Immunology

Question 1

VDJ & VJ rearrangement

Answer 1

• VDJ = heavy chain

- VJ = light chain

Question 2

Tdt

Answer 2

• randomly inserts nucleotides into DNA sequence at the junctions of V, D, J segments.
• only found in lymphoblasts.
• marker for ALL.

Question 3

Outer cortex of LN

Answer 3

B cells & follicles

-brutons agammaglobinemia: hypoplastic cortex.

Question 4

Para-cortex of LN

Answer 4

T cells

• paracortex hyperplasia in viral infections.
• hypoplastic in diGeorges
• contains high endothelial venules.

Question 5

Skin above umbilicus: LN drainage

Answer 5

axillary LNs

Question 6

Lower rectum to anal canal (above pectinate)

Answer 6

Internal iliac LNs

Question 7

Anal canal below pectinate

Answer 7

Superficial inguinal LNs

Question 8

Right lymphatic duct

Answer 8

Drains right side of body above diaphragm.

Question 9

Spleen marginal zone

Answer 9

Where APCs reside and present blood born AGs.

Question 10

Splenectomy: affect on CBC

Answer 10

thrombocytosis.

granulocytosis.

Question 11

Thymus:
cortex=
medulla=

Answer 11

cortex = immature T cells. (+) selection here.
medulla = mature T cells (MM). (-) selection here.

Question 12

MHC 1

Answer 12

HLA-A
HLA-B
HLA-C
-bind TCR & CD8

Question 13

MHC 2

Answer 13

HLA-DR
HLA-DP
HLA-DQ
-bind TCR & CD4

Question 14

β2-microglobulin

Answer 14

required for expression of MHC1. If it was gone, the
active site of the MHC 1 protein would be fucked up
and not work.

Question 15

Th2 helper Ts

Answer 15

• promote humoral (Ab) immunity (extracellular).
• release IL-4 and IL-5, which promote class switching.
• release IL-10 to shut down Th1 cells. So we dont activate too many T cells, only want Th2 active.

Question 16

Th1 helper Ts

Answer 16

• intracellular bugs/viruses = cell mediated immunity.
• IL-12 causes formation of Th1 from Th0.
• released IFN-gamma & IL-2
• IFN-gamma shuts down Th2 cells.

Question 17

Treg

Answer 17

FOXP3, CD25, CD3, CD4

-prod anti-infl. cytokines: IL-10 and TGF-β.

Question 18

Brutons agammaglobinemia

Answer 18

• problem w/B cell maturation
• no mature B cells (unlike CVID)
• absent/small LNs & tonsils.
• pan-hypogammaglobinemia.

Question 19

B Cell immunodeficiency mnemonic

Answer 19

SBC = shitty B cells

• Selective IgA deficiency
• Brutons agammaglobinemia
• CVID

Question 20

Most common cause of death in DiGeorge?

Answer 20

Congenital heart disease

-tetralogy of fallot, truncus arteriosus, etc.

Question 21

Autosomal dominant hyper-IgE syndrome

Job syndrome

Answer 21

• Deficiency of Th17 cells due to STAT3 mutation.
• impaired recruitment of neutrophils to sites of infection.

-FATED: coarse Facies, cold (noninflamed) staphylococcal Abscesses, retained primary Teeth,  inc. IgE, Dermatologic problems (eczema).

Question 22

Ataxia Telangiectasia

Answer 22

• IgA deficiency (also IgG & IgE).
• inc. AFP
• lymphopenia.

Question 23

Chronic transplant rejection (CTR)

Heart

Answer 23

atherosclerosis

Question 24

CTR: lungs

Answer 24

bronchiolitis obliterans

-terminal bronchioles are inflamed/fibrosed.

Question 25

CTR: liver

Answer 25

vanishing bile ducts

Question 26

CTR: kidney

Answer 26

vascular fibrosis, glomerulopathy.

Question 27

Side effects of vincristine

Answer 27

• sensory/motor neuropathies.
• -can have muscle weakness, obtunded reflexes, parasthesias, etc.
• NO BMS.

Question 28

Filgrastim use:

Answer 28

• enhance neutrophil production.

- aka granulocyte colony-stimulating factor (GCSF)

Question 29

Febuxostat

Answer 29

• xanthine oxidase inhibitor.

- watch out if you’re taking azathioprine/6-MP.

Question 30

Which hepatitis is DNA?

Answer 30

Hep B