opsonin; fixes complement and facilitates phagocytosis)
Ferritin (binds and sequesters iron to inhibit microbial iron scavenging)
Fibrinogen (coagulation factor, promotes endothelia repair; correlates with ESR)
Hepcidin (prevents release of iron bound by ferritin)
Serum amyloid A (prolonged elevation can lead to amyloidosis)
40
Negative (downregulated) acute phase reactants
Albumin (reduction conserves AA for positive reactants)
| Transferrin (internalized by macrophages to sequester iron)
41
Function: C3b, IgG
opsonization (2 primary opsonins in bacterial defense)
42
Function: C3a, C4a, C5a
anaphylaxis
43
Function: C5a
neutrophil chemotaxis
44
Function: C5b-C9
MAC
45
Function: CD55
Decay acclerating factor (aka DAF) helps accelerate decay of C3 convertase to help protect against complement.
46
C1 esterase inhibitor deficiency
Hereditary angioedema (episodes of non-pitting, painless, well-circumscribed edema). ACE inhibitors contraindicated
47
C3 deficiency
Incrases risk of severe, recurrent pyogenic sinus and respiratory infections; increases suceptibility to type III hypersensitivity rxns (especially glomerulonephritis)
48
C5-C9 deficiencies
Terminal complement deficiency increases suceptibility to recurrent Neisseria bacteremia
49
DAF (GPI-anchored enzyme) deficiency
Causes complement-mediated lysis of RBCS and paroxysmal nocturnal hemoglobinuria
50
IL-1
Secreted by?
Function?
Macrophages
Also called osteoclast activating factor. Causes fever, acute inflammation. Activates endothelium to express adhesion molecules. Induces chemokine secretion to recruit WBCs
51
IL-6
Secreted by?
Function?
Macrophages
| Causes fever and stimulates production of acute-phase proteins
52
IL-8
Secreted by?
Function?
Macrophages
| Major chemotactic factor for neutrophils
53
IL 12
Secreted by?
Function?
Macrophages
| Function: Induce differentiation of T cells into Th1 cells. Activates NK cells
54
TNF-alpha
Secreted by?
Function?
Macrophages
| Mediates septic shock. Activates endothelium. Causes WBC recruitment, vascular leak
55
IL-2
Secreted by?
Function?
All T cells
Stimulates growth of helper,cytotoxic, and regulatory T cells, and NK cells. Increase activity of T cells and NK cells thought to be responsible for IL-2's anti-cancer effect on metastatic melanoma and renal cell carcinoma
56
IL-3
Secreted by?
Function?
All T cells
| Supports growth and differentiation of bone marrow cells. Functions like GM-CSF
57
IFN-gamma
Secreted by?
Function?
Secreted by NK cells in response to IL-12 from macrophages; stimulates macrophages to kill phagocytosed pathogens. Also activates NK cells to kill virus-infected cells. Increases MHC expression and antigen presentation by all cells
58
IL-4
Secreted by?
Function?
```
Th2 cells
Induces differentiation of Th0 cells into Th2 cells. Promotes growth of B cells. Enchances class switching to IgE and IgG
"BEG 4 it"--> B-cell growth, Class switch to IgE/IgG, 4 for IL-4
```
59
IL-5
Secreted by?
Function?
```
Th2 cells
Promotes differentation of B cells. Enchances class switching to IgA. Stimulates growth and differentiation of eosinophils
```
60
IL-10
Secreted by?
Function?
Modulates inflammatory response. Decreases expression of MHC Class II and Th1 cytokines. Inhibits activated macrophages and dendritic cells. also secreted by regulatory T cells
61
What cytokines attenuate immune response
IL-10, TGF-B
62
Hot T-bone stEAK
```
IL-1-fever
IL-2 (stimulates T cells)
IL-3 (growth and differentiation of bone marrow cells)
IL-4 (stimulates IgE production)
IL-5 (Stimulates IgA production)
IL-6-stimulates aKute-phase protein
```
63
T cell receptors
TCR, CD3, CD28
64
Helper T cells
CD4, CD40L, TCR, CD3, CD28
65
Cytotoxic T cells
CD8, TCR, CD3, CD28
66
B cells
Ig (binds antigen), CD 19, 20, 21, 40 MHC II, B7
67
Macrophages
CD14, 40 MHC II, B7, Fc and C3b receptors (enhanced phagocytosis)
68
NK Cells
CD 16 (binds Fc of IgG), CD56 (unique marker for NK)
69
Heamtopoietic stem cells
CD 34
70
Bacteria, viruses and parasites with classic examples of antigenic variation
Bacteria-Salmonella (2 flaggelar variants), N gonnorhoeae (pilus protein), Boreilla recurrentis (relapsing fever)
Viruses (HCV, HIV, influenza)
Protazoa (trypanosomes)
71
After exposure to what should unvaccinated patients be given preformed antibodies (passive)
Tetanus toxin, Botulinum toxin, HBV, Varicella, Rabies virus
| " To Be Healed Very Rapidly"
72
What two situations can combined passive and active immunizations be given for?
Hepatitis B and rabies exposure
73
What is best way to prevent neonatal tetanus and why?
vaccination of toxoid vaccine of women to allow transfer of protective IgG antitoxin antibodies across placenta to the fetus
74
Function of toxoid vaccine?
Produce antitoxin antibodies
75
Only live attenuated vaccine given to ppl with HIV
MMR with CD4>200
76
Live attenuated vaccines
Polio, varicella, yellow fever, MMR, Rotavirus, intranasal influenza
Attention (attenuated viral vaccines)! Please Vaccinate Young Infants w/ MMR Regularly (Polio (oral, sabin), varicella, yellow fever, MMR, Rotavirus, intranasal infleunza
77
Inactiated or killed vaccine
Rabies, Influenza (injection), Polio (Salk), hepatitis A (RIP Always)
78
Which two vaccines should you not use if you are allergic to eggs?
Influenza/yellow fever vaccine
79
Why does sabin provide more protection via stronger IgA mucosal response than salk?
Increase in mucosal IgA offers immune protection at site of viral entry by inhibiting attachement to intestinal epithelia l cells. Stimulation of local secretory IgA production best promoted when corresponding mucosal surfaces are directly stimulated by antigen
80
When does serum sickness occur?
Generally 5-10 days after antigen expsoure
81
When does arthrus reaction occur?
Generally 4-12 hours after characterized by edema, necrosis, and complement activation
82
Type of hypersensitivity
| Eczema
Type 1
83
Hives
Type 1
84
Asthma
Type 1
85
Contact dermatitis
Type IV
86
Swelling and inflammation following tetanus vaccine
Type III (example of arthus reaction)
87
SLE
Type III
88
GVHD
Type IV
89
Multiple sclerosis
Type IV
90
Polyarteritis nodosa
Type III
91
PSGN
Type III
92
Acute hemolytic transfusion reactions
Type II
93
Autoimmune hemolytic anemia
Type II
94
Graves disease
Type II
95
PPD skin test
Type IV
96
Rheumatic fever
Type II
97
Pernicious anemia
Type II
98
Guillian barre
Type II
99
Myasthenia gravis
Type II
100
Erythroblastosis fetalis
Type II
101
Antimitochondrial ab
Primary biliary chirrhosis
102
Antinuclear ab
SLE, nonspecific
103
Anti-smooth muscle
Autoimmune hepatitis
104
Anti-SSA anti-SSB (anti-Ro, anti-La)
Sjogren syndrome
105
Anti-TSH receptor
Graves disease
106
Anti-U1 RNP (ribonucleoprotein)
MCTD
107
MPO-ANCA/p-ANCA
Microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)
108
B cell deficiencies tend to produce more suceptibility to ______ while T cell deficiencies tend to have more suceptibility to __________
Bacterial and protozoal infections
Viral and bacterial infections
109
Graft from self
Autograft
110
Graft from identical twin or clone
Syngeneic graft (isograft)
111
Graft from nonidentical individual of same species
Allograft
112
Graft from different species
Xenograft
113
One of main determinants of severity of rejection for transplant btwn donor and recipient
Difference in MHC antigens
114
GVHD is most likely a complication of what and why?
Bone marrow and liver transplants (rich in lymphocytes)
115
Main toxicity of calcineurin inhibitors
Both are highly nephrotoxic
116
Cytokine treatment for RCC or metastatic melanoma
Aldesleukin (IL-2)
117
Cytokine treatment Anemias (especially in renal failure)
Epoetin alfa (erythropoietin)
118
Cytokine treatment for recovery of bone marroy
Filgastrim (G-CSF) or Sargramostim (GM-CSF)
119
IFN alpha use
Chronic hep B/C, kaposi sarcoma, malignant melanoma
120
IFN beta use
MS
121
IFN gamma use
CGD
122
Treatment with cytokines for thrombocytopenia
Romiplostim, eltrombopag, oprelevekin (IL-11)
123
Alemtuzumab
Target?
clinical use?
CD52
| CLL
124
Bevacizumab
Target?
Clinical use?
VEGF
| Colorectal cancer, renal cell carcinoma
125
Cetuximab
Target?
Clinical use?
EGFR
| Stage IV colorectal cancer, head and neck cancer
126
Rituximab
Target?
Clinical use?
B-cell non hodgkin lymphoma, CLL, rheumatoid arthritis, ITP
127
Trastuzumab
Target?
Clinical use?
Her2/neu
| Breast cancer
128
Adalimumab, infliximab
Target?
Clinical use?
Soluble TNF-alpha
| IBD, RA, ankylosing spondylitis, psoriasis
129
What is a decoy TNF-alpha receptor and not a monoclonal antibody
Etanercept
130
Eculizumab
Target?
Clinical use?
Complement protein C5
| Paroxysmal nocturnal hemoglobinuria
131
Natalizumab
Target?
Clinical use?
```
alpha4 integrin (involved in WBC adhesion)
Multiple scelrosis, Crohn disease
```
132
Abciximab
Target?
Clinical use?
Gp IIb/IIIa platelet glycoproteins
| Antiplatelet agents for prevention of ischemic complications in patients undergoing percutaneous coronary intervention
133
Denosumab
Target?
Clinical use?
RANKL
| Osteoporosis; inhibit osteoclast maturation
134
Digoxin immune Fab
Target?
Clinical use?
Digoxin
| Antidote for digoxin toxicity
135
Omalizumab
Target?
Clinical use?
IgE
| Prevents IgE from binding to FcRI in allergic asthma patients
136
Palivizumab
Target?
Clinical use?
RSV F protein
| RSV prophylaxis for high-risk infants
137
Ranibizumab, bevacizumab
Target?
clinical use?
VEGF
| Neovascular age-related macular degeneration
138
Drain all cutaneous lymph from umbilicus to feet, including external genitalia and anus (up to dentate/pectinate line)
Superficial inguinal node
139
Method by which aspirin is an irreversible inhibitor?
acetylation
