Immunology Flashcards
1
Q
What cells are included in granulocyte?
A
Neutrophils/eosinophils/basophils
2
Q
What kind of cells are included under myeloid cells?
A
Monocyte/granulocyte/erythrocyte/platelet
3
Q
What kind of cells are included under lymphoid stem cells?
A
Plasma cells/T cells/natural killer cells
4
Q
What is the normal white blood cell count?
A
4,000 to 10,000/uL
5
Q
What cells are included in leukocyte (WBC)?
A
Granulocyte/T cell/monocyte
6
Q
What causes hypereosinophilia?
A
NAACP
Neoplastic/asthma/allergic reaction/collagen vascular disease/parasites
7
Q
Histamine increase ___ production in the stomach and causes ___?
A
Gastric acid/peptic ulcer
8
Q
Where are basophil and mast cells found in the body?
A
Basophil—>mature in bone marrow and stay in blood
Mast cell—>mature in tissues and stay in tissues
9
Q
How does dendritic cell present antigens to B and T cell?
A
It carries it through lymphatic system to the lymph nodes
10
Q
Where do B and T cell mature?
A
B—>bone marrow
T—>thymus
11
Q
Which cell’s nuclei has a clock face appearance?
A
Plasma cell
12
Q
What are primary and secondary follicles in the lymph nodes?
A
B cells reside in there
Primary—>dense center (nonactive)
Secondary—>pale center (active)
13
Q
Where are B/T/plasma cells in the lymph nodes?
A
B—>cortex
T—>paracortex
Plasma cell—>Cord of the medulla
14
Q
Where do B/T cells enter the lymph node?
A
High endothelial venules (in paracortex)
15
Q
Why don’t you biopsy testicular cancer?
A
Because testicle and scrotum drains into different lymph nodes
Testicle—>periaortic
Scrotum—>superficial inguinal
16
Q
Where do the lymph of right arm and head drain into?
A
Right lymphatic duct—>right subclavian vein
17
Q
What cells are in red pulp/white pulp/PALS in the spleen?
A
Red—>RBC
White—>WBC
PALS—>T cells
18
Q
Why is pt with asplenia is more susceptible to encapsulated bacteria?
A
Spleen makes IgM—>activate complement
19
Q
What are the 3 signs of asplenia?
A
Howell-Jolly bodies/target cell/thrombocytosis
20
Q
What happens in the cortex/corticomedullary junction/medulla in the thymus?
A
Immature T cells in cortex/T cell maturation in corticomedullary junction/mature T cell in medulla
21
Q
Where are Hassall’s corpuscles found?
A
Medulla of the spleen
22
Q
What are the positive and negative selection of T cells?
A
Positive—>see if T cell bind to self MHC—>yes then survive
Negative—>see if it binds too strongly—>get rid of the ones that bind too strongly
23
Q
List 3 examples of innate immunity
A
Lysosome/defencin (inside neutrophilic granules—>break cell wall)/surfactin
24
Q
What are the 3 chemotaxis for neutrophil?
A
IL-8 (macrophages)/C5a/LTb4
25
What surface receptor do neutrophil use to attach to the bacteria?
TLR/C3b/IgG
26
What is the process of O2 dependent killing in the phagolysosome?
NADPH is oxidized to NADP+ in the cytoplasm--->H+ goes into the phagolysosome--->NADPH oxidase combine e- from NADPH with O2 to produces superoxide anion (O2-)--->superoxide dismutase combine O2- and H+ into H2O2--->break down to hydroxal (OH-) radical--->kill the bacteria
27
How does myeloperoxidase kill bacteria in the phagolysosome?
It converts H2O2 and Cl into OCl- (hypochloride)--->kill the bacteria
28
How does mast cells respond to inflammation?
C5a is released from the infected region--->C5a binds to C5a receptor on mast cell--->degranulation
29
What does histamine do to the endothelial cells of the blood vessel?
It regulates P-selectin
30
How does neutrophil bind to endothelial cell of the blood vessel?
Through P and E-selectin (low affinity) via integrin on neutrophil--->rolling on the surface (slow down leukocyte)--->
31
How does neutrophil diapedesis happens?
IL8 binds to proteoglycan on the endothelial cell--->neutrophil binds to IL8 (high affinity binding)
32
What is chronic granulomatous disease?
Inherited disease with defective NADPH oxidase--->can't produce superoxide (O2-) anion--->chronic infection of catalase + bacteria
33
Why is chronic granulomatous disease pt not susceptible to catalase - bacteria?
Catalase - bacteria produces H2O2--->MPO convert it to OCl- in phagolysosome and then kill the bacteria
34
Why is MPO deficiency usually asymptomatic?
Because NADPH oxidase can still produce OH- to kill the bacteria
35
What bacteria infection is MPO deficiency susceptible to?
Candida
36
What is type I leukocyte adhesion deficiency?
Beta 2 integrin (low affinity) (CD18) deficiency on leukocyte--->recurrent infection and delay in umbilical cord separation
37
Where do you find MHC class II protein?
On APCs
38
Where are the antigen loaded and presented to for MHC class I and II protein?
Class I--->loaded in rough ER and presented to CD8 cells
| Class II--->loaded in endosomes and presented to CD4 cells
39
What are class I and II MHC structure compose of ?
Class I--->alpha chain and beta microglobulin
| Class II--->alpha chain/beta chain/invariant chain (released when antigen is loaded)
40
What disease does the pt in risk for with HLA-B27?
Seronegative spondyloarthropathy (ankylosing spondylitis/inflammatory bowl disease/reactive arthritis/psoriasis)
41
What disease does the pt in risk for with HLA-DR3 and DR4?
DR3--->type I DM/Hashimoto
| DR4--->type I DM/rheumatoid arthritis
42
Is natural killer cell a part of innate or adaptive immune response? and what protein does it look for?
Innate/MHC class I
43
What happens when natural killer cell encounter a normal cell?
Normal cell express MHC class I--->natural killer cell express KIR (killer cell immunoglobulin like receptor)--->normal cell bind to KIR and inhibit natural killer cell
44
What happens when natural killer cell encounter a foreign cell?
No MHC class I/no KIR--->KAR receptor is activated on natural killer cell--->attack by producing perforin (poke a hole) and then insert granzyme (induce apoptosis)
45
What is the most prominent cell present in graft vs. host disease?
Natural killer cell
46
What are the interleukens that are responsible for Th1 and Th2 cell differentiation?
Th1 cell--->IL-12
| Th2 cell--->IL-4
47
What is the first signal for the activation of T cell by APCs?
MHC class II on the APCs bind with TCR (then CD4 binds to it) and the help of CD3 on the T cell surface
48
What is the costimulatory signal that is needed to activate T cell along with the first signal?
CD28 on the T cell surface binds with B7 on the APCs
49
What are the first and second signal that are needed to activate CD8 cells?
First signal--->Infected cells present antigen to CD8 through Class I MHC
Second signal--->Helper T cell secretes IL-2--->IL-2 binds to CD8 cells
50
Which T helper cells activate CD8 cells and which one for B cell?
Th1--->activate CD8 cells
| Th2--->activate B cells
51
What are the 2 signals for activation of B cells?
```
1st--->CD40 ligand from Th2 cells bind to CD40 on B cell
2nd--->Interleukens (IL-4/5/6/13) are secreted from Th2 cells for B cell class switch
```
52
Where does B cells activation occur?
Lymph nodes/spleen
53
What do Th1 and Th2 cell secrete to inhibit each other?
Th1--->IFN gamma
| Th2--->IL-10
54
How do CD8 cells kill?
Same as natural killer cells
55
What are the 2 types of antibody light chain?
Kappa and lambda
56
What are the 2 ends of a antibody and what do they consist?
Fab--->top--->bind to antigen
| Fc--->bottom--->bind to APC--->determine if the antibody is IgA/G/A/D/E
57
What are the 4 ways to create antibody diversity?
1. Random recombination of genes:
light chain --- VJ recombination (v-variable/j-joined region)
heavy chain --- VDJ recombination (d-diversity region)
2. Random recombination of chains
3. Somatic hypermutation:
B cell stimulation--->B cell proliferation--->sloppy proofreading--->mutations--->more diverse antibodies produced
4. TdT add random nucleotide into the DNA
58
What are the 3 functions of antibody?
Opsonization/neutralization/complement activation
59
Which Ig can cross placenta and which is secreted as a dimer and which forms pentamer?
IgG/IgA/IgM
60
What cell does IgE bind to to initiate allergic reaction?
Mast cell
61
What are thymus independent and dependent antigens?
```
Independent (no peptide component)--->can not be presented to T cell (e.g. LPS of gram - rod)/stimulate IgM--->no immunologic memory
Dependent (has peptide component)--->allow antibody class switch--->has immunologic memory
```
62
What are the 2 IL secreted by macrophages that are responsible for fever during inflammation?
IL-1/IL-6
63
Which cytokine secreted by macrophages that is responsible for sepsis?
TNF-alpa
64
Which 5 main cytokines do macrophages secrete?
IL-1/IL-6/IL-8/IL-12/TNF-alpha
65
Wh does cytokines do Th1 and Th2 cell secrete?
Th1--->IL-2 (activate CD8 cells)/IL-3/IFN-gamma (activate macrophages)
Th2--->IL-4 (IgE and IgG production)/5 (IgA production)/10 (inhibitory)
66
What do IFN alpha and beta do?
They inhibit viral protein synthesis and are used to treat many viral infections
67
What are the 3 CD markers for B cells?
CD19/20/21
68
What are the CD marker in macrophage and what does it bind?
CD14--->bind to LPS--->release IL-1 and TNF-alpha
69
What is the CD marker for NK cell?
CD56
70
What does anergy of T cell mean?
Self reactive T cell bind to APC without costimulatory signal--->die
71
How does superantigen work? and does it relate to any specific antigen?
```
Cross link TCR with MHC class II--->over activation of T cells
No, it crosses link without any antigen
```
72
What are the 3 bacteria/1 virus/2 parasites that exhibit antigenic variation?
Salmonella/Borrelia/Gonorrhea
Influenza
Trypanosoma brucei rhodesiense
Trypanosome brucei gambiense
73
What is passive immunity and what infection do we use this to treat?
Inject preform antibodies/C. tetani, rabies, hep B, C. botulinum
74
What are the 3 pathways of complement activation?
Classical--->C1 attaches to IgG or IgM that is bound to the bacteria/virus
Lectin--->activated by lectin that binds to the mannose residuals on the surface of bacteria/fungi/viruses
Alternative--->activated by C3b binding to bacteria (mediated by properdin)
75
What does complement accomplish?
1. Makes C3b and mark it onto the target cell for opsonization
2. Makes and cleave C5 into C5a and C5b--->C5b combines with C6/7/8/9 to form membrane attack complex--->kill the bacteria
76
Which 3 anaphylatoxins do the 3 complement pathway produce and what do they do?
C3a/4a/5a--->promote inflammatory response
77
Deficiency in C1 inhibitor gives?
Hereditary angioedema
78
Deficiency in classical pathways give?
SLE and recurrent encapsulated bacteria
79
Complement deficiency pt is susceptible to what bacteria infections?
Neisseria/H. influenza/S. pneumoniae
80
Deficiency in alternative pathway indicate a deficiency in what enzyme? and what does it cause?
Properdin/fulminant N. menigitidis
81
What are the assay that are used to test the classical and alternative pathway?
CH50/AH50
82
When do you know the immunodeficiency is acquired?
When both CH50/AH50 are below 50% but still detectable
83
What is the process of antigen presenting?
Phagocytes eat a bacteria--->phagolysosome kills it--->MHC class II comes into it and pick up some antigen and go to the cell surface
84
What is the progression of B cell activation?
B cell is activated--->proliferation--->differentiation--->antibody production
85
What is TAP protein?
It's located in the ER to allow antigen in to be presented on MHC class I
86
Pt with MHC class I deficiency is susceptible to ___ infection and thus ___ vaccine?
Viral/live attenuated
87
What are the 3 bacteria/1 virus/2 parasites are known for their antigen variation?
Salmonella (2 different flagella)/Borrelia (change surface protein)/gonorrhea (pili protein)
Influenza
Trypanosoma brucei rhodesiense
Trypanosome brucei gambiense
88
What type of hypersensitivity is responsible for serum sickness (foreign protein) or arthus reaction (local reaction)?
Type III
89
What is the most common example of arthus reaction?
Tetanus vaccine
90
What kind of immune deficiency is more prone to type III hypersensitivity reaction?
C3 deficiency
91
What are common examples of type IV hypersensitivity?
Transplant rejection (excluding hyperacute)/PPD test/contact dermatitis
92
For type I hypersensitivity reaction, what is the first antibody produced?
IgM
93
Which cytokine would inhibit type IV hypersensitivity reaction?
IL-10
94
Which antibody is against which antibody in rheumoatoid arthritis?
IgM against IgG
95
Antimitochondria antibody is associated with which disease?
Primary biliary cirrhosis
96
What is B (boy) ruton's agammaglobulinemia?
X-linked/defect in BTK gene/B cell unable to differentiate
97
What is hyper IgM syndrome?
Defect in CD40L which is necessary for B cell class switch/B cell unable to differentiate into other Igs
98
DNA in Heterochromatin is methylated or acetylated? what about euchromatin?
Methylated/acetylated
99
What's the difference between nucleoside and nucleotide?
Nucleoside--->base/ribose
| Nucleotide--->base/ribose/phosphate
100
Carbamoyl phosphate is involved in what 2 pathways?
De novo pyrimidine synthesis/urea cycle
101
Ornithine transcarbamylase deficiency has a build up of ___?
Carbamoyl phosphate
102
Thymidylate synthase depends on ___?
Folic acid
103
What does C3a and C5a activate?
Mast cell
