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UWorld > Immuno > Flashcards

Immuno Flashcards

1
Q

Head and neck

A

cervical

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2
Q

Lungs

A

Hilar

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3
Q

Trachea and esophagus

A

Mediastinal

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4
Q

Upper limb, breast, skin above umbilicus

A

Axillary

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5
Q

Liver, stomach, spleen, pancreas, upper duodenum

A

Celiac

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6
Q

Lower duodenum, jejunum, ileum, colon to splenic flexure

A

Superior Mesenteric

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7
Q

Colon from splenic flexure to upper rectum

A

Inferior Mesenteric

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8
Q

Lower rectum to anal canal (above pectinate line), bladder, vagina (middle 3rd), prostate

A

Internal iliac

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9
Q

Testes, ovaries, kidneys, uterus

A

Para-aortic

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10
Q

Anal canal (below pectinate line), skin below umbilicus (except popliteal territory)

A

Superficial inguinal

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11
Q

Dorsolateral foot, posterior calf

A

Popliteal

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12
Q

Right side of the body above diaphragm (RUQ)

A

Right lymphatic duct

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13
Q

Everything except RUQ

A

Thoracic duct

- Into junction of L Subclavian and internal jugular veins

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14
Q

What are the SHiNE SKiS organisms?

A

Encapsulated organisms to which one is more susceptible post-splenectomy

(S)trep pneumo
(H) flu
(N)eisseria
(E) coli

(S)almonella
(K)lebsiella
Group B (S)trep

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15
Q

HLA A3 is associated with what disease?

A

Hemochromatosis

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16
Q

HLA B27 is associated with what disease?

A

Seronegtive arthropathies (PAIR)

  • Psoriatic arthritis
  • Ankylosing spondylitis
  • IBD
  • Reactive arthritis (Reiter’s syndrome)`
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17
Q

HLA DQ2/DQ8 is associated with what disease?

A

Celiac

DQ2 4, 6, 8! Don’t forget and gluten-ate!

Can’t go to DQ because lactose intolerance goes with CELIAC.

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18
Q

HLA DR2 is associated with what disease?

A

MS, hay fever, SLE, Goodpasture

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19
Q

HLA DR3 is associated with what disease?

A

DM1. SLE, Graves

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20
Q

HLA DR4 is associated with what disease?

A

Rheumatoid arthritis, DM1

There are 4 walls in a “rheum” (room).

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21
Q

HLA DR5 is associated with what disease?

A

Pernicious anemia > Vitamin B12 def.

Hashimoto thyroiditis

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22
Q

Anti-Ach

A

Myasthenia Gravis

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23
Q

Anti-BM

A

Goodpasture’s

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24
Q

Anti-cardiolipin, lupus anticoagulant

A

SLE, antiphospholipid syndrome

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25
Q

Anti-centromere

A

CREST

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26
Q

Anti-desmoglein

A

Pemphigus vulgaris

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27
Q

Anti-dsDNa, anti-Smith

A

SLE

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28
Q

Anti-glutamate decarboxylase

A

type 1 DM

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29
Q

Anti-hemidesmosome

A

Bullous pemphigoid

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30
Q

Anti-histone

A

Drug-induced lupus

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31
Q

Anti-Jo, anti-SRP, anti-M1-2

A

Polymyositis, dermatomyositis

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32
Q

Anti-microsomal, anti-thyroglobulin

A

Hashimoto thyroiditis

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33
Q

Anti-mitochondrial

A

Primary Bilary Cirrhosis

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34
Q

Anti-nuclear Antibodies (ANA)

A

SLE, nonspecific

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35
Q

Anti-Scl7- (Anti-DNA topoisomerase I)

A

Scleroderma (diffuse)

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36
Q

Anti-smooth muscle

A

Autoimmune hepatitis

37
Q

Anti-SSA, anti-SSB (anti-Ro, Anti-la)

A

Sjogren’s

38
Q

Anti-TSH receptor

A

Graves

39
Q

Anti-U1 RNP

A

Mixed connective tissue disease

40
Q

c-ANCA (PR3)

A

GPA (Wegner’s)

41
Q

p-ANCA (MPO)

A

MPA, Churg-Strauss

42
Q

IgA anti-endomysial, IgA anti-tissue transglutaminase

A

Celiac

43
Q

Rheumatoid factor, anti-CCP

A

Rheumatoid arthritis

44
Q

What cells are implicated in graft vs. host disease?

A

Donor CD4 and CD8 T cells vs. host MHC

45
Q

What is the typical time frame in which graft vs. host disease occurs?

A

Within 1 wk of transplant

46
Q

What inflammatory mediator induces cachexia/wasting syndrome?

A

TNF-a

  • Decreased appetite
  • Inhibits LPL
  • Increased insulin resistance
47
Q

What is the function of endogenous IFN-a and -b?

A

Produced by host cells in response to virus
Induce cells to make antiviral proteins that
- Degrade intracellular mRNA
- Impair protein synthesis

48
Q

What are type I interferons?

A

IFN-a and IFN-b

49
Q

What is a type II interferon?

A

INF-g

50
Q

From what cell and what function:

IL-1

A

Macros, Fever (& inflammatory cascade)

HOT

51
Q

From what cell and what function:

IL-2

A

T cells, stimulates other T cells

T

52
Q

From what cell and what function:

IL-3

A

T cells, stimulates bone marrow stem cells

BONE

53
Q

From what cell and what function:

IL-4

A

Th2, IgE and IgG

stEak

54
Q

From what cell and what function:

IL-5

A

Th2, IgA and eosinophils

steAk

55
Q

From what cell and what function:

IL-6

A

Macros, acute phase reactants

steaK

56
Q

What cytokines are secreted by macrophages?

A

IL-1 and IL-6

57
Q

What cytokines are secreted by T cells?

A

IL-2, 3, 4, 5

58
Q

MoAbs: Anti-what? Treats what?

Rituximab

A

anti-CD20, lymphoma

RIITA’s Italian Ices in LCRBA
R= rituximab; LEMon= LYMphoma

59
Q

MoAbs: Anti-what? Treats what?

Imatinib

A

bcr-abl TK, CML

note: not a moab

RIITA’s Italian Ices in LCRBA
(I= imatinib; ChiriMoya = CML)

60
Q

MoAbs: Anti-what? Treats what?

Infliximab

A

TNF-a, RA ankylosing spondylitis, Crohn’s

RIITA’s Italian inces in LCRBA
I= infliximab; RAspberry = RA

61
Q

MoAbs: Anti-what? Treats what?

Trastuzumab

A

HER2/neu (Herceptin), breast cancer

RIITA’s Italian Ices in LCRBA

(T= trastuzumab; BRambleberry = breast ca.)

62
Q

MoAbs: Anti-what? Treats what?

Abciximab

A

GPIIbIIIa, angioplasty in acute coronary syndrome

RIITA’s Italian Ices in LCRBA
A= abciximab; ApriCot = acute coronary

63
Q

Live vaccination stimulates increased…from the duodenal mucosa?

A

IgA

SERUM IgA and IgG are increased by live and killed vaccines

64
Q

Acute hemolytic transfusion reaction is what kind of hst rxn?

A

Type II

65
Q

What are the steps that produce acute hemolytic transfusion reaction?

A
  • Antibodies against ABO
  • Anaplyatoxins: C3a and C5a > vasodilation & shock
  • MAC: C5b-9: complement mediated cell lysis
66
Q

What are the 2 anti-inflammatory cytokines?

A

IL-10 and TGF-b

- Down-regulated cytokine production

67
Q

What drugs cause DILE, drug induced lupus erythematosus?

A

“Main Qs (to determine DILE, are in the) HPI”

  • Minocycline
  • Quinidine
  • Hydralazine
  • Procainamide
  • Isoniazid

Slow acetylators at high risk

68
Q

ANA antibodies are seen in (SLE vs. DILE)

A

both

69
Q

anti-ds DNA antibodies are seen in (SLE vs. DILE)

A

SLE

70
Q

anti-histone antibodies are seen in (SLE vs. DILE)

A

DILE

71
Q

What cytokines mediate the systemic inflammatory response?

A

IL-1: fever
IL-6: acute phase reactants
TNF-a: septic shock and cachexia

72
Q

Describe the steps of Leukocyte Accumulation.

A
  1. Margination
  2. Rolling
  3. Activation
  4. Adhesion + crawling
  5. Transmigration
73
Q

What proteins are needed for Rolling?

A

L-selectin on neutros

E/P selectin on endothelium

74
Q

What proteins are needed for Adhesion and Crawling?

A

Integrins, ICAM-1

75
Q

What proteins are needed for Transmigration?

A

PECAM-1

76
Q

What is positive selection of T cells?

A

T cells are positively selected if they have sufficient affinity for self-MHC

Occurs in the cortex

“Positive is self-confidence in your core”

77
Q

What is negative selection of T cells?

A

T cells are negatively selected if they have too much affinity for self-MHC or self-Ag

Occurs in the medulla

78
Q

Absent B cell numbers
No germinal center
BUT, respond to Candida antigen

Diagnosis?

A

Bruton agammaglobulinemia

79
Q

What ist he defect in Bruton Agammaglobulinemia?

A

BTK (tyrosine kinase) signal transduction, which is important to maturation of B cells
- X linked

80
Q

What is the composition of MHC II

A

a and b chains held together by an invariant chain, which is degraded during antigen processing in macros and replaced by antigen

81
Q

What is serum sickness?

A

Type III hst rxn to nonhuman proteins (like chimeric Abs) or nonhuman Igs (venom, antitoxin)

82
Q

What are the sx of serum sickness?

A

Fever, pruritic skin rash, arthralgias, 7-10 days post exposure

Fibrinoid necrosis

83
Q

What are the lab findings in serum sickness?

A

Decreased C3 because of consumption (type III hst)

84
Q

What is DRESS Syndrome?

A

Drug Reaction w Eosinophilia and Systemic Symptoms

  • 2 to 8 wks post high-risk drugs which include:
  • Anticonvulsants
  • Allopurinol
  • Sulfas
  • Antibiotics

Fever, general LAD, facial edema, diffuse rash, and marked eos!

85
Q

What cells mediate acute transplant rejection?

A

T cells (interstitial lymphocytosis)

86
Q

What cells mediate chronic transplant rejection?

A

T cells, B cells, and antibodies

fibrotic, scant inflammatory cells

87
Q

What is the fx of Calcineurin?

A

Activates IL-2 > increased T cells

88
Q

What immunosuppressants block Calcineurin?

A

Tacrolimus and Cyclophosphamide

- Used post transplant

UWorld (15 decks)

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