Immunology Flashcards
The majority of fluid distributed in the body is where?
Intracellularly
Where is plasma contained?
Cardiovascular system
What is the most common plasma protein?
Albumins
Where are the plasma proteins synthesized?
In the Liver
Binding to plasma proteins helps what with hormones?
prevents inappropriate metabolism and/or excretion
Plasma albumin binds mainly to?
acidic drugs
The general functions of plasma include what?
transport of nutrients for energy, growth and repair, removal of wastes; transport of hormones and regulation of body temperature
Plasma is what percentage of blood volume?
55%
Plasma is ___ percent water
91%
What is the lifespan of Erythrocytes?
100-120 days
what is the duration of development of Erythrocytes?
5-7 days
How many Erythrocytes are in a microliter of blood?
4-6 million
what is the function of Erythrocytes?
Transport oxygen and carbon dioxide
How many Neutrophils are in a microliter of blood?
3000-7000
How many Eosinophils are in one microliter of blood?
100-400
How many Basophils are in one microliter of blood?
20-50
How many lymphocytes are in one microliter of blood?
1500-3000
How many monocytes are in one microliter of blood?
100-700
How many platelets are in one microliter of blood?
150,000-500,000
What is the Duration of development for Neutrophils?
6-9 days
What is the duration of development for Eosinophils?
6-9 days
What is the duration of development for Basophils?
3-7 days
What is the duration of development for Lymphocytes?
days to weeks
what is the duration of development for monocytes?
2-3 days
what is the duration of development for platelets?
4-5 days
what is the life span of neutrophils?
6 hours to a few days
How many Leukocytes are in one microliter of blood?
4800-11,000
What is the lifespan of eosinophils?
8-12 days
what is the lifespan of Basophils?
a few hours to a few days
what is the lifespan of lymphocytes?
hours to years
what is the lifespan of platelets?
5-10 days
what is the function of neutrophils?
destroy bacteria by phagocytosis
what is the function of Eosinophils?
turn off allergic responses and kill parasites
what is the function of Basophils?
Release histamine and other mediators of inflammation
what is the function of lymphocytes?
mount immune response by direct cell attack (T-cells) or via antibodies (B-cells)
what is the function of monocytes?
Phagocytosis; develop into macrophages in tissues
what is the function of platelets?
Seal small tears in blood vessels; instrumental in blood clotting
Hemoglobin (Hb) is a _____ protein
heterotetrameric
Do mature RBC’s have a nucleus?
no, they cannot divide
Do mature RBC’s have any mitochondria or endoplasmic reticulums?
No, they only produce energy through glycolysis
what state is the iron in when used by hemoglobin?
Ferrous (Fe 2+)
Where are RBC’s produced after twenty years of age?
membranous bones such as the vertebrae, sternum, and ribs.
In the embryo primitive nucleated RBC’s are produced in the ___ ___
yolk sac
By the middle of the last trimester production of RBC’s has moved exclusively to the ___ ____ in the ____ and ____
bone marrow in the femur and tibia
All blood cells originate from ____ _____ stem cells
pluripotential hematopoietic
By the _____ stage the ____ and ____ have either been absorbed or ejected from the immature RBC.
reticulocyte stage; nucleus and ER
Reticulocytes leave the bone marrow and enter the circulation to complete the maturation process which lasts how long?
one to two days
Lack of oxygen stimulates what?
Erythropoietin which causes an increase in production of RBC’s but only can be worked with a little because it thickens the blood
What is hypoxia?
lack of oxygen delivery to tissues
What produces Erythropoietin?
The kidneys
What is anemia?
a decrease in the ability of the blood to carry oxygen
what vitamins are important for RBC’s?
Iron, B12 and folate
How is hemoglobin formed?
Succinyl-CoA combines with glycine to form pyrrole and four of these compose to make protoporphyrin IX which binds to ferrous to make heme. Lastly heme is joined to the polypeptide globin.
fetal Hb has a ____ ____ to oxygen than the mother
higher affinity
The iron in each heme group binds how many oxygen molecules?
one
Each hemoglobin molecule can bind to how many oxygen molecules
four (100% saturated)
Where does the body transfer the iron from?
GI tract
Where do RBC’s self-destruct in the body?
in the spleen as they squeeze through the “red pulp” reticular mesh
Pernicious anemia results from
lack of absorption of B12
Sprue results from
lack of absorption of Folic acid
Sickle cell anemia is due to what?
a single amino acid change in a specific position in the globin polypeptide chain of Hb
What is Erythroblastosis fetalis?
when a Rh- mother has a child with Rh + and the mother’s immune system produces antibodies to attack the baby (will have severe anemia)
What is polycythemia vera?
when too many RBC’s are produced: causes the blood to be difficult to pump
what is hemostasis?
the prevention of blood loss when a vessel is severed or ruptured.
To limit blood loss what does a vessel do?
vascular constriction, formation of a platelet plug, formation of a blood clot, clot retraction, and finally removal of the clot, (dissolved), after repair.
What is the synthesis of TXA2?
PLA2 to Arachidonic acid to COX then to TXA2
what is the most important factor to cause vasoconstriction?
Thromboxane A2 (TXA2)
When activated platelets become ____
sticky
platelets are formed from
megakaryocytes in the bone marrow or blood from cell fragmentation
Platelets contain remnants of the ____ and ____ ____ in order to produce enzymes and store calcium.
ER and Golgi apparatus
fibroblasts are necessary for the platelets to do what?
multiply and grow
fibrin-stabilizing factor is necessary for platelets to do what?
repair
what prevents platelets from adhering to the undamaged vessel walls?
glycoproteins
platelets contain high concentrations of ____ that are involved in blood clotting.
phospholipids
platelets are removed by what?
macrophages in the spleen
What strengthens the clot?
fibrin fibers
A blood clot starts to form after ______ if trauma is significant and after ____ if minor
15-20 seconds if significant and 1-2 minutes if minor
after ____ most reasonable holes are plugged
3-6 minutes
after _____ the clot retracts due to platelets and closes the hole even tighter.
20-60 minutes
Once a clot has formed it can do what two things?
be invaded by fibroblasts or be dissolved
If invaded by fibroblasts the repair is usually _____ after 1-2 weeks
complete
Synonym for fibrinogen
factor I
synonym for prothrombin
factor II
synonym for tissue factor
factor III
synonym for calcium
factor IV
synonym for factor V
Proaccelerin
synonym for factor VII
serum prothrombin conversion accelerator (spca)
synonym for factor VIII
antihemophilic factor (AHF)
synonym for factor IX
plasma thromboplastin component (PTC)
synonym for factor X
stuart factor
synonym for factor XI
plasma thromboplastin antecedent (PTA)
synonym for factor XII
Hageman factor
synonym for factor XIII
fibrin stabilizing factor
synonym for prekallikrein
fletcher factor
synonym for high-molecular-weight kininogen
fitzgerald factor
What is the rate of turnover of RBC’s?
10 to the 11th power
What kind of fats make vessels rougher?
saturated fats
what two factors are inhibited by activated protein C?
factor V and factor VIII
what is the most important in preventing inappropriate clotting?
endothelial surface factors
What inactivates or removes thrombin?
fibrin fibers and alpha-globulin a.k.a antithrombin III
What factors does heparin block?
Factors 2, 9, 10, 11, 12
Heparin combines with what to block clotting factors?
antithrombin III; this increases its activity a lot
What inactivates heparin?
heparinase (about 1.5-4 hours)
Warfarin decreases plasma levels of ____ and factors (3 different ones), by competing with ____?
decreases levels of prothrombin II and factors 7, 9, and 10 by competing with vitamin K
What is special about Rivaroxaban being specifically a factor Xa inhibitor?
I acts further “upstream” of the clotting factor cascade thus having a wider therapeutic window and less monitoring needed.
What three conditions are notorious for causing excessive bleeding?
vitamin K deficiency, hemophila, and thrombocytopenia
Vitamin K is necessary for the synthesis of what four important clotting factors?
Prothrombin II and factors 7, 9, and 10 also to note is that protein C is affected (anti-coagulant)
vitamin K is normally synthesized by ____ ____
gut flora
Hemophilia primarily effects males because…
it is a genetic disease that is sex-linked
Thrombocytopenia can be noticed by what?
purpura; which is purplish blotches on the skin from loss of clot retraction by platelets
what two things kill virtually all pathogens entering the GI tract?
HCl secretion and the protease pepsin
What does mother’s milk contain that is antimicrobial to help protect the baby?
the enzyme lactoperoxidase
Defecation and vomiting caused by some microbial toxins acting on the smooth muscle of the GI tract work via _____ areas to expel toxins
chemosensitive
Where are Leukocytes produced?
bone marrow
What is the function of Neutrophils?
Phagocytosis, releases chemicals involved in inflammation
what is the function of Basophils?
release histamine and other chemicals involved in inflammation
what is the function of Eosinophils?
Destroy multicellular parasites, participate in immediate hypersensitivity reactions
what is the function of monocytes?
carry out functions in blood similar to those of macrophages in tissues, enter tissues and transform into macrophages
what is the function of macrophages?
phagocytosis, extracellular killing via secretion of toxic chemicals, process and present antigens to helper T cells, secretion of cytokines involved in inflammation, activation and differentiation of helper T cells, and systemic responses to infection or injury
Where is IL-1, tumor necrosis factor, and IL-6 located?
Antigen-presenting cells (e.g. macrophages)
What is the target cell of IL-1, tumor necrosis factor, and IL-6?
Helper T cells; certain brain cells; numerous systemic cells
what is the major function of IL-1, tumor necrosis factor, and IL-6?
stimulate IL-2 secretion and IL-2 receptor expression; induce fever; stimulate systemic responses to inflammation, infection, and injury
what is the source of IL-2?
Most immune cells
what is the target cell of IL-2
Helper T cells; cytotoxic T cells; NK cells; B cells
What are the major functions of IL-2?
stimulate proliferation, promote conversion to plasma cells
What is the source of Interferons?
Most cell types
what are the target cells of interferons?
most cell types
what is the major function of interferons?
stimulate cells to produce antiviral proteins (nonspecific response)
what is the source of interferon-gamma?
NK cells and activated helper T cells
what are the target cells of interferon-gamma?
NK cells and macrophages
what are the major functions of interferon-gamma?
stimulate proliferation and secretion of cytotoxic compounds
what is the source of Chemokines?
damaged cells, including endothelial cells
what are the target cells of chemokines?
neutrophils and other leukocytes
what are the major functions of chemokines?
facilitate accumulation of leukocytes at sites of injury and inflammation
what is the source of Colony-stimulating factors?
Macrophages
what are the target cells of colony-stimulating factors?
bone marrow
what are the major functions of colony-stimulating factors?
Stimulate proliferation of neutrophils and monocytes
What is diapedesis?
mobile cells pass through gaps in the capillary endothelium to enter the tissues and can follow chemical trails
What two mechanisms are innate and help direct WBC’s to pathogens?
they have rough surfaces and most pathogens lack the repellant protective coats that our cells posses
What is the alternate complement pathway?
where the complement system is activated without the involvement of antibodies during inflammation to tag bacterial pathogens
What is opsonization?
The relatively non-specific binding of the complement system factor C3b to cell surface/cell wall carbs of bacteria which allows more effective phagocytosis
What does the MAC do?
perforate bacterial membranes which makes them leaky and kills the bacteria
What is a phagosome?
Where a pathogen that is enveloped by the cell
what is a phagolysosome?
the pathogen when enveloped fuses with lysosomes
about how many bacteria can a neutrophil phagocytize?
20-Mar
Macrophages can typically ingest how many bacteria?
around 100
some tissues/organs have their own subclass of macrophages such as ____
Kupffer cells in liver and Dendritic cells of the skin
Anything not phagocytized must be removed via the ____ as it cannot cross the endothelium and enter the blood.
lymph
If an invading organism enters the blood it can be removed by what?
the spleen and bone marrow by macrophages
What is the first stage of attraction for a Leukocyte?
chemokine expression
what occurs after chemokine expression in the attraction of leukocytes?
the change in integrin receptors to facilitate diapedesis (increases affinity)
What can interferons do within a cell?
they are cytokines that inhibit viral replication inside host cells with the secretion of antiviral proteins.
When are eosinophils produced in higher concentrations?
in response to parasitic infections when they are attracted by chemotaxis
What are the primary cells involved in an increased response of Eosinophils?
Mast cells and basophils
What is the Eosinophil Chemotactic Factor?
the substance released by mast cells and basophils that attract eosinophils which may then detoxify certain substances involved in inflammation.
What antibody is released during an allergic response?
IgE
What chemicals are released during an allergic response by basophils?
histamine, bradykinin, serotonin, heparin, setc.
what is leukopenia?
bone marrow condition where it starts to produce very few WBC’s
What can cause leukopenia?
radiation, chemicals
What is Leukemia?
cancerous mutations of WBC precursor cells where an uncontrolled production of WBC’s occurs
where does myelogenous leukemia originate?
bone marrow
where does leukemia spread?
throughout the body especially to lymph nodes, spleen, and liver…cells are often undifferentiated with bizarre shapes.
what is the primary result of leukemia?
the production of non-functional/partially functional WBC’s in inappropriate areas of the body resulting in infection, severe anemia, and a tendency to bleed due to thrombocytopenia
Why does leukemia cause thrombocytopenia and a tendency to bleed?
it is caused by the physical displacement of normally functioning bone marrow by the cancerous cells
what is the most significant effect on the patient by leukemia?
a very high metabolic demand placed on the body by these rapidly dividing cells; other tissues can be starved and forced to rely on protein catabolism
B-lymphocytes produce a humoral response by synthesizing ____ ____ that target the invader for destruction .
circulating antibodies
T-lymphocytes produce activated ____ ____ that directly destroy the invaders.
Killer Cells
antigens are recognized specifically by _______
immunoglobulins
What do T-lymphocytes require to activate?
APC’s (Antigen-Presenting Cells)
When molecules are identified as foreign what is produced?
antigens
what is the function of lymphocytes?
recognition cells
What is the function of B cells?
initiate antibody mediated immune responses by binding antigens to the B cell’s plasma membrane receptors
What happens to B cells once activated?
They transform into plasma cells and present antigen to helper T cells
what is the function of cytotoxic T cells?
bind to antigens on plasma membrane of target cells and directly destroy the cells
what is the function of helper T cells?
secrete cytokines that help to activate B cells, cytotoxic T cells, NK cells, and macrophages
what is the function of NK cells?
Bind directly and nonspecifically to virus-infected cells and cancer cells and kill them…they also function as killer cells in antibody-dependent cellular cytotoxicity (ADCC)
what is the function of plasma cells?
they secrete antibodies
Potential T-lymphocytes first migrate to the ___ for processing.
thymus
potential B-lymphocytes first migrate to the ___ ___ for processing.
liver prior to birth but afterwards the Bone Marrow
each T-lymphocyte develops specific reactivity to how many antigens?
one
What three cells principally can present antigens to T-cells?
Macrophages, B-lymphocytes, and Dendritic cells
Macrophages secrete what to promote reproduction and growth of lymphocyte clones?
IL-1
What three events are required for activation of helper T-lymphocytes?
Presentation of an antigen bound to MHC II, Binding of matching non-antigenic proteins, secretion by APC or B-cell of cytokines including IL-1 and TNF which act on the helper lymphocyte
T-lymphocytes only respond when the ____ is ____ to special surface molecules called what?
antigen is bound to the special surface molecules call major histocompatibility complexes (MHC’s)
What proteins are vital to present to and activate Helper T-cells?
MHC II proteins
MHC 1’s present to what cells?
Cytotoxic T-lymphocytes
MHC 2’s present to what cells?
Helper T-cells
To activate the T-cell after the MHC binding what must occur?
a second “handshake” between the T-Helpers and APC’s by binding of matching, non-antigenic proteins
Lastly the secretion by the APC of ____ fully activates the T-Helper cells.
Cytokines (especially IL-1 and TNF)
Helper T-cells secrete ____ after activation which enhances the activation of processed ____.
lymphokines; B-lymphocytes
What do memory cells help with?
when presented to the same antigen they can produce a far more rapid and effective response
Antibodies are gamma globulins called what?
immunoglobulins
The specificity of the antigen biding sites is due to what?
appropriate amino acids forming a highly specific binding site analogous to a drug receptor or enzyme active site
what are the five different antibodies?
IgM, IgG, IgA, IgD, and IgE
what is the most commonly found antibody in the body?
IgG
IgM is produced during the ____ response and is effective due to what?
the primary response and is effective due to having ten binding sites
what is agglutination?
when large invaders become bound together via antibodies into a clump
what is precipitation?
when the linked molecules become so large that they become insoluble (such as toxins)
what is neutralization?
when binding antibodies cover and inactivate toxic sites on the invader
what is Lysis?
some antibodies can rupture the cell membranes of invading organisms, however are not sufficient enough on their own.
Antibodies are also used for what?
pharmacological tools and treatments
What are the four different types of T-lymphocytes?
Helper, cytotoxic, suppressor, and natural killer (NK)
what are Helper T-lymphocytes?
most numerous and they help the immune system function effectively and are involved in regulating virtually all immune functions
What are suppressor T-lymphocytes?
decrease function of cytotoxic and helper T-cells to suppress autoimmune responses
what are cytotoxic T-lymphocytes?
kill invading organisms by punching a hole through their membranes via perforins
What are NK cells?
they target virus-infected and cancerous cells. They kill their target after binding to them…not much is known on how
Infection in the body leads the Brain to do what?
fever, decreased appetite, decrease food intake, sleepiness, fatigue
Infection in the body leads the Liver to do what?
Retain Fe, Zn, secrete acute phase proteins
Infection in the body leads the Bone Marrow to do what?
Increase production and release of leukocytes
Infection in the body leads the Adipose tissue to do what?
increase lipolysis
Infection in the body leads the Muscle to do what?
increase protein breakdown and amino acid release
Infection in the body leads the Hypothalamus to do what?
increase ACTH secretion
A rise in ACTH secretion due to infection in the body leads the Adrenal cortex to do what?
increase cortisol secretion
Immunization eliminates what to speed up response time?
eliminates the time lag required for specific recognition
What is anaphylaxis?
An extreme response triggered in tissues surrounding small blood vessels due to Mast cells and eosinophils that rapidly spread throughout the circulation
What is Urticaria?
triggered by antigens entering the skin and releasing histamine (hives)
What is Hay fever?
the allergen-regain reaction occurs in nasal passages with released histamine, also causes sneezing as the body tries to eject the causative agent
What is Asthma?
the allergen-regain reaction in the bronchioles
What is type I hypersensitivity?
immediate hypersensitivity from a release of mast cell mediators, IgE
what is Type II hypersensitivity?
antibody mediated, IgM, IgG antibodies
What is type III hypersensitivity?
immune complex mediated, formation of immune complexes, activates inflammatory cells
What is type IV hypersensitivity?
CD4+Tcells (delayed), macrophage activation of cytokine-mediated inflammation
What is the additional sugar residue on Group B blood?
Galactose
what is the additional sugar residue on Group A blood?
N acetyl-galactosamine
What antigen is on blood group A?
A
what antigen is on blood group B?
B
what antigen is on blood group AB?
A and B
what antigen is on blood group O?
neither A or B
what antibody is found on blood group A?
Anti-B
what antibody is found on blood group B?
Anti-A
what antibody is found on blood group AB?
neither A or B
what antibody is found on blood group O?
Anti-A and Anti-B
Which blood groups can have a homozygous and heterozygous form?
group A and group B (AA or AO) (BB or BO)
which blood group does not have a homozygous form?
AB
which blood grouping does not have a heterozygous form?
O
Which blood type is the universal donor?
O
which blood type is the universal acceptor?
AB
Where are the antibodies to the non-expressed antigen found?
in the plasma
Blood antibodies are mostly which immunoglobulins?
IgG and IgM
Antibody production is stimulated by what for A-B-O grouping?
certain bacteria and food
Which blood groups will A not interact with?
O and A
Which blood groups will B not interact with?
O and B
Which blood groups will O not interact with?
O
Which blood groups will AB not interact with?
AB, O, B, A
Unlike the O-A-B system rhesus antigens are not normally produced until when?
exposure to the antigens from an exogenous source
What are the common types of Rh antigens?
C,D,E, c, d, e
Which Rh antigen is most widely expressed in the population?
D
What is Erythroblastosis fetalis?
when the Rh- mother’s antibodies attack her Rh+ baby’s blood cells
Isograft is between what?
identical twins
Autograft is between what?
within an individual
Allograft is between what?
beings of the same species
Xenograft is between what?
beings of different species
