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First Aid Diseases > Immuno > Flashcards

Immuno Flashcards

1
Q

Encapsulated org’s?

A 
SHiNE SKiS
Strep. pneumoniae
Haemophilus influenzae type B
Neisseria meningitidis
E. coli
Salmonella
Klebsiella pneumoniae
Group B Streptococci
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2
Q 
HLA subtypes assoc'd w/ dz?
A3
B27
DQ2/DQ8
DR2, 3, 4, 5
A

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

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3
Q

C1 esterase inhibitor defic -> ?

A

Hereditary angioedema (don’t give ACEI)

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4
Q

C3 defic -> ?

A

recurrent pyogenic sinus and RT infec’s; incr’d susceptibility to T3 HSRs

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5
Q

C5-C9 defic -> ?

A

recurrent Neisseria bacteremia

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6
Q

DAF defic -> ?

A

C’ mediated lysis of RBCs and PNH

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7
Q 
IL1-5 do what?
6?
8?
10?
12?
A

“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)

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8
Q

Mphage secrete what cytokines?

A

IL-1,6, and TNFa

also IL-8, 12 (N’s and Th1/NK cells)

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9
Q

IFNg does what? Secreted by who?

A

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

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10
Q 
Cell surface pr's on:
T cells
Th cells
CTLs
B cells
Mphage
NK cells
A
  • 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)
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11
Q

Vaccines:
Live -> ? type of immunity; ex’s?
Dead -> ? type of immunity; ex’s?

A
  • cellular response (lymphocytes)
    Measles, mumps, rubella, polio (Sabin), varicella, yellow fever
  • humoral immunity (B cells)
    Cholera, hepA, polio (Salk), rabies
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12
Q

4 hypersensitivity rxns =

A

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

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13
Q

Bruton’s agammaglobulinemia

  • defect
  • clin features
A
  • XR, mutated BTK so B cells don’t mature from pro-B cells

- sinopulm infec’s after 6mo, decr’d Iggs

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14
Q

IgA deficiency

  • defect
  • clin features
  • false (+) what test?
A
  • 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
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15
Q

Common variable immunodeficiency (CVID)

  • defect
  • clin features
A
  • B cells don’t mature to pl cells

- sinopulm infec’s, GI, pneum, autoimm dz, malig; decr’d Iggs (nl # B cells)

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16
Q

DiGeorge syndrome

  • defect
  • clin features
  • struc problems?
A
  • 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
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17
Q

SCID

  • defect
  • clin features
  • trtmt
A
  • 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!)
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18
Q

Wiskott-Aldrich syndrome

  • defect
  • clin features
  • changes in Ig levels
A
  • 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
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19
Q

Ataxia-telangectasia

  • defect
  • clin features
  • Which Iggs are decr’d?
A
  • 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
20
Q

What enhances NK activity?

A

IL-2,12, IFN-a,b

21
Q

T cell act’n - 2 signals?

B cell act’n - 2 signals?

A

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

22
Q

Th1

  • secrete ?
  • act ?
  • inhib’d by?
A
  • IFN-g
  • Mphage
  • IL-4,10 from Th2 cells
23
Q

Th2

  • secrete ?
  • act ?
  • inhib’d by?
A
  • 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
24
Q

How to Mphage and T cells stim ea other?

A

T cells release IFN-g to stim Mphage and Mphage release IL-1 and TNF-a to stim T cells (lymphocytes)

25
Q

Regulatory T cells

  • express on cell surface?
  • produce ? cytokines
A
  • CD3, 4, 25 (alpha chain of IL-2 R)

- anti-inflamm cytokines: IL-10, TGF-b

26
Q

What cytokines are secreted by all T cells? What do they do?

A

IL-2 -> stim’s helper, cytotox and reg T cells

IL-3 -> growth and differentiation of BM SCs, func’s like GM-CSF

27
Q 
What cell is it on:
CD3
CD14
CD16, func?
CD19, 20, 21 (R for?)
CD40
CD40L
CD56
B7
A 
T cells
Mphage (endotox R for Gm- pr's)
NK cells, binds Fc of IgG
B cells (21 is R for EBV)
B cells and Mphage
Th cells
NK - unique marker!
APC (Mphage, DC, B cells)
28
Q

What happens w/ bac infec if you:

  • don’t have T cells?
  • don’t have B cells?
  • don’t have granulocytes?
  • don’t have C’?
A
  • sepsis
  • encap’d org’s (SHiN SKiS)
  • Staph, Burkholderia cepacia, Serratia, Nocardia
  • Neisseria (no MAC)
29
Q

What happens w/ fungal infec if you:

  • don’t have T cells?
  • don’t have B cells?
  • don’t have granulocytes?
A
  • Candida, PCP
  • GI giardiasis (no IgA)
  • Candida, Aspergillus
30
Q

What happens w/ viral infec if you:

  • don’t have T cells?
  • don’t have B cells?
A
  • CMV, EBV, VZV, chronic infec w/ resp/GI viruses

- Enteroviral encephalitis, poliov. (don’t give live vaccine!)

31
Q

T cell defic’s ->

vs. B cell defic’s ->

A
  • fungal and viral infec’s

- recurrent bac infec’s

32
Q

IL-12 R defic

  • defect
  • clin features
A
  • decr’d Th1 response (bc need IL-12 from Mphage and B cells to be act’d)
  • disseminated mycobac infec’s, decr’d IFN-g (bc Th1 aren’t act’d to make it)
33
Q

Hyper-IgE synd (Job’s synd)

  • defect
  • clin features
A
  • Th1 don’t make IFN-g -> N’s don’t work
  • FATED: coarse Faces, cold (noninflamm’d) staph Abscesses, keep 1* Teeth, incr’d IgE, Dermatitis
    + red hair
34
Q

Chronic mucocutaneous candidiasis

  • defect
  • clin features
A
  • T cell dysfunc’n

- Candida albicans infec’s of skin and mucous mem’s

35
Q

Hyper-IgM synd

  • defect
  • clin features
A
  • no CD40L on T cells so no B cell class switching

- pyogenic infec’s as baby, not Ig’s other than IgM

36
Q

Leukocyte adhesion defic (type 1)

  • defect
  • clin features
A
  • no LFA-1 integrin (CD18) on phagocytes

- recurrent bac infec’s, no pus, delayed separation of umbilical cord; neutrophila (bc they can’t migrate thr vessel)

37
Q

Chediak-Higashi synd

  • defect
  • clin features
  • histo shows
A
  • AR, no LYST (lysosomal trafficking R), microtubule dysfunc in phagosome-lysosome fusion -> less phagocytosis
  • recurrent pyogenic infec’s by Staph and Strep, partial albinism, periph neuropathy
  • giant granules in N’s
38
Q

CGD (chronic granulomatous dz)

  • defect
  • clin features
  • abnl test
A
  • no NADPH oxidase -> no ROS and no resp burst from N’s
  • infec’s from cat (+) org’s (Staph. aureus, E. coli, Aspergillus)
  • DHR (dihydrorhodamine) flow cytometry test; nitroblue tetrazolium dye (doesn’t turn blue)
39
Q

Defective CD11a/CD18 ->

A

leukocyte adhesion defect

40
Q

IFN a/b do what?

- IFNg?

A

IFNa/b inhib viral pr syn by producing ribonuclease that degrades viral mRNA
- IFNg incr’s MHC-I/II exp’n on all cells (from Th1)

41
Q

What 3 bac, 1 virus and 1 parasite have Ag variation on them to escape imm sys?

A

Bac: Salmonella (2 flagella varients), Borrelia (relapsing F), N. gonorrhoeae (pilus pr)
Virus: influenza
Parasite: trypanosomes (programmed rearrangement)

42
Q

After exposure to what 4 bad things are you given preformed Abs (aka passive immunity)

A 
"To Be Healed Rapidly"
Tetanus toxin
Botulinum toxin
HBV
Rabies v.
43
Q

Serum sickness =

  • usu due to?
  • sx?
A

IC dz (T3 HSR) in which Abs to foreign pr’s are made (5d) -> form ICs which deposit in mem’s, fix C’ and causes tissue damage

  • usu due to drugs acting as haptens
  • F, urticaria, arthralgias, proteinuria, lymphadenopathy
44
Q

Arthus rxn =

  • sx
  • seen w/?
A

local subacute T3 HSR from intradermal injection of Ag -> Abs made -> IC in skin made

  • edema, necrosis and act’n of C’
  • swelling and inflamm post-tetanus vaccine
45
Q

Transplant rejections:

  • hyperacute is due to?
  • acute?
  • chronic?
  • GVH?
A
  • w/in min: T2 HSR from pt has anti-donor Abs (occludes vessels -> ischemia/necrosis)
  • wks: CMI from CTLs against donor MHC, reverse w/ immsupp’s (vasculitis of graft w/ inflamm infiltrate)
  • mo-yrs: CTLs see donor MHC as self presenting non-self Ag (irreversible, vascular damage, fibrosis)
  • graft T cells prolif in pt and reject cells self cells -> organ dysfunc (usu in BM and liver transplant -> rash, jaundice, HSM and D)

First Aid Diseases (16 decks)

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