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Immunology Flashcards

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1
Q

Medullary region of lymph nodes contains what types of cells?

A

Reticular cells

Macrophages

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2
Q

What is present on blood smear in a person with splenectomy?

A

Howell jolly bodies
Target cells
Thrombocytosis

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3
Q

What are the features of the innate immune system?

A

Fast, Nonspecific, No memory

PMNs, Macs, NKs, Dendritic cells, Complement

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4
Q

MHC 1 features?

A

HLA [A, B ,C]
On all nucleated cells expect RBCs
heavy chain + B2 microglobulin

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5
Q

MHC II features?

A

HLA [DP, DQ, DR]
Only Ag presenting cells
2 alpha chains 2 beta chains

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6
Q

What are the associations with HLA-B27?

A

Psoriasis
Ankylosing spondylitis
IBD
Reiters syndrome

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7
Q

What HLA is associated with Celiac disease?

A

HLA DQ2/8

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8
Q

What HLA is associated with MS, SLE, and Goodpasteurs?

A

HLA DR2

*Notice its an MHC II cause caused by antibodies

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9
Q

What HLA is associated with DM and Graves? RA? Pernicious anemia?

A 
DM= HLA DR3
RA = HLA DR4
Per = HLA DR5
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10
Q

What cells use perforins and granzymes to induce apoptosis in virally infected cells and Tumor cells in the absence of MHC 1 on the surface?

A

NK cells

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11
Q

What cytokines activate NK cells?

A

IL-2
IL-12
IFN- alpha & Beta

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12
Q

WHat are the key features of the Innate immune system that “recognize” pathogens?

A

TLRs

PAMPs (LPS, ssRNA, flagella)

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13
Q

What is the mechanism of Antigen loading onto MHC 1?

A

Antigen “PEPTIDES” loaded in RER after delivery via TAP transporter

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14
Q

What is the mechanism of Antigen loading onto MCH II?

A

Loaded following Invariant chain in acidified Endosome

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15
Q

What is the co-stimulatory signal required to activate T cells?

A

B7 on APC —> CD28 on Tcell

**B7 on macs and dendritic cells

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16
Q

What is the costimulatory signal that induces B cell class switching?

A

CD40 L on Tcell –> CD40r on Bcells

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17
Q

What cytokines do Th1 secrete?

A

IFN gamma to activate Macrophages and CTLs

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18
Q

What cytokines do Th2 secrete?

A

IL-4 –> IgE
IL-5–> IgA + Eosinophils
IL-6 –> Acute phase proteins
IL-13 –> Igs

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19
Q

What is the macrophage Lymphocyte reaction needed for Granulomas?

A

Macs release IL-12 –> T-cells differentiate into Th1 cells.
Th1 secrete IFN g to activate macs

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20
Q

What is the function of Regulatory Tcells?

A

Maintain specific immune tolerance by suppressing CD4/ CD8 cells
*Once activated= Anti-inflammatory
secrete IL-10, TGFbeta

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21
Q

What are the Surface markers for Treg cells?

A

CD3
CD4
***CD25

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22
Q

What are the anti-inflammatory cytokines?

A

IL-10

TGF beta

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23
Q

What are the Fab and Fc portions of Antibodies?

A 
Fab = Antigen binding site, Variable site, Ag specificity site
Fc= Constant, Complements binding site
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24
Q

What processes cause antibody diversity?

A

Recombination of VJ regions
Heavy chain rearrangement
Somatic hypermutation= Germinal centers
Addition of Nucleotides to DNA during recombination

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25
Q

What are the features of IgG?

A

Most abundant Ig
Crosses placenta
Opsonizes bacteria
Neutralizes toxins/ viruses

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26
Q

What are the features of IgA?

A

Monomer in circulation
Dimer when Secreted
Crosses epithelial cells via TRANSCYTOSIS

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27
Q

Features of IgE?

A

Binds Mast cells and basophils
Immunity against worms via Eosinophils
LOWEST concentration in serum due to rapid binding via Mast cells

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28
Q

What are the Acute phase reactants “Unregulated” during inflammation?

A

Serum amyloid A
CRP= opsonin, fixes complement
Ferritin= sequesters IRON
Fibrinogen= Coagulation, endo repair, ESR
Hepcidin= Prevents release of IRON by ferritin

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29
Q

What Acute phase reactants are “Down-regulated” during inflammation?

A

Albumin= Conserve AAs

Transferrin

30
Q

What activates the Activators for Complement:
Classical pathway
Alternative pathway
Lectin pathway

A 
Classical= IgM + IgG
Alternative = Microbe Surface 
Lectin = Mannose
31
Q

What are the functions of:
C3a
C3b
C5a

A

C3a + C5a = Anaphylaxis
C3b = Opsonin + Clear ICs
C5a = PMN chemotactic

32
Q

What inhibit Complement activation on self cells?

A

DAF

C1 esterase inhibitor

33
Q

What is the flow of the Alternative complement system?

A

C3b + B/D –> C3 convertase –> C3b (C5 convertase)

34
Q

What is the flow of the Lectin pathway?

A

MBL-> C1 complex -> C4b {C3 convertase}

35
Q

What is the flow of the Classical pathway?

A

C1 complex -> C2b + C4b= C3 convertase

36
Q

What is the main difference btwn Classical and Alternative pathways?

A 
Classical = C1 + C2 + C4 
Alternative = C3 + B/D
37
Q

Low C4 levels will be seen when what complement pathway is activated?

A

Classical == IgM + IgG

38
Q

C1 esterase inhibitor deficiency?

A

Hereditary Angioedema

ACE CI

39
Q

C3 deficiency?

A

Recurrent Pyogenic sinus infections

Inc susceptibility to T3HS rxn

40
Q

GPI anchored DAF def?

A

PNH

41
Q

What are the functions of IL-1?

A

Fever

Activate endothelial cells to express adhesion molecules

42
Q

What are the functions of IL-12?

A

Induces Th1 differentiation

Activates NKs

43
Q

What are the functions of TNF alpha?

A

Septic shock
Endothelial activation
Leukocyte recruitment
Vascular leakage

44
Q

What cytokine function like GM-CSF?

A

IL-3

45
Q

What cytokine suppresses Th2, and has Antiviral & antiTumor properties via NK cell activation?

A

IFN gamma

46
Q

What are the functions of IL-5?

A

IgA

Eosinophil growth and differentiation

47
Q

What are the mechanism of IFN actions?

A

Induce Ribonuclease that inhibit viral protein synthesis
Degrade viral mRNA {alpha & beta}
Gamma= increases MHC I + II expression & activates NK cells

48
Q

What cells express CD28?

A

T cells

49
Q

What cells express CD21? What is this a receptor for?

A

B cells

EBV receptor

50
Q

What cells express CD14?

A

Macs

**also have Fc & C3b receptors

51
Q

What cells express CD56 and CD16?

A

NK cells

52
Q

What is the unique marker for NK cells?

A

CD56

53
Q

What bacteria classically undergo Antigen variation?

A

Borrelia = relapsing fever
gonorrhea (PILUS protein)
Salmonella (flagella)
Trypanosomes

54
Q

Endotoxins and LPS directly stimulate?

A

Macrophages via CD14
NO Th cells involvement
**Unlike SuperAgs that activate T cell receptors

55
Q

For what can Passive immunity be given?

A

Tetanus
Botulinum
HBV
Rabies

56
Q

Features of T1 HS?

A

IgE + immediate
Asthma, hay fever, drugs
Mast cells = First release Histamine/ Eos chemotactic
Late; release PGs and LTs

57
Q

What are the 3 mechanisms of T2HS cell destruction?

A

Opsonization
Complement
ADCC via NK cells

58
Q

Direct vs Indirect coombs?

A 
Direct= Detect Abs that HAVE bound pts cells
Indirect= Detect Abs that CAN bind pt serum
59
Q

Serum sickness and arthus reactions are examples of what?

A

T3HS
Serum sickness= 5days post Foreign protein causing Abs to form and bind it. Deposit in tissue and activate Complement
Arthus= Ag-Ab complexes in Skin= necrosis

60
Q

Blood transfusion reactions symptoms & Rx: Allergic reaction?

A

Urticaria
Wheezing
Fever
Rx: Anti-histamines

61
Q

Blood transfusion reactions symptoms & Rx: Anaphylactic reaction?

A

Dyspnea = Bronchospasms
Hypotension
Respiratory arrest/ shock

62
Q

Blood transfusion reactions symptoms & Rx: Febrile nonhemolytic rxn?

A

Fever
headache
chills
Flushing

63
Q

Blood transfusion reactions symptoms & Rx: Acute hemolytic rxn?

A 
Hypotension
Tachypnea
Tachycardia
Flank pain 
Hemoglobulinemia
Jaundice
64
Q 
Auto-antibodies and diseases:
Anti-CCP
 Anti-Topo1 
Anti-mitochondrial
Anti-endomysial 
Anti-Transglutaminase
Anti-Jo1/SRP/ Mi-2
Anti-smooth muscle
Anti-glutamate Decarboxylase
A 
CCP= RA
Topo1= Scleroderma
Mito= Primary biliary cirrhosis
Endomysial= Celiac
Transglutaminase= Celiac
Jo1/ SRP/ Mi2= Polymyositis/ Dermatomyositis
Smooth muscle= AI hepatitis 
Glutamate dc= T1 DM
65
Q

Pt that has recurrent TB or disseminated TB has what def?

A

IL-12 or INF gamma

66
Q

Pt with coarse face, Staph abscesses, Eczema, and Increased IgE?

A

Jobs syndrome = Hyper IgE

  • *Th1 cells fail to produce IFN gamma
  • PMNs inability to respond to chemotactic
67
Q

Pt with cerebellar defect, spider angiomas, IgA def and increase AFP?

A

Ataxia-telangiectasia= DNA repair defect

68
Q

Pt with thrombocytopenia, recurrent infections, and Eczema. What is the underlying cause of his symptoms? What is seen on Ig differential?

A

Wiskott aldrich = T cells unable to reorganize **ACTIN cytoskeleton
**Inc IgE + IgA but Low IgM

69
Q

Pt with neutrophilia but inability to form pus has what defect?

A

Leukocyte adhesion def =
Def= LFA1 Integrins or CD18
**Delayed umbilical cord seperation

70
Q

Pt with a recent kidney transplant presents with rash, jaundice, diarrhea, and hepatosplenomegaly. what is the dx?

A

Graft vs Host

71
Q

Main mediators of Rejection:
Hyperacute
Acute
Chronic

A 
Hyperacute= Abs (occlude BVs, necrosis)
Acute= CTLs (vasculitis, infiltrate)
Chronic= CTL recog MHC1 presentation as nonself (FIBROSIS, vascular damage, Irreversible)

FA genetics/ Biochem (10 decks)

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