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Immunology Flashcards

1
Q

IL-10

A

anti-inflammatory bc it attenuates pro-inflammatory Th1 cytokines (IL2 and IFN gamma) and MHC II expression

inhibits activated dendritic cells and macrophages

released by Th2 cells and Treg

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2
Q

IL-1

A

produced by macrophages and epithelial cells

proinflamm. :
- endothelium activation
- increased chemokine expression (promoting leukocyte recruitment)
- induction of fever

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3
Q

IL-5

A

secreted by Th2 cells

promotes humoral response –> stim differentiation of BCs and IgA production

promotes growth and differentiation of eos –> possible role in allergies

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4
Q

IL-12

A

secreted by macros and BCs

induces differentiation of Th1 cells and activation of NK cells

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5
Q

Interferon-y

A

secreted by Th1

pro-inflamm:

  • activates macros
  • inc Ag presentation
  • inducing apoptosis of epithelial cells
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6
Q

TNF-alpha

A

produced by macros, NK, TCs

pro-inflamm.

  • leukocyte recruitment
  • activates endothelium (inc adhesion molecules and leuk recruitment) –> vascular leak

Mediates septic shock

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7
Q

Bradykinin

A

vasodilation, inc vascular permeability, stimulates smooth muscle contraction, mediates pain

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8
Q

leukotriene B4

A

metabolite of arachidonic acid

stimulates neutrophil migration to site of inflammation

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9
Q

Platelet-activating factor

A

vasoconstriction, bronchoconstriction, platelet stimulation

small amounts = vasodilation and inc vascular permeability

enhances leukocyte adhesion to endothelium, chemotaxis, phagocytosis and degranulation

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10
Q

Acute-phase reactant production

A

IL-1, IL-6, TNF-a stimulate hepatic secretion of APRs like fibrinogen –> ESR hence marker of inflammation

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11
Q

Pneumococcal polysaccharide vaccine (PPSV23)

A

TC independent BC response that’s less effective in children

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12
Q

Pneumococcal conjugate vaccine (PCV13)

A

covalently attached to recombinant, inactivated diphtheria toxin –> induces active immunity via a TC dependent BC response

better immunogenicity and formation of higher affinity Ab and memory cells even in children

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13
Q

capsular polysaccharide vaccines

A

PPSV23 (pneumococcal), neisseria meningitidis, HiB

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14
Q

killed bacteria vaccines

A

oral cholera

require multiple inoculations or boosters to induce and maintain immunity

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15
Q

Live attenuated bacterial vaccines

A

BCG and oral typhoid

can revert to virulent strains

contraindicated in immunocompromised hosts

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16
Q

recombinant surface protein vaccine

A

HBV

insert relevant DNA into a host organism (e.g. baker’s yeast) –> produces Ag in desired quantity

require boosters or multiple inoculations to achieve and maintain sufficient immunity

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17
Q

Inactivated toxin (toxoid) vaccines

A

diphtheria and tetanus vaccines

useful when toxin is the cause of morbidity and mortality –> produce neutralizing Ab to toxin

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18
Q

CD15

A

present on granulocytes and all Reed-Sternberg cells –> used in dx Hodgkin lymphoma

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19
Q

CD16

A

low-affinity Fc receptor found on NK cells, neutrophils, and macrophages

i.e. weak role in opsonization

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20
Q

Graft-versus-host disease

A

after allogeneic bone marrow transplant or transplant of organs rich in lymphocytes (eg, liver) or transfusion of non-irradiated blood

donor TC from graft survives –> migrates to host tissues –> recognize host MHC Ag –> sensitized –> activation –> donor CD4 and CD8 cells destroy host cells –> typically affects skin, liver, GI tract

sx = diffuse maculopapular rash of palms and soles, desquamation, diarrhea, intestinal bleeding, abdominal pain, abnormal LFTs 2/2 liver damage

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21
Q

Acute and chronic graft rejections mechanism

A

host T and B cel sensitization against graft MHC Ag –> graft failure w/o involvement of other organ systems

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22
Q

Mechanism of susceptibility to encapsulated organisms postsplenectomy

A

dec IgM –> dec complement activation –> dec C3b opsonization –> inc susceptibility

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23
Q

Encapsulated organisms

A

SHiN SKiS

Streptococcus pneumoniae
Haemophilus influenzae type B
Neisseria meningitidis
Salmonella
Klebsiella pneumoniae
Group B streptococci
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24
Q

postsplenectomy findings:

A

Howell-Jolly bodies (nuclear remnants)
Target cells
Thrombocytosis

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25
costimulatory signal on dendritic cells that activate immature TC
B7 on DC binds CD28 on TC
26
signal 2 in activation of BCs
CD40 ligand on TC binds CD40 receptor on BC
27
BC class switching
dictated by cytokines released by Th cell --> class switching, affinity maturation, Ab production
28
Treg cells
promote immune tolerance express CD3, CD4, CD25 (alpha chain of IL2 receptor) secrete IL-10 and TGF-beta = anti-inflammatory cytokines
29
Fc region
- Constant - Carboxy terminal - Complement binding at CH2 = second fragment of heavy chain (IgM and IgG only) - Carbohydrate side chains - Determines isotype (IgM, IgD, etc)
30
Ab methods of generating diversity
- VJ recombination = light chain - VDJ recombination = heavy chain - Somatic hypermutation = after Ag stimulation - Terminal deoxynucleotidyl transferase = adds nucleotides during recombination
31
Alternative complement pathway
activated spontaneously or by microbial surfaces C3-->C3b --> C3 convertase + other crap --> c3a and C3b --> c3b activates C5 convertase --> C5b + C6-9 --> MAC
32
Lectin complement pathway
activates by microbial surfaces e.g. mannose MBL --> C1-like complex --> C4b --> C3 convertase --> C3b --> C5 convertase --> C5b + C6-9 --> MAC
33
Classic complement pathway
Ag-Ab mediated; only IgG and IgM C1--> C1 complex --> C2 split --> C2a activates C3 convertase --> C3b --> C5 convertase --> C5b + C6-9 --> MAC
34
C3b
opsonization
35
C3a and C5a
anaphylaxis
36
C5a
neutrophil chemotaxis
37
C5b-9
MAC and cytolysis
38
C1 esterase inhibitor deficiency
hereditary angioedema normally C1 esterase inhibitor helps prevent complement activation on self cells like RBCs ACEi contraindicated
39
C3 deficiency
severe, recurrent pyogenic sinus and respiratory infections inc susceptibility to type III hypersensitivity reactions bc C3b also helps clear immune complexes in addition to its job of opsonization
40
C5-9 deficiencies
recurrent neisseria bacteremia
41
DAF (GP1 anchored enzyme) deficiency
complement-mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria (PNH) bc DAF1 usually helps prevent complement activation on self cells like RBCs
42
IL-8
major chemotactic factor for neutrophils "clean up on aisle 8"
43
IL-6
endogenous pyrogen --> fever and production of acute phase reactants secreted by Th2
44
IL-2
stimulates growth of helper, cytotoxic and regulatory TCs
45
IL-3
supports growth and differentiation of bone marrow stem cells fxns like GM-CSF secreted by TCs
46
INF-gamma
secreted by Th1 cells suppresses Th2 cells antiviral and antitumor properties inc MHC I and II expression and Ag presentation in all cells
47
IL-4
``` induces differentiation into Th2 cells Promotes growth of BCs enhances class switching to IgE and IgG ```
48
TGF-beta
anti-inflammatory similar to IL-10
49
Mneumonic for important cytokines
"Hot T-Bone stEAk" ``` IL 1 = fever IL 2 = TC stimulation IL 3 = BM stimulation IL 4 = IgE production IL 5 = IgA production ```
50
Interferons
INTERfere with viruses alpha and beta = inhibit viral protein synthesis via ribonuclease that's specific for viral mRNA gama = inc MHC I and II expression and Ag presentation in all cells activates NK cells to kill virus-infected cells
51
what is the EBV receptor on BCs?
CD21
52
serum sickness
sx = fever, urticaria, arthralgias, proteinuria, LAD 5-10 days after exposure Ab produced against foreign protein, takes ~5 days --> immune complex deposited in membranes --> fix complement --> tissue damage more common than Arthus reaction
53
Arthus reaction
local subacute type III reaction intradermal injection of Ag --> Ab induction --> immune complexes in skin --> edema, necrosis and activation of complement
54
Type IV hypersensitivity reactions
cell-mediated, not transferable by serum 4 T's: - TC mediated - transplant rejection - TB skin tests - touching (contact dermatitis)
55
Allergic reaction to blood transfusion
Type I hypersensitivity sx - urticaria, pruritus, wheezing, fever tx - antihistamines
56
anaphylactic reaction to blood transfusion
severe. IgA deficient individuals must reveice blood products lacking IgA sx = dyspnea, bronchospasm, hypotension, respiratory arrest, shock
57
Febrile nonhemolytic transfusion reaction (FNHTR)
Type II hypersensitivity reaction host Ab against donor HLA-Ag and leukocytes sx = fever, HA, chills, flushing
58
Acute hemolytic transfusion reaction (HTR)
Type II hypersensitivity reaction intravascular hemolysis (ABO blood group incompatibility) or extravascular hemolysis (host Ab reaction against foreign Ag on donor RBC) sx = fever, HoTN, tachypnea, tachycardia, flank pain, Hb-emia (intravascular), jaundice (extravascular hemolysis)
59
Hyper IgE Syndrome (Job's syndrome)
Th1 cells don't produce IFN-gamma --> neutrophils can't respond to chemotactic stimuli ``` FATED: coarse Facies cold (noninflamed) staph Abscesses retained primary Teeth inc IgE Derm problems (eczema) ```
60
Wiskott Aldrich Syndrome
x-linked, WAS gene on X chromosome TCs can't reorganize actin cytoskeleton Triad (TIE): Thrombocytopenic purpura Infections Eczema low IgM, high IgE and A, thrombocytopenia
61
Cyclosporine
blocks differentiation and activation of TCs by inhibiting calcineurin --> prevents production of IL-2 and receptor use for organ rejection and AI d/o SE = nephrotoxicity, gingival hyperplasia, hirsutism (also HTN, HLD, hypergly)
62
Tacrolimus
binds FK-binding protein --> inhibits calcineurin and secretion of IL-2 use for organ transplant rejections SE = same as cyclosporine but NO GINGIVAL HYPERPLASIA OR HIRSUTISM
63
Sirlomius = rapamycin
inhibits mTOR --> inhibits TC proliferation in response to IL-2 use for kidney transplant immunosuppression + cyclosporine and steroids; also drug-eluting stents SE = HLD, thrombocytopenia, leukopenia
64
Azathioprine
precursor to 6MP interferes with metabolism and synthesis of nucleic acids --> inhibits lymphocyte proliferation use for kidney transplant, glomerulonephritis, hemolytic anemia SE = bone marrow suppression -- worsened by allopurinol because the active metabolite 6MP is also degraded by xanthine oxidase
65
Muromonab = OKT3
monoclonal Ab binding CD3 --> blocks TCR transduction immunuosuppression after kidney transplant SE = cytokine release syndrome, hypersensitivity reaction
66
Digoxin immune Fab
antidote for digoxin intoxication
67
infliximab
targets TNF-alpha Crohn's, RA, psoriatic arthritis, ankylosing spondylitis
68
adalimumab
targets TNF-alpha Crohn's RA, prosiatic arthritis
69
Abciximab
targets glycoprotein IIb/IIIa unstable angina and percutaneous coronary intervention
70
Omalizumab
targets IgE severe asthma
71
Bone marrow recovery
Filgrastim (GCSF) Sargramostim (Granulocyte-macrophage colony-stimulating factor)
72
alpha interferon
HBV, HCV, Kaposi sarcoma, leukmia, malignant melanoma
73
beta interferon
MS
74
gamma interferon
chronic granulomatous disease
75
thrombocytopenia cytokine tx
oprelvekin (IL-11), TPO

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