Immuno Flashcards
Encapsulated org’s?
SHiNE SKiS Strep. pneumoniae Haemophilus influenzae type B Neisseria meningitidis E. coli Salmonella Klebsiella pneumoniae Group B Streptococci
HLA subtypes assoc'd w/ dz? A3 B27 DQ2/DQ8 DR2, 3, 4, 5
A3: hemochromatosis
B27: PAIR=Psoriasis, Ankylosing spondylitis, IBD, Reiter’s synd
DQ2/8: Celiac dz
DR2: MS, hay fever, SLE, Goodpasture’s
DR3: T1DM, Graves’ dz
DR4: RA, T1DM
DR5: pernicious anemia -> B12 defic, Hashimoto’s thyroiditis
C1 esterase inhibitor defic -> ?
Hereditary angioedema (don’t give ACEI)
C3 defic -> ?
recurrent pyogenic sinus and RT infec’s; incr’d susceptibility to T3 HSRs
C5-C9 defic -> ?
recurrent Neisseria bacteremia
DAF defic -> ?
C’ mediated lysis of RBCs and PNH
IL1-5 do what? 6? 8? 10? 12?
“Hot T-Bone stEAk”
1 - F (Hot), acute inflamm, act’d endo to express adhesion molec’s (from Mphage)
2 - stim’s T cells (secreted by T cells)
3 - stim’s BM (from T cells)
4 - stim’s IgE prod and Th2, also IgG (from Th2)
5 - stim’s IgA prod; Eo’s (from Th2)
6 - pyrogen, stim’s acute phase rcts (from Mphage and Th2)
8 - “Clean up on aisle 8” -> recruits N’s to clear infec (from Mphage)
10 - modulates inflamm response, like TGFb bc decr’s inflamm, inhib’s Th1 (from Th2 and Treg’s)
12 - induces T->Th1, act’s NK cells (from Mphage and B cells)
Mphage secrete what cytokines?
IL-1,6, and TNFa
also IL-8, 12 (N’s and Th1/NK cells)
IFNg does what? Secreted by who?
secreted by Th1 cells
act’s Mphage and Th1, inhib’s Th2, act’s antiviral and antitumor properties, incr’s MHC-I/II exp’n on all cells
Cell surface pr's on: T cells Th cells CTLs B cells Mphage NK cells
- TCR, CD3, CD28 (binds B7)
- CD4, CD40L
- CD8
- Ig, CD19,20,21 (R for EBV), CD40, MHC-II, B7
“Drink Beer at Bar at age 21: B cells, EBV, CD-21” - CD14,40 (endotox’s bind to activate), MHC-II, B7, Fc and C3b Rs
- CD16 (binds Fc of IgG), CD56 (unique to NK)
Vaccines:
Live -> ? type of immunity; ex’s?
Dead -> ? type of immunity; ex’s?
- cellular response (lymphocytes)
Measles, mumps, rubella, polio (Sabin), varicella, yellow fever - humoral immunity (B cells)
Cholera, hepA, polio (Salk), rabies
4 hypersensitivity rxns =
ACID
1 = A = anaphylactic and atopic (vasodil at postcap venules); FAST
2 = C = cytotoxic, Ab mediated (IgM, IgG) bind fixed Ag on cell surface -> cell destruction (check w/ Coomb’s test)
3 = I = imm complex (IgG:Ag) -> C’ -> N’s and lysosomal NZs
4 = D = delayed (T cell mediated) -> act Mphage
Bruton’s agammaglobulinemia
- defect
- clin features
- XR, mutated BTK so B cells don’t mature from pro-B cells
- sinopulm infec’s after 6mo, decr’d Iggs
IgA deficiency
- defect
- clin features
- false (+) what test?
- IgA B cells don’t become pl cells
- sinopulm infec’s, giardia, decr’d IgA, anaphylaxis to bl products that have IgA
- b-HCG test due to heterophile Ab presence
Common variable immunodeficiency (CVID)
- defect
- clin features
- B cells don’t mature to pl cells
- sinopulm infec’s, GI, pneum, autoimm dz, malig; decr’d Iggs (nl # B cells)
DiGeorge syndrome
- defect
- clin features
- struc problems?
- 22q11 deletion; 3rd/4th pouches don’t develop -> no thymus nor PT gl’s
- HypoPT -> hypoCa (tetany), no thymic shadow on XR, PCP, danger of GVH rxn
- heart defects, lower face and cleft palate defects
SCID
- defect
- clin features
- trtmt
- AR ADA (adenosine deaminase) defic -> adenine toxic to B/T cells and less DNA syn; OR defective IL-2 R (X-linked)
- no CMI, decr’d Iggs -> failure to thrive, chronic D, thursh, recurrent infec’s, no thymic shadow on XR, no germinal centers, no B cells
- gene tx, BM transplant (no allograft rejection!)
Wiskott-Aldrich syndrome
- defect
- clin features
- changes in Ig levels
- XR, progressive deletion of B/T cells; WASP gene mutation -> T cells can’t recognize actin skeleton
- 3 (TIE): Thrombocytopenia, sinopulm Infec’s, Eczema; + risk of lymphoma, no CMI
- decr’d IgM, nl IgG, incr’d IgA/E
Ataxia-telangectasia
- defect
- clin features
- Which Iggs are decr’d?
- AR mutation in ATM gene, which is DNA repair NZ, thymic hypoplasia
- 3: Ce ataxia, telangectasias of eyes/skin, and IgA defic…also incr’d risk lymphoma/leukemia; adenoca; incr’d serum AFP
- decr’d IgA/E/G, decr’d T cell func
What enhances NK activity?
IL-2,12, IFN-a,b
T cell act’n - 2 signals?
B cell act’n - 2 signals?
1) MHC on DC w/ TCR on T cell
2) B7 on DC w/ CD28 on naive T cell
1) MHC-II on B cell w/ TCR on T cell
2) CD40 on B cell w/ CD40L on T cell
3) T cell secretes cytokines -> B cell act’s and class switches, aff maturation and Ab production
Th1
- secrete ?
- act ?
- inhib’d by?
- IFN-g
- Mphage
- IL-4,10 from Th2 cells
Th2
- secrete ?
- act ?
- inhib’d by?
- IL-4, 5, 10, 13
- recruits Eo’s for parasite defense and promotes IgE prod by B cells (IL-13 is for allergy)
- inhib’d by IFNg from Th1 cells
How to Mphage and T cells stim ea other?
T cells release IFN-g to stim Mphage and Mphage release IL-1 and TNF-a to stim T cells (lymphocytes)
