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SMART 2 > Immunology > Flashcards

Immunology Flashcards

1
Q

Where is the site of B-cell localization and maturation?

A

Follicle of lymph node

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2
Q

Which part of the lymph node contains contain Reticular cells and Macrophages

A

Medulla

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3
Q

The region of the cortex between follicles and medulla is called

A

Paracortex

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4
Q

Where is T cells housed in the lymph node

A

Paracortex

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5
Q

Lymphatic drainage for the head and neck

A

Cervical Lymph node

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6
Q

Lymphatic drainage for the LUNGS

A

Hilar Lymph node

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7
Q

Lymphatic drainage for the Trachea and esophagus

A

Mediastinal Lymph Node

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8
Q

Lymphatic drainage for the Upper limb, breast, skin above umbilicus

A

Axillary Lymph node

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9
Q

Lymphatic drainage for the Liver, stomach, spleen, pancreas, upper duodenum

A

Celiac Lymph node

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10
Q

Lymphatic drainage for Lower duodenum, jejunum, ileum, colon to splenic flexure

A

Superior Mesenteric Lymph node

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11
Q

Lymphatic drainage for Colon from splenic flexure to upper rectum

A

Inferior Mesenteric Lymph Node

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12
Q

Lymphatic drainage for Lower rectum to anal canal (above pectinate line), bladder, vagina (middle third) cervix, prostate

A

Internal Iliac Lymph Node

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13
Q

Lymphatic drainage for Testes, Ovaries, Kidneys, Uterus

A

Para-aortic Lymph Node

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14
Q

Lymphatic drainage for Anal canal (below pectinate line), skin below umbilicus (except popliteal area), scrotum, vulva

A

Superficial Inguinal Lymph Node

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15
Q

T and B-cell activation is through

A

APC (antigen presenting cells)

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16
Q

What are the antigen presenting cells

A

B-cells, Dendritic cells, Langerhans cells, Macrophages

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17
Q

Which cells require Two signals before they can be activated

A

T-cells, B-cells and Class switching

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18
Q

Which SPECIALIZED APC cells sample antigens, processes antigens and migrates them to the draining lymph node

A

Dendritic Cells

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19
Q

What is the 1st signal in T-cell activation?

A
  1. Antigen is presented on MHC II and recognized by
    TCR on Th (CD4+) cells— ( exogenous synthesized)
  2. Endogenous or cross-presented antigen is presented
    on MHC I to Tc (CD8+) cell
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20
Q

What is the 2nd signal in T-cell activation?

A
  1. Co-stimulatory signal via interaction of B7 protein on
    dendritic cells (CD80/86) and CD28 on naive T cell.
    ** The cells activate and produce cytokines.
    **     Tc cells activate and is able to recognize and kill
    virus-infected cells
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21
Q

What is B-cell receptor-mediated endocytosis

A

Foreign antigen is presented on MHC II and recognized by TCR on Th cell

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22
Q

Which receptor binds the CD40L on Th cell during B-cell receptor mediated endocytosis

A

CD40 receptor

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23
Q

What happens in B-cell receptor endocytosis after the binding of CD40 and CD40L

A

Th cell secretes cytokines that determine Ig class switching of B-cell

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24
Q

What determines the unique antigen-binding pocket

A

Fab region

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25
Q

What determines the Isotype (eg. IgM, IgD etc)

A

Fc region

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26
Q

Which cytokine when secreted causes 1. Fever, 2. acute inflammation, 3. activates endothelium to express adhesion molecules and 4. Induce chemokine secretion to recruit WBC’s

A

Interleukin -1

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27
Q

Interleukin-6 causes

A

Fever and stimulate production of acute phase proteins

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28
Q

Cytokine for Major Chemotactic factor for neutrophils

A

Interleukin-8

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29
Q

Interleukin-12

A
  1. Induces differentiation of T cells into Th1 cells and

2. Activates NK cells

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30
Q

What does Tumor necrosis factor-alpha do

A
  1. Activates endothelium 2. Causes WBC recruitment

3. Vascular leak

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31
Q

Which cytokines are secreted by T-cell

A
  1. Interleukin-2 and 2. Interleukin-3
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32
Q

Cytokine for Stimulating GROWTH of 1. Helper,

2. Cytotoxic and 3. Regulatory T cells and 4. NK cells

A

Interleukin-2

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33
Q

Interleukin-3 secretion is for

A

Supporting growth and differentiation of bone marrow stem cells. Function like GM-CSF

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34
Q

What are the components of innate immunity?

A
  1. Neutrophils
  2. Macrophages
  3. Dendritic Cells
  4. Natural Killer Cells (NK) - lymphoid origin
  5. Complement
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35
Q

How does innate immunity respond to pathogens?

A
  1. Nonspecific
  2. Rapid response (Minutes –> Hours)
  3. No memory response
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36
Q

What are the secreted proteins associated with innate immunity?

A
  1. Lysozyme
  2. Complement
  3. C-reactive protein (CRP)
  4. Defensins
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37
Q

What are the components of adaptive immunity?

A
  1. T cells
  2. B cells
  3. Circulating antibodies
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38
Q

How does adaptive immunity respond to pathogens?

A
  1. Highly specific
  2. Refined over time
  3. Develops over long periods
  4. Memory response that is faster and more robust
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39
Q

What are the secreted proteins associated with the adaptive immune response?

A

Immunoglobulins (Ig)

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40
Q

What cytokine is secreted by NK cells and T cells in response to antigen or IL-2 from macrohages

A

Interferon-gamma

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41
Q

Which cytokine stimulates macrophages to kill phagocytosed pathogens and inhibit differentiation of Th2 cells

A

Interferon-gamma

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42
Q

Cytokine that 1. Activates NK cells to kill virus-infected cells and 2. Increases MHC expression and antigen presentation by all cells

A

Interferon-gamma

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43
Q

Which cytokines is produced from Th2 cells

A

Interleukin-4, Interleukin-5 and Interleukin-10

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44
Q

Function of interleukin-4

A
  1. Induces differentiation of T cells into Th2 cells
  2. Promote growth of B cells
  3. Enhances class switching to IgE and IgG
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45
Q

Function of Interleukin-5

A
  1. Promote growth and differentiation of B cells
  2. Enhance class switching to IgA
  3. Stimulate growth and differentiation of Eosinophils
46
Q

Function of Interleukin-10

A
  1. Attenuates inflammatory response
  2. Decreases expression of MHC class II and Th1
    cytokines
  3. Inhibits activated macrophages and dendritic cells
47
Q

Which cytokines ATTENUATE immune response

A

TGF-beta and Interleukin-10

48
Q

Which enzyme place a role in the creation and neutralization of reactive oxygen species

A

NADPH oxidase

49
Q

NADPH oxidase deficiency

A

Chronic granulomatous disease

50
Q

Which enzyme has the blue green heme containing pigment that gives sputum its color

A

Myeloperoxidase

51
Q

Which enzyme converts O2- to H2O2

A

Superoxide dismutase

52
Q

What condition are patients with Chronic granulomatous disease at risk of

A

Increased risk of infection with

(catalase +) species. { staph aureus, Aspergillus)

53
Q

Why are patients with chronic granulomatous disease at an increased risk with catalase + species

A

They are capable of neutralizing their own H2O2

54
Q

What does Pseudomonas aeruginosa use to generate reactive oxygen species (ROS) to kill competing microbes

55
Q

What are the major functions of T cells?

A
  1. Cell mediated immunity
  2. CD8+ T cells directly kills virus infected cells
  3. CD4+ T cells help B cells help B cells make Ab and produce cytokines
  4. Assoc with delayed cell mediated hypersensitivity (IV)
  5. Assoc with chronic cellular organ rejection
56
Q

Which interferons are synthesized by virus-infected cells that act locally on UNinfected cells to prime them for viral defens by helping degrade viral nucleic acid and protein

A

Interferon alpha and interferon-beta

57
Q

Where are T cells located in the spleen?

A

Periarteriolar lymphatic sheath (PALS) in the white pulp

58
Q

Where B cells found in the spleen?

A

Follicles within the white pulp

59
Q

What is positive selection?

A

Ability for TCR of T cells to survive the binding to self MHC on cortical epithelial cells

60
Q

What is negative selection?

A

T cells expressing TCR with high affinity for self Ag undergo apoptosis

61
Q

What should pts undergoing splenectomy or are asplenic or SS pts be vaccinated against?

A

encapsulated organisms:
1. HiB
2 Pneumococcus
3. Menningococcus

62
Q

Where do antigen presenting cells (APC) capture blood-borne antigens for recognition by lymphocytes

A

Marginal zone

63
Q

Where are B cells found

A

Follicles within white pulp

64
Q

Where are T cells found

A

Periarteriolar lymphatic sheath (PALS)

65
Q

What happens in splenic dysfunction (eg. sickle cell disease, post-splenectomy)

A

decrease IgM—> decrease complement activation—> decrease C3b opsonization—> increase susceptibility to encapsulated organisms

66
Q

What infection should a patient be vaccinated against before undergoing splenectomy

A

pneumococcal, Hib, meningococcal)

67
Q

Which pharyngeal pouch is the thymus derived from

A

Third pouch

68
Q

The thymus is hypoplastic in which condition

A

DiGeorge and SCID

69
Q

The thymus is derived from which pharygeal pouch?

A

3rd pharyngeal pouch

70
Q

What does the cortex of the thymus contain?

A

Immature T cells

71
Q

What does the medulla of the thymus contain?

A 
Mature T cells
Hassal corpuscles (contain epithelial reticular cells)
72
Q

What is a thymoma?

A

Benign neoplasm of the thymus

73
Q

What dz is associated with thymoma?

A
  1. Myasthenia Gravis

2. Superior Vena Cava syndrome

74
Q

What is superior vena cava syndrome?

A

Obstruction of the superior vena cava —> impaired blood drainage from the head, inc. ICP

75
Q

What dz are associated with hypoplastic thymus?

A
  1. SCID

2. DiGeorge syndrome

76
Q

What cytokines enhances the activity of Natural Killer cells?

A

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

77
Q

What is the MOA of Natural Killer cells?

A

Use perforin and granzyme to induce apoptosis of virally infected cells and tumor cells

78
Q

What are the major functions of B cells?

A
  1. Humoral immunity
  2. Recognize Ag
  3. Produce Ab
  4. Maintain immunological memory
79
Q

What are the major functions of T cells?

A
  1. Cell mediated immunity

2.

80
Q

What is the general function of cytokines?

A

Recruit phagocytes and produce cytokines

81
Q

Where does positive selection of T cell occur?

A

Cortex of thymus

82
Q

Where does negative selection of T cell occur?

A

Medulla of thymus

83
Q

Why is tissue specific Ag expressed in the thymus?

A

d/t action of (AIRE) autoimmune regulator

84
Q

What is the cause of autoimmune polyendocrine syndrome-1

A

Deficiency in AIRE

85
Q

What does T helper cell differentiate into?

A

Th1, Th2, Th17 and T-reg

86
Q

What Ig are expressed on the surface of mature, naive B cells prior to their activation?

A

IgM and IgD

87
Q

Where do B cells differentiate?

A

In germinal center of the lymph node

88
Q

What do B cells class switch to?

A

Plasma cells that secrete IgA, IgE or IgG

89
Q

What the functions of IgE?

A
  1. Bind mast cells and basophils
  2. Mediate type I hypersensitivity
  3. Release inflammatory mediators eg: histamine
  4. Activate eosinophils (immune response to worms)
90
Q

Where is IgD found?

A

In serum and on the surface of B cells

91
Q

What is the function of MHC

A

Present antigen fragments to T cells and bind T cell receptor and are coded by HLA genes

92
Q

What is the Loci of MHC I

A

HLA-A, HLA-B, HLA-C

93
Q

MHC I binds to which components

A

TCR and CD8

94
Q

MHC II binds to which components

A

TCR and CD4

95
Q

Where are MHC I expressed

A

All Nucleated cells, APCs, Platelets but Not RBC

96
Q

Where are MHC II expressed

97
Q

What is the structure of MHC I

A

1 long chain and 1 short chain

98
Q

The structure of MHC II

A

2 equal length chain

99
Q

What are the loci of MHC II

A

HLA-DP, HLA-DQ, HLA-DR

100
Q

Which MHC class present ENDOGENOUSLY synthesized ANTIGENS (eg. viral or cytosolic proteins) to CD8+ cytotoxic T cells

101
Q

EXOGENOUSLY synthesized ANTIGENS (eg. bacterial proteins) are presented to CD4+ helper T cell by

102
Q

Which protein is associated to MHC I

A

Beta2-microglobulin

103
Q

Invariant Chain is associated to which class of MHC

104
Q

Hemochromatosis is associated to which subtype of HLA

105
Q

HLA - B8 is associated to which conditions

A

Add Mye Graves Bi8/ B8 is GAMe

  1. Addison disease—— Add
  2. Myasthenia Gravis— Mye
  3. Graves disease——- Graves
106
Q

HLA - B27 is associated to which conditions

A

PAIR of B27 bombers/ Seronegative PAIR

  1. Psoriatic arthritis
  2. Ankylosing spondylitis
  3. IBD-associated arthritis
  4. Reactive arthritis
107
Q

Which HLA subtype is associated with Celiac disease

A 
I ate (8) too (2) much gluten at DQ
HLA-DQ2/ HLA-DQ8
108
Q

HLA-DR2 is associated to which disease

A

2 GLAM to give a damn!/ Hey MSG

  1. Multiple sclerosis
  2. Hay fever (Allergic Rhinitis)
  3. SLE (Lupus)
  4. Goodpasture syndrome
109
Q

Which two HLA subtypes are associated to SLE

A

HLA-DR2 and HLA-DR3

110
Q

Diabetes mellitus type -1, Graves disease, Hashimoto thyroiditis, Addison disease and SLE are associated to which HLA subtype

111
Q

HLA-DR4 is associated with which diseases

A

There are 4 walls in a Rheum (room)

  1. Rheumatoid arthritis
  2. Diabetes mellitus type 1
  3. Addison disease
112
Q

Hashimoto thyroiditis, Pernicious anemia—–> vitamin B12 deficiency is associated to which HLA subtype

A

HLA-DR5

Hush Puppies

SMART 2 (7 decks)

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