Immuno rapid facts Flashcards
1
Q
Which lymph nodes drain your arm and lateral breast?
A
Axillary nodes
2
Q
Which lymph nodes drain your lateral side of dorsum of foot?
A
Popliteal lymph node
3
Q
Which lymph nodes drain your thighs?
A
Superficial inguinal node
4
Q
Which lymph nodes drain your stomach, liver, spleen, pancreas, and upper duodenum?
A
celiac nodes
5
Q
Which lymph nodes drain your lower duodenum and jejunum.
A
Superior mesenteric nodes
6
Q
Which lymph nodes drain your colon from splenic flexure to upper rectum?
A
Inferior mesenteric nodes
7
Q
Which lymph nodes drain your upper rectum?
A
Pararectal (DIT)
8
Q
Which lymph nodes drain your lower rectum above pectinate line? (+bladder, middle 1/3 of vagina, and prostate)
A
internal iliac node
9
Q
Which lymph nodes drain your anus below the pectinate line, scrotum, and skin below umbilicus?
A
superficial inguinal nodes
10
Q
Which lymph nodes drain your testes, ovaries, kidneys, uterus?
A
Para-aortic nodes
11
Q
Which lymph ducts drain your right arm and right half of your head?
A
Right lymphatic duct
12
Q
Which lymph duct drains everywhere else besides right arm and right half of head?
A
Thoracic duct
13
Q
Live attenuated vaccines.
A
“ATTENtion. Please Vaccinate Young Infants with MMR Regularly”
Attenuated P = Polio (Sabin) V = Varicella Y = Yellow fever I = Intranasal influenza virus MMR = measles, mumps, rubella R = rotavirus
14
Q
In the lymph node where can you find B cells?
A
Follicles in the cortex
15
Q
Describe the contents of the medulla of a lymph node.
A
Medullary sinus - spaces between cords
Medullary cords - stacks of lymphocytes and plasma cells
16
Q
In the lymph node where can you find T cells?
A
Paracortex between follicles and medulla.
Contains high endothelial venules
Absent in DiGeorge syndrome
17
Q
What is found in the red pulp?
A
Sinusoids –> vascular channels with fenestrated barrel hoop basement membrane
18
Q
Where are the T-cells in the spleen?
A
Periarteriolar lymphatic sheath (PALS) around the central arteriole
19
Q
Where are the B cells in the spleen?
A
Germinal center
20
Q
What is found in the marginal zone of the spleen between white and red pulp?
A
APC / specialized B cells –> can capture blood borne antigens
21
Q
What type of antigen does MHC I present and to which cell?
A
Endogenously synthesized antigens - CD8 T cells
22
Q
What type of antigen does MHC II present and to which cell?
A
Exogenously synthesized antigens - CD4 T cells
23
Q
HLA A3
A
Hemochromatosis
24
Q
HLA B27
A
Seronegative spondyloartrhopathies
25
HLA DQ2/DQ8
Celiac Disease
26
HLA DR2
multiple sclerosis, hay fever, SLE, Goodpasture syndrome
27
HLA DR3
DM 1
SLE
Graves Disease
Hashimoto Thyroiditis
28
HLA DR4
Rheumatoid Arthritis
| DM1
29
HLA DR5
Pernicious anemia
| Hashimotos thyroiditis
30
What 2 things on a cell surface can induce an NK cell to kill it?
Non-specific activation signal on target cell
Absence of class I MHC (downregulation by virus infected or neoplastic cell)
31
What is anti-body dependent cell mediated cytotoxicity?
CD16 of NK cell, macro, monocyte, or PMN binds Fc region of bound Ig and kills the cell.
32
What cytokines to Th1 cells secrete?
IFN gamma
IL-2
IL-3
33
What cytokines do Th2 cells secrete?
```
IL-2
IL-3
IL-4
IL-5
IL-10
```
34
Which cytokines activate Th1 cells?
IL-12 and IFN gamma
35
Which cytokines activate Th2 cells?
IL-4
36
Which cytokines inhibit Th1 cells?
IL-4 and IL-10
37
Which cytokines inhibit Th2 cells?
IFN gamma
38
What type of cells do cytotoxic t cells kill?
Virus infected
neoplastic
donor graft cells
39
What two methods does a cytotoxic t cell use to kill a target cell?
perforin / granzyme B
| Expression of FasL on its surface
40
What are the 3 things IgG does?
Fixes complement
opsonizes bacteria
neutralizes toxins and viruses
crosses placent / t1/2 = 21 days
41
Describe the functions of IgA.
Prevent attachment of bacteria and viruses to mucous membrane (Does not fix complement)
42
What is IgA in circulation? When secreted?
Monomer when in circulation
Dimer when secreted --> secreted with secretory component (protein) that protects it
43
Describe the function of IgM.
Immediate response
Fixes complement
Does not cross placenta
Monomer when attached to the surface of a B-cell
Pentamer when secreted. --> avid binding to antigen while humoral response develops
44
Describe the function of IgE
Binds mast cells and basophils
Cross-links when exposed to allergen
Mediates Type I hypersensitivity
45
What is a thymus independent antigen?
Antigen lacking a peptide component. (ie. LPS)
Cannot be presented by MHC to T cells
Vaccines usually need boosters
46
What is a thymus dependent antigen
Antigen containing a protein component (Diphtheria vaccine)
47
What are your acute phase reactants?
```
CRP
Ferritin
Fibrinogen
Hepcidin
Serum Amyloid A
```
48
Function of C3b
opsonization
49
Function of C3a, C4a, C5a
anaphylaxis - C3a can stimulate mast cells and basophils
50
Function of C5a
neutrophil chemotaxis
51
Function of C5b - C9
MAC
52
What are the bodies 2 main opsonizers.
C3b and IgG
53
What does C1 esterase inhibitor deficiency cause?
Hereditary angioedema
ACE inhibitors contraindicated
54
What does C3 deficiency look like?
Severe, recurrent pyogenic sinus and respiratory tract infections
H. Influenzae / S. Pneumo especially
55
What does C5-C9 deficiency look like?
Increased risk of infection by both neisseria species.
56
DAF (CD55) deficiency
Causes paroxysmal nocturnal hemoglobinuria
57
What is the sequence called where breaks in dsDNA start VDJ recombination.
Recombination signal sequence (flanking VDJ coding regions)
58
What is the protein that recognizes break in dsDNA and initiates VDJ recombination?
RAG-1 / RAG-2
Recombination activating gene
59
What is the co-stimulatory signal for naive t cell activation?
B7 on APC binds CD28 on T cell
60
what is the co-stimulatory signal for naive B cell activation and class switching?
CD40 on the B cell binds CD40 L on the Th Cell
61
What secretes IL-1 and what does it cause?
Macrophages
Fever, acute inflammation, activation of endothelium
62
What secretes IL-6 and what does it cause?
Macrophages
Fever and production of acute phase proteins
63
What secretes IL-8 and what does it cause?
Macrophages
chemotaxis for neutrophils
64
What secretes IL-12 and what does it cause?
Macrophages
Activation of Th0 --> Th1 cells
Activation of NK cells
65
What secretes TNF alpha and what does it cause?
Macrophages
Septic shock
66
What secretes IL-2 and what does it do?
All T cells
Growth of helper, cytotoxic, and regulatoryT cells
67
What secretes IL-3 and what does it do?
All T cells
Bone marrow growth and differentiation (functions much like GM-CSF)
68
What secretes IFN Gamma and what does it do?
Secreted by NK cells in response to IL-12 from macros AND Th1 cells.
Stimulates macrophages to kill
69
What secretes IL-4 and what does it do?
Th2 cells
Differentiation of Th0 --> Th2
B cell growth
class switch to IgE and IgG
BEG 4 it
70
What secretes IL-5 and what does it do?
Th2 cells
Differentiation of B cells
Class switching to IgA
Differentiation of eosinophils
71
What secretes IL-10 and what does it do?
Th2 cells / T-regs
Decreases expression of MCH Class II and Th1 cytokines
Inhibits activated macros and dendritic cells
72
What secretes IFN alpha and B and what does it do?
Virus infected cells
Tells neighboring cells to
1) Stop cellular protein synthesis
2) Encourage activation of a ribonuclease that degrades viral mRNA
3) activates NK cells
73
Helper T cell surface receptors and their action.
TCR - binding MHC II
CD3 - helps TCR signaling
CD 28 - binds B7 on APCs
CD 4
74
Cytotoxic T cell surface receptors and their action
TCR - binding MHC II
CD3 - helps TCR signaling
CD28 binds B7 on APCs
CD8
75
B cell surface receptors and their action
```
IgM / IgD
CD 19, 20
CD 21 (receptor for EBV)
CD 40 - binds CD 40L on T cells which activates the B cell
MHC II
B7 - binds CD 28 on T cells
```
76
Macrophage cell surface receptors
```
CD 14
CD 40
MHC II
B7
Fc and C3b receptors
```
77
NK cell surface receptors
CD 16 - binds Fc of IgG
| CD 56 - unique NK cell marker
78
Hematopoietic stem cell marker
CD34
79
What is anergy?
state during which cell cannot become activated by exposure to its antigen
AKA --> no co-stimulatory signal
Mech of self tolerance
80
Mechanism of superantigens (supertoxins)
Cross links beta region of TCR to the MHC class II on APCs
Can activate any CD4 cell --> massive release of cytokines
81
Mechanism of action for LPS
directly stimulates macrophages by binding to endotoxin receptor --> TLR 4 / CD14
82
What are some vaccines that are live attenuated?
```
MMR
Polio (sabin)
influenza (intranasal)
Varicella
Yellow fever
```
83
What are some vaccines that are killed
Rabies
Influenza (shot)
Polio (Salk)
Hepatitis A
84
What are the bacterial vaccines that exist
```
Tetanus toxoid
S. Pneumo (capsular polysaccharide)
H. Influenzae (capsular polysaccharide)
Vibrio Cholera (killed bacteria)
Typhoid (live attenuated)
BCG (live attenuated)
```
85
Describe Type I Hypersensitivity
Anaphylactic and atopic (immediate response)
Free antigen cross links IgE on pre-sensitized mast cell and basophil.
Release of vasoactive amines
86
Describe Type II Hypersensitivity
Cytotoxic (antibody mediated)
IgM and IgG bind a antigen on an enemy cell surface and are:
Opsonized and phagocytosed
Complement and Fc receptor mediated
Anti-body mediated cellular dysfunction
87
What is the direct coombs test?
Detects antibodies that have adhered to patients RBC's
88
What is the indirect coombs test?
Detects serum antibodies that can adhere to other RBCs
89
Describe Type III Hypersensitivity
immune complexes - free floating antigen + antibodies with attraction of neutrophils
90
What is serum sickness and some causes?
Immune complex disease in which antibodies to foreign proteins are produced and deposited in membranes --> Fix complement
Most caused by drugs acting as haptents.
Fever, urticaria, arthralgia, proteinuria, lymphadenopathy
```
chimeric monoclonal Abs
non-human immunoglobulins
penecillin
cephalosporin
TMP-SMX
```
91
What is an arthus reaction?
Local subacute antibody mediated hypersensitivity
92
Describe Type IV sensitivity and some causes
Delayed (T-cell mediated) - sensitized T cells encounter antigen and then release cytokines
No antibodies
Contact dermatitis
PPD
Transplant rejections
93
What type of hypersensitivity is allergic and atopic disorders
1
94
What type of hypersensitivity is anaphylaxis
1
95
What type of hypersensitivity is acute hemolytic transfusion reactions
2
96
What type of hypersensitivity is autoimmune hemolytic anemia
2
97
What type of hypersensitivity is bullous pemphigoid
2
98
What type of hypersensitivity is erythroblastosis fetalis
2
99
What type of hypersensitivity is goodpasture syndrome
2
100
What type of hypersensitivity is graves disease
2
101
What type of hypersensitivity is guillan barre
2
102
What type of hypersensitivity is Idiopathic thrombocytopenic purpura
2
103
What type of hypersensitivity is myasthenia gravis
2
104
What type of hypersensitivity is pemphigus vulgaris
2
105
What type of hypersensitivity is pernicious anemia
2
106
What type of hypersensitivity is rheumatic fever
2
107
What type of hypersensitivity is Arthus reaction
3
108
What type of hypersensitivity is SLE
3
109
What type of hypersensitivity is Polyarteritis nodosa
3
110
What type of hypersensitivity is post-strep glomerulonephritis
3
111
What type of hypersensitivity is serum sickness
3
112
What type of hypersensitivity is Contact dermatitis
4
113
What type of hypersensitivity is GVHD
4
114
What type of hypersensitivity is Multiple sclerosis
4
115
What type of hypersensitivity is PPD
4
116
Anti-ACh receptor antibody
Myasthenia Gravis
117
Anti-basement membrane antibody
Goodpasture syndrome
118
Anticardiolipin, lupus anticoagulant antibody
SLE, antiphospholipid syndrome
119
Anti centromere antibody
Limited Scleroderma (CREST)
120
Anti-desmosome (desmoglein) antibody
Pemphigus vulgaris
121
Anti-dsDNA, Anti-smith antibody
SLE
122
Anti-glutamic acid decarboxylase (GAD-65) antibody
DM Type 1
123
Anti-hemidesmosome antibody
Bullous pemphigoid
124
Anti-histone antibody
Drug induced SLE
125
Anti-Jo1 / anti-SRP, anti-Mi-2 antibody
Polymyositis / Dermatomyositis
126
Antimicromsomal / antithyroglobulin / anti-thyroid peroxidase antibody
Hashimoto Thyroiditis
127
Anti-mitochondrial antibody
Primary billiary cirrhosis
128
Antinuclear antibodies
SLE non specific
129
Anti-parietal cell antibody
Pernicious anemia
130
Anti Scl-70 (anti DNA topoisomerase I) antibody
Scleroderma (diffuse)
131
Anti-smooth muscle antibody
Autoimmune hepatitis
132
Anti-SSA or Anti-SSB (Ro and La)
Sjogren syndrome
133
Anti-TSH receptor antibody
Graves Disease
134
Anti-U1 RNP antibody
Mixed connective tissue disease
135
IgA anti-endomysial, IgA anti-tissue transglutaminase
Celiac Disease
136
MPO-ANCA/p-ANCA
Microscopic polyangiitis
| Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
137
PR3-ANCA / c-ANCA
Granulomatosis with polyangiitis (Wegener)
138
Rheumatoid factor / anti-CCP
Rheumatoid arthritis
139
What viruses are you susceptible towards with a decrease in T-cells?
```
CMV
EBV
JCV
VZV
chronic infections with respiratory and GI viruses
```
140
Which fungi/parasites are you susceptible towards with a decrease in T cells?
Candida (local)
| PCP
141
Which bacteria are you susceptible towards with a decrease in B cells?
Encapsulated bacteria
142
Which viruses are you susceptible towards with a decrease in B cells
Enteroviral encephalitis
| Poliovirus
143
Which fungi/parasite are you susceptible to with a decrease in B cells.
GI Giardiasis (No IgA)
144
What bacteria are you susceptible to with a decrease in granulocytes?
```
Staph
Burkholderia cepacia
Pseudomonas aeruginosa
Serratia
Nocardia
```
145
Which fungi / parasites are you susceptible to with a decrease in granulocytes?
Candida (systemic)
| Aspergillus
146
Which bacteria are you susceptible to with a decrease in complement?
Encaspulated species with early component deficiency
Neisseria with late component deficiency
