Immunology Flashcards
Sigmoid colon drains to which lymph node
Inferior mesenteric
Upper rectum drains to which lymph node
Pararectal
Lower rectum (above pectinate line) drains to which lymph node
Internal Iliac
Lower rectum (below pectinate line) drains to which lymph node
Superficial inguinal
Arm & Lateral breast drains to which lymph node
axillary
Lateral foot drains to which lymph node
popliteal
Thigh drains to which lymph node
superficial inguinal
Stomach drains to which lymph node
celiac
Duodenum & Jejunum drains to which lymph node
superior mesenteric
Testes drains to which lymph node
para-aortic
Scrotum drains to which lymph node
superficial inguinal
Right arm & Right half of head drains to which lymph node
Right lymphatic duct
Thoracic duct dumps into
junction b/w left subclavian & internal jugular
Cells of the adaptive immune system
B & T lymphocytes
Components of the innate immune system
Macrophages, Dendritic cells, Neutrophils, Eosinophils, Basophils, NK cells, Mast cells
Complement proteins, skin, protective barriers
Peyer patches location
Lamina propria of Ileum
M-cells of Peyer patches
bring Ags across the epithelium to interact w/ immune system
Germinal Center
collection of mature plasma cells
Lymph node site for B-cells
Cortex (follicles of the cortex)
Lymph node site for T-cells
Paracortex
Lymph node site for plasma cells
Medullary cords
Lymph node site for Macrophages
Medullary sinus
Conditions associated w/ HLA-B27
“PAIR” Psoriatic arthritis, Akylosing spondylitis, Inflammatory bowel ds, Reactive Arthritis
Conditions associated w/ HLA-DR3 & -DR4
Type I Diabetes
Cell types that present to CD4+ T cells
Dendritic cells, Macrophages, B-cells
Molecules on the surface of Dendritic cells
CD40, B7, MHC class I & II
Langerhans cells
dendritic cells found in the epidermal layers of the skin
Langerhans cell histiocytosis - cell markers
S100 & CD1a
Langerhans cell histiocytosis - Histology
Birbeck granules
CD3
Found on lymphocytes, allows for intracellular signaling
CD4+ T cells bind
MHC Class II
CD8+ T cells bind
MHC Class I
Genes that code for MHC Class II molecules
HLA-A, -B, -C
Genes that code for MHC Class I molecules
HLA-DR, -DP, -DQ
Positive Selection of T cells
ability to bind MHC I or II
Negative Selection
inability to bind self antigen
Location of Positive Selection of T cells
Cortex
Location of Negative Selection of T cells
Corticomedullary junction
Th1 cells release
IL-2, IFN-gamma
Th2 cells release
IL-2, IL-4, IL-5, IL-10
Th1 cell differentiation is activated by
IL-12
Th2 cell differentiation is activated by
IL-4
Th1 cell differentiation is inhibited by
IL-10
Th2 cell differentiation is activated by
IFN-gamma
Th1 stimulates activation and proliferation of
Cytotoxic T-cells & Macrophages
Th2 stimulates activation and proliferation of
Th2, B-cells
IL-2 causes
proliferation of T cells
IL-4 causes
proliferation of B-cells & Th0–>Th2
IL-5 causes
proliferation of B-cells
IL-10 causes
inhibits Th–>Th1 & macrophages
IL-12 causes
activates Th0–>Th1
IFN-gamma causes
activates macrophages & inhibits Th2
NK cells are enhanced by
IL-12, IL-2, IFN-alpha, IFN-beta
NK cells secretes
IFN-gamma
NK cells surface markers
CD16, CD56
CD16 –>
binds constant region of antibody to induce (ADCC) Antibody-Dependent Cell-mediated Cytotoxicity
Helper T cell surface marker that binds B7 on APC
CD28
B cell activation
B-cell Ab binds Ag, B-cell acts as APC to Th2 (CD40 binds CD40L); Th2 secretes IL-2, IL-4, IL-5 to activate B-cells
Hyperacute transplant rejection
type II HSN (Ab-mediated) occurs in min-hrs
Acute transplant rejection
cell-mediated, Tc cells attack foreign MHC I; occurs over wks-mos
Chronic transplant rejection
Mediated by Ab & T-cells, cytotoxic T-cells treat transplant cell as self cells presenting foreign antigen
Chronic transplant rejection features
fibrosis, vascular damage, & irreversible damage
Graft-v-Host transplant rejection
grafted T-cells attack host –> maculopapular rash, hemolysis/jaundice, HSM, n/v, diarrhea
Test for Chronic Granulomatous Ds
negative Nitroblue Tetrazolium (NBT) test
Anti-endomysial
Celiac Disease
Anti-tissue transglutaminase
Celiac Disease
Anti-gliadin
Celiac Disease
Bruton Agammaglobulinemia - defect?
BTK (tyrosine kinase) defect –> no B cell maturation
Bruton Agammaglobulinemia - S/S
recurrent bacterial & enteroviral infections after 6mo (maternal IgG decreases)
Bruton Agammaglobulinemia - Immune findings
Normal CD19+ B cell count, low Ig of all classes
Selective IgA Deficiency - defect?
unknown; most common
Selective IgA Deficiency - S/S
aSx or airway & GI infections, AI ds, Atopy, Anaphylaxis to IgA-containing products
Selective IgA Deficiency - Immune findings
Low IgA, normal IgG, IgM
Common variable immunodeficiency - defect?
defect in B-cell differentiation
Common variable immunodeficiency - S/S
acquired in 20-30s, risk of AI ds, bronchiectasis, lymphoma
Common variable immunodeficiency - Immune findings
low plasma cells & low Igs
DiGeorge Syndome - Thymic Aplasia - defect
22q11 deletion –> failure of the 3-4 pharyngeal pouches to develop
DiGeorge Syndome - Thymic Aplasia - S/S
Hypocalcemia, recurrent viral/fungal infections, TA or ToF,
DiGeorge Syndome - Thymic Aplasia - Findings
Low T-cells, Low PTH, Low Ca2+, absent thymic shadow, 22q11 deletion w/ FISH
IL-12 Receptor Deficiency - defect
AR IL-12 receptor defect –> Low Th1 response
IL-12 Receptor Deficiency - S/S
Disseminated mycobacterial & fungal infections, may present after BCG vaccine
IL-12 Receptor Deficiency - Findings
low IFN-gamma (IL-12 –> Th1 –> IFN-gamma –> macrophages)
Hyper-IgE Syndrome - defect
Deficient Th17 cells d/t STAT3 mutation –> impaired neutrophil chemotaxis
Hyper-IgE Syndrome - S/S
Coarse facies, cold staphylococcal abscesses, retained primary teeth, high IgE, Eczema
Hyper-IgE Syndrome - Findings
High IgE, Low IFN-gamma
Chronic Mucocutaneous Candidiasis - defect?
T-cell dysfunction
Chronic Mucocutaneous Candidiasis - S/S
C. albicans infections
Severe Combined Immunodeficiency (SCID) - defect?
Defective IL-2R gamma chain (X-linked) or Adenosine Deaminase deficiency (AR)
Severe Combined Immunodeficiency (SCID) - S/S
failure to thrive, diarrhea, thrush, recurrent viral, fungal, & bacterial infections (bone marrow transplant needed)
Severe Combined Immunodeficiency (SCID) - Findings
Low T-cell receptor excision circles (TREC), absent thymic shadow, absent germinal centers in lymph nodes, & absent T cells
Ataxia-Telangiectasia - defect
ATM gene defect –> dsDNA breaks –> cell cycle arrest
Ataxia-Telangiectasia - Sx
ataxia, spider angiomas, IgA def
Ataxia-Telangiectasia - Findings
high AFP, low IgA, IgG & IgE, lymphopenia, cerebellar atrophy
Hyper-IgM Syndrome - defect
CD40L defect –> class switching defect
Hyper-IgM Syndrome - S/S
pyogenic infections, pneumocystis, Cryptosporidium, CMV
Hyper-IgM Syndrome - Findings
High IgM, Low IgG, IgE, IgA
Wiskott-Aldrich Syndrome - defect
WAS gene mutation –> unable to rearrange actin cytoskeleton
Wiskott-Aldrich Syndrome - S/S
Thrombocytopenia purpura, eczema, recurrent infections
Wiskott-Aldrich Syndrome - findings
low IgG, IgM, High IgE, IgA
Leukocyte Adhesion Deficiency - defect
LFA-1 integrin (CD18) defect –> impaired migration & chemotaxis
Leukocyte Adhesion Deficiency - S/S
recurrent bacterial infections w/ ABSENCE of pus, impaired wound healing, delayed umbilical cord separation
Leukocyte Adhesion Deficiency - Findings
high neutrophils, but no neutrophils at infection site
Chediak-Higashi Syndrome - defect
Defective lysosomal trafficking regulator gene (LYST) –> MT dysfunction inhibiting phagosome & lysosome fusion
Chediak-Higashi Syndrome - S/S
pyogenic infections, albinism, peripheral neuropathy, neurodegeneration, infiltrative lymphohistiocytosis
Chediak-Higashi Syndrome - Findings
Giant granules in neutrophils and platelets, pancytopenia, mild coagulation defects
Chronic Granulomatous Disease - defect
NADPH oxidase defect –> absent respiratory burst
Chronic Granulomatous Disease - S/S
susceptibility to Catalase + organisms (PLACESS)
Chronic Granulomatous Disease - Findings
abnormal dihydrorhodamine test, negative nitroblue tetrazolium dye test