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board review > immuno board review > Flashcards

immuno board review Flashcards

1
Q

defense against organisms that enter the body

inflammation: immune cells (neutrophils), chemical mediators (cytokines)

complement activation

antigen presentation by activation of adaptive immune system

are all examples of what kind of immunity

A

innate

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2
Q

histamine is part of the exudative component of inflammation)

what does histamine do?

A

vasodilation of arterioles –> blood flow

increased permeability of blood vessels (by producing endothelial gaps in the venules* and arterioles –> a net loss of blood plasma ( exudate high in plasma proteins)

the exudate will provide opsonins (IgG and C3b) and dilutes the bacterial toxins)

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3
Q

what does the exudate released by histamine stimulate provide?

A

opsonins (IgG and C3b)

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4
Q

Q on boards

during the first few seconds of inflammation the arterioles will be constricted.

what is this due to?

A

a neurogenic reflex (pain)

not part of the inflammation

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5
Q

lecukocyte migration and extravasation what three steps?

A

margination

transmigration (diapedesis)

chemotaxis

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6
Q

Q on boards

the process of extravasation takes place predominantly through the endothelium of the?

A

venules

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7
Q

integrin is a cell adhesion molecule that promotes _____binding of the leukocytes to the endothelial cells ?

A

tight binding

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8
Q

a pt on corticosteroids. you would expect an increase in what cell in the blood

A

neutrophils

corticosteriod have a demargination effect on the neutrophils –> inc neutrophil count

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9
Q

what chemotaxic agents stimulate leukocyte movement (neutrophils)

A

C5a

IL-8

LT- B4

Kallikrein

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10
Q

ON THE BOARDS

neonate presenting with

omphalitis, pneumonia, or periotonitis

what is the pathology of this disease

A

Leukocyte adhesion def (LAD)

leukocytosis but no abscess formation bc granulocytes cannot migrate to the site of infection

two substypes

  1. mut in B chain of CD18 Integrin subunit (required for tight binding of neutrophils to endothelium)
  2. dec selectin required for rolling neutrophils along endothelial surface
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11
Q

what disease ahs a dec CD18 integrin subunit

A

Leukocyte adhesion def type 1

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12
Q

TB produces _____ that inhibits leukocyte migration –> chronic granuloma formation

A

cord factor

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13
Q

what type of lesion will form if a splinter is left in the skin?

A

granuloma or chronic inflammation

or collection of cells (macrophages w. fibrobast)

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14
Q

Q on boards

what cells are found in the skin and have branched projections

A

dendritic cells

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15
Q

involving neutrophilic respiratory burst pathway

can H2O2 kill microbes

A

.false

it cannot kill microbes

only hypochloride can.

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16
Q

major basic protein ​is secreted by eosinophils and

has a good cytotoxic effect on ______ vs a minor activity on ?

this is a o2 independent microbial kiling mechanism

A

strong effect on Parasites

minor activity on bacteria

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17
Q

opsonization.

is the process of binding the antigen by ?

A

IgG and or C3b to facillitate pahgocytosis.

how? they cover the negative charge on the antigen by binding to Fc and CR1 receptors on the antigen surface.

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18
Q

Q on boards

a pt with gram negative sepsis. the endotoxin (lipopolysaccharide) Lipid A will activate what on macrophages to induce sepsis?

A

toll like receptor 4 (TLR4) on the macrophages to induce

IL-1 –> fever

TNF a and NO –> vasodilation, hypotension

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19
Q

what is responsible for gram - sepsis

A

TNF -a

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20
Q

on the boards

chronic granulomatous disease (NADPH oxidase def) is caused by?

A

persistence of chronic inflammation.

this was the answer.

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21
Q

CGD

has what type of inheritance

what is the main problem in this disease

pts have increased susceptibility to what organisms?

A

defect of NADPH oxidase –> dec reactive oxygen species (superoxide) and dec resiratory burst in neutrophils

X linked

Catase + organism. (staph, pseudomonas Aspergillus, nocardia, )

22
Q

pt with CGD

nitroblue tetrazolium dye will show?

dihydrorhodamine (flow cytometry) test will show?

treatment?

A

nitroblue tetrazolium dye reduction test fails to turn blue

abnormal dihydrorhodamine shows dec green fluorescence

tx: interferon gamma

23
Q

triad of symptoms

  1. recurrent pyogenic infections (by staphylococci and streptococci)
  2. partial albinism (** oculocutaneous albinism)

3. peripheral neuropathy. –> progess to neurodegeneration, infiltrative lymphohistiocytosis.

horizontal nystagmus

peripheral blood smear shows giant granules in graunlocytes and platelets (impaired emptying phagocytic cells)

whats the cause of this disease

A

lysosomal trafficking regulator gene (LYST)

microtubule dysfunction in phagosome-lysosome fusion

24
Q

what disease

autosomal recessive

recurrent acute/chronic infections with no pus formation (bc lack of leukocyte recruitment

no signs of inflammation except .fever

no umbilical cord stump rejection

A

leukocyte adhesion def.

25
Q

C3b opsonatization stimulates opsonization

def –> recurrent pyogenic sinus and respiratory infections (from encapsulated organisms)

Which one is not opsonized?

A. strept pneumonia

B. N. Mengingitis

C. N. Gonorrhea

A

N gonorrheae

bc it is not encapsulated.

26
Q

C3a

C5a

stimulate?

A

anaphylaxis

27
Q

(C5b, C6-9) + C3 –> (membrane attack complex) –> .perforation of the pathogen cell membrane —> cytolysis

def leads to>

A

inc risk of disseminated Neisseria bacteremia

28
Q

C1 esterase inhibitor def –?

classic finding:edema of skin (periorbitial) + mucosal surfaces

A

Hereditary angioedema

characterized by dec C4 levels.

avoid ACE inhibitors.

29
Q

C55 and CD59 def –>

A

Paroxysmal nocturnal hemoglobinuria

30
Q

what do CD55 and CD59 do

A

block C3 and C5 convertase

31
Q

what falls under Acquired (specific) immunity

A

humoral immune response

- mediated by B lymphocytes –> antibodies (Ig M, …)

Cell-mediated immune rxn

-it is the main function of T .cells;

in addition to regulation of antibody production by B cells

32
Q

Question on boards

pt with recurrent Bacterial infections

problem is B cells

where are they located in

LN ?

Spleen?

A

LN: the outer cortex in germinal center of the ocrtical follicles

spleen: lymphoid follicles of the white pulp

33
Q

on the boards

pt with recurrent fungal infections. what cell is def

T cells

where are they located in the LN and Spleen

A

LN: paracortical area

Spleen periarteriolar lymphoid sheaths in the white pulp

34
Q

immunoglobulin will perform their functions by

A

opsonization (by coating the microorganism to make them susceptible to phagocytosis

complement cascade activation. –> microbial cell wall lysis (IgG and IgM)

neutralization - preventing bacterial adherence to mucosa.

35
Q

on the boards

6-8 month old infant

w/ recurrent bacterial infections

large tonsils and palpable lymph nodes

labs: high IgM , low levels of other types of Ig

**what the cause?

A

CD-40 ligand on helper T cells is absent

diagnosis hyper-IgM syndrome

36
Q

what immunoglobulin is a monomer in circulation but when secreted it forms a dimer linked by J chains

A

IgA

37
Q

what immunoglobulin is the

primary immune response and complement fixation

A

IgM

38
Q

on the boards (immunoglobulin pearls

IgM In the serum of a neonate this indicates what? and what is the most likely cause?

A

indicates intrauterine infection

look for congenital rubella.

since IgM cant cross the placenta like (igG)

39
Q

which immunodeficiency disease has

low IgM

elvated IgA and normal IgE (maybe elevated)

pt have inc susceptibility to pyogenic infections, eczema, and thrombocytopenia –> petechiae and bleeding

A

wiskott-Aldrich syndrome

40
Q

wiskott Aldirhc syndrome

pts have an increase risk for what malignancies

what is the treatment

A

leukemia and lymphoma

tx: bone marrow transplantation

41
Q

what is the TCR complex?

A

TCR + CD3

know that CD3 is seen in both CD4 and CD8 T cells.

and is involved in the transduction of signals into the T cell after bidning TCR with antigen.

42
Q

Q on boards

in positive selection in the thymic .cortex

thymocytes (immature T cell) that do not bind to the MHC/antigen complex will die via what mechanism?

A

lack of growth signals ​

43
Q

Q on boards

where do lymphocytes have both CD 4 and CD8 expression

A

immature T cells in the cortex of the thymus.

44
Q

during negative selection in the thymus

thymocytes that strongly interact with self antigen will be removed by?

A

apoptosis

45
Q

Q

if pt has mutation of the FAS protein this will block the process of apoptosis

this puts the pt at increased risk for?

A

autoimmune disorders

bc no apoptosis in negative selection in thymus –> persistent auto -reactive lymphocytes

46
Q

Interleukins are mainly secreted by?

A

helper CD4+ T lymphocytes

47
Q

garanteed question on boards

IL-1 is secreted by macrophages and acts on the ? –> fever ( like IL-6)

A

il-1 acts on the hypothalamus

48
Q

know for boards

IL-4 –>

IL-5 –>

A

IL-4 —> IgE production

IL-5 —> inc eosinophils and inc IgA production

49
Q

example how IL-6 can cause fever

A

il-6 –> able to cross BBB –> inc synthesis of PGE2 in the hypothalamus –> changing the body temps setpoint

50
Q
A

board review (20 decks)

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