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Immunology Flashcards

1
Q

LN drainage: what does the celiac LN cluster drain?

A 
Liver
Stomach
Spleen
Pancreas
Upper duodenum
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2
Q

LN drainage: what does the superior mesenteric LN cluster drain?

A

Lower duodenum
Jejunum
Ileum
Colon to splenic flexure

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3
Q

LN drainage: what does the inferior mesenteric LN cluster drain?

A

Colon from splenic flexure to upper rectum

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4
Q

LN drainage: what does the internal iliac LN cluster drain?

A 
Lower rectum to anal canal (above pectinate line)
Bladder
Vagina (middle third)
Cervix
Prostate
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5
Q

LN drainage: what does the para-aortic LN cluster drain?

A

Testes
Ovaries
Kidneys
Uterus

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6
Q

LN drainage: what does the superficial inguinal LN cluster drain?

A

Skin below umbilicus (except popliteal area)
Anal canal below pectinate line
Scrotum
Vulva

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7
Q

LN drainage: what does the popliteal LN cluster drain?

A

Dorsolateral foot

Posterior calf

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8
Q

LN drainage: what does the axillary cluster drain?

A

Upper limb
Breast
Skin above umbilicus

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9
Q

Where are B cells found in the spleen? T cells?

A

B: follicles
T: PALS

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10
Q

What findings might you see in RBCs post-splenectomy?

A

Howell-Jolly bodies (nuclear remnants)
Target cells
Thrombocytosis (lack of removal/sequestration)
Lymphocytosis (lack of sequestration)

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11
Q

What is the thymus derived from?

A

3rd pharyngeal pouch (DeGeorge)

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12
Q

Lymphocytes are of ______________ origin.

A

mesenchymal

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13
Q

What cytokines enhance killing by NK cells?

A

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

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14
Q

What types of cells express CD3, CD4, CD25, and FOXP3?

A

Tregs

anti-inflammatory, produce IL-10 and TGF-beta

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15
Q

What binds MHC?

A

TCR + co-receptor (CD4/8)

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16
Q

What cell contains B7 and what cell contains B28?

A

B7 (AKA CD80/86) = APC

CD28 = naive T cell (being activated by APC

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17
Q

While B7 to CD28 interaction is important for naive T cell activation, what is the analogous signal of CD40/CD40L used for?

A

CD4+ = CD40L

B cell = CD40 (B cell being activated by CD4+)

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18
Q

What Ig crosses placenta and provides infants w/passive immunity?

A

IgG

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19
Q

Which of the following does NOT fix complement:
IgG
IgA
IgM

A

IgA (dimer)

  • J chain from secretory cells, protects Fc portion from luminal proteases
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20
Q

What is a thymus-independent antigen?

A

Lacks a peptide component (eg LPS)

  • Cannot be presented by MHC
  • Weakly immunogenic
  • Vaccines often require boosters/adjuvants

There are two classes of antigens for B cells, T cell‐dependent (thymus‐dependent, TD) and T cell‐independent (TI) antigens. The former require the presence of cognate T‐helper (TH) cells to trigger a B‐cell response, whereas the TI antigens can mount an antibody response in the absence of TH.

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21
Q

What is CD25?

A

IL-2R

eg found on Tregs

22
Q

What protein causes anemia of chronic disease?

A

Hepcidin

  • Degrades ferroportin to decrease Fe absorption. (less Fe for microbes)
  • Decreases Fe release from macrophages (less for microbes)
23
Q

What protein binds/sequesters Fe to inhibit microbial Fe scavenging?

24
Q

Def. of DAF (CD55) would cause what disease and why?

A

Paroxysmal nocturnal hemoglobinuria

  • DAH inhibits complement for RBCs, so you see lysis without it during low O2 at night time
25
What does Hot T-bone stEAK help us remember?
``` IL-1 = fever (hot) IL-2 = T cells IL-3 = bone marrow IL-4 = IgE IL-5 = IgA IL-6 = aKute phase protein production ```
26
IL-4 promotes class-switching to Ig__, while IL-5 promotes class-switching to Ig__.
IL-4: IgE (+ IgG, also induces Th2 differentiation and B cell growth) IL-5: IgA (+growth/differentiation of eosinophils, B cells).
27
Def. in NADPH oxidase would result in what disease?
CGD Risk of infections w/catalase+ organisms (because they can neutralize their own H2O2; esp. pseudomonas).
28
Unique CD marker for macrophages?
CD14 (receptor for PAMPs, eg *LPS, binds TLR4) | recall: they have CCR5
29
Unique CD marker for NK cells?
*CD56 (unique to NK cells) CD16 (binds Fc of IgG)
30
Unique CD marker for HSC's?
CD34
31
In what infections are pts given pre-formed AB's?
Tetanus, botulism, HBV, varicella, or rabies
32
What is the only live-attenuated vaccine given to HIV+ people?
MMR
33
What does BCG vaccine protect against?
TB (live-attenuated) Note: yellow fever is live attenuated as well
34
What type of hypersensitivity rxn's are serum sickness and Arthus rxn? What's the difference b/w them?
Both T3HS Serum sickness takes 5 days because you make AB's, then complexes form. Arthus is faster, you have pre-formed AB's and they form complexes upon exposure to foreign substance.
35
What are the 4 T's of T4HS rxns?
T cells Transplant rejections TB skin tests Touching (contact dermatitis)
36
What is defective in X-linked agammaglobulinemia?
Bruton tyrosine kinase (BTK)
37
Most common Ig immunodeficiency?
IgA
38
What is the defect in common variable immunodeficiency?
Defect in B cell differentiation (many causes)
39
An IL-12 def. (AR) would cause decreased response of what cell type?
Th1 (therefore decreased IFN-gamma)
40
Someone w/chronic mucocutaneous candidiasis would likely have a dysfunction of what cell type?
T cells (normally fights of fungus)
41
What's another way to get SCID besides ADA def. (AR)?
IL-2R gamma chain defect (X-linked) *Unique to SCID: no concern for rejection of bone marrow xplant
42
What is the problem in ataxia-telangiectasia? What protein would be elevated?
ATM gene: failure to repair ds-breaks | ^ AFP ataxia due to cerebellar defects
43
What usually causes hyper-IgM syndrome?
Defective CD40L on Th cells (can't class switch by binding CD40 of B cells, *but B cells can still be activated by directly binding pathogens).
44
What is defective in Leukocyte adhesion def. (type 1)?
Defect in LFA-1 integrin on phagocytes, leading to impaired migration and chemotaxis (AR). Leads to increased infections/poor wound healing, delayed separation of umbilical cord, neutrophilia (*in blood, but none at infection site!).
45
What is dysfunctional in Chediak-Higashi syndrome?
Defect in lysosomal trafficking gene regulator (AR). MT disfuction, can't fuse phagosomes w/lysosomes (see giant granules in cells). Also pancytopenia (can't divide) leading to recurrent pyogenic infections (staph, strep).
46
What has replaced the nitroblue tetrazolium test for CGD?
See abnormal dihydrorhodamine (flow cytometry) test, decreased green fluoresnce.
47
What fungal infections are those w/low T cells prone to? B cells? Granulocytes?
T cells def: candida, PCP B cells def: GI giardiasis (no IgA) Granulocyte def: candida, aspergillus
48
Def. of what types of immune cells renders someone susceptible to encapsulated organisms? What are 2 encapsulated organisms that don't have obvious capsules on sketchy?
B cells Klebsiella Strep pneumo
49
How long until onset of hyperacute rejection? What causes it?
W/in minutes Pre-existing AB's
50
How long until onset of acute rejection? What causes it?
Weeks to months CD8+ response vs. donor MHC (T4HS). AB development. *Prevent acute rejection w/immunosuppressants
51
How long until onset of chronic rejection? What causes it?
Months to years CD4+ T cells respond to recipient APC's presenting foreign peptide (which is the host's body), T2&4HS. T cells secrete cytokines: proliferation of vascular smooth muscle, parenchymal atrophy, interstitial fibrosis (bronchiolitis obliterans, accelerated atherosclerosis, chronic graft nephropathy, vanishing bile duct syndrome).
52
What types of transplants more commonly result in GVH dz?
Bone marrow and liver (rich in grafted lymphocytes, T4HS). | but may benefit leukemia pts (might attack the cancer).

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