Immunology Flashcards
Which cytokine is released when a macrophage is activated?
IL-1
Which cytokines do T-helper cells stimulate?
All IL’s except IL-1
Which enlarged lymph nodes are most likely malignant?
Supraclavicular, Epitrochlear (above the elbow), inguinal
What is CD8?
T-killer or T-suppressor cell
Responds to MHC-1 complex (self)
Which of your cells express MHC-1?
All nucleated cells except the immune-privileged cells/tissues, RBC’s and Platelets
What are the classifications of MHC-1?
HLA-A, HLA-B and HLA-C
What are the Immuno-privileged sites?
Areas of the body that have no lymphatic flow, no antigens, and these areas can be transplanted without fear of rejection (brain, cornea, thymus, and testes) they do not express MHC-1
Which cells express MHC-2?
Antigen presenting cells
macrophages, dendritic cells, and neutrophils
What are the classifications of MHC-2?
HLA-DP, HLA-DQ, HLA-DR
What are CD4 cells?
T-helper cell - Responds to MHC-2 (foreign attack)
What type of immunity does TH1 provide?
Enhances cell mediated immunity
What type of immunity does TH2 provide?
Enhances humoral immunity
What do B cell deficiency patients die of?
Bacterial infection?
What is Common Variable Immuno. Def?
Young adults with B cells that do not work
What is Bruton’s Agammaglobulinemia?
Kids ( < 1 y/o) with defective tyrosine kinase; they have no antibodies and have x-linked transmission
What is Job’s Syndrome?
Seen in red headed females
they are stuck in the IgE stage
What is Multiple Myeloma?
Multiple osteolytic lesions
Increased IgG and kappa light chains
Rouleaux formation seen on slide
What is Heavy Chain Disease?
IgA and Multiple Myeloma of the GI tract
What is selective IgG2 Deficiency?
Seen in patients with recurrent encapsulated infections
What is Selective IgA Deficiency?
Seen in transfusion, anaphylaxis, and mucus membrane infections
What is Hairy Cell Leukemia?
Cells have a fried egg/ Sunburst appearance and TRAP +
What is Ataxia Telangiectasia?
Patients have low IgA and neurological problems, difficulty ambulating and spider like blood vessels
What is Hyper IgM Syndrome?
High IgM and all other Ig’s are low
What do T cell deficiency patients die of?
Viral infections, fungal, etc
except bacterial
What is DiGeorge Syndrome?
No Thymus, inferior Parathyroid and low calcium
What is Chronic Mucocutaneous Candidiasis?
T-cell defect against Candida Albicans and chronic fatigue
What is SCID?
No Thymus (no T-cells) frayed long bones (no B-cells) baby dies by 18 months
What is Wiskott-Aldrich?
Low IgM, Low Platelets High IgA Eczema Petechiae X-linked
What does the viral load tell you?
Progression of HIV
What organs have the most CD4 receptors?
Blood vessels brain testicles cervix rectum
What are the 3 tests used to screen for HIV?
ELISA: Detects IgG Ab to p24 Ag
Western Blot: Proteins
PCR: Detects Virus (used in babies)
What is the definition of AIDS?
CD4 count less than 200 or defining illness
What are the LIVE Vaccines?
"Bring Your Own Very Small Virus and MMR" B - BCG Y - Yellow Fever O - OPV (Sabin) = oral polio V - Varicella S - Smallpox V - Rotavirus M - Measles = Rubeola M - Mumps R - Rubella = German 3 day measles
What is a Neutrophil?
The Phagocyte (it has Antimicrobials, most abundant)
What is an Eosinophil?
The parasite destroyer and allergy inducer
What is a Basophil?
The allergy helper (IgE receptor - histamine release)
What is a Monocyte?
The destroyer - macrophage (has hydrolytic enzymes and a coffee bean nucleus)
What is a Lymphocyte?
The warrior - T, B, and NK cells
What is a Platelet?
The clotter (has no nuclei and smallest cells)
What is a Blast?
Baby hematopoietic cell
What is a Band?
Baby Neutrophil
What is Chronic Granulomatous Disease?
NADPH Oxidase deficiency - they have recurrent Staph / Aspergillus infections (Nitro-blue Tetrazolium Stain Negative) or Dihydrorhodamine flow and Cytometry test
What does MPO deficiency cause?
Catalase positive infections
What is Chediak Higashi?
Lazy Leukocyte Syndrome
Lysosomes are slow to fuse around bacteria
What is the most common transplant?
Blood transfusion
What is an Autograft?
Twin to twin (spare parts)
What is an Allograft?
Human to human transplant
What is a Xenograft?
1 species to another species (pig heart into humans)
What is a Hyperacute Rejection?
Autoimmune response within 12 hours, preformed antibodies responded
This is a Type 2 hypersensitivity reaction
What is an Acute Rejection?
Occurs 4 days to months later. T-cell and macrophage response
What is Chronic Rejection?
Occurs months to years later and fibroblasts are present
What is Graft vs. Host Disease?
When the graft attacks the body (T-Killer cells and macrophages responded)
What Diseases have a low LAP?
CML & PNH (paroxysmal nocturnal hemoglobinemia)
What has high LAP?
Leukemoid reaction
What is the difference between Acute and Chronic Leukemia’s?
Acute: started out in the bone marrow, squeezes RBC out of the marrow
Chronic: started in the periphery, not constrained and will expand
What is the difference between Myeloid and Lymphoid Leukemia’s?
Myeloid: increased RBC, WBC, platelets, macrophages (decreased Luymphoid cells) and bone marrow biopsy
Lymphoid: increased NK, T, B cells (decreased Myeloid cells) and do lymph node biopsy
What defines ALL?
0-15 year old males, bone pain, + PAS stain and +TdT. CALLA antigen positive
T (12;21)
What defines AML?
15-30 y/o males Sudan Stain Auer Rods, (CD30) T (15;17) - D M3 AML subtype treat with ATRA
What defines CML?
30-50 y/o females t(9;22)
Philadelphia Chromosome
bcr-abl
What defines CLL?
50+ y/o males with lymphadenopathy
soccer ball nuclei
Present with autoimmune Hemolytic anemia
What defines Hodgkin’s Lymphoma?
EBV and may have Reed-Sternberg cells
What are the B cell Non-Hodgkin’s Lymphomas?
Follicular: t(14;18) and bcl-2
Burkitt: t(8;14), c-myc, Starry sky, Macrophages
in american kids: abdominal mass
in african kids: jaw mass
What are the T-cell Non-Hodgkin Lymphomas?
Mcosis Fungoides: total body rash
Sezary Syndrome: Cerebreform cells in the blood
What is Myelofibrosis?
Megakaryocytes, fibrotic bone marrow, teardrop cells (RBC’s) and extramedullary Hematopoiesis
What are Plasma Neoplasms?
They produce many antibodies
What is Waldenstrom Macroglobulinemia?
IgM and Hyperviscosity of the blood
What is Monoclonal Gammopathy of undetermined significance?
Old Person with Gamma Spike (from years of building up)
What is Multiple Myeloma?
Male >40 with lower back pain Serum M protein (IgG) Bence-Jones Proteins in the urine Rouleaux formation Punched out lesions on x-ray
What is Heavy Chain Disease?
Increased IgA