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Belle Phase 2a > Immunology > Flashcards

Immunology Flashcards

1
Q

Lymphoma

A

Location: lymph tissue
Increased: mature naive T-cells and B-cells

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2
Q

Multiple myeloma

A

Location: bone marrow
Increased: plasma cells

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3
Q

Myeloproliferative disorders

A

Location: bone marrow
Increased: thrombocytes, erythrocytes, granulocytes, monocytes

Includes CML

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4
Q

Primary lymphoid organs

A

Bone marrow: all immune cells originate here, B-cell maturation

Thymus: T-cell maturation

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5
Q

Secondary lymphoid organs

A

Lymph nodes: site of dendritic cell (bringing the foreign antigen), B-cell and T-cell interaction

Spleen: site of removal of RBCs and AB-coated bacteria, storage of cells (RBCs, lymphocytes, platelets)

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6
Q

Tertiary lymphoid organs

A

Lymph node like ectopic structures that form during chronic inflammation

E.g. in MS, focal TLOs form in the brain which produce anti-myelin antibodies

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7
Q

Mucosa associated lymphoid tissue (MALT)

A

Network of lymphoid tissue distributed in submucosal layers of the GI, genital, respiratory and urinalysis tracts as well as the eyes, skin, thyroid, breasts

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8
Q

Innate immunity

A

Short duration (days)
No memory or recognition of specific antigens
Local and generalised
Cells: macrophages, neutrophils, NK cells

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9
Q

Recognition in innate immunity

A

Macrophages have toll-like receptors (TLRs) that recognise pathogen-associated molecular patterns (PAMPs) on foreign invaders

Response: phagocytosis, cytokine release, interferon release

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10
Q

Cells responsible for phagocytosis

A

Macrophages and neutrophils

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11
Q

Four stages of phagocytosis

A 
Attachment e.g. bacterium to macrophage 
Engulfment 
Phagosome formation 
Lysosomal fusion and digestion
Antigen presentation (MHC II)
Secretion of waste products
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12
Q

Cytokines

A 
Interleukins 
Colony-stimulating factor
Tumour necrosis factor
Growth factor
Chemokine
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13
Q

Cytokine roles in innate immunity inflammation

A 
Activate more macrophages 
Recruiting monocytes 
Recruiting and activating neutrophils 
Recruiting and activating NK cells
Bring opsonins (help macrophages and neutrophils recognise and phagocytosis pathogens)
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14
Q

Interferons

A

Cytokines produced by macrophages, NK cells, endothelial and epithelial cells

  • Block viral entry into cells and block viral replication inside cells (interfere with viruses)
  • Activate macrophages and NK cells
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15
Q

NK functions

A

Spray target with cytokines causing apoptosis

Secrete interferon gamma (IFN-y) which further activates macrophages

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16
Q

C3b role in the complement system

A

Acts as an opsonin for phagocytosis of the attached cells

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17
Q

Specific/adaptive immunity

A 
Highly specific 
Slow (days to weeks) with long duration (months to years)
Immune memory 
T helper cells
Production of antibodies
Production of cytotoxic T cells
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18
Q

T cell receptors

A

Recognise antigens with their variable domain

Antigen needs to be presented to them by major histocompatibility complex (MHC) molecules on the surface of other cells

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19
Q

Human form of MHC

A

Human leukocyte antigen (HLA)

Specific variants found in various diseases e.g. HLA B27 in ankylosing spondylitis

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20
Q

Two types of MHC molecules

A

Class 1: present antigens that come from within the cells (i.e. from a virus that is replicating within the cell); recognised exclusively by CD8 T-cells (leads to destruction of the cell)

Class 2: found mostly on dendritic cells, macrophages, monocytes and B-cells; present antigens that come from outside the cell; recognised exclusively by CD4 T-cells (leads to differentiation into T helper cells)

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21
Q

T helper (CD4+) 1 cells

A

Cell mediated immunity
Secrete IL-2: CD4 and CD8 cells
Delayed type (IV) hypersensitivity reaction: travel to site of infection and release cytokines (macrophage recruitment)
Stimulate B cells to produce IgG

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22
Q

T helper (CD4+) 2 cells role

A

Humoral immunity
Stimulate B cells to produce all antibodies but notably more IgE
Travel to site of infection and release cytokines: (mast cell and eosinophil recruitment)
Important in parasitic infections and type 1 hypersensitivity reactions (allergy) and asthma

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23
Q

CD8 cells

A 
Have TcRs specific to antigens displayed on MHC class 1 molecules on dendritic cells 
Undergo dramatic proliferation and differentiation into cytotoxic T cells specific to the antigen
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24
Q

Cytotoxic T cell mechanisms

A

Granule exocytosis

Activate Fas molecule (apoptosis)

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25
Antibody heavily secreted in mucous to protect mucous membranes from infection e.g. saliva, breast milk
IgA
26
IgD antibody
Found on the surface of B cells
27
IgE antibodies
Least abundant in the blood Important in asthma and allergy Bound to mast cells and basophils by FcR
28
IgG antibodies
Most abundant in the blood Highly specific Important in secondary response (second exposure to antigen) Useful in measuring a patients immunity (vaccine or previous infection)
29
IgM
First antibody produced in acute infection Tends to disappear once the infection is going (unlike IgG) Most antibodies on B-cells are IgM
30
B cells
Sit in lymph nodes, spleen or MALT IgM surface antibodies recognise specific antigens Present the antigen on MHC class II molecules Stimulate T helper cells to release cytokines that activate the B cell Differentiation into plasma cells or memory B cells (happens in the germinal centre of lymph tissue)
31
Differentiation into plasma cells
Make the antibody more specific to the antigen (affinity maturation) Antibody class switch: chooses whether to produce IgA, IgE, IgG, IgM or IgD e.g. IL-4 promotes IgE class switching Start to produce vast amounts of antibodies
32
Four functions of antibodies
Ab-Ag complexes: Activation of the complement system Neutralisation of toxin effects Agglutination (attach to pathogen and clump together to slow the spread) Act as opsonins Antibody-dependent cell mediated cytotoxicity (attach to cells and recognised by NK cells, neutrophils, macrophages and eosinophils)
33
Cell mediated immunity
Immune response not involving antibodies | Phagocytes, antigen specific cytotoxic T cells, release of cytokines
34
Humoral immunity
Immunity mediated by the secretion of antibodies and the complement system
35
Mature B cell marker
CD20
36
Target of rituximab
CD20
37
Toll like receptor 4 (TLR4)
Sense gram-negative lipopolysaccarides
38
Antigen presenting cells
Dendritic cells Macrophages B cells
39
Mast cells
Involved in anaphylaxis and asthma | IgE binds to the allergen, which binds to mast cells, causes them to release histamines
40
Type I hypersensitivity reaction
Anaphylaxis Atopy (e.g. asthma, eczema, hay fever) ``` IgE mediated: CD4+ cells recognise allergen T helper 2 cells release IL-4 which stimulates IgE production by B cells IgE binds to mast cells and basophils Degranulation: histamine and TNF-a ```
41
Type 2 hypersensitivity reaction
Autoimmune haemolytic anaemia Goodpastures syndrome Pernicious anaemia Rheumatic fever IgG and IgM binds to self antigens on cell surface leading to damage
42
Type 3 hypersensitivity reaction
Systemic lupus erythematous (SLE) Post streptococcal glomerulonephritis Rheumatoid arthritis (RF = IgM that recognises IgG as an antigen) Antibody-Antigen complexes deposited in tissues Activate complement system and cause inflammation
43
Type 4 hypersensitivity reaction
TB Multiple sclerosis Guillain-Barré syndrome Delayed type (24-72 hours) T helper 1 cells activated by dendritic cell T helper cells travel to site Macrophage recruitment and cytokine release
44
First line treatment for anaphylaxis
ABCDE | IM adrenaline
45
Four examples of live attenuated vaccines
Contain a weakened version of the virus (avoid in immunosuppressed patients) MMR BCG (TB) Shingles (varicella zoster) Nasal influenza vaccine
46
Passive immunity
Antibodies introduced from outside the body Takes effect immediately Short term Maternal (passed from mother to child through breast milk or the placenta) Injected antibodies
47
Active immunity
Antibodies produced inside the body Takes effect over time (several weeks) Long term ``` Direct infection (natural active) Vaccination (artificial active) ```
48
HLA DR4
T1DM Rheumatoid arthritis ‘HLA DIABETES RHEUMATOID 4’
49
Macrophage cell surface markers
CD14 | CD40
50
Cytokine primarily responsible for activating macrophages
INF-y
51
Key cytokine in type 1 hypersensitivity
``` IL-4 Causes class switching to IgE ```
52
Markers of disease progression in HIV+ patients
CD4 cell count (HIV uses CD4 to enter CD4+ cells) AIDS: <200 HIV viral load
53
Name 3 risk groups for HIV
Men who have sex with men Intravenous drug users Commercial sex workers
54
Age group for which 50% of all new HIV infections occur worldwide
19-24 years old
55
Different types of polymorphonuclear leukocytes
Neutrophils (most abundant) Basophil Eosinophil
56
Fever, rash and non-specific symptoms
Ask about sexual history | Think of HIV seroconversion
57
Most common opportunistic infection in HIV
PCP
58
Treatment of HIV
``` Antiretroviral treatment (ART) HAART ```
59
CA-125 biomarker
Ovarian cancer
60
CA 19-9 biomarker
Pancreatic cancer
61
HER-2 biomarker
Breast cancer
62
Lifecycle of malaria parasite
Sporozoites introduced by a mosquito bite > migrate to the liver > multiply into thousands of merozoites > merozoites infect red blood cells and replicate > parasites form gametocytes, which are taken up by a mosquito, continuing the life cycle
63
Malaria causative microorganism
Plasmodium species Many of the symptoms associated with severe malaria are caused by the tendency of P. falciparum to bind to blood vessel walls and cause damage

Belle Phase 2a (14 decks)

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