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Step 1 High Yield > Immunology > Flashcards

Immunology Flashcards

1
Q

Which lymph node drains the head and neck?

A

Cervical

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2
Q

Which lymph node drains the lungs?

A

Hilar

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3
Q

Which lymph node drains the trachea and esophagus?

A

Mediastinal

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4
Q

Which lymph node drains the upper limb, breast and skin above the umbilicus?

A

Axillary

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5
Q

Which lymph node drains the Liver, stomach, spleen, pancreas, and upper duodenum?

A

Celiac

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6
Q

Which lymph node drains the Lower duodenum, jejunum, ileum, and colon to splenic flexure?

A

Superior mesenteric

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7
Q

Which lymph node drains the Colon from splenic flexure to upper rectum?

A

Inferior mesenteric

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8
Q

Which lymph node drains the Lower rectum to anal canal (above pectinate line), bladder, vagina (middle third), and prostate?

A

Internal iliac

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9
Q

Which lymph node drains the testes, ovaries, kidneys, and uterus?

A

Para-aortic

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10
Q

Which lymph node drains the anal canal (below pectinate line), skin below umbilicus (except politeal territory)?

A

Superficial inguinal

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11
Q

Which lymph node drains the dorsolateral foot and posterior calf?

A

Popliteal

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12
Q

What is drained by the right lymphatic duct?

What is drained by the thoracic duct?

A

Right lymphatic duct: Right side of body above diaphragm

Thoracic duct: Everything else (to junction of left subclavian and internal jugular veins)

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13
Q

What encapsulated organisms have increased virulence with splenic dysfunction?

A 
SHiNE SKiS
Streptococcus pneumoniae
Haemophilus influenzae (type B)
Neisseria meningitidis
Escheria Coli
Salmonella spp
Klebsiella pneumoniae
Group B Streptococci
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14
Q

Lymphocytes in the thymus originate from what type of tissue?

A

Mesenchymal

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15
Q

What are Hassall corpuscles?

A

Area of the medulla of the thymus conatining epithelial reticular cells

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16
Q

Which HLAs determine MHCI? MHCII?

A

MHCI: HLA-A, HLA-B, HLA-C
MHCII: HLA-DR, HLA-DP, HLA-DQ

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17
Q

What is the MHC-I mode of transport to the cell surface?

A

Beta 2 microglobulin

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18
Q 
What are the following HLA subtypes associated with?
HLA-A3:
HLA-B27:
HLA-DQ2/DQ8:
HLA-DR2:
HLA-DR3:
HLA-DR4:
HLA-DR5:
A

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

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19
Q

What is secreted by the Th1 cell?

What is secreted by the Th2 cell?

A

Th1: IFN-gamma
Th2: IL-4, IL-5, IL-6, IL-13 (IL-10)

20
Q

What are the functions of perforin and granzyme?

A

Perforin: Helps deliver the content of granules into target cell
Granzyme: Serine protease that activates apoptosis inside the target cell

21
Q

What are the cell surface markers/identification factors on regulatory T cells?

A

CD3, CD4, CD25 (alpha chain of IL-2 receptor), and transcription factor FOXP3

22
Q

What enzyme adds nucleotides to antibody DNA during recombination (VDJ)?

A

terminal deoxynucleotidyl transferase

23
Q

Which antibody fixes compliment, crosses the placenta and is the main antibody in delayed response to an antigen?

A

IgG

24
Q

Which antibody is a monomer in circulation, a dimer when secreted, and crosses epithelial cells by transcytosis? (associated with secretions)

A

IgA

25
Q

Which antibody is secreted as a pentamer and can trap free antigens out of tissue while the humoral response evolves?

A

IgM

26
Q

Which antibody binds mast cells and basophils, mediating type 1 hypersensitivity through release of histamine?

A

IgE

27
Q

What induces acute-phase reactants (factors that change concentration in response to inflammation)?

A

IL-6, IL-1, TNF-alpha, IFN-gamma

28
Q

What are the functions of ferritin, transferrin, and hepcidin in chronic inflammatory states?

A

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

29
Q

What is C-reactive protein?

A

An opsonin: fixes complement and facilitates phagocytosis; measured as sign of ongoing inflammation

30
Q

What complement proteins are associated with anaphylaxis? Neutrophil chemotaxis? MAC?

A

Anaphylaxis: C3a, C4a, C5a
Neutrophil chemotaxis: C5a
MAC: C5b-9

31
Q

What is CD55 (DAF)?

A

Decay accelerating factor and C1 esterase inhibitor help prevent complement activation on self cells (deficient in paroxysmal nocturnal hemogobinuria)

32
Q

What drugs are contraindicated in a C1 esterase inhibitor deficiency? What does this deficiency cause?

A

ACE inhibitors; causes hereditary angioedema

33
Q

What can be caused by C3 deficiency?

A

Increases risk of severe, recurrent, pyogenic sinus and respiratory tract infections; increased susceptibility to type III hypersensitivity reactions

34
Q

Explain the mnemonic, Hot T-Bone stEAK in terms of IL-1,2,3,4,5 and 6

A 
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
35
Q

What is the function of IL-8 (“clean up on aisle 8”)

A

Major chemotactic factor for neutrophils (Neutrophils are recruited by IL-8 to clear infections)

36
Q

Which interleukin induces differentiation of T-cells into Th1 cells and activates NK cells (secreted by macrophages and B cells)?

A

IL-12

37
Q

What is the function of TNF-alpha (secreted by macrophages)?

A

Mediates septic shock. Activates endothelium. Causes leukocyte recruitment, vascular leak

38
Q

What is the function of IL-10 (from Th2 cells)? What also secretes it?

A

Modulates inflammatory response and inhibits actions of activated T cells and Th1; Also secreted by regulatory T cells

39
Q

What is the function of interferons?

A

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)

40
Q

What are cell surface proteins on Macrophages and NK cels?

A

Macrophages: CD14, CD40, MHCII, B7, C3b and Fc

NK cells: CD16 (binds Fc of IgG), CD56

41
Q

Which infectious agents can undergo antigenic variation?

A

Bacteria: Salmonella, Borrelia, Neisseria Gonorrhoeae
Virus: Influenza
Parasites: Trypanosomes

42
Q

When are patients given preformed antibodies?

A

After exposure to Tetanus toxin, Botulinum toxin, HBV, or Rabies virus

43
Q

Desscribe serum sickness and the Arthus reaction (Type III hypersensitivity reactions)

A

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

44
Q

Which disorders are assosiated with Type III hypersensitivity reactions?

A

SLE, Polyarteritis nodosa, Poststreptococcal glomerulonephritis, serum sickness, Arthus reaction

45
Q

What disorders are associated with type IV Hypersensitivity reaction?

A 
Multiple sclerosis
Guillain-Barre syndrome
Graft versus host disease
PPD (test for M. tuberculosis)
Contact dermatitis (poison ivy, nickel alergy)
46
Q

Which diseases can be prevented with live attenuated vaccines?

A

Measles, mumps, rubella, polio, influenza, varicella, yellow fever

Step 1 High Yield (21 decks)

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