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Rapid Fire Facts > Immuno rapid facts > Flashcards

Immuno rapid facts Flashcards

1
Q

Which lymph nodes drain your arm and lateral breast?

A

Axillary nodes

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2
Q

Which lymph nodes drain your lateral side of dorsum of foot?

A

Popliteal lymph node

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3
Q

Which lymph nodes drain your thighs?

A

Superficial inguinal node

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4
Q

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

A

celiac nodes

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5
Q

Which lymph nodes drain your lower duodenum and jejunum.

A

Superior mesenteric nodes

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6
Q

Which lymph nodes drain your colon from splenic flexure to upper rectum?

A

Inferior mesenteric nodes

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7
Q

Which lymph nodes drain your upper rectum?

A

Pararectal (DIT)

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8
Q

Which lymph nodes drain your lower rectum above pectinate line? (+bladder, middle 1/3 of vagina, and prostate)

A

internal iliac node

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9
Q

Which lymph nodes drain your anus below the pectinate line, scrotum, and skin below umbilicus?

A

superficial inguinal nodes

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10
Q

Which lymph nodes drain your testes, ovaries, kidneys, uterus?

A

Para-aortic nodes

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11
Q

Which lymph ducts drain your right arm and right half of your head?

A

Right lymphatic duct

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12
Q

Which lymph duct drains everywhere else besides right arm and right half of head?

A

Thoracic duct

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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
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14
Q

In the lymph node where can you find B cells?

A

Follicles in the cortex

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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

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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

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17
Q

What is found in the red pulp?

A

Sinusoids –> vascular channels with fenestrated barrel hoop basement membrane

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18
Q

Where are the T-cells in the spleen?

A

Periarteriolar lymphatic sheath (PALS) around the central arteriole

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19
Q

Where are the B cells in the spleen?

A

Germinal center

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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

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21
Q

What type of antigen does MHC I present and to which cell?

A

Endogenously synthesized antigens - CD8 T cells

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22
Q

What type of antigen does MHC II present and to which cell?

A

Exogenously synthesized antigens - CD4 T cells

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23
Q

HLA A3

A

Hemochromatosis

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24
Q

HLA B27

A

Seronegative spondyloartrhopathies

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25
Q

HLA DQ2/DQ8

A

Celiac Disease

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26
Q

HLA DR2

A

multiple sclerosis, hay fever, SLE, Goodpasture syndrome

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27
Q

HLA DR3

A

DM 1
SLE
Graves Disease
Hashimoto Thyroiditis

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28
Q

HLA DR4

A

Rheumatoid Arthritis

DM1

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29
Q

HLA DR5

A

Pernicious anemia

Hashimotos thyroiditis

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30
Q

What 2 things on a cell surface can induce an NK cell to kill it?

A

Non-specific activation signal on target cell

Absence of class I MHC (downregulation by virus infected or neoplastic cell)

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31
Q

What is anti-body dependent cell mediated cytotoxicity?

A

CD16 of NK cell, macro, monocyte, or PMN binds Fc region of bound Ig and kills the cell.

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32
Q

What cytokines to Th1 cells secrete?

A

IFN gamma
IL-2
IL-3

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33
Q

What cytokines do Th2 cells secrete?

A 
IL-2
IL-3 
IL-4
IL-5
IL-10
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34
Q

Which cytokines activate Th1 cells?

A

IL-12 and IFN gamma

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35
Q

Which cytokines activate Th2 cells?

A

IL-4

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36
Q

Which cytokines inhibit Th1 cells?

A

IL-4 and IL-10

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37
Q

Which cytokines inhibit Th2 cells?

A

IFN gamma

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38
Q

What type of cells do cytotoxic t cells kill?

A

Virus infected
neoplastic
donor graft cells

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39
Q

What two methods does a cytotoxic t cell use to kill a target cell?

A

perforin / granzyme B

Expression of FasL on its surface

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40
Q

What are the 3 things IgG does?

A

Fixes complement
opsonizes bacteria
neutralizes toxins and viruses

crosses placent / t1/2 = 21 days

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41
Q

Describe the functions of IgA.

A

Prevent attachment of bacteria and viruses to mucous membrane (Does not fix complement)

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42
Q

What is IgA in circulation? When secreted?

A

Monomer when in circulation

Dimer when secreted –> secreted with secretory component (protein) that protects it

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43
Q

Describe the function of IgM.

A

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

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44
Q

Describe the function of IgE

A

Binds mast cells and basophils
Cross-links when exposed to allergen
Mediates Type I hypersensitivity

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45
Q

What is a thymus independent antigen?

A

Antigen lacking a peptide component. (ie. LPS)

Cannot be presented by MHC to T cells

Vaccines usually need boosters

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46
Q

What is a thymus dependent antigen

A

Antigen containing a protein component (Diphtheria vaccine)

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47
Q

What are your acute phase reactants?

A 
CRP
Ferritin
Fibrinogen
Hepcidin
Serum Amyloid A
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48
Q

Function of C3b

A

opsonization

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49
Q

Function of C3a, C4a, C5a

A

anaphylaxis - C3a can stimulate mast cells and basophils

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50
Q

Function of C5a

A

neutrophil chemotaxis

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51
Q

Function of C5b - C9

A

MAC

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52
Q

What are the bodies 2 main opsonizers.

A

C3b and IgG

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53
Q

What does C1 esterase inhibitor deficiency cause?

A

Hereditary angioedema

ACE inhibitors contraindicated

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54
Q

What does C3 deficiency look like?

A

Severe, recurrent pyogenic sinus and respiratory tract infections

H. Influenzae / S. Pneumo especially

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55
Q

What does C5-C9 deficiency look like?

A

Increased risk of infection by both neisseria species.

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56
Q

DAF (CD55) deficiency

A

Causes paroxysmal nocturnal hemoglobinuria

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57
Q

What is the sequence called where breaks in dsDNA start VDJ recombination.

A

Recombination signal sequence (flanking VDJ coding regions)

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58
Q

What is the protein that recognizes break in dsDNA and initiates VDJ recombination?

A

RAG-1 / RAG-2

Recombination activating gene

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59
Q

What is the co-stimulatory signal for naive t cell activation?

A

B7 on APC binds CD28 on T cell

60
Q

what is the co-stimulatory signal for naive B cell activation and class switching?

A

CD40 on the B cell binds CD40 L on the Th Cell

61
Q

What secretes IL-1 and what does it cause?

A

Macrophages

Fever, acute inflammation, activation of endothelium

62
Q

What secretes IL-6 and what does it cause?

A

Macrophages

Fever and production of acute phase proteins

63
Q

What secretes IL-8 and what does it cause?

A

Macrophages

chemotaxis for neutrophils

64
Q

What secretes IL-12 and what does it cause?

A

Macrophages

Activation of Th0 –> Th1 cells
Activation of NK cells

65
Q

What secretes TNF alpha and what does it cause?

A

Macrophages

Septic shock

66
Q

What secretes IL-2 and what does it do?

A

All T cells

Growth of helper, cytotoxic, and regulatoryT cells

67
Q

What secretes IL-3 and what does it do?

A

All T cells

Bone marrow growth and differentiation (functions much like GM-CSF)

68
Q

What secretes IFN Gamma and what does it do?

A

Secreted by NK cells in response to IL-12 from macros AND Th1 cells.

Stimulates macrophages to kill

69
Q

What secretes IL-4 and what does it do?

A

Th2 cells

Differentiation of Th0 –> Th2
B cell growth
class switch to IgE and IgG

BEG 4 it

70
Q

What secretes IL-5 and what does it do?

A

Th2 cells

Differentiation of B cells
Class switching to IgA
Differentiation of eosinophils

71
Q

What secretes IL-10 and what does it do?

A

Th2 cells / T-regs

Decreases expression of MCH Class II and Th1 cytokines
Inhibits activated macros and dendritic cells

72
Q

What secretes IFN alpha and B and what does it do?

A

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
Q

Helper T cell surface receptors and their action.

A

TCR - binding MHC II
CD3 - helps TCR signaling
CD 28 - binds B7 on APCs
CD 4

74
Q

Cytotoxic T cell surface receptors and their action

A

TCR - binding MHC II
CD3 - helps TCR signaling
CD28 binds B7 on APCs
CD8

75
Q

B cell surface receptors and their action

A 
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
Q

Macrophage cell surface receptors

A 
CD 14
CD 40 
MHC II
B7 
Fc and C3b receptors
77
Q

NK cell surface receptors

A

CD 16 - binds Fc of IgG

CD 56 - unique NK cell marker

78
Q

Hematopoietic stem cell marker

A

CD34

79
Q

What is anergy?

A

state during which cell cannot become activated by exposure to its antigen

AKA –> no co-stimulatory signal

Mech of self tolerance

80
Q

Mechanism of superantigens (supertoxins)

A

Cross links beta region of TCR to the MHC class II on APCs

Can activate any CD4 cell –> massive release of cytokines

81
Q

Mechanism of action for LPS

A

directly stimulates macrophages by binding to endotoxin receptor –> TLR 4 / CD14

82
Q

What are some vaccines that are live attenuated?

A 
MMR 
Polio (sabin) 
influenza (intranasal)
Varicella
Yellow fever
83
Q

What are some vaccines that are killed

A

Rabies
Influenza (shot)
Polio (Salk)
Hepatitis A

84
Q

What are the bacterial vaccines that exist

A 
Tetanus toxoid
S. Pneumo (capsular polysaccharide)
H. Influenzae (capsular polysaccharide)
Vibrio Cholera (killed bacteria)
Typhoid (live attenuated)
BCG (live attenuated)
85
Q

Describe Type I Hypersensitivity

A

Anaphylactic and atopic (immediate response)

Free antigen cross links IgE on pre-sensitized mast cell and basophil.

Release of vasoactive amines

86
Q

Describe Type II Hypersensitivity

A

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
Q

What is the direct coombs test?

A

Detects antibodies that have adhered to patients RBC’s

88
Q

What is the indirect coombs test?

A

Detects serum antibodies that can adhere to other RBCs

89
Q

Describe Type III Hypersensitivity

A

immune complexes - free floating antigen + antibodies with attraction of neutrophils

90
Q

What is serum sickness and some causes?

A

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
Q

What is an arthus reaction?

A

Local subacute antibody mediated hypersensitivity

92
Q

Describe Type IV sensitivity and some causes

A

Delayed (T-cell mediated) - sensitized T cells encounter antigen and then release cytokines

No antibodies

Contact dermatitis
PPD
Transplant rejections

93
Q

What type of hypersensitivity is allergic and atopic disorders

A

1

94
Q

What type of hypersensitivity is anaphylaxis

A

1

95
Q

What type of hypersensitivity is acute hemolytic transfusion reactions

A

2

96
Q

What type of hypersensitivity is autoimmune hemolytic anemia

A

2

97
Q

What type of hypersensitivity is bullous pemphigoid

A

2

98
Q

What type of hypersensitivity is erythroblastosis fetalis

A

2

99
Q

What type of hypersensitivity is goodpasture syndrome

A

2

100
Q

What type of hypersensitivity is graves disease

A

2

101
Q

What type of hypersensitivity is guillan barre

A

2

102
Q

What type of hypersensitivity is Idiopathic thrombocytopenic purpura

A

2

103
Q

What type of hypersensitivity is myasthenia gravis

A

2

104
Q

What type of hypersensitivity is pemphigus vulgaris

A

2

105
Q

What type of hypersensitivity is pernicious anemia

A

2

106
Q

What type of hypersensitivity is rheumatic fever

A

2

107
Q

What type of hypersensitivity is Arthus reaction

A

3

108
Q

What type of hypersensitivity is SLE

A

3

109
Q

What type of hypersensitivity is Polyarteritis nodosa

A

3

110
Q

What type of hypersensitivity is post-strep glomerulonephritis

A

3

111
Q

What type of hypersensitivity is serum sickness

A

3

112
Q

What type of hypersensitivity is Contact dermatitis

A

4

113
Q

What type of hypersensitivity is GVHD

A

4

114
Q

What type of hypersensitivity is Multiple sclerosis

A

4

115
Q

What type of hypersensitivity is PPD

A

4

116
Q

Anti-ACh receptor antibody

A

Myasthenia Gravis

117
Q

Anti-basement membrane antibody

A

Goodpasture syndrome

118
Q

Anticardiolipin, lupus anticoagulant antibody

A

SLE, antiphospholipid syndrome

119
Q

Anti centromere antibody

A

Limited Scleroderma (CREST)

120
Q

Anti-desmosome (desmoglein) antibody

A

Pemphigus vulgaris

121
Q

Anti-dsDNA, Anti-smith antibody

A

SLE

122
Q

Anti-glutamic acid decarboxylase (GAD-65) antibody

A

DM Type 1

123
Q

Anti-hemidesmosome antibody

A

Bullous pemphigoid

124
Q

Anti-histone antibody

A

Drug induced SLE

125
Q

Anti-Jo1 / anti-SRP, anti-Mi-2 antibody

A

Polymyositis / Dermatomyositis

126
Q

Antimicromsomal / antithyroglobulin / anti-thyroid peroxidase antibody

A

Hashimoto Thyroiditis

127
Q

Anti-mitochondrial antibody

A

Primary billiary cirrhosis

128
Q

Antinuclear antibodies

A

SLE non specific

129
Q

Anti-parietal cell antibody

A

Pernicious anemia

130
Q

Anti Scl-70 (anti DNA topoisomerase I) antibody

A

Scleroderma (diffuse)

131
Q

Anti-smooth muscle antibody

A

Autoimmune hepatitis

132
Q

Anti-SSA or Anti-SSB (Ro and La)

A

Sjogren syndrome

133
Q

Anti-TSH receptor antibody

A

Graves Disease

134
Q

Anti-U1 RNP antibody

A

Mixed connective tissue disease

135
Q

IgA anti-endomysial, IgA anti-tissue transglutaminase

A

Celiac Disease

136
Q

MPO-ANCA/p-ANCA

A

Microscopic polyangiitis

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)

137
Q

PR3-ANCA / c-ANCA

A

Granulomatosis with polyangiitis (Wegener)

138
Q

Rheumatoid factor / anti-CCP

A

Rheumatoid arthritis

139
Q

What viruses are you susceptible towards with a decrease in T-cells?

A 
CMV
EBV
JCV
VZV
chronic infections with respiratory and GI viruses
140
Q

Which fungi/parasites are you susceptible towards with a decrease in T cells?

A

Candida (local)

PCP

141
Q

Which bacteria are you susceptible towards with a decrease in B cells?

A

Encapsulated bacteria

142
Q

Which viruses are you susceptible towards with a decrease in B cells

A

Enteroviral encephalitis

Poliovirus

143
Q

Which fungi/parasite are you susceptible to with a decrease in B cells.

A

GI Giardiasis (No IgA)

144
Q

What bacteria are you susceptible to with a decrease in granulocytes?

A 
Staph
Burkholderia cepacia
Pseudomonas aeruginosa
Serratia
Nocardia
145
Q

Which fungi / parasites are you susceptible to with a decrease in granulocytes?

A

Candida (systemic)

Aspergillus

146
Q

Which bacteria are you susceptible to with a decrease in complement?

A

Encaspulated species with early component deficiency

Neisseria with late component deficiency

Rapid Fire Facts (13 decks)

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