Immunology Flashcards
C1 Esterase Inhibitor Deficiency
Hereditary Edema (C1 complement activates pathway)
C3 Deficiency
Recurrent pyogenic URI & Sinusitis infections; Increased type III HSN
C5-C9 Deficiency
Neisseria infections
DAF Deficiency
complement-mediated RBC lysis –> paroxysmal nocturnal hemoglobinuria
IL-1
fever
IL-2
T cell activation
IL-3
Bone Marrow Activation
IL-4
IgE
IL-5
IgA & eosinophil differentiation
IL-6
fever & acute phase proteins
IL-8
Neutrophil chemotaxis
IL-10
Inhibits inflammation
TNF-alpha
septic shock mediator
TNF-beta
Inhibits inflammation
INF-alpha & -beta
produced by virus-infected cells –> prime uninfected cells –> if infection occurs viral dsRNA will trigger RNase L & protein kinase –> degradation of viral/host mRNA & protein synthesis inhibition –> Apoptosis
Cell surface proteins on B-cells
CD19, CD20, CD21, CD40, MHC-II, B7
Cell surface proteins on T cells
TCR, CD3, CD28 (binds B7)
Cell surface proteins on Helper T cells
CD4, CD40
Cell surface proteins on Cytotoxic T cells
CD8
Cell surface proteins on Macrophages
CD14, CD40, MHC-II, B7, Fc, C3b
Cell surface proteins on NK cells
CD16, CD56
Type I HSN
Ag binds IgE-mast cell & basophil –> histamine release
Delayed response —> AA derivatives (Leukotriene)
Type II HSN
IgM, IgG bind fixed Ag –> Opsonization & Phagocytosis or Complement-Mediated Lysis or ADCC
Direct Coombs
detects Ab already bound to RBC
Indirect Coombs
detects free Ab
Type II HSN
IC deposition (IgG-Ag) in tissues activating complement
Serum Sickness
type III HSN –> IC deposition in tissue –> complement activation –> Arthus reaction
Arthus reaction
edema, necrosis, complement d/t type III HSN
Type IV HSN
delayed T-cell-mediated type –> Tcells bind Ag –> lymphokine release –> macrophage activation
Transplant rejections HSN reaction
Type IV
TB skin test HSN reaction
Type IV
Contact Dermatitis HSN reaction
Type IV
Hyperacute Transplantation Rejection
immediate d/t pre-existing recipient Abs react to donor Ag (type II)
Features of Hyperacute Transplantation Rejection
thrombosis –> ischemia & necrosis (remove graft)
Acute Transplantation Rejection
Cellular (CTLs attack donor MHC) & Humoral (Abs produced against donor tissue) CD4 & 8
ANA
SLE, Sjogren Syndrome, non-specific
Anti-dsDNA Ab
SLE
Anti-Smith Ab
SLE
Antiphospholipid Ab
SLE
Anticardiolipin Ab
SLE & used for testing for Syphilis (False +)
Antiphospholipid Antibody Syndrome
high levels of antiphospholipid Ab cause a hypercoaguable state –> thrombosis, stroke
Antihistone Ab
Drug-induced Lupus
Rheumatoid Factor
RA, Sjogren Syndrome
anti-SSA & anti-SSB
Sjogren Syndrome
Anti-ribonucleoprotein Ab
Sjogren Syndrome
CREST Syndrome (limited Scleroderma)
Calcinosis, Raynauds, Esophageal dysmotility, Sclerodactyly, Telangiectasias
anti-Centromere Ab
CREST Syndrome (limited Scleroderma)
Acute Transplantation Rejection Features
Vasculitis, dense interstitial lymphocytic infiltrates (immunosuppressives)
Chronic Transplantation Rejection
T-cells perceive donor MHC as self & attack donor Ags presented
Chronic Transplantation Rejection Features
Fibrosis, Irreversible
Diffuse Scleroderma Features
Raynauds, Esophageal dysmotility, Lung involvement, Renal involvement
Anti-DNA Topoisomerase I
Diffuse Scleroderma
Anti-U1 ribonucleoprotein
Mixed connective tissue disorder
Autoantibody Anti-ACh receptor
Mysthenia Gravis
Autoantibody Anti-basement membrane
Goodpasture’s Syndrome
Autoantibody Anti-Cardiolipin
SLE
Autoantibody Anti-centromere
CREST Syndrome (limited Scleroderma)
Autoantibody Anti-Desmoglein
Pemphigus vulgaris
Autoantibody Anti-dsDNA
SLE
Autoantibody Anti-Smith
SLE
Autoantibody Anti-Glutamate Decarboxylase
DM type I
Autoantibody Anti-hemidesmosomes
Bullous pemphigus
Autoantibody Anti-histone
drug-induced lupus
Autoantibody Anti-Jo-1 (Anti-histidyl-tRNA)
Polymyositis
Autoantibody Anti-SRP
Polymyositis, Dermatomyositis
Autoantibody Anti-Mi-2
Polymyositis, Dermatomyositis
Autoantibody Anti-microsomal
Hashimoto thyroiditis
Autoantibody Anti-thyroglobulin
Hashimoto thyroiditis
Autoantibody Anti-mitochondrial
Primary Biliary Cirrhosis
Autoantibody Anti-nuclear
SLE, non-specific
Autoantibody Anti-Scl-70 (DNA topoisomerase 1)
Scleroderma (diffuse)
Autoantibody Anti-smooth muscle
Autoimmune Hepatitis
Autoantibody Anti-SSA/SSB
Sjogrens Syndrome
Autoantibody Anti-Ro & Anti-La
Sjogrens Syndrome
Autoantibody Anti-TSH receptor
Graves Disease
Autoantibody Anti-UI ribonucleotide
Mixed CT disease
Autoantibody c-ANCA
Granulomatosis w/ polyangiitis (Wegener)
Autoantibody p-ANCA
Microscopic polyangiitis, Churg-Strauss Syndrome
Autoantibody Rheumatoid Factor
Rheumatoid Arthritis
Autoantibody Anti-CCP
Rheumatoid Arthritis
IgA antiendomysial
Celiac Disease
Goodpasture’s Disease is a Type _____ HSN
type II
SLE is a Type _____ HSN
type III
SLE genetic susceptibility
HLA-DR2/3
X-Linked Agammaglobulinemia defect
BTK defect (Bruton Tyrosine kinase)
Acute GVHD
CD8 & cytokines
Chronic GVHD
CD4 & cytokines
speckled ANA
Mixed CT disease
Tacrolimus
transplant rejection prophylactic (FK506) to reduce T cell activation med by IL-2
Common Variable Immunodeficiency
defect in Bcell differentiation (low # plasma cells, low Ig)
Selective IgA Deficiency
Most common; low IgA, normal IgG & IgM
Hyper IgM Syndrome
Class switching defect -> Th fxn reduced (X-linked, defective CD40L)
Hyper IgM Syndrome defect
CD40L on Th cells
DiGeorge Syndrome
22q11 deletion —> athymic (T-cell deficiency), absent parathyroid (hypocalcemia), ToF, TA
2 causes of Severe Combined Immunodeficiency (SCID)
defective IL-2R gamma chain (X-linked)
Deficient Adenosine Deaminase (AR)
Severe Combined Immunodeficiency (SCID)
low # T-cells (infants w/ candida, diarrhea, viral, bacterial)
Wiskott-Aldrich defect
mutation in WAS gene (X-linked) -> inability to reorganize actin cytoskeleton
Wiskott-Aldrich Sx
Thrombocytopenic purpura, eczema, recurrent infection
Wiskott-Aldrich Labs
low IgG, IgM
High IgE, IgA
Chediak-Higaski
Defect in lysosomal trafficking regulator gene (LYST) -> MT dysfunction
Chediak-Higaski Sx
pyogenic infections, albinism, lymphohistiocytosis
Chronic Granulomatous Disease
deficient in NADPH oxidase = infxn w/catalase positive S. aureus, Candida, Aspergillus
Amyloidosis
Congo red stain showing apple-green biferengence
Multiple Myeloma
proliferation of plasma cells –> amyloidosis d/t free light chain deposition in tissues
ALL defect
Tyrosine kinase mutations (BCR-ABL), transcription factor mutations (PML, MML)
ALL Sx
depression of BM fxn – anemia, infection, bleeding
AML Stain
MPO+
ALL Stain
PAS+
Chronic Lymphocytic Leukemia
lymphocytosis > 4000 (CLL)
Mantle Cell Lymphoma Markers
IgM & IgD, CD19, 20, 5
Reed Sternberg Cell
Hodgkin
Popcorn cell
Reed-Steinburg cell variant - lymphohistiocyte CD20