Immuno quiz Flashcards
Bilateral hilar adenopathy, ACE elevation, serum Ca elevation
Sarcoidosis
Non caseating granulomas
Sarcoid granules produce 1,25-dihydroxy-cholecalciferol and ACE
pulmonary sarcoidosis accumulate CD4 and high CD4/CD8 (over 2:1) on bronchoalveolar lavage
Hypersensitivity pneumonitis
CD8 cell bonchoalveolar lavage
Bird handling is a risk
Eosinophil action on parasites
Antibody dependent cellular cytotoxicity
IgE bind to parasite- Fc binds to eosinophil cell surface- causes eosinophil to release its proteins and enzymes to destroy parasite
Macrophages and NK cells also rely on antibody dependent cytotoxicity
Tuberculosis destruction
Cell mediated immune response
It is facultative intracellular organism that can survive and multiply within macrophages- CD4 activate the macrophages to form granulomas
Transplant rejection
Usually T cell mediated
HYperacute
Acute- some b cell can form
Chornic
Graft verses host disease
Leukocyte adhesion deficiency
LAD type one leads to defect in CD18 on phagocytes leads to impaired tight adhesion, crawling, and transmigration
Clinical: Recurrent skin infection W/O pus and delayed detatchment of umbilical cord, and poor wound healing
Inflammation
Passage of circulating inflammatory leukocytes into the inflamed tissue
1) Margination
2) rolling
3) Activation
4) Tight adhesion and crawling
5) Transmigration (Platelet endothelial cell adhesion molecule 1 PECAM-1)
Ataxia telangiectasia symptoms
Immunodeficiency with repeated sinopulmonary infections
Sensitive to IONIZING radiation
Can’t repair DNA double strand breaks
Defect in ATM gene
Triad: Ataxia from cerebellar defect, spider angiomas, IgA deficiency
Racquet shaped intracytoplasmic granule
Birbeck granule in langerhan cells- skin dendritic cells
Kupffer cells
Monocytes located in liver
Meckel cells
neuroendocrine cells in the basal layer of epidermis that perceives touch
Cells in lymph node cortical follicle
B cells
Cells in lymph node paracortex
T cell and dendritic cells
Cells in lymph node medulary cord
B cell, plasma cell, macrophages
Cells in lymph node medulary sinus
Reticular cell and macrophage
Gram positive bacteria isolated from tonsilar exudates that have polar granules that stain deeply with aniline dies
Cornebacterium diptheriae
Contain metachromic granules that stain with aniline dyes (methylene blue)
Recurrent Neisseria infection
Inability to form Mebrane Attack Complex C5C9
Selective IgA defeciency
Recurrent GI and sinopulmunary infections
including sinusitis bronnchitis, otitis media, and pneumonias
Assosiated with anaphylactic response to transfused blood products due to immune response against IgA– anaphylaxis after transfusion
Asymptomatic (majority)
Airway and GI
Anaphylaxis to IgA
Candida defense mechanism
Local infection- Tcells (Th cells)
Disseminated infection
Neutropenia
Apoptosis process
Initiation phase- protein hydrolizing caspases and activated
Execution phase- caspases bring about death by cleaving cellular proteins and activating DNAses
Intrinsic vs Extrinsic apoptosis
Intrinsic- mitochondria become permeable and pro-apoptotic substance are released into the cytoplasm
Extrinsic- engagement of death receptor on cell surface
Tumor necrosis factor receptor (TNFR1) and Fas (CD95) and form binding site for death domain containin adapter protien FADD
leads to caspase activation
Reactive arthritis
Cant see, cant pee, cant climb a tree
Conjuctivitis, urethritis, arthritis
Preceeded by GU infection (Chlamydia infection), Enteritis: Salmonella, Shigella, Yersinia, Campylobacter, C diff
Associated with HLA-B27- Which is also associated w/ anklylosing spondylitis
HLA B27
PAIR Psoriatic arthritis Ankylosing spondylitis Inflammatory bowel disease Reactive arthritis- after chlamydia or GI disease
HLA class 1 vs 2
Class 1- A,B,C
Class 2- DR, DP, DQ
HLA DR4-
Rheumatoid arthritis
There is 4 walls in a “Rheum”
Interferon Class 1 vs 2
Class 1 – alpha, beta - causes neighboring cells to reduce protein synthesis and degrade mRNA when virus infects it
Class 2- gamma- leads to activation of Th1 differentiation and increase intracelluar killing of macrophages
Wiskott-Aldrich syndrome
WATER Wiskott Aldrich Thombocytopenia Eczema Recurrent infections
Defect in both T and B cells
more infection by encapsulated and opportunistic (Pneumocystis jiroveci and herpesviridae)
Treat with bone marrow transplant
Chediak Higashi
Messed up lysosomal trafficking regulation- cant fuse lysosome with phagosome
Oculocutaneous albinism, peripheral neuropathy, and immunodeficient fusion of lysosome and phagosome
DiHydroRhodamine flow cytometry absence of green color
NADPH oxidase deficiency
Chronic granulomatous disease
Impaired intracellular killing
Old test was Nitroblue tetrazolium
abscence of blue color means deficiency
Urushiol
allergenic substance produced by Poison Ivy
Type 4, CD8 T-cell mediated allergy
Affinity maturation
Bcell only
when they are exposed to antigen, only high affinity binding Bcells survive
T cell Negative selection
Occur in medulla- cells that bind thymic medullary epithelial and dendritic cells too strongly are destroyed
T cell Positive selection
Occur in cortex of thymus
Double positive cells (CD4 and CD8) that cannot bind to thymic cortical epithelial cell self MHC apoptose
Absent thymic shadow
SVID vs DiGeorge
SVID- severe bacterial and viral infection during infancy, mucocutaenous candida, persistent diarrhea, Failure to thrive
DiGeorge Cardiac defect Abnormal facies Thymic aplasia Cleft lips Hypocalcemia
Henoch-Schonlein pupura
Palpable skin lesion with abdominal pain, arthralgia, and renal involvement
Deposition of IgA immune complex on blood vessels and renal mesangium activates complement and leads to inflammation
Leukoclastic vasculitis
Acute hemolytic transfusion reaction
Fever chills, hypotention, dyspnea, chestpain and or back pain, hemoglobinuria
Occure minutes to hr after blood transfusion
Acute serum sickness
Tissue deposit of circulating immune complex (due to administration of chimeric monoclonal antibodies- rituxumab and infliximab —- or non human immunoglobulins- venom antitoxins) Also associated with penicillin, cefaclor, and bactrim
Clinical- fever, pruritic skin rash, arthralgia and low C3 C4
Lead to decreased C3 levels because complement consumption
Mono infection
Atypical lymphocytes in peripheral blood smears- Activated CD8 cytotoxic T lymphocytes that are larger than quiescent lymphocytes with abundant cytoplasm, eccentrically placed nuclease, and cell membrane that conform the boarder of neighboring cells
These destroy infected B cells
CD14
Monocyte and macrophage- receptor for lipopolysaccaride – binding results in activation
Leukocyte adhesion process
1) rolling - selectins
2) firm adhesion and migration- integrins
Abscence of CD18 (needed for integrins)
Myloperoxidase deficiency
Both catalase and non catalase bacteria survivie
Macrophage can convert H2O2 to ClO
Antiphospholipid antibody syndrome
Part of lupus
Can give false postive RPR for mono by reacting with cardiolipin
Has prolonged aPTT but actually is hypercoagulatable
Has recurrent miscarriages
Omalizumab
Antibody against IgE
Help with Asthma
Chemotactic molecule
IL-8
neutrophil chemotaxis
“Clean up on aIsLe 8”
Others include- leukotriene b4, 5-HETE (leukotriene precursor), complement C5a
IL-10
Anti inflammatory cytokine
Produced by Th2 and macrophages to reduce Th1 stuff (IL2, IL3, TNFa)
Leukotriene
Intense vasoconstriction, increase vascular permeability, bronchospasms
Interferon a, b, gamma
GAMMA SIGNALS MACROPHAGE KILLING
A and B are antiviral
E.Coli UTI virulence factor
P fimbriae- allow adhesion to uroepithelium
Endrophonium
Reversible anticholinesterase inhibitor
Can reverse symptoms of Myasthenia gravis
IL-2
T cell activation and proliferation
Inc NK cell and macrophage activation
Bcell growth
