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First Aid Step 1 > Immuno (Lymphoid Structures) > Flashcards

Immuno (Lymphoid Structures) Flashcards

1
Q

What are the primary immune system organs?

A

1) Bone marrow

2) Thymus

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2
Q

What are the functions of the bone marrow?

A

1) Immune cell production

2) B-cell maturation

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3
Q

What is the function of the thymus?

A

T-cell maturation

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4
Q

What are the secondary organs of the immune system?

A

1) Spleen
2) Lymph nodes
3) Tonsils
4) Peyer patches

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5
Q

What is the function of the secondary immune organs?

A

Allows immune cells to interact with antigen.

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6
Q

What are the functions of the lymph node?

A

1) Nonspecific filtration by macrophages
2) Circulation of B and T cells
3) Immune response activation

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7
Q

True or false:

Lymph nodes are unencapsulated and have trabeculae

A

False; they are encapsulated and have trabeculae

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8
Q

What are the 3 areas of the lymph node?

A

1) Follicle
2) Medulla
3) Paracortex

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9
Q

The lymph node follicles are the site of:

A

B-cell localization and proliferation.

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10
Q

Where are the lymph node follicles found?

A

In the outer cortex.

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11
Q

Primary follicles are _____ (dense and quiescent/active and have pale germinal centers) while secondary follicles are ____ (dense and quiescent/active and have pale germinal centers).

A

Dense and quiescent; active and have pale germinal centers.

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12
Q

What does the medulla of the lymph node consist of?

A

Medullary cords and medullary sinuses.

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13
Q

What are medullary cords?

A

Closely packed lymphocytes and plasma cells.

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14
Q

What do the medullary sinuses communicate with?

A

Efferent lymphatics.

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15
Q

What do the medullary sinuses contain?

A

Reticular cells and macrophages.

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16
Q

What does the paracortex contain?

A

1) T-cells

2) High endothelial venules (HEV) through which B and T cells enter from the blood.

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17
Q

Which lymph node area is not well developed in patients with DiGeorge syndrome?

A

The paracortex.

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18
Q

Where is the paracortex found?

A

The region of cortex between follicles and medulla.

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19
Q

Which part of the lymph node enlarges in extreme cellular immune response?

A

The paracortex.

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20
Q

If a person was infected with EBV (or other viral infections), which area of the lymph node would we expect show hyperplasia?

A

The paracortex

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21
Q

Which lymph nodes drain the oral cavity?

A

Submandibular

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22
Q

Which lymph nodes drain the head, neck, and oropharynx?

A

Deep cervical

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23
Q

Which lymph nodes drain the abdomen and pelvis?

A

Supraclavicular (Virchow node) and Periumbilical (Sister Mary Joseph node)

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24
Q

Which lymph nodes drain the trachea and esophagus?

A

Mediastinal

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25
Q

Which lymph nodes drain the lungs?

A

Hilar

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26
Q

Which lymph nodes drain the upper limbs, breasts, and skin above the umbilicus?

A

Axillary

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27
Q

Which lymph nodes drain the hands and forearms?

A

Epitrochlear

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28
Q

Which lymph nodes drain the liver, stomach, spleen, pancreas, and upper duodenum?

A

Celiac

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29
Q

Which lymph nodes drain the lower duodenum, jejunum, ileum, colon to splenic fixture?

A

Superior mesenteric

30
Q

Which lymph nodes drain the colon from the splenic fixture to the upper rectum?

A

Inferior mesenteric

31
Q

Which lymph nodes drain the pair of testes, ovaries, kidneys, and fallopian tubes (uterus)?

A

Para-aortic

32
Q

Which lymph nodes drain the cervix, superior bladder, and the body of uterus?

A

External iliac

33
Q

Which lymph nodes drain the lower rectum to anal canal (above pectinate line), bladder, vagina (middle third), cervix, and prostate?

A

Internal iliac

34
Q

Which lymph nodes drain the anal canal (below pectinate line), skin below umbilicus (except the popliteal area), scrotum, and vulva?

A

Superficial inguinal

35
Q

Which lymph nodes drain the dorsolateral foot and posterior calf?

A

Popliteal

36
Q

Which lymph nodes are associated gastric cancer?

A

Periumbilical (Sister Mary Joseph node)

37
Q

Which lymph nodes are associated with malignancy of abdomen and pelvis?

A

Supraclavicular (Virchow node)

38
Q

Which lymph nodes are associated with malignancy of the oral cavity?

A

Submandibular

39
Q

List 4 pathologies associated with the deep cervical lymph nodes.

A

1) URTI
2) Infectious mononucleosis
3) Kawasaki disease
4) Malignancy of head, neck, and oropharynx

40
Q

Which lymph nodes are associated with Pulmonary TB (unilateral hilar), Sarcoidosis (bilateral hilar), Lung cancer, and Granulomatous disease?

A

Mediastinal and Hilar

41
Q

List 2 pathologies associated with axillary lymph nodes.

A

1) Mastitis

2) Metastasis (especially breast cancer)

42
Q

Which lymph nodes are associated with secondary syphilis?

A

Epitrochlear

43
Q

Which lymph nodes are associated with Mesenteric lynphadenitis, inflammatory bowel disease, and celiac disease?

A

1) Celiac
2) Superior Mesenteric
3) Inferior Mesenteric

44
Q

What pathology is associated sith the para-aortic lynph nodes?

A

Metastasis

45
Q

Which lymph nodes are associated with Sexually transmitted infections and Medial foot/leg cellulitis (superficial inguinal)?

A

1) Superficial inguinal
2) External iliac
3) Internal iliac

46
Q

Which lymph nodes are associated with Lateral foot/leg cellulitis?

A

Popliteal

47
Q

What drains the right side of the body above the diaphragm? Where does it drain to?

A

Right lymphatic duct; the junction of the right subclavian and internal jugular vein.

48
Q

What drains the left side of the body below the diaphragm? Where does it drain to?

A

Thoracic duct; the junction of the left subclavian and internal jugular veins.

49
Q

What can cause chylothorax?

A

Rupture of the thoracic duct

50
Q

In which quadrant is the spleen located in?

A

Left upper quadrant of the abdomen

51
Q

What are the relations of the spleen?

A

Anterolateral to the left kidney and protected by the 9th-11th ribs.

52
Q

Splenic dysfunction (as in postsplenectomy or sickle cell disease autosplenectomy) results in what?

A

Less IgM = less complement activation = less C3b opsonization = more susceptibility to encapsulated organisms.

53
Q

What are some postsplenectomy findings?

A

1) Howell-Jolly bodies (nuclear remnants)
2) Target cells
3) Thrombocytosis (loss of sequestration and removal)
4) Lymphocytosis (loss of sequestration)

54
Q

What precuation should patients undergoinf a splenectomy take?

A

They should take vaccines against encapsulated organisms (such as pneumococci, Hib, meningococci..)

55
Q

What are the 3 areas found in the spleen?

A

1) Periarteriolar lymphatic sheath (PALS)
2) Follicle
3) Marginal zone

56
Q

What does the Periarteriolar lymphatic sheath contain? Where is it located?

A

T-cells; within the white pulp

57
Q

What does the Follicle contain? Where is it located?

A

B-cells; within the white pulp

58
Q

What does the Marginal zone contain? It is the site where what happens? Where is it located?

A

Macrophages and specialized B-cells; it’s the site where antigen-presenting cells (APCs) capture blood-borne antigens for recognition by lymphocytes; located between the red pulp and the white pulp.

59
Q

Where is the Thymus located?

A

In the anterosuperior mediastinum.

60
Q

Is the Thymus encapsulated or unencapsulated?

A

Encapsulated

61
Q

The Thymus is the site of what?

A

The site of T-cell differentiation and maturation.

62
Q

The thymus epithelium is derived from ____(mesoderm/endoderm), while the thymic lymphocytes are derived from___(mesoderm/endoderm)

A

Endoderm;mesoderm

63
Q

Where exactly is the thymus derived from?

A

The third pharyngeal pouch (endodermal)

64
Q

Does the cortex have immature or mature T-cells?

A

It is dense with immature T-cells.

65
Q

What does the medulla contain?

A

It is pale with mature T-cells and Hassall corpuscles containing epithelial reticular cells.

66
Q

What does the thymus look like in a normal neonate on a chest x-ray?

A

Sail-shaped.

67
Q

By what age should the thymus involute?

A

3 years of age.

68
Q

How does the thumus present on a chest X-ray in some immunodeficiencies (such as SCID or DiGeorge syndrome)?

A

Absent thymic shadow or hypoplastic thymus.

69
Q

What is a thymoma?

A

Neoplasm of the thymus

70
Q

What is a thymoma associated with?

A

1) Myasthenia Gravis
2) Superior Vena Cava Syndrome
3) Pure Red Cell Aplasia
4) Good syndrome

First Aid Step 1 (4 decks)

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