Immunology Flashcards
Cells in follicle of LN
B cell
Cells in paracortex of LN
T cells
Site of LN enlarged during reaction to virus
paracortex
Primar vs secondary follicle in LN
Primar- dense and dormant
Secondary- pale center, active
Cells in medulla of LN
reticular cells and macrophages
Location and function of high endothelial venules of LN
paracortex, T and B cells enter from blood
LNs that drain upper limb, breast, skin above umbilicus
axillary
LNs that drain testes, ovaries, kidneys, uterus
para-aortic
LNs that drain dorsolateral foot, posterior calf
popliteal
LNs that drain lung
hilar
LNs that drain trachea, esophagus
mediastinal
Pathways affected by splenic dysfunction
IgM, C3b opsonization
Cells in periarterial lymphatic sheath of spleen
T cells
Cells in Red pulp of spleen
RBCs
Cells in germinal centers of spleen
B cells
Cells in marginal zone of spleen
APCs, B cells
Describe cortex of thymus
dense, immature T cells, positive selection
Describe medulla of thymus
pale, mature T cells, negative selection
What is contained in Hassall corpuscle of thymus
epithelial reticular cells
Origin of thymus
epithelium of 3rd pharyngeal pouch
MHC I loci (HLA)
HLA-A, HLA-B, HLA-C
MHC II loci (HLA)
HLA-DR, HLA-DP, HLA-DQ
MHC: CD4 vs CD8
MHC I binds CD8, MHC II binds CD4
what does b2 microblobulin do?
transports MHC 1 to surface
HLA-A3 assoc with
hemochromatosis
HLA-B27 assoc with (PAIR)
Psoriatic arthritis
Ankylosing spondilitis
IBD
Reactive arthritis
HLA-DQ2/DQ8 assoc with
Celiac
HLA-DR2 assoc with
MS
hay fever
SLE
Goodpasture syndrome
HLA-DR3 assoc with
DM1
SLE
Graves
HLA-DR4 assoc with
Rheumatoid arthritis
DM1
HLA-DR5 assoc with
pernicious anemia
hashimoto thyroiditis
What cytokines enhance NK cells
IL-2, IL-12, IFN-b, IFN-a
What do NK cells secrete to induce apoptosis
perforin, granzyme
Costimulatory signal for Naive T cell
B7 from dendritic cell binds CD28
Costimulator signal for B cell
CD40L from T cell binds CD40
What cytokine promotes Th1 cell
IL-12
What cytokine promotes Th2 cell
IL-4
what cytokines promote Th17 cell
TGFb, IL-6
What cytokine promotes Treg cell
TGFb
Function of terminal deoxynucleotidyl transferase
Addition of nucleotides to DNA during, increases antibody diversity
Ab produced by mature B lymphcytes
IgM, IgD
Ab produced by plasma cells
IgA, IgE, IgG
What determines if antigen is thymus dependent?
Does it contain a protein component (If doesnt, cannot present by MHC to T cells)
What cytokines induce acute-phase reactants
IL-6, IL-1, TNFa, IFNg
Classic complement pathway
IgM or IgG mediated
Alternative complement pathway
microbe surface molecules
Lectin complement pathway
mannose or sugar on microbe
Function of C3b
opsonization
Function of C3a, C4a, C5a
anaphylaxis
Function of C5a
neutrophil chemotaxis
Function of C5b-C9
MAC
Inhibitors of complement
CD55 (DAF), C1 esterase inhibitor
Disease caused by C1 esterase inhibitor deficiency; what is contraindicated
hereditary angioedema; ACE inhib contraindicated
What are increase risk associated with C3 deficeincy
pyogenic sinus and resp tract infx, type III hypersensitivity
Incr risk with C5-C9 deficiency
Neisseria bacteremia
IL-1 function
fever, acute inflammation
IL-2 function
Stimulate T cell growth
IL-6 function
fever, acute-phase reactants
IL-8 function
chemotaxis for neutrophils
TNFa function
activates endothelium, septic shock
IL3 function
bone marrow growth
IFNg
antiviral, antitumor, NK activation, MHC expression incr
IL5 function
B cell differentiation, IgA
IL10 function
inhibits Th1 cells
NK cell surface markers
CD16 (binds Fc), CD56
B cell receptor for EBV
CD21
What is endotoxin receptor of macrophages
CD14
Type of immunity in live attenuated vs inactivated vaccine
Live= cellular response, lifelong immunity inactivated= humoral response, requires booster, safer
Mechanism of Type 1 reaction
Antigen crosslinks IgE of mast cell, basophil
Mechanism of Type II reaction
IgM, IgG bind, MAC formation
Mechanism of Type III reaction
Immune complex formation
Serum sickness
Type III reaction- drugs form hapten, cause fever, urticaria, arthralgia 5 days after exposure
Arthus reaction
Type III reaction- local reaction (edema, necrosis) to intradermal antigen injection
Mechanism of type IV reaction
delayed T cell mediated response
Anti-ACH receptor
Myasthenia gravis
Anti-basement membrane
Goodpasture syndrome
Anti-cardiolipin
SLE, APLS
Anticentromere
CREST syndrome (limited scleroderma
Anti-desmoglein
pemphigus vulgaris
Anti-hemidesmosome
bullous pemphigoid
antihistione
drug-induced lupus
Anti- glutamate decarboxylase
T1 DM
Anti-Jo-1, anti-SRP, anti-Mi-2
polymyositis, dermatomyositis
antimicrosomal
hashimoto thyroiditis
antimitochondrial
primary biliary cirrhosis
anti-Scl-70
diffuse scleroderma (topoisomerase I)
Anti-smooth muscle
autoimmune hepatitis
Anti-U1 RNP
mixed connective tissue disease
c-ANCA
Granulomatosis with polyangitis
IgA antiendomysial, anti-tissue transgltaminase
celiac disease
p-ANCA
microscopic polyangitis, Churg-strauss syndrome
RF, anti-CCP
rheumatoid arthritis
X-linked (bruton) agammaglobulinemia defect
BTK- tyrosine kinase; no B cell maturation
recurrent bacterial, enteroviral infection after 6 mo
X-linked (bruton) agammaglobulinemia
asymptomatic, airway and GI infx, autoimmune, atopy
Selective IgA deficiency presentation
B-cell differentiation defect; autoimmune disease, bronchiectasis, lymphoma, sinopulmonary infections
Common variable immunodifiency defect, presentation
DiGeorge syndrome defect
22q11 deletion; absent thymus, parathyroid (3rd and 4th pharyngeal pouches)
IL-12 Receptor deficiency
Autosomal recessive; decr Th1- mycobacterial and fungal infx
Job syndrome defect
absent Th17 due to STAT3 mutation
course facies, staphylococcal abscesses, retained primary teeth, incr IgE, eczema
Jobs syndrome
Defects, inheritance in SCID
IL2R- Xlinked
Adenosine deaminase deficiency- autosomal recessive
Failure to thrive, recurrent diarrhea, thrush; recurrent viral, bacterial, fungal, protozoal infection
SCID
Cerebellar defect, spider angioma, IgA deficiency
Ataxia-telangiectasia
Ataxia-telangiectasia defect
defect of ATM gene, DNA strand breaks
Thrombocyopenic purpura, eczema, recurrent infection
Wiskott-Aldrich syndrome
Defect in Wiskott-Aldrich syndrome
X-linked recessive WAS gene; T cells unable to reorganize actin cytoskeleton
Defect in hyper-IgM syndrome
Defective CD40Lin Th cell- class switching failure X-linked recessive
severe pyogenic infection early in life; opportunistic infection with pneumocysits, cryptosporidium, CMV
Hyper-IgM syndrome
Recurrent bacterial skin and mucosal infection, absent pus formation, impaired wound healing, delayed umbilical cord separation
Leukocyte adhesion deficiency (type-1)
Defect in LFA-1
Defect LFA-1 integrin, CD18 on phagocytes; impaired migration and chemotaxis; AR
Recurrent pyogenic infections by staph, strep; partial albinism, peripheral neuropathy, progressive neurodegeneration, inflitrative lymphohistiocitysos
Chediak-Higashi syndrome
Chediak-Higashi syndrome defect and finding
LYST- lysosomal trafficking regulator gene; microtubule dysfunction in phagosome-lysosome fusion; giant granules in neutrophils and platelets; AR
Susceptibility to catalase positive organisms
Chronic granulomatous disease
Chronic granulomatous disease defect
NADPH oxidase, X-linked recessive
Abnormal dihydrohodamine test
Chronic granulomatous disease
Cyclosporine mechanism
calcineurin inhibitor; binds cyclophilin; prevents IL-2 transcription
Toxicity of calcineurin inh
nephrotoxicity
Tacrolimus mechanism
calcineurin inhibitor; binds FKBP; prevents IL-2 transcription
Sirolimus mechanism
mTOR inhibitor; binds FKBP; prevents IL-2 signal transduction
Basiliximab
mAb against IL-2R
Azathioprine
6-MP
Alemtuzumab target, use
CD52, CLL
Cetximab target, use
EGFR, colorectal Ca, head & neck cancer
Infliximab target
TNF-a
adalimumab target
TNFa
Natalizumab target, use
a4-integrin (leukoctye adhesion); MS, crohns
Denosumab target
RANKL
Palivizumab target, use
RSV F protein; prophylaxis for at risk infants