Immunology Flashcards
Which lymph node drains the head and neck?
Cervical
Which lymph node drains the lungs?
Hilar
Which lymph node drains the trachea and esophagus?
Mediastinal
Which lymph node drains the upper limb, breast and skin above the umbilicus?
Axillary
Which lymph node drains the Liver, stomach, spleen, pancreas, and upper duodenum?
Celiac
Which lymph node drains the Lower duodenum, jejunum, ileum, and colon to splenic flexure?
Superior mesenteric
Which lymph node drains the Colon from splenic flexure to upper rectum?
Inferior mesenteric
Which lymph node drains the Lower rectum to anal canal (above pectinate line), bladder, vagina (middle third), and prostate?
Internal iliac
Which lymph node drains the testes, ovaries, kidneys, and uterus?
Para-aortic
Which lymph node drains the anal canal (below pectinate line), skin below umbilicus (except politeal territory)?
Superficial inguinal
Which lymph node drains the dorsolateral foot and posterior calf?
Popliteal
What is drained by the right lymphatic duct?
What is drained by the thoracic duct?
Right lymphatic duct: Right side of body above diaphragm
Thoracic duct: Everything else (to junction of left subclavian and internal jugular veins)
What encapsulated organisms have increased virulence with splenic dysfunction?
SHiNE SKiS Streptococcus pneumoniae Haemophilus influenzae (type B) Neisseria meningitidis Escheria Coli Salmonella spp Klebsiella pneumoniae Group B Streptococci
Lymphocytes in the thymus originate from what type of tissue?
Mesenchymal
What are Hassall corpuscles?
Area of the medulla of the thymus conatining epithelial reticular cells
Which HLAs determine MHCI? MHCII?
MHCI: HLA-A, HLA-B, HLA-C
MHCII: HLA-DR, HLA-DP, HLA-DQ
What is the MHC-I mode of transport to the cell surface?
Beta 2 microglobulin
What are the following HLA subtypes associated with? HLA-A3: HLA-B27: HLA-DQ2/DQ8: HLA-DR2: HLA-DR3: HLA-DR4: HLA-DR5:
HLA-A3: Hemochromatosis
HLA-B27:Psoriatic arthritis, Ankylosing spondylitis, IBD arthritis, Reactive arthritis
HLA-DQ2/DQ8: Celiac disease
HLA-DR2: Multiple sclerosis, SLE, hay fever, Goodpasture syndrome
HLA-DR3: Diabetes Mellitus Type I, SLE, Graves disease
HLA-DR4: Rheumatoid arthritis, diabetes mellitus type 1
HLA-DR5: Pernicious anemia, Hashimoto thyroiditis
What is secreted by the Th1 cell?
What is secreted by the Th2 cell?
Th1: IFN-gamma
Th2: IL-4, IL-5, IL-6, IL-13 (IL-10)
What are the functions of perforin and granzyme?
Perforin: Helps deliver the content of granules into target cell
Granzyme: Serine protease that activates apoptosis inside the target cell
What are the cell surface markers/identification factors on regulatory T cells?
CD3, CD4, CD25 (alpha chain of IL-2 receptor), and transcription factor FOXP3
What enzyme adds nucleotides to antibody DNA during recombination (VDJ)?
terminal deoxynucleotidyl transferase
Which antibody fixes compliment, crosses the placenta and is the main antibody in delayed response to an antigen?
IgG
Which antibody is a monomer in circulation, a dimer when secreted, and crosses epithelial cells by transcytosis? (associated with secretions)
IgA
Which antibody is secreted as a pentamer and can trap free antigens out of tissue while the humoral response evolves?
IgM
Which antibody binds mast cells and basophils, mediating type 1 hypersensitivity through release of histamine?
IgE
What induces acute-phase reactants (factors that change concentration in response to inflammation)?
IL-6, IL-1, TNF-alpha, IFN-gamma
What are the functions of ferritin, transferrin, and hepcidin in chronic inflammatory states?
Ferritin: Binds and sequesters iron to inhibit microbial iron scavenging
Transferrin: Internalized by macrophages to sequester iron (downregulated)
Hepcidin: prevents release of iron bound by ferritin
What is C-reactive protein?
An opsonin: fixes complement and facilitates phagocytosis; measured as sign of ongoing inflammation
What complement proteins are associated with anaphylaxis? Neutrophil chemotaxis? MAC?
Anaphylaxis: C3a, C4a, C5a
Neutrophil chemotaxis: C5a
MAC: C5b-9
What is CD55 (DAF)?
Decay accelerating factor and C1 esterase inhibitor help prevent complement activation on self cells (deficient in paroxysmal nocturnal hemogobinuria)
What drugs are contraindicated in a C1 esterase inhibitor deficiency? What does this deficiency cause?
ACE inhibitors; causes hereditary angioedema
What can be caused by C3 deficiency?
Increases risk of severe, recurrent, pyogenic sinus and respiratory tract infections; increased susceptibility to type III hypersensitivity reactions
Explain the mnemonic, Hot T-Bone stEAK in terms of IL-1,2,3,4,5 and 6
IL-1: Fever- pyrogen (hot) IL-2: Stimulates T cells IL-3: Stimulates BONE marrow IL-4: Stimulates IgE production IL-5: Stimulates IgA production IL-6: Stimulates aKute phase protein production
What is the function of IL-8 (“clean up on aisle 8”)
Major chemotactic factor for neutrophils (Neutrophils are recruited by IL-8 to clear infections)
Which interleukin induces differentiation of T-cells into Th1 cells and activates NK cells (secreted by macrophages and B cells)?
IL-12
What is the function of TNF-alpha (secreted by macrophages)?
Mediates septic shock. Activates endothelium. Causes leukocyte recruitment, vascular leak
What is the function of IL-10 (from Th2 cells)? What also secretes it?
Modulates inflammatory response and inhibits actions of activated T cells and Th1; Also secreted by regulatory T cells
What is the function of interferons?
Glycoproteins synthesized by viral-infected cells that act locally on uninfected cells “priming” them for viral defense - activate RNAseL (degredation of viral host mRNA) and protein kinase (inhibition of viral/host protein synthesis)
What are cell surface proteins on Macrophages and NK cels?
Macrophages: CD14, CD40, MHCII, B7, C3b and Fc
NK cells: CD16 (binds Fc of IgG), CD56
Which infectious agents can undergo antigenic variation?
Bacteria: Salmonella, Borrelia, Neisseria Gonorrhoeae
Virus: Influenza
Parasites: Trypanosomes
When are patients given preformed antibodies?
After exposure to Tetanus toxin, Botulinum toxin, HBV, or Rabies virus
Desscribe serum sickness and the Arthus reaction (Type III hypersensitivity reactions)
Serum sickness: Antibodies to a foreign particle are produced (takes 5 days) - immune complexes form and are deposited in membranes, where they fix complement (leads to tissue damage)
Arthus reaction: Intradermal injection of antigen induces antibodies which form antigen-antibody complexes in the skin
Which disorders are assosiated with Type III hypersensitivity reactions?
SLE, Polyarteritis nodosa, Poststreptococcal glomerulonephritis, serum sickness, Arthus reaction
What disorders are associated with type IV Hypersensitivity reaction?
Multiple sclerosis Guillain-Barre syndrome Graft versus host disease PPD (test for M. tuberculosis) Contact dermatitis (poison ivy, nickel alergy)
Which diseases can be prevented with live attenuated vaccines?
Measles, mumps, rubella, polio, influenza, varicella, yellow fever
