Immunology Flashcards
What part of a lymph node would enlarge during a viral infection?
Paracortex
What cell is found in the PALS of the white pulp of the spleen?
Tcells
What happens in the marginal zone?
where APCs present blood borne antigen
What immunoglobulin is decreased post-splenectomy?
IgM
Which two additonal bacteria are encapsulated and arent in your mnemonic?
E. coli
GBS
Which pharyngeal pouch does the thymus develop from?
3rd
What type of Tcells are in the cortex?
Immature T cells
What type of Tcells are in the medulla?
mature T cells
What type of viral nucleic acid do innate immune cells respond to?
ssRNA
Which HLA loci correspond to MHC One?
A/B/C
Which HLA loci correspond to MHC Two?
DP/DQ/DR
What MHC event activates NK Cells?
loss of MHC One
In what organelle is antigen loaded onto MHC One? Via what protein?
rER
TAP transporter
In what organelle is antigen loaded onto MHC Two?
acidified endosome
Which HLA-Haplotype is associated with hemochromatosis?
HLA-A3
What condition is associated with HLA-B27?
PAIR
What HLA haplotype is associated with Pernicious anemia?
HLA-DR5
Which HLA haplotype is associated with Graves?
DR3
Which four cytokines activate NK cells?
IL2
IL12
IFN-α
IFN-β
Which CD molecule on NK cells mediates ADCC?
CD16
What is the function of CD16?
binds Fc of IgG
Where does positive Tcell selection occur?
cortex
Where does negative Tcell selection occur?
medulla
What is positive selection?
Capable of interacting with MHC
What is negative selection?
removes cells that bind MHC too much
Which CD molecules does an immature Tcell express?
CD4 and CD8
Which interleukin induces a TH1 response?
IL-12
Which interleukin induces a TH2 response?
IL-4
Which two cytokines induce a TH17 cell?
TGF-β
IL-6
What the the costimulatory molecules for Tcells?
B7 and CD28
What is the costimulatory molecule for Bcells?
CD40L
Do Tcells contain B7 or CD28?
CD28
Which cell secretes CD40L?
CD4
Which two interleukins inhibit a TH1 response?
IL4 and IL10
Which cell secretes IL12?
macrophages
Which CD molecule is unique to Tregs? What is this?
CD25
α-chain of IL2R
What is the txn factor for Tregs?
FOXP3
Which two cytokines do Tregs produce? What is the function of these cytokines?
IL10 and TGFβ
anti-inflammatory
What part of an antibody fixes complement?
Fc
Does the heavy or light chain contribute to both the Fab and Fc portion of an antibody?
Heavy
Does the Fc or Fab part of an antibody has carbohydrate side chains?
Fc
Which portion of the antibody determines its isotype?
Fc
What is the function of Tdt?
addition of nucleotides to DNA during recombination
What type of lymphocytes express IgM and IgD on their surface?
Mature Bcells
What is the most abundant immunoglobulin isotype in serum?
IgG
When is IgA a monomer?
circulation
When is IgA a dimer?
secreted
Which immunoglobulin isotype picks up a secretory component?
IgA
Is IgM a monomer when secreted or when on Mature Bcell?
Mature Bcell
Is IgM a pentamer when secreted or when on Mature Bcell?
secreted
Which two cell types can IgE bind?
basophils and mast cells
Which immunoglobulin is found in the lowest concentration in the serum?
IgE
What type of component must antigens have in order to be presented by MHC?
peptide
What are the two major functions of CRP?
opsonin
fix complement
Which two acute phase reactants are down-regulated during an immune response?
Albumin
Transferrin
Which complement protein is the main opsonin?
C3b
Which complement proteins mediate anaphylaxis?
C3a/C4a/C5a
Which complement protein is a chemoattractant for netrophils?
C5a
What are the two main opsonins?
IgG and C3b
Which complement protein can help clear immune complexes?
C3b
Which CD molecule is DAF?
CD55
What activates the alternative complement pathway?
spontaneous
microbial surfaces
What complement protein is activated by the alternative complement pathway?
C3b
What activates the lectin pathway of complement? Specifically?
microbial surfaces
mannose
What activates the classic complement pathway?
antigen-antibody complexes
Which version of C5 joins the MAC?
C5b
What condition causes Hereditary Angioedema?
C1 Esterase Inhibitor
C3 deficiency would predispose one to what type of infections?
severe pyogenic sinus and respiratory
A deficiency in what complement protein would predispose one to immune complex diseases?
C3
Which interleukin is an osteoclast activating factor?
IL1
Which cytokine mediates septic shock?
TNF-α
Which interleukin functions like GM-CSF?
IL-3
Which cytokine activates NK cells to kill virus infected cells?
IFN-gamma
Which cytokine increases MHC expression?
IFN-gamma
IL4 induces the class switching of what two immunoglobulins?
IgE and IgG
Which interleukin induces the growth of Bcells?
IL4
Which interleukin promotes the class switching to IgA?
IL-5
Which interleukin promotes the differentiation of eosinophils?
IL5
Which interleukin inhibits TH1 responses?
IL-10
Which type of nucleic acid can activate interferon?
dsRNA
What enzyme is produced in response to interferon?
RNaseL
What is the receptor for EBV?
CD21
What cell synthesizes and secretes B7?
Antigen presenting cells
Which three CD molecules are expressed on Bcells?
CD19/CD20/CD21
What is the unique marker for NK cells?
CD56
What two proteins are linked by superantigens?
β-region of TCR to class two MHC
What does CD14 bind?
LPS
What is the antigenic variation component of salmonella?
flagella
What does antigenic variation do for Borrelia?
relapsing fever
What is the antigenic variation component of Neisseria?
pillus
What causes major antigenic variation in influenza?
shift
What causes minor antigenic variation in influenza?
drift
Which four exposures can one receive pre-formed antibodies?
Tetanus
Botulism
HBV
Rabies
What are the live attenuated vaccines?
measles/mumps/rubella
polio (saban)
flu (intranasal)
varicella
yellow fever
What are the five inactivated vaccines?
Polio (salk)
Hepatitis A
Cholera
Rabies
Influenza (IM)
Which antibodies mediate Type Two Hypersensitivity Rxns?
IgM/IgG
What two things are attracted during a Type Three reaction?
complement and neutrophils
How long does it take for serum sickness to set in?
five days
What is the stain for an Arthus reaction?
fluorescence
What are the three main Type Four Hypersensitivity Rxns?
Transplant rejection
TB skin tests
Contact dermatitis
What type of immune reaction is Bullous Pemphigoid?
two
What type of immune reaction is Pemphigus Vulgaris?
two
What type of immune reaction is Guillain Barrie?
four
What type of immune reaction is MS?
four
An allergic Blood Transfusion Reaction is against what antigen?
plasma proteins in blood
What is the treatment for an allergic Blood Transfusion Reaction?
anti-histamines
What is the antigen for an anaphylactic Blood Transfusion Reaction?
IgA
What is the antigen during a Febrile nonhemolytic transfusion reaction?
HLA
What is the antigen during an Acute Hemolytic transfusion reaction?
ABO
What is the antigen during anti-phospholipid syndrome of Lupus?
cardiolipin
What is the antigen during Limited Scleroderma?
anticentromere
What are the two specific antibodies found in SLE?
anti-dsDNA
anti-smith
What is the antigen for anti-smith antibodies?
ribonuclear protein
What is the auto-antibody during T1DM?
anti-glutamate decarboxylase
What are the three main autoantibody during polymyositis and dermatomyositis?
anti-Jo
anti-SRP
anti-Mi-2
What are the two autoantibodies during Hashimoto?
anti-microsomal
anti-thyroglobulin
What is the autoantibody during Diffuse Scleroderma? Against what?
anti-SCL-70
DNA topoisomerase
What is the autoantibody during Mixed Connective Tissue Disease?
anti-U1-RNP
What are the two autoantibodies during Rheumatoid?
IgM to Fc of IgG
anti-citrullinated
Agranulocytosis predisposes a person to infection with which four bacteria?
Staph
Burkholderia cepacia
Nocardia
Serratia
What two fungi arise when a patient lacks Tcells?
Candida and PCP
IgA deficiency could lead to what bug?
Giardia
No granulocytes could predispose a person to infection by what two fungi?
Candida and aspergillus
Are recurrent bacterial infections indicative of Tcell or Bcell deficiency?
Bcell
Are recurrent fungal infections indicative of Tcell or Bcell deficiency?
Tcell
What is the inheritance pattern for Brutons agammaglobulinemia?
X-linked recessive
What is absent during Brutons agammaglobulinemia?
CD19 Bcell count
What two structures are missing during Brutons?
tonsils and lymph nodes
Which immunoglobulins are decreased during Brutons agammaglobulinemia?
all classes
What are IgA levels during selective IgA deficiency?
less than 7
What is defective during Common Variable Immunodeficiency?
Bcell maturation into plasma cells
What is a patient with Common Variable Immunodeficiency at an increased risk of?
autoimmune disease
What three infections are patients with Common Variable Immunodeficiency susceptible to?
lymphoma
bronchiectasis
sinopulmonary infections
What cell is decreased during Common Variable Immunodeficiency? What does this result in?
plasma
decreased all classes of immunoglobulin
What pharyngeal structure is disrupted during DiGeorge?
pouch
How is the gene deletion detected in DiGeorge?
FISH
What type of cell response is defective during IL12 Receptor Deficiency?
decrease TH1
What cytokine is decreased during IL12 Receptor Deficiency?
IFN-gamma
What two bugs is a person with IL-12 deficiency susceptible to?
mycobacterial
fungal
What disease may present after BCG vaccination?
IL12 receptor deficiency
What is the mode of inheritance of Job Syndrome?
Autosomal Dominant
What cell type is deficient in Job Syndrome?
TH17
What protein is mutated during Job Syndrome?
STAT3
A recruitment of which immune cell fails during Job Syndrome?
neutrophil
Which immunodeficiency can result in cold abscesses?
Job Syndrome
What bacteria is a person with Job Syndrome particularly susceptible at forming an abscess full of?
Staph
Which immune syndrome can result with retained primary teeth?
Job
Which immunoglobulin is high during Job Syndrome?
IgE
Which cytokine is low during Job Syndrome?
IFN-gamma
What is the mode of inheritance for IL2R Deficiency?
X-linked
What is the mode of inheritance for ADA Deficiency?
Autosomal Recessive
What is the cure for SCID?
Bone marrow transplant
What is the function of the ATM Gene?
repair DNA double stranded breaks
What is the triad of Ataxia Telangiectasia?
Ataxia
spider Angiomas
IgA deficiency
What is the marker for Ataxia Telangiectasia?
AFP
What are the immunoglobulin levels during Ataxia Telangiectasia?
↓ IgG/ ↓ IgA / ↓ IgE
What atrophies during Ataxia Telangiectasia?
Cerebellum
What hematological abnormality is present during Ataxia Telangiectasia?
Lymphopenia
What is the mode of inheritance for Hyper IgM?
X-linked
What is defective during Hyper IgM?
CD40L
Which two parasites can be found during Hyper IgM? Virus?
Cryptosporidium Parvum
Pneumocystis
CMV
What are immunoglobulins are decreased during Hyper IgM?
↓IgG/ ↓ IgA / ↓ IgE
What is the mode of inheritance for Wiskott-Aldrich?
X-linked recessive
What process is defective during Wiskott-Aldrich?
Tcells are unable to rearrange cytoskeleton
Which immunoglobulins are decreased during Wiskott-Aldrich?
↓ to normal IgM and IgG
Which immunoglobulins are increased during Wiskott-Aldrich?
↑ IgA/ ↑ IgE
Which cells are defective during Wiskott Aldrich?
Tcells
Which two types of diseases is a person with Wiskott-Aldrich at an increased risk of inheriting?
Autoimmune and Malignancy
What is another name for CD18?
Lymphocyte Function Associated Antigen-1
What is the mode of inheritance for Leukocyte Adhesion Deficiency-1?
autosomal recessive
What hematological abnormality would be present during LAD1?
neutrophilia
What is the Mode of Inheritance for Chediak Higashi?
Autosomal recessive
What protein is defective during Chediak Higashi?
LYST
What is the word-for-word function of LYST?
microtubule dysfunction in phagosome-lysosome fusion
Which two bacteria would a person with Chediak Higashi be susceptible to?
Staph and Strep
What would be seen on a blood smear during Chediak-Higashi?
giant granules in neutrophils and platelets
What immunodeficiency would present with partial albinism?
Chediak Higashi
What immunodeficiency would present with peripheral neuropathy?
Chediak Higashi
What immunodeficiency would present with pancytopenia?
Chediak Higashi
What immunodeficiency would present with mild coagulation defects?
Chediak-Higashi
What is the mode of inheritance for CGD?
X-linked recessive
Which seven organisms is a person with CGD susceptible to?
Pseudomonas
Listeria
Aspergillus
Candidia
E. coli
S. aureus
Serratia
What common characteristic do bacteria a person with CGD is susceptible to have in common?
catalase positive
What does a negative tetrazolium blue test indicate?
NADPH is absent
What other test can be used for CGD other than Nitroblue Tetrazolium?
Dihydrorhodamine
Where is an autograft from?
yourself
Where is an allograft from?
different individual of same species
Where is a xenograft from?
different species
What mediates a hyperactue graft rejection?
pre-formed antibody
What type of immune reaction with hyperactue graft rejection be?
Type Two
What type of Hypersensitivity is cellular acute graft rejection?
Type four
What is the antigen during cellular Acute Graft Rejection?
donor MHCs
What type of inflammation takes place during acute graft rejection?
vasculitis
What immune cell invades during acute graft rejection?
lymphocytic
Is chronic graft rejection mediated by Tcells or Bcells?
both
What happens to the heart during Chronic Graft Rejection?
atherosclerosis
What happens to the Lungs during Chronic Graft Rejection?
bronchiolitis obliterans
What happens to the Liver during Chronic Graft Rejection?
vanishing bile ducts
What two things happen to the kidney during Chronic Graft Rejection?
vascular fibrosis
glomerulopathy
Which cells mediate GVHD?
grafted Tcells
WHat are four symptoms of GVHD?
Rash
Jaundice
Diarrhea
Hepatosplenomegaly
Which two transplants most often have GVHD?
bone marrow and liver
Chronic Immune Suppression can result in which two abnormalaties?
infection and cancer
What two proteins does cyclosporine inhibit?
Calcineurin and cyclophilin
What is the MOA of cyclosporin?
blocks IL2 txn
What is the main toxicity of cyclosporin?
nephrotoxic
Which immunosuppressive can cause poor BMP findings?
cyclosporine
What are the two odd toxicities of cyclosporine?
hirsutism and gingival hyperplasia
What are the two immunosuppressants that inhibit calcineurin?
Cyclosporine and Tacrolimus
Drugs ending in what suffix inhibit FKBP?
-limus
What does FKBP stand for?
FK Binding Protein 506
What does tacrolimus inhibit?
IL2 txn
What are two toxicities of cyclosporine that tacrolimus lacks?
gingival hyperplasia and hirsutism
What are two additional toxicities of tacrolimus that cyclosporine does not have?
diabetes and neurotoxicity
What does sirolimus inhibit?
mTor
What is the MOA of sirolimus?
inhibit IL2 signaling
Which immunosuppressant has poor hematological toxicities?
Sirolimus
Is sirolimus nephrotoxic?
no
What are the three toxicities of Basiliximab?
edema
HTN
tremor
Which immune cell does azathioprine inhibit?
lymphocytes
What is the main toxicity of azathioprine?
myelosuppression
What drug can increase the toxicity of azathioprine?
allopurinol
Which immune protein is inhibited by glucocorticoids?
NFKB
What enzyme does Mycophenolate Mofetil inhibit?
IMP Dehydrogenase
What nucleotide does Mycophenolate Mofetil inhibit the synthesis of?
GMP
Which interleukin is Oprevelkin an analogue of?
IL-11
What condition is Oprevelkin used to treat?
thrombocytopenia
Which drug is a G-CSF?
Filgrastim
What drug is a GM-CSF?
Sargramostim
Which interleukin molecule is Aldesleukin an analogue of?
IL2
What two conditions is Aldesleukin used to treat?
renal cell carcinoma
metastatic melanoma
What CD molecule is targeted by Alemtuzumab?
CD52
What disease is treated with Alemtuzumab?
CLL
What is the VEGF antibody?
Bevacizumab
What two diseases for Bevacizumab treat?
colorectal cancer
renal cell carcinoma
What does Cetuximab target?
EGFR
What two diseases are treated with Cituximab?
stage four colon cancer
head/neck cancer
What is treated with Rituximab?
NHL
Rheumatoid
ITP
Which two cancers are treated with Trastuzumab?
breast and gastric
What diseases are treated with Infliximab/Adalimumab?
PAIR
Which two diseases is Natalizumab used to treat?
MS
Crohns
Which disease could Natalizumab cause?
PML
What antibody targets RANKL?
Denosumab
What antibody targets IgE?
Omalizumab
Which antibody targets RSV Fusion protein?
Palivizumab
What does Muromonab target?
CD3
What antibody targets C5 Convertase?
Eculizumab
Which four areas drain into the para-aortic lymph nodes?
Kidney
Ovary
Ureter
Testicles
What part of the foot drains into the popliteal nodes?
dorso-lateral
Where nodes does the prostate lymph drain into?
internal iliac
Between what two vessels does the thoracic duct drain?
subclavian and internal jugular
What embryonic layer are lymphocytes derived from?
mesenchyme
What two blood cell abnormalities can be seen post-splenectomy?
thrombocytosis
lymphocytosis
Would endogenous or exogenous antigens be presented on MHC One?
endogenous
Would endogenous or exogenous antigens be presented on MHC Two?
exogenous
What haplotypes are found with SLE?
DR2 and DR3
What is the function of Tdt?
VDJ rearrangement
Which virus is notorious for appearing after a kidney transplant?
BK Virus
What type of hypersensitivity could TH17 cells contribute to?
type three
What cytokine do TH1 cells secrete?
IFN-gamma
Which immunoglobulin is the antigen receptor on the surface of Bcells?
IgM
What are thymus dependent antigens?
peptides
What are thymus independent antigens?
non-peptides
Which Acute Phase Reactant promotes endothelial cell repair?
Fibrinogen
Which two CD molecules inhibit complement activation?
CD55
C1 Esterase Inhibitor
Which two interleukins are the endogenous pyrogens?
IL1 and IL6
What is the F of FACES regarding Job Syndrome?
coarse Facies
What is the A of FACES regarding Job Syndrome?
cold Abscess
What is the T of FACES regarding Job Syndrome?
retained Teeth
What is the E of FACES regarding Job Syndrome?
IgE
What is the D of FACES regarding Job Syndrome?
Dermatological
What is a syngenic graft?
from identical twin or clone
What does Palivizumab block?
RSV fusion protein
Early complement deficiencies predispose to what type of bacteria?
encapsulated
What two types of immune cells are located in the medulla of a lymph node?
plasma cells and lymphocytes
What type of immune cells are located in the medullary sinus of a lymph node?
macrophages
A spleenectomy can cause what myeloid cell to become more numerous?
thrombocytosis
Which cytokine is involved in cachexia?
TNF
Which three substances can result in IgE Independent Mast Cell Degranulation?
opioids
vancomycin
radiocontrast dyes
A large population of CD4/CD8 containing Tcells can be indicative of what disease?
Hodgkiins lymphoma
Where does Bcell somatic hypermutation occur?
Bcell germinal centers
By what mechanism does IgA cross epithelial cell membranes?
Transcytosis
The spleen synthesizes what specific isotype of immunoglobulin?
IgM
Which Acute Phase Reactant is a coagulation factor?
fibrinogen
Which Acute Phase Reactant correlates with ESR?
fibrinogen
What starts the Alternative Complement pathway?
bacteria
What starts the Lectin Complement pathway?
mannose
Which two proteins help prevent complement mediated destruction of self cells?
DAF/CD55
C1 Esterase Inhibitor
Which interleukin activates NK cells?
IL12
Which complement protein does EBV bind?
C3d
Which innate immune cell possessed Fc and C3b receptors?
macrophages
Which two viruses have active and passive immunity?
HBV and rabies
Antibodies to what antigen of influenza are created?
Hemagglutinin
Which two immunoglobulin do macrophages have a receptor for? Not for?
IgG
not for = IgM
What enzyme does Protein Kinase R inactivate?
EF2
What is the function of CTLA4?
down-regulate immune system
Which live vaccine is the only one that can be given to a HIV positive person?
MMR
How many days after insult does serum sickness take place?
5–10 days
What are three symptoms of Serum Sickness?
Fever
Arthralgias
Urticaria
What is another name for a desmosome?
desmoglein
What genes for SCID?
Rag genes
Delay Accelerating Factor inhibits what two complement proteins?
C3 and C5 convertase
Mixed connective tissue disease has manifestations of what three other autoimmune diseases?
Lupus
Polymyositis
Systemic sclerosis
Not having Bcells predisposes to what two viruses?
Polio
enteroviruses
Which stage of maturation of Bcells is stopped during Brutons Agammaglobulinemia?
pro-Bcells
Patients with Selective IgA Deficiency can have anaphylactic reactions to what?
blood products
Which immune disease can predispose to fungal/viral/bacterial and protozoan infection?
SCID
What rxn does ADA Catalyze?
adenosine into inosine
What disease is indicative of decreased Tcell Receptor Excision Circles?
SCID
What are the two characteristics of platelets during Wiskott Aldrich?
smaller and fewer
Which specific subunit is defective during LFA1?
beta-two-integrin
What specific gene is defective during Chediak Higashi?
Lysosomal Trafficking Regulator Gene
Do integrins mediate tight or loose adherment?
tight
Which immunosuppressant can cause hyperlipidemia?
sirolimus
Which immunosuppressant can cause insulin resistance?
sirolimus
Which immunosuppressant is sirolimus synergistic with?
cyclosporine
What organelle does bortezimib inhibit? What disease?
Proteasome
Multiple Myeloma
What txn factor is normally activated by Calcineurin?
NFAT
Which six diseases can be treated with IFN-alpha?
Hep B and C
Kaposi
Hairy/Renal/Melanoma
What are two side effects of EPO agents?
HTN and thromboembolic events
Which gene functions as an ‘Off-Switch’ for Tcell responses?
CTLA4
What is the target of Natalizumab? What does this target inhibit?
alpha-4-integrin
leukocyte migration
What are the two functions of CRP?
fix complement
opsonin
What is the function of DAF?
decay C3 and C5
