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immunology Flashcards

1
Q

submandibular & submental nodes

A

oral cavity mets & malignancy

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2
Q

deep cervical nodes

A

head, neck, oropharynx

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3
Q

supraclavicular nodes

A

malignancies of thorax, abdomen, pelvis

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4
Q

mediastinal nodes

A

TB, sarcoid, lung CA, granulomatous dz

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5
Q

hilar nodes

A

lungs

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6
Q

axillary nodes

A

mastitis & mets for breast cancer

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7
Q

superior mesenteric nodes

A

lower duodenum, jejunum, ileum, colon to splenic flexure (mesenteric lymphadenitis, celiac, IBD)

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8
Q

inferior mesenteric nodes

A

colon from splenic flexure to upper rectum

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9
Q

HLA B27

A

psoriatic arthritis, ankylosing spondylitis, IBD arthritis, reactive arthritis

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10
Q

HLA B57

A

abacavir HSN

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11
Q

DQ2/8

A

celiac disease

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12
Q

DR3

A

T1DM, SLE, Grave’s, Hashimoto thyroiditis, Addison

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13
Q

DR4

A

RA, T1DM, Addison

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14
Q

Th1 –> IFN Y, IL2

A

activate macrophages & cytotoxic T cells

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15
Q

Th2 –> IL4, 5, 6, 10, 13

A

activate eosinophils, increase IgE

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16
Q

Th 17 –> IL 17, 21, 22

A

induce neutrophilic infiltration

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17
Q

Treg –> TGF B, Il10, 35

A

prevent autoimmunity (maintain tolerance)

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18
Q

IgG

A

2ndary response to Ag / most abundant / fixes C’, neutralizes bacteria & viruses / crosses placenta giving babies passive immunity / warm autoimmune hemolytic anemia

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19
Q

IgA

A

prevents attachment of bacteria & viruses to mucous membranes / produced in Peyer’s patches in the GIT & protects against gut infections

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20
Q

IgM

A

first Ab produced during immune response / fixes C’ / cold autoimmune hemolytic anemia

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21
Q
A
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22
Q

IgE

A

binds mast cells & basophils / mediates type 1 HSN via release of inflammatory mediators like histamine / activates eosinophils in parasites

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23
Q

IL 1

A

secreted by macrophages
fever, acute inflammation / express adhesion molecules / induce chemokine secretion

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24
Q

IL 6

A

secreted by macrophages
- cause fever & produces acute phase proteins

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25
Q

tumor necrosis factor alpha

A

secreted by macrophages
- causes WBC recruitment / maintains granulomas in TB

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26
Q

IL 1 + IL 6 + TNF alpha

A

mediates fever & sepsis together

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27
Q

IL 8

A

secreted by macrophages
- chemotactic factor for neutrophils / clears infections

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28
Q

IL 12

A

secreted by macrophages
- differentiates T cells into Th1 cells / activates NK cells

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29
Q

IL 2

A

secreted by T cells
- growth of helper, cytotoxic & regulatory T cells & NK cells

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30
Q

IL 3

A

secreted by T cells
- differentiation of bone marrow stem cells

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31
Q

IFN gamma

A

secreted by th1 cells (NKs & Ts) in response to Ag or IL12 from macrophages
- stimulates macrophages to kill phagocytosed pathogens / induce IgG switching in B cells / increase MHC expression

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32
Q

IL 4

A

from Th2 cells
- induce diff of T cells into Th2 cells / growth of B cells / class switch IgE & IgG

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33
Q

IL 5

A

from Th2 cells
- diff B cells / class switch to IgA / diff eosinophils

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34
Q

IL 10

A

from Th2 cells
- attenuates inflammatory response

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35
Q

IL 13

A

from TH2 cells
- IgE production / induce alt macrophage activation

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36
Q

T cell surface proteins

A

TCR, CD3, CD28

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37
Q

helper T cell surface proteins

A

CD4, CD40L, CXCR4/CCR5

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38
Q

cytotoxic T cells

A

CD8

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39
Q

regulatory T cells

A

CD4, CD25

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40
Q

B cells

A

Ig, CD19, CD20, CD21, CD40, CD80/86

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41
Q

NK cells

A

CD16, CD56

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42
Q

macrophages

A

CD14, CD40, CCR5,

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43
Q

hematopoietic stem cells

A

CD34

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44
Q

live attenuated vaccines

A

microorganism rendered nonpathogenic
- induce cellular & humoral response / strong lifelong immunity / CI pregnancy
ex - adenovirus, typhoid, polio, varicella, smallpox, BCG, flu, MMR, rotavirus

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45
Q

killed or inactivated vaccine

A

pathogen inactivated by heat or chemical / safer than live vaccines
ex - HepA, typhoid, rabies, flu, polio

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46
Q

subunit, recombinant, polysaccharide & conjugate vaccines

A

use specific Ags to best stimulate immune system / targets specific epitopes of Ag
ex - HBV, HPV, neisseria meningitidis, strep PNA, H flu b, herpes zoster

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47
Q

toxoid vaccine

A

denatured bacterial toxin with intact receptor binding site / protects against bacterial toxins
ex - clostridium tetani, diphtheriae

48
Q

mRNA vaccine

A

causes cells to synthesize foreign material / induce cellular & humoral immunity / high efficacy
ex - SARS-CoV-2

49
Q

T1 HSN

A

immediate (histamine) & late phase (chemokines)
ex - anaphylaxis, allergic asthma

50
Q

T2 HSN

A
  1. cellular destruction (phagocytosis & NK cells) - autoimmune hemolytic anemia, ITP
  2. inflammation - Goodpasture, Rheumatic fever
  3. cellular dysfunction - MG, Grave’s, pemphigus vulgaris
51
Q

T3 HSN

A

Ag-Ab-C’ complexes
ex - SLE, RA, reactive arthritis, polyarteritis nodosa, PSGN, IgA vasculitis
sx - fever, urticaria, arthralgia, proteinuria, lymphadenopathy 1-2 weeks post Ag exposure

52
Q

serum sickness

A

T3 HSN
- complexes form & deposit 1-2 weeks laters leading to inflammation & tissue damage

53
Q

Arthus rxn

A

T3 HSN
- local subacute HSN in the skin –> edema, fibrinoid necrosis & activation of C’
ex - enhanced local rxn to a booster vaccination

54
Q

T4 HSN

A

direct CD8 cytotoxicity + inflammatory with CD4 / no Abs involved
ex - contact derm, DRESS, graft vs host dz
test - PPD for TB infection

55
Q

anti postsynaptic Ach receptor

A

myasthenia gravis

56
Q

anti presynaptic VG Ca2+ channel

A

LEMS

57
Q

anti B2 glycoprotein 1

A

antiphospholipid syndrome

58
Q

antinuclear (ANA)

A

nonspecific / often associated with SLE

59
Q

anticardiolipin, lupus anticoag

A

SLE, antiphospholipid syndrome

60
Q

anti ds-DNA, anti Smith

A

SLE

61
Q

antihistone

A

drug induced lupus

62
Q

anti U1 RNP

A

mixed CT dz

63
Q

rheumatoid factor

A

RA

64
Q

anti Ro/SSA, anti La/SSB

A

Sjogren syndrome

65
Q

anti Scl 70

A

scleroderma (diffuse)

66
Q

anticentromere

A

limited scleroderma (CREST syndrome)

67
Q

antisynthetase (anti Jo1), anti SRP, anti helicase

A

polymyositis, dermatomyositis

68
Q

antimitochondrial

A

primary biliary cholangitis

69
Q

anti smooth muscle, anti liver/kidney microsomal 1

A

autoimmune hepatitis

70
Q

MPO-ANCA, p-ANCA

A

microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis, UC, primary sclerosing cholangitis

71
Q

PR3-ANCA/ c-ANCA

A

GPA

72
Q

anti phospholipase A2 receptor

A

primary membranous nephropathy

73
Q

anti hemidesmosome

A

bullous pemphigoid

74
Q

anti desmoglein

A

pemphigus vulgaris

75
Q

antithyroglobulin, antithyroid peroxidase

A

Hashimoto thyroiditis

76
Q

anti TSH receptor

A

Graves dz

77
Q

IgA antiendomysial, IgA anti TTG, IgA & IgG deamidated gliadin peptide

A

Celiac dz

78
Q

anti glutamic acid decarboxylase, islet cell cytoplasmic Abs

A

T1DM

79
Q

antiparietal cell, anti IF

A

pernicious anemia

80
Q

anti glomerular BM

A

Goodpasture syndrome

81
Q

decreased Ig of all classes

A

X linked (Bruton) agammaglobulinemia

82
Q

defect in BTK, X linked recessive, no B cell maturation

A

X linked (Bruton) agammaglobulinemia

83
Q

decreased IgA with normal IgG & IgM levels

A

selective IgA deficiency

84
Q

22q11 microdeletion / failure to develop 3rd & 4th pharyngeal pouches

A

thymic aplasia

85
Q

DiGeorge syndrome

A

22q11 deletion
sx - thymic, parathyroid & cardiac defects

86
Q

decreased T cell, decreased PTH, decreased Ca2+

A

thymic aplasia

87
Q

ataxia telangectasia

A

defect in ATM gene = failure to detect DNA damage
sx - ataxia, spider angiomas (telangectasias), low IgA
labs - low TRECs

88
Q

Hyper IgM syndrome

A

defective CD40L on Th cells = class switching defect
labs - normal or high IgM / very low IgA, IgG & IgE

89
Q

mutation in WAS gene

A

Wiskott Aldrich syndrome

90
Q

Wiskott Aldrich syndrome labs

A

low to normal IgG, IgM / high IgE & IgA

91
Q

defect in lysosomal trafficking regulator gene (LYST) & microtubule dysfunction

A

Chediak Higashi syndrome

92
Q

Cyclosporine

A
  • calcineurin inh, binds cyclophilin / prevents IL2 transcription
  • tx: psoriasis, RA
  • SE = nephrotoxicity, gingival hyperplasia, hirsutism
93
Q

Tacrolimus (FK506)

A
  • calcineurin inh / prevents IL2 transcription
    tx - after solid organ transplant
    SE - nephrotoxicity, no gingival sx
94
Q

Sirolimus (Rapamycin)

A

mTOR inh, blocks T cell activation, prevents IL2 respone
tx - kidney transplant rejection prophylaxis
SE - pancytopenia, not nephrotoxic

95
Q

Basiliximab

A

blocks IL-2R
SE - edema, HTN, tremor

96
Q

Azathioprine

A

antimetabolite precursor of 6MP / blocks nucleotide synthesis
tx - RA, Crohn’s, glomerulonephritis
SE - pancytopenia

97
Q

Mycophenolate mofetil

A

reversibly inhibits IMP dehydrogenase, prevents purine synthesis
tx - rheumatic dz
SE - GI sx, pancytopenia, HTN

98
Q

glucocorticoids

A

inhibit NF-kB, suppress B & T cell function, induce T cell apoptosis
tx - a lot
SE - avascular necrosis of femoral head, osteoporosis, PUD, cataracts

99
Q

what does IFN-alpha treat

A

chronic hep C & B, renal cell CA

100
Q

what does IFN beta treat

A

multiple sclerosis

101
Q

what does IFN gamma treat

A

chronic granulomatous disease

102
Q

what does Filgrastin (G CSF) & sargramostim (GM-CSF) treat

A

leukopenia; recovery of granulocyte & monocyte counts

103
Q

what does Epo alfa treat

A

anemias

104
Q

what do TPO analogs treat

A

autoimmune thrombocytopenia, platelet stimulator

105
Q

Adalimumab, Certolizumab, Golimumab, Infliximab

A

targets soluble TNF-alpha
tx - IBD, RA, ankylosing spondylitis, psoriasis

106
Q

Eculizumab

A

targets C5
tx - paroxysmal noctural hemoglobinuria

107
Q

Guselkumab

A

targets IL 23
tx psoriasis

108
Q

Ixekizumab, sexukinumab

A

targets IL 17A
tx psoriasis, psoriatic arthritis

109
Q

Natalizumab

A

targets alpha4 integrin
tx MS, Crohn’s

110
Q

Ustekinumab

A

targets IL 12 & 23
tx psoriasis, psoriatic arthritis

111
Q

Vedolizumab

A

targets alpha4 integrin
tx IBD

112
Q

Denosumab

A

targets RANKL
tx osteoporosis (inhibit osteoclast maturation)

113
Q

Emicizumab

A

targets factors IXa & X
tx Hemophilia A

114
Q

Omalizumab

A

targets IgE
tx refractory allergic asthma

115
Q

Palivizumab

A

targets RSV F protein
tx RSV prophylaxis for high risk infants

116
Q

IL 8

A

Granulocytes - main component of pus in an abscess / stimulates recruited neutrophils

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