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USMLE First Aid > Immunology > Flashcards

Immunology Flashcards

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USMLE® Step 1 flashcards
1
Q

3 main parts of a lymph node

A

Follicle, paracortex, medulla

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2
Q

Follicles

A

site of B cell localization, primary are dense and dormant

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3
Q

Medulla

A

contains cords (lymphocytes, plasma cells) and sinuses (communication with efferents, contain reticular macrophages)

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4
Q

Paracortex

A

close to follicles, contains T cells, high endothelial venules enter here

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5
Q

which region is poorly developed in DiGeorge syndrome?

A

paracortex

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6
Q

Where are T cells located in spleen?

A

White pulp, periarteriolar lymphatic sheath

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7
Q

Where are B cells located in spleen?

A

White pulp, in follicles

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8
Q

Where are APCs located in spleen?

A

Marginal zone between red and white pulp

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9
Q

Encapsulated organism pneumonic

A 
SHiNE SKiS
Strep pneumo
Haemophilus influenzae B
Neisseria meningititus
E Coli
Salmonella
Klebsiella pneumo
Strep pyo (group B)
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10
Q

Why are asplenic individuals susceptible to encapsulated organisms?

A

Lower IgM –> lower complement activation –> lower C3b opsonization

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11
Q

Peripheral smear findings post splenectomy

A

Howell Jolly Bodies (no removal of nuclear remnants)
Target cells (HALT)
Thrombocytosis (loss of storage and removal by reticulars)
Lymphocytosis (loss of storage)

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12
Q

Which pharyngeal pouch creates the thymus?

A

Third

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13
Q

MHC I Loci

A

HLA-A, HLA-B, and HLA-C

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14
Q

MHC II Loci

A

HLA-DR, HLA-DP, HLA-DQ

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15
Q

Protein associated w/ MHC I

A

beta2 microglobulin

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16
Q

Protein associated w/ MHC II

A

invariant chain

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17
Q

HLA-A3 disease association

A

Hemochromatosis

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18
Q

HLA-B27 disease association

A

Psoriatic Arthritis, Anklyosing Spondylitis, IBD, and Reactive Arthritis

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19
Q

HLA-DQ2/8 disease association

A

Celiac disease

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20
Q

HLA-DR2 disease association

A

MS, hay fever, SLE, Good Pasture

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21
Q

HLA-DR3 disease association

A

DM, SLE, Graves, Hashimoto thyroiditis

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22
Q

HLA-DR4 disease association

A

RA, DM

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23
Q

HLA-DR5 disease association

A

pernicious anemia (vit b12 deficient)

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24
Q

Natural Killer cell enzymes

A

granzymes and perforin

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25
Q

TH1 Cells secrete…..

A

IFN-gamma to activate macrophages and CTLs

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26
Q

TH2 cells secrete….

A

IL-4, IL-5, IL-10, IL-13
Recruit Eosinophils for parasite defense
Promote IgE production by B cells

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27
Q

Which cytokines activate TH1 cells?

A

Interferon Gamma and IL-12 (macrophages)

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28
Q

Which cytokines activate TH2 cells?

A

IL-4

29
Q

Which ABs are on B cell surfaces?

A

IgG and IgM

30
Q

Most common AB in serum?

A

IgG

31
Q

First AB made in response to antigen?

A

IgM

32
Q

Which AB doesn’t cross placenta?

A

IgM

33
Q

Which AB does not fix complement?

A

IgA

34
Q

Most produced AB?

A

IgA

35
Q

Which AB is involved in Type I Hypersensitivity reactions?

A

IgE

36
Q

Which vaccines require adjuvants?

A

Non-peptide antigens

37
Q

Which cytokine induces acute phase reactants?

A

IL-6

38
Q

C-reactive Protein

A

Opsonin that fixes complement to facilitate phagocytosis

39
Q

Ferritin

A

Binds iron and sequesters in cells to inhibit microbial growth

40
Q

Fibrinogen

A

Coagulation factor, also promotes endothelial repair

Correlated to ESR

41
Q

Hepcidin

A

Prevents release of iron from ferritin

–> elevated in anemia of chronic disease

42
Q

Serum Amyloid A

A

Prolonged elevation leads to amyloidosis…..

43
Q

Albumin’s relation to acute phase reactants

A

Might be reduced in order to conserve amino acids for positive reactant production

44
Q

Transferin (during acute phase reaction)

A

internalized by macrophages to sequester iron

45
Q

Where is complement synthesized?

A

Liver

46
Q

Classic Pathway mediators

A

IgG and IgM mediated

47
Q

Alternative Pathway mediators

A

microbe surface molecules

48
Q

Lectin pathway mediators

A

mannose or other sugars

49
Q

List of major complement disorders

A

C1 esterase inhibitor deficiency
C3 deficiency
C5-9 deficiencies
DAF deficiency

50
Q

C1 esterase inhibitor deficiency

A

causes angioedema, ACE inhibitors contraindicated

51
Q

C3 deficiency

A

Increased risk of pyogenic sinus and respiratory infections

increased type 3 hypersensitivity reactions

52
Q

C5-9 deficiencies

A

increased susceptibility to recurrent Neisseria infections

53
Q

DAF deficiency

A

complement-mediated hemolysis, paroxysmal nocturnal hemoglobinuria

54
Q

Cytokines Secreted by Macrophages

A

IL-1, IL-6, IL-8, IL-12, and TNF-alpha

55
Q

Pneumonic for remembering what IL-1 to IL-6 do

A 
Hot T-Bone stEAK
IL-1: Hot (fever)
IL-2: T (T-cells)
IL-3: Bone (marrow stim)
IL-4: E (IgE)
IL-5: A (IgA)
IL-6: K (acute phase reactants)
56
Q

IL-1 functions

A

fever, endothelial activation for adhesion

57
Q

IL-6 functions

A

fever and acute phase proteins

58
Q

IL-8 functions

A

Neutrophil chemotaxis

59
Q

IL-12 functions

A

Activates NKs, TH1 differentiation

60
Q

TNF-alpha functions

A

septic shock, endothelial activation

61
Q

Cytokines secreted by T cells

A

IL-2 and IL-3

62
Q

IL-2 functions

A

growth of helper Ts, CTLs, regulatory Ts, NKCs

63
Q

IL-3 functions

A

bone marrow stimulation

64
Q

Cytokines from TH1 cells

A

Interferon gamma

65
Q

Cytokines form TH2 cells

A

IL-4, IL-5, and IL-10

66
Q

IL-4 functions

A

IgE class switching, TH2 differentiation

67
Q

IL-5 functions

A

IgA class switching

68
Q

IL-10 functions

A

Attenuates immune response

USMLE First Aid (4 decks)

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