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First Aid 2014 > IMMUNOLOGY > Flashcards

IMMUNOLOGY Flashcards

1
Q

What are the three main regions of a lymph node?

A

1) Follicle
2) Medulla
3) Paracortex

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2
Q

Where is the follicle of a lymph node located?

A

In the outer cortex

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3
Q

What type of cell is house in the follicle of the lymph node?

A

B-cells

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4
Q

What is the difference between a primary follicle and secondary follicle?

A

Primary= houses dormant B-cells that haven’t been stimulated by antigen

Secondary= same follicle that is now ramping up its B-cell production in response to antigenic stimulation

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5
Q

Where are medullary cords located in a lymph node?

A

In the medulla of the lymph node

*Note that the medulla contains: a) medullary cords, b) medullary sinuses

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6
Q

What cells are located in the medullary cords?

A

Plasma cells

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7
Q

What cells are located in the medullary sinus?

A

Macrophages

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8
Q

Where is the paracortex located in the lymph node?

A

Between the outer cortex (contains follicles) and the inner medulla

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9
Q

What cell type is housed in the paracortex of the lymph node?

A

T-cells

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10
Q

What are HEVs and where are they located?

A

HEV= High Endothelial Venules

- Located in paracortex

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11
Q

What is the function of HEVs?

A

This is how B and T-cells from lymph nodes enter the blood

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12
Q

What region of the body is drained by the cervical lymph nodes?

A

Head and neck

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13
Q

What region of the body is drained by the hilar lymph nodes?

A

Lungs

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14
Q

What region of the body is drained by the mediastinal lymph nodes?

A

Trachea and esophagus

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15
Q

What region of the body is drained by the axillary lymph nodes?

A
  • Upper limbs
  • Breast
  • Skin above the umbilicus
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16
Q

What region of the body is drained by the celiac lymph nodes?

A

Remember FOREGUT derivatives*

  • Liver
  • Stomach
  • Spleen
  • Pancreas
  • Upper duodenum
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17
Q

What region of the body is drained by the superior mesenteric lymph nodes?

A

Remember MIDGUT derivatives*

  • Lower duodenum
  • jejunum
  • ileum
  • colon to splenic flexure
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18
Q

What region of the body is drained by the inferior mesenteric lymph nodes?

A

Remember HINDGUT derivatives*

- Colon from splenic flexure to rectum

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19
Q

What region of the body is drained by the internal iliac lymph nodes?

A
  • Lower rectum to anal canal ABOVE the pectinate line
  • Bladder
  • Vagina
  • Prostate
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20
Q

What region of the body is drained by the para-aortic lymph nodes?

A
  • Testes
  • Ovaries
  • Kidneys
  • Uterus
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21
Q

What region of the body is drained by the superficial inguinal lymph nodes?

A
  • Anal canal BELOW the pectinate line

- Skin below the umbilicus, EXCEPT the popliteal area

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22
Q

What region of the body is drained by the popliteal lymph nodes?

A

Dorsolateral foot and posterior calf

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23
Q

What drains into the right lymphatic duct?

A

Right side of the body above the diaphragm

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24
Q

What drains into the left lymphatic duct i.e. the thoracic duct?

A

EVERYTHING, EXCEPT the right side of the body above the diaphragm

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25
Outline the flow of blood into and out of the spleen.
1) Splenic artery 2) Trabecular artery 3) Central artery 4) Sinusoids 5) Red pulp veins 6) Trabecular vein 7) Splenic vein
26
Describe the histologic architecture of the spleen.
- Outer region is red pulp - Inside the red pulp is the white pulp - Between the red and white pulp is the marginal zone
27
What cell types are contained in the red pulp of the spleen?
RBCs
28
What cell types are contained in the marginal zone of the spleen?
Macrophages
29
What is the important function of splenic macrophages?
Removal of encapsulated bacteria i.e. SSHiN - Salmonella - Streptococcus pneumoniae - Haemphilus influenza - Niserria meningitidis
30
What are the type parts of the white pulp in the spleen?
- Outer region with germinal centers | - Inner region or Periarterial Lymphatic Sheath (PALS)
31
What cells are contained in the germinal centers of the while pulp?
B-cells
32
What cells are contained in the PALS?
T-cells
33
What loci encode for MHC I?
HLA-A, B, and C
34
What loci encode for MHC II?
HLA-DR, DP, and DQ
35
What is the difference between the expression of MHC I and II?
MHC I= all nucleated cells (NOT RBCs) | MHC II= only on APCs
36
What disease is the HLA Subtype, A3 associated with?
Hemochromatosis
37
What disease is the HLA Subtype, B27 associated with?
PAIR ``` P= psoriatic arthritis A= Ankylosing spondylitis I= IBD R= Reactive arthritis ```
38
What disease is the HLA Subtype, DQ2/DQ8 associated with?
Celiac Disease
39
What disease is the HLA Subtype, DR2 associated with?
- MS - Hay fever - SLE - Goodpasture Syndrome
40
What disease is the HLA Subtype, DR3 associated with?
- DM-I - SLE - Grave's Disease
41
What disease is the HLA Subtype, DR4 associated with?
- Rheumatoid arthritis | - DM-I
42
What disease is the HLA Subtype, DR5 associated with?
Pernicious anemia
43
What type of T-cell is produced in the bone marrow?
T-cell precursor
44
What happens to T-cell precursors in the thymus?
Differentiation to CD4 or 8+ T-cells
45
What type of selection do T-cells undergo in the thymus?
1) Positive selection | 2) Negative selection
46
What is positive selection? Where does it happen?
- T-cells expressing TCRs that can bind MHC survive | - Thymic cortex
47
What is negative selection? Where does it happen?
- T-cells with TCRs that bind self-antigen undergo apoptosis | - Medulla of the thymus
48
What are the four different fates of CD4+ T-cells?
1) Th1 cell 2) Th2 cell 3) Th17 cell 4) T-reg cell
49
What cytokine drives a CD4+ helper T-cell toward becoming a Th1 cell?
IL-12
50
What cytokine drives a CD4+ helper T-cell toward becoming a Th2 cell?
IL-4
51
What cytokines drive a CD4+ helper T-cell toward becoming a Th17 cell?
- TGF-B | - IL-6
52
What cytokine drives a CD4+ helper T-cell toward becoming a Treg cell?
- TGF-B
53
What is the "second signal/ costimulatory signal" required for T-cell activation?
B7 and CD28 - CD28= on the naive T-cell - B7= on the dendritic cell i.e. APC
54
What is the "second signal" required for B-cell activation and class switching?
CD40 and CD40L - CD40= on the B-cell - CD40L= on the CD4+ T-cell
55
What is the function of Th1 cells?
Activation of MACROPHAGES and CD8+ T-cells
56
What is the function of Th2 cells?
- Recruitment of eosinophils (parasitic defense) | - Promotion of IgE production by B-cells
57
What cytokine is produced by Th1 cells?
IFN-gamma
58
What cytokines are produced by Th2 cells?
IL-4. 5, 6 and 13
59
Describe the relationship between Th1 cells and macrophages.
- Macrophages produce IL-12 that stimulates CD4+ T-cells to become Th1 cells - Th1 cells produce IFN-gamma that further activates macrophages
60
What cytokines are produced by Tregs?
IL-10 TFG-B *****These are ANTI-INFLAMMATORY cytokines and will DAMPEN the immune response*****
61
What are the cell surface markers that identify Tregs?
CD3 CD4 CD25 FOXP3--transcription factor
62
What generates antibody diversity?
1) VJ (light chain) and VDJ (heavy chain) recombination 2) Random combination of heavy chains and light chains 3) Somatic hypermutation 4) Addition of nucleotides to DNA by terminal deoxynucleotidyl transferase
63
What antibody is produced in the immediate response to an antigen?
IgM
64
What antibody is produced in the secondary or delayed response to an antigen?
IgG
65
What is the most abundant antibody isotype in the serum?
IgG
66
What antibody is responsible for mucosal defense?
IgA
67
What form is IgA in when it is in circulation? What about when it is secreted?
``` Circulation= monomer Secreted= dimer ```
68
List the four primary places where IgA is found.
1) Tears 2) Saliva 3) Mucous 4) Colostrum
69
What form is IgM in when it is on B-cells? Secreted?
``` B-cell= monomer Secreted= pentamer ```
70
What antibody type normally has the lowest concentration in serum?
IgE
71
What antibody type is responsible for parasite defense and mediates allergic reactions?
IgE
72
What are "thymus independent antigens?"
Antigens lacking peptide= weak immune response
73
What are "thymus dependent antigens?"
Antigens WITH a peptide component
74
What cytokines induce production of the acute phase reactants?
IL-6 IL-1 TNF-a IFN-y
75
What are the positive acute phase reactants?
Factors produced by the liver in response to inflammation: - Serum amyloid A - CRP - Ferritin - Fibrinogen - Hepcidin
76
What can chronic inflammation and upregulated Serum Amyloid A cause?
Amyloidosis
77
What the function of CRP as an acute phase reactant?
Opsonization
78
What is the function of ferritin as an acute phase reactant?
- Binds and sequesters iron | - Limits microbacterial access to iron (necessary for growth)
79
What is the function of Fibrinogen as an acute phase reactant?
Coagulation factor that promotes endothelial repair
80
What is the function of Hepcidin as an acute phase reactant?
Prevents release of iron bound by ferritin
81
What are the negative acute phase reactants?
Factors that are downregulated in response to inflammation - Albumin - Transferrin
82
Why is Albumin downregulated in response to inflammation?
To converse amino acids for production of the positive acute phase reactants
83
What are the three complement pathways?
1) Classic (IgM and IgG) 2) Alternative i.e activated by microbial surfaces 3) Lectin i.e. binding mannose or sugars on microbial surface
84
What is the function of complement C3b?
Opsonization
85
What pathologic process are C3a, C4a, and C5a implicated in?
Remember that "a" is for ANAPHYLAXIS
86
What is the role of C5a?
Neutrophil chemotaxis
87
What complement factors form MAC?
C5b-C9
88
What are the two primary opsonins of complement?
C3b and IgG
89
What are the two main inhibitors of complement?
1) DAF i.e. "Decay-accelerating factor" | 2) C1 esterase inhibitor
90
What cell differentiation marker identifies DAF?
CD55
91
What is the clinical manifestation of C1 esterase inhibitor deficiency?
Hereditary angioedema
92
What is the clinical manifestation of a C3 deficiency?
- Increased pyogenic sinus and respiratory tract infections | - Increased risk of Type III hypersensitivity reactions
93
What is the clinical manifestation of a C5-C9 deficiency?
Susceptibility to Neisseria infections
94
What is the clinical manifestation of a DAF deficiency?
Paroxysmal Nocturnal Hemoglobinuria
95
List the major cytokines secreted by macrophages.
``` IL-1 IL-6 IL-8 IL-12 TNF-a ```
96
What is the function of IL-1?
- Endogenous pyrogen-->fever and acute inflammation - Activates endothelium to produce adhesion molecules - Induces chemokine secretion
97
What is the function of IL-6?
Endogenous pyrogen--> fever and production of acute phase reactants
98
What is the function of IL-8?
Neutrophil chemotaxis
99
What is the function of IL-12?
- Induces CD4+ cell differentiation into Th1 | - Activates NK cells
100
What is the function of TNF-a?
- Mediates SEPTIC SHOCK - Activates endothelium - Leukocyte recruitment - Vascular leak

First Aid 2014 (8 decks)

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