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USMLE > Immunology > Flashcards

Immunology Flashcards

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USMLE® Step 1 flashcards
1
Q

Biomarkers for T-cells

Helper T

Cytotoxic T

A

T-Cells: TCR (bind MHC), CD3, CD28 (bind B7 on APC)

Helper T: CD4, CD40L

Cytotoxic: CD8

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2
Q

Biomarkers for B-cells

A

Ig, CD19, CD20, CD21 (receptor for EBV), CD40, MHCII, B7

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3
Q

Biomarkers for Macrophages

A

MHC II, B7, CD40, CD14 (endotoxin receptor), (receptors for Fc and C3b - Opsons)

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4
Q

BIomarkers for NK Cells

A

MHC1, CD16 (binds Fc of IgG), CD56

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5
Q

Acute phase reactants

A

IL-1, IL-6, TNF-a

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6
Q

IL-1

A

Causes fever, acute inflammation

Activates endothelium to express adhesion molecules

Induce chemokines to recruit leukocytes

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7
Q

IL-6

A

Fever

Secreted by Th and Macropages

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8
Q

IL-8

A

Chemotactic for netrophils (along with C5a and Leukotriene B4)

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9
Q

IL-12

A

Differentiate Th1

Activates NK cells. Secreted by B-cells

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10
Q

TNF-a

A

Septic shock, leukocyte recruitment, vascular leak

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11
Q

IL-3

A

Stimulate bone marrow stem cell growth

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12
Q

IL-2

A

Stimulate growth of helper/cytotoxic T-cells

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13
Q

IFN-g

A

Activate macrophage/Th1. Suppress Th2. Antiviral/antitumor properties

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14
Q

IL-4

A

Differentiation of Th2. Class switch of IgE and IgG

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15
Q

IL-5

A

Differentiate B-cells. Class switch to IgA. Simulate eosinophils.

(Mucous interleukin)

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16
Q

IL-10

A

Inhibit activated Th1. Activate Th2. Secreted by regulatory T-cells.

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17
Q

Antinuclear Antibody

A

SLE, Sjogren’s, RA, etc… (nonspecific)

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18
Q

Anti-dsDNA

A

SLE (Renal disease)

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19
Q

Anti-Smith

A

SLE

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20
Q

Anti-histone

A

Drug-induced SLE

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21
Q

Anti-IgG

A

IgM vs IgG (Rheumatoid Arthritis)

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22
Q

Anti-centromere

A

Scleroderma (CREST)

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23
Q

Anti-Scl70 (anti-DNA topoisomerase I)

A

Scleroderma (diffuse)

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24
Q

Anti-mitochondrial

A

Primary biliary cirrhosis

25
Q

Antigliadin, antiendomysial

A

Celiac’s

26
Q

Anti-basement membrane

A

Good pasteur’s

27
Q

Anti-demoglein

A

Pemphigus vulgaris

28
Q

Antimicrosomal, antithyroidglobulin

A

Hashimoto’s

29
Q

Anti-Jo-1

A

Polymyositis, dermatomyositis

30
Q

Anti-SSA (anti-Ro)

A

Vs. ribonucleoprotein

Sjogren’s, SLE

31
Q

Anti-SSB (anti-La)

A

Vs. ribonucleoprotein

Sjogren’s, SLE

32
Q

Anti-U1 RNP (ribonucleoprotein)

A

Mixed connective tissue disease

33
Q

Anti-smooth muscle

A

Autoimmune hepatitis

34
Q

Anti-glutamate (glutamic acid) decarboxylase

A

Type 1 DM

35
Q

c-ANCA

A

Wegner’s granulomatosis

36
Q

p-ANCA

A

microscopic polyangitis

Chrugg-Strauss

37
Q

Anti-TSH

A

Graves

38
Q

Anti-ACh Receptor

A

Myanesthenia Gravis

39
Q

Complements C1, C2, C3, C4

A

Viral neutralization

40
Q

C3b

A

Bacterial opsonization

41
Q

C3a, C5a

A

Anaphylaxis

C5a (Neutrophil chemotaxis)

42
Q

Deficency of C1 esterase inhibitor

A

Hereditary angioedema (Increase bradykinin) -> perioribital edema and mucosal surfaces

43
Q

Deficiency in c3

A

Reucrrent pygoenic sinus and respiratory tract infection (strep pneumo, H. influenza)

Increase susceptibility to type 3 hypersensitivity (glomerulonephritis)

44
Q

Deficiency in C5-8

A

Recurrent Nisseria infection

45
Q

Deficiency of decay acclerated factor (DAF) - CD55/59

A

Complement mediated lysis of RBC + paroxysmal nocturnal hemoglobinuria (PNH)

46
Q

Bruton’s/X-linked agammaglobulinemia

A

X-linked recessive (Defective BKT - Bruton tyrosine kinase)

Defective B-cell differentation - Low Ig (all)

Recurrent infections after 6 months

Avoid live vaccines

47
Q

Hyper IgM

A

Defective CD40L on T-cells (Inability to class switch)

Increased IgM, decreased others

Severe pyogenic infections early

48
Q

Selective Ig deficiency

A

Defective isotype switch -> def in specific Ig class

IgA def most common

Sinus/lung infections, milk allergies and diarrhea. Anaphylaxis with exposure to blood products with IgA

49
Q

Common variable immunodeficiency (CVID)

A

Defective B-cell maturation (many causes)

Normal number of B-cells, decreased plasma cells/Ig -> bacterial, enterovirus (no IgA), giardia infections

Can be acquired; increased risk of autoimmune dz, lymphoma, sinopulmonary infection

50
Q

DiGeorge

A

22q11, failure of 3rd and 4th pouch

Decrease T, decrease PTH and Ca2+, absent thymic shadow

Tetany, recurrent viral/fungal infection, congenital heart/great vessel defects

51
Q

IL-12 deficiency

A

Decrease Th1 response

Decrease IFN-g

Disseminated mycobacterial infection

52
Q

HyperIgE (job’s syndrome)

A

Th cells fail to produce IFN-g - inability of neutrophils to respond to chemotactic stimuli

FATED: coarse Facies, cold staph Abscess, primary Teeth, IgE, Dematologic problems (unusal eczema)

53
Q

Chronic mucocutaneous candidasis

A

T-cell dysfunction

Candida albicans infection of skin and mucous membranes

54
Q

Severe combined immunodeficiency

A

Several types: 1. Defective IL-2 receptor most common, 2. adenosine deaminase deficiency, 3. failure to synthesize MHC II (required to activate CD4 to activate CD8 and B-cells)

Decrease IL-2R = decrease T-cell activation

Increased adenosine = toxic to B/Tcells (decrease dNTP)

Recurrent viral, bacterial, fungal and protozoal infections due to B- and T-cell deficiency

Tx: bone marrow transplant

55
Q

Ataxia-telangiectasia

A

Defect in DNA repair

IgA deficiency

Triad: Cerebellar defects (ataxia), spider angiomas (telangiectasia), IgA deficiency

56
Q

Wiskott-Aldrich syndrome

A

X-linked recessive defect. Progressive deletion of B- and T-cells

Increased IgE, IgA; Decreased IgM

Triad (TIE): Thrombocytopenic purpura, Infections, Eczema

57
Q

Leukocyte adhesion deficiency (type 1)

A

Defective LFA-1 integrin (CD18) on phagocytes

Neutrophilia

Recurrent bacterial infection, absent pus, delayed separation of umbilicus

58
Q

Chediak-Higashi syndrome

A

Auto. recessive; defect in microtubular function -> decrease phagocytosis

Reucrrent pyogenic infections by staph/strep; partial albinism, peripheral neuopathy

59
Q

Chronic Granulomatous disease

A

Lack NADPH oxidase

Negative nitroblue tetrazolium dye reduction test

Increase catalase-positive infections (Psuedomonas, Listeria, Aspergillus, candida, e.coli, s aureus, serratia)
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USMLE (8 decks)

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