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0001 STEP ONE RAPID REVIEW DX > Immunology > Flashcards

Immunology Flashcards

1
Q

HEAD AND NECK

A

CERVICAL

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2
Q

LUNGS

A

HILAR

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3
Q

TRACHEA AND ESOPHAGUS

A

MEDIASTINAL

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4
Q

UPPER LIMB, BREAST, SKIN ABOVE THE UMBILICUS

A

AXILLARY

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5
Q

LIVER, STOMACH, SPLEEN, PANCREAS, UPPER DUODENUM

A

CELIAC

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6
Q

LOWER DUODENUM, J, I, COLON TO SPLENIC FLEXURE

A

SUPERIOR MESENTERIC

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7
Q

COLON FROM SPLENIC FLECTURE TO UPPER RECTUM

A

INFERIOR MESENTERIC

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8
Q

LOWER RECTUM TO ANAL CANAL (ABOVE PECTINATE LINE) BLADDER, VAGINA (MIDDLE THIRD), PROSTATE

A

INTERNAL ILIAC

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9
Q

TESTES, OVARIES, KIDNEYS, UTERUS

A

PARA-AORTIC

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10
Q

ANAL CANAL (BELOW THE PECTINATE LINE) SKIN BELOW THE UMBILICUS (EXCEPT POPLITEAL TERRITORY) SCROTUM

A

SUPERFICIAL INGUINAL

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11
Q

DORSOLATERAL FOOT

POSTERIOR CALF

A

POPLITEAL

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12
Q

Asplenia associated with which pathogens

A 
due to decreased IgM --> decreased complement --> decreased C3b opsonization we see increased susceptiblity to ecapsulated organisms 
SHiNE SKiS
Strep Pneumo
Heam Influezae
Neisseria Meningitidis
Escherischia Coli
Salmonella
Klebsiella 
Group B Streptococci
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13
Q

HLA loci for MHC-1 and MHC-II

A

MHC-I
HLA-A; HLA-B; HLA-C
MHC-II
HLA-DR; HLA-DP; HLA-DQ

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14
Q

HLA associated with hemochromatosis

A

HLA-A3

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15
Q

HLA-B27 associated with

A 
PAIR (seronegative arthropathies)
Psoriatic 
Ankylosing Spondylitis
Inflammatory bowel disease 
Reactive Arthritis
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16
Q

HLA-DQ2/DQ8

A

Celiac

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17
Q

HLA-DR2

A

MS
Hay fever
SLE
Goodpasteur

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18
Q

HLA-DR3

A

DM-I
SLE
Graves and Hashimotos thyroiditis

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19
Q

HLA-DR4

A

Rheumatoid arthritis

DM-1

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20
Q

HLA-DR5

A

Pernicious anemia

Hashimotos

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21
Q

Natural killer cell

cytokines that enhance activity

A

IL-2
IL-12
IFN-alpha
IFN-beta

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22
Q

Natural killer cells can also kill via antibody mediated how?

A

CD16 binds FC of bound Ig

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23
Q

Cytokines secreted by macrophages

A 
IL1
IL6
IL8
IL12
TNF-alpha
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24
Q

IL-1 (osteoclast activating factor?)

A

Secreted by macrophage
Causes fever / acute inflammation / activates endothelium to express adhesion molecules
induces chemokine secretion to recruit WBCs

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25
IL-2
Secreted by all T cells | stimulates growth of helper / cytotoxic / and regulatory T cells and NK cells (bone marrow)
26
IL-3
Secreted by all T cells | supports growth and differentiation of bone marrow stem cells - functions like GM-CSF
27
IL-4
Secreted by Th2 induces differentiation into Th2 Promotes growth of B cells Enhances class switching to IgE and IgG
28
IL-5
Secreted by Th2 promotes differentiation of B cells Enhances class switching to IgA Stimulates growth and differentiation of eosinophils
29
IL-6
Secreted by macrophages increases acute phase reactants fever
30
IL-8
major chemotactic factor for neutrophils | secreted by macrophages
31
IL-12
Secreted by macrophages Induces differentiation of T cells into Th1 Cells Activates NK cells so we are priming for the cell mediated response (like we would see in mycoplasma)
32
Interferon gamma
Secreted by Th1 cells also by NK cells in response to IL-12 stimulation from macrophages stimulates macrophages to kill phagocytosed pathogens so its like a check and balance mac eats pathogen - secretes IL-12 IL-12 activated T cells secretes Interferon gamma telling macrophage to destroy Also interferon gamms activates NK cells to kill-virus infected cells. Increases MHC expression and antigen presentation by all cells
33
IL-10
Secreted by TH2 cells modulates inflammatory response (chill out factor) Decreases the expression of MHC class II and Th1 cytokines Inhibits the activation of macrophages and dendritic cells. Also secreted by regulatory T cells
34
Which cytokines attenuate the immune response
IL-10 | TGF-beta
35
T cell surface protein
MHC I is present on all cells (except RBC) TCR (binds antigen-MHC complex) CD3 (associated with TCR for signal transduction) CD28 (binds B7 on APC)
36
Helper T cells surface protein
CD4 | CD40L - interacts with B cell CD40
37
Cytotoxic T cell surface protein
CD8
38
Regulatory T cell surface protein
CD4 | CD25
39
B cells | surface proteins
IgG - binds antigen CD19, CD20, CD21 (receptor for EBV), CD40 MHCII B7 interacts with Tcell CD28 (B7 acts as APC)
40
Receptor for epstein barr?
CD21
41
Macrophage cell surface receptors
CD14; CD40 (binds CD40L on Helper T cell) MHCII B7 interacts with Tcell CD28 (B7 acts as APC) Fc and C3b - receptors for opsonization
42
NK cell surface receptors
CD16 - binds Fc of IgG | CD56 - unique marker :)
43
Marker for hematopoeitic stem cells?
CD34
44
Anti-ACh
Myasthenia gravis
45
Anti-basement membrane
Goodpasteur
46
Anticardiolipin, lupus anticoagulant
lupus | antiphospholipid syndrome
47
Anticentromere
Limited scleroderma - CREST syndrome | CREST - Calcinosis; raynaud phenomenon ; esophageal dysmotility ; sclerodactyly ; telangectasia
48
Antidesmosome - anti-desmogelin
Pemphigus vulgaris - this is the one where it attack within the epithelium so you have moveable blisters :( - not tight - pop
49
Anti-dsDNA
SLE
50
Anti-smith
SLE
51
Anti-glutamic acid decarboxylase (GAD-65)
DM-I
52
Anti-hemidesmosome
Bullous-pemphigoid - this is the one where you attack at the border between epidermis and dermis - so have taught bulla
53
Anti-histone
Drug induced lupus Isoniazid - TB - mycolic acid cell wall inhibitor (p450 inh) Procainamide - class Ia antiarryhthmetic Hydralazine - BP direct vasodilator - good for black people
54
Anti-Jo-1
Polymyositis / dermatomyositis
55
Antimitochondrial
primary biliary cirrhosis
56
Anti-SRP
Polymyositis / dermatomyositis
57
Anti-Mi-2
Polymyositis / dermatomyosits
58
Antimicrosomal
Hashimoto thyroiditis
59
Antinuclear
SLE nonspecific
60
Antithyroglobulin
Hashimotos
61
Antiparietal cell
pernicious anemia
62
Anti-SCl-70 (anti-DNA topoisomerase)
Scleroderma (Diffuse)
63
Anti smooth muscle
Autoimmune hepatitis
64
Anti-SSA, anti-SSB (anti-ro, anti-La)
Sjogren syndrome (attack exocrine gland - like tear ducts and salivary glands)
65
Anti-TSH
GRAVES
66
Anti-U1 RNP ribonucleoprotein
Mixed connective tissue disease
67
IgA anti-endomysial, IgA anti-tissue transglutaminase
Celiac disase
68
MPO-ANCA/p-ANCA
Microscopic polyangitis, eosinophilic granulomatosis with polyangitis (Churg-Strauss syndrome) - which is -granulomatous necrotizing vasculitis with eosinophilia - presents wtih asthma, sinusitis, skin nodules or purpura, wrist or foot drop, can also involve heart, GI, kidney
69
PR3-ANCA / c-ANCA
Granulomatosis with polyangitis (Wegeners) - necrotizing granulomas of vasculitis / lung / and upper airway - also kidney
70
``` Rheumatoid factor (IgM antibody that targets IgG Fc region) anti-CCP (more specific) citrillin protein ```
RA
71
Chronic granulomatous disease increased susceptibility to catalase (+) bugs because they can break down the H2O2 that NADPH oxidase deficient people could potentially use to make other reactive oxygen species What bugs are these?
``` Need PLACESS Nocardia Pseudomonas Listeria Aspergillus Candida E Coli S. aureus Serratia ```
72
CD18
Protein on phagocytes - characteristically absent in Leukocyte adhesion deficiency type I (AR) LFA-1integrin Impaired leukocyte migration and chemotaxis Recurrent bacterial and skin mucosal infection Absent pus formation Delayed wound Delayed umbilical separation
73
So what is the problem in CD18 absence?
You've got the cells but they cant get out to fight :(
74
Important chemotactic agents?
Leukotriene B4 (made from arachidonic acid) 5-HETE (leukotriene precursor) C5a IL-8
75
Bronchiolar lavage demonstrating a high CD4:CD8 ration can be helpful to distinguish
sarcoidosis - which is characterized by noncaseating granulomas - chest x-ray will show bilateral hilar adenopathy - what can be used to distinguish
76
Ataxia Sinopulmonary infections (IgA deficiency) Telangiectasias
Ataxia Telangiectasia | ATM gene - failure to repair double strand breaks
77
Oculocutaneous albinism Pyogenic infections Progressive neurological dysfunction
Chediak Higashi syndrome - LYST - failure in microtubule functions leads to failure in lysosome and phagosome fusion (AR)
78
Severe bacterial and fungal infections | Granuloma formation
``` Chronic granulomatous disease - Defect in NADPH oxidase X-linked recessive most common nitroblue tetrazolium dye reduction test (-) increased susceptibilty to catalase (+) organisms Need PLACESS Nocardia Pseudomonas Listeria Apergillus Candida E Coli S Aureus Serratia ```
79
Congenital heart disease Dysmorphic facies Hypocalcemia***
DiGeorge (CATCH22) Recurrent viral and fungal infections - Absence of thymus and Parathyroids because 3rd and 4th pharyngeal arch pooped out
80
Severe bacterial and viral infections in infancy chronic diarrhea mucocutaneous candidiasis ***
SCID | X-linked Adenosine Deaminase deficiency most common - TRECs
81
Recurrent Neisseiria infection
Terminal complement deficiency C5B-C9
82
Recurrent infections that worsen with age Easy bleeding Eczema
Wiskott Aldrich | Xlinked WAS
83
fucked up T cells (like in Digeorge) would predispose to?
viral fungal protozoan intracellular bacteria
84
region of the lymph node populated by T cells and dendritic cells
paracortex
85
omalizumab
IgE MAB for add on rx in patients with severe asthma (allergic)
86
B-cell disorders (3)
X linked Agammaglobulinemia (Defect in BTK --> not b cell maturation) Selective IgA - can see airway and GI infections (anaphylaxis to IgA blood) CVID - defect in B cell differentiation acquired (increased risk autoimmune/sinopulmonary) acquired 20s/30s
87
T-Cell Disorders (4)
DiGeorge - CATCH22q11 IL12 Receptor deficiency - disseminated mycobacterial and fungal - decreased IFN-g Autosomal dominant hyper-IgE syndrome (Job) - Deficiency in Th17 cells due to STAT3 mutation - impairs neutrophil recruitment - FATED Chronic mucocutaneous candidiasis - T-cell dysfunction (many causes)
88
JOB - FATED
``` Facies Abscesses (cold non-inflammed) Teeth - retained primary IgE increased Dermatolgic eczema ```
89
B and T cell Disorders (4)
SCID - X linked (IL-2R) or AR (Adenosine deaminase) - failure to thrive - diarrhea - need BM x - see TRECs Ataxia Telangiectasia - ATM gene - fail to repair double strand breaks Hyper IgM - defective CD40L on Th - class switching defect - X linked Wiskott Aldrich - WAS - x linked - can't reorganize cytoskeleton - WATER - Thrombocytopenia - Eczema - Recurrent infection - inreased malignancy
90
ATM - triad
Ataxia Angiomas IgA deficiency also see high afp / cerebellar atrophy
91
Phagocyte Autoimmune (3)
Leukocyte Adhesion 1 - LFA-1 integri (CD18) impairs migration out of vasculature - delayed umbilical cord sep - Neutropenia Chediak Higashi - LYST - microtubule dysfunction can't fuse phago and lysosome - albinism and neuropathy - giant blobby lysosomal inclusions Chronic Granulomatous Disease - most X-linked - NADPH oxidase problemo - Nitroblue dye (-)

0001 STEP ONE RAPID REVIEW DX (25 decks)

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