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Step I > immunology > Flashcards

immunology Flashcards

1
Q

lymph node Cx

A

follicles of B cells
primary follicles dense and dormant
secondary follicles pale central germinal center and are active

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2
Q

lymph node medullar

A

medullary cords and sinuses

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3
Q

lymph node paraCx

A

T cells

underdeveloped in DiGeorge

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4
Q

mediastinal nodes

A

drain trachea and esophagus

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5
Q

celiac nodes

A

drain liver, stomach, spleen, pancreas, upper duodenum

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6
Q

superior mesenteric nodes

A

lower duodenum, jejunum, ileum, colon to splenic flexure

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7
Q

inferior mesenteric nodes

A

colon from splenic flexure to upper rectum

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8
Q

internal iliac nodes

A

drain lower rectum to anal canal above pectinate line, bladder, vagina (middle 1/3), prostate

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9
Q

para-aortic nodes

A

testes, ovaries, kidneys, uterus

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10
Q

superficial inguinal nodes

A

anal canal (below pectinate line), skin below umbilicus, scrotum

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11
Q

popliteal nodes

A

dosolateral foot, post calf

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12
Q

what infections are asplenic pts prone to?

A 
encapsulated
SHiNE SKiS:
S. pneumoniae
H. influenza B
N. menigitidis
E. coli
Salmonella
Klebsiella
group B Strep
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13
Q

where are T cells in spleen

A

perarteriolar lymphatic sheath (PALS)

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14
Q

where are B cells in spleen

A

follicles in white pulp

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15
Q

what is in the marginal zone?

A

APCs

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16
Q

what do you see in blood of asplenic?

A

Howell-jolly bodies
target cells
thrombocytosis
lymphocytosis

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17
Q

what is thymus derived from?

A

3rd pharyngeal pouch

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18
Q

MHCI

A 
HLA-A/B/C
expressed on all nucleated cells
present endogenously synthesized Ags (viral) to CD8 cells
Ag loaded in RER 
associated w/beta2 micrglobulin
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19
Q

MHCII

A

HLA-D
expressed on APCs
present exogenously synthesized Ags (bacterial) to CD4 cells
associated w/invariant chain

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20
Q

HLA-A3

A

hemochromatosis

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21
Q

HLA-B27

A 
seronegative arthropathies
PAIR 
psoriatic arthritis
ankylosing spondylitis
arthritis of IBD
Reactive arthritis (reiter syndrome)
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22
Q

HLA-DQ2/DQ8

A

celiac disease

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23
Q

HLA-D2D

A

MS
hay fever
SLE
goodpastures

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24
Q

HLA-DR3

A

DMI
SLE
graves
hashimotos

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25
Q

DR4

A

RA (4 walls to a rheum)

DMI

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26
Q

DR5

A

pernicious anemia -> vit B12 deficiency

hashimotos

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27
Q

what enhances NK cells

A

IL2, 12
INF-alpha
INF-beta
detect cells w/o MHCI on surface

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28
Q

TH1

A

secrete INF-y to activate macros and CD8 cells
activated by INF-y and IL-12
inhibited by IL-4 and IL-10

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29
Q

TH2

A

secretes IL-4, 5, 10, 13
recruits eos, promotes IgE
activated by IL-4
Inhibited by INF-y

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30
Q

Treg

A

surpress CD4 and CD8
express CD3,4,25, and FOXP3
produce IL10, TGF beta

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31
Q

naive T cell activation

A

DC presents Ag to T cells in lymph node

B7 (on DC) and CD28 (on Tcell) must interact as well

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32
Q

B cell activation and class switching

A

B cell presents Ag to activated Th cell

CD40L (on Th) binds CD40R (on B cell)

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33
Q

fab

A

variable region
fragment
Ag binding
determine idiotype

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34
Q

Fc

A 
Constant
Carboxy terminal
C' binding
Carbohydrate side chains
determine isotype (IgM, IgG etc)
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35
Q

IgG

A 
main Ab in secondary response
most abundant type in serum 
fixes C'
crosses placenta
opsonizes bacteria
neutralizes bacterial toxins and viruses
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36
Q

IgA

A 
mucous membranes
does NOT fix C'
monomer in circulation, dimer when secreted
most produced Ab overall 
in breast milk
37
Q

IgM

A 
primary response
fixes C' 
does not cross placenta
monomer on B cells
pentamer when secreted
38
Q

IgD

A

unknown fnx

39
Q

IgE

A

binds mast cells and basophils
cross links when exposed to allergen - type 1 hypersensitivity rxn
lowest concentration in serum

40
Q

acute phase reactants that are upregulated

A 
mostly d/t IL-6
CRP
Ferritin
Fibrinogen
Hepcidin
Serum amyloid A
41
Q

downregulated acute phase reactants

A 
albumin 
transferrin (internalized by macros)
42
Q

CRP

A

opsonin and fixes C’

43
Q

ferritin

A

binds and sequesters Fe

44
Q

Fibringoen

A

coagulation factor

promotes endothelial repair, correlates w/ESR

45
Q

hepcidin

A

prevents release of Fe bound by ferritin

leads to Anemia of chronic disease

46
Q

serum amyloid A

A

prolonged elevation -> amyloidosis

47
Q

classic activation of C’

A

IgG or IgM mediated

GM makes classic cars

48
Q

alternative activation of C’

A

microbe surface molecules

49
Q

lectin pathway activation of C’

A

mannose of other sugars on microbes surface

50
Q

C3b

A

opsonization

3b binds bacteria

51
Q

C3a, C4a, C5a

A

anaphylaxis

52
Q

C5a

A

neutrophil chemotazis

53
Q

MAC

A

C5B-9

54
Q

C’ inhibitors

A

decay-accelerating factor (DAF, aka CD55)

C1 esterase inhibitor

55
Q

C1 esterase inhibitor deficeincy

A

hereditary angioedema

ACE inhibitors CI

56
Q

C3 deficiency

A

increases risk of severe recurrent pyogenic sinus and respiratory tract infections
increased susceptibility to type III hypersensitivity rxns

57
Q

C5-9 deficiencies

A

Neisseria

58
Q

DAF deficiency

A

aka CD55 or CPI anchored enzyme

C’ mediated lysis of RBCs -> paroxysmal nocturnal hemoglobinuria

59
Q

C3 nephritic factor Ab

A

usually stabilizes C’ convertase
w/o it you get too much C3b -> stuck in kidneys -> membranoproliferative glomerulonephritis
serum C3b is low

60
Q

cytokines secreted by macros

A 
IL-1
IL-6
IL-8
IL-12
TNFalpha
61
Q

cytokines from all T cells

A

IL-2

IL-3

62
Q

cytokines from Th1

A

INF-y

63
Q

cytokines from Th2

A

IL-4
IL-5
IL-10

64
Q

Hot T-bone stEAK

A 
IL-1 hot (fever)
IL-2 stimulates T cells
IL-3 stimulates bone marrow
IL-4 stimulates IgE
IL-5 stimulates IgA
IL-6 stimulates aKute phase protein production
65
Q

IL-8

A

major chemotactic factor for neutros

66
Q

IL10

A

atTENuates immune response
decreases expression of MHC class II and Th1 cytokines
inhibits activated macros and dendritic cells

67
Q

IL-12

A

induces differentiation of T cells into Th1

activates NK

68
Q

INF-y

A

stimulates macros

activates NK cells

69
Q

what gives sputum color?

A

myeloperoxidase

blue-green heme containing pigment

70
Q

chronic granulomatous disease

A

at risk fro catalase + species
S. aureus
Aspergillus
etc

71
Q

INF- alpha and beta

A

defense against viruses for apoptosis of infected cells

72
Q

T cell markers

A

TCR (binds Ag MHC complex)
CD3
CD28 (binds B7 on APC)

73
Q

Th markers

A

CD4

CD40L

74
Q

Cytotoxic T cell markers

A

CD8

75
Q

Treg markers

A

CD4

CD25

76
Q

B cell markers

A 
Ig
CD19, 20, 21
CD40
MCH II
B7
77
Q

macro markers

A 
CD14
CD40
MCH II
B7
Fc and C3b Rs
78
Q

NK cell markers

A

CD16

CD56

79
Q

HSC markers

A

CD34

80
Q

what organisms can be Tx w/preformed Abs?

A 
To Be Healed Very Rapidly
Tetanus toxin
Botulinum toxin 
HBV
Varicella 
Rabies
81
Q

what is the difference in immune response to live vs killed vaccine

A

live- cellular and humoral response

killed- humoral only response

82
Q

type I hypersensitivity rxn

A

skin test for specific IgE

83
Q

direct coombs test

A

detects Abs that have adhered to pts RBCs

84
Q

indirect coombs test

A

detects serum Abs that can adhere to other RBCs

85
Q

Serum sickness

A

type III- IC
deposit in membranes and fix C’
usually caused by drugs 5-10 days after exposure
fever, urticaria, arthralgia, proteinuria, lymphadenopathy

86
Q

arthus rxn

A

local subacute type III- IC
occurs after subdermal injection
edema, necrosis, activation of C’
test w/immunoflorescence staining

87
Q

type IV rxns

A 
T cell mediates
transplant rejections
TB skin tests
Touching- contact dermatitis 
MS
88
Q

type II rxns

A 
acute hemolytic transfusion rxn
autoimmune hemolytic anemia
bullous pemphigoid
erythroblastosis fetalis
ITP
pemphigus vulgaris
89
Q

type III RXNS

A 
arthus rxn
SLE
polyarteritis nodosa
poststreptococcal glomerulonephritis
serum sickness

Step I (22 decks)

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